Do the Hard Things First: A Randomized Controlled Trial Testing the Effects of Exemplar Selection on Generalization Following Therapy for Grammatical Morphology.

Purpose: Complexity-based approaches to treatment have been gaining popularity in domains such as phonology and aphasia but have not yet been tested in child morphological acquisition. In this study, we examined whether beginning treatment with easier-to-inflect (easy first) or harder-to-inflect (hard first) verbs led to greater progress in the production of regular past-tense -ed by children with developmental language disorder.

Method: Eighteen children with developmental language disorder (ages 4-10) participated in a randomized controlled trial (easy first, N = 10, hard first, N = 8). Verbs were selected on the basis of frequency, phonological complexity, and telicity (i.e., the completedness of the event). Progress was measured by the duration of therapy, number of verb lists trained to criterion, and pre/post gains in accuracy for trained and untrained verbs on structured probes.

Results: The hard-first group made greater gains in accuracy on both trained and untrained verbs but did not have fewer therapy visits or train to criterion on more verb lists than the easy-first group. Treatment fidelity, average recasts per session, and verbs learned did not differ across conditions.

Conclusion: When targeting grammatical morphemes, it may be most efficient for clinicians to select harder rather than easier exemplars of the target.