Shaping children’s sentences: trialling visual support for children with language difficulties using the SHAPE CODING system in mainstream primary schools

INTERVENTION: This study aims to investigate the effectiveness of SHAPE CODING intervention for children with language difficulties (including DLD) aged 5‐10 years old in mainstream schools by carrying out a 4‐stage sequential design study. The study team will partner with private speech and language therapy practices that provide Speech and Language Therapy (SLT) services to schools. They will approach schools they work in and ask if they would like to participate in the project. If the headteacher consents, the SLT will then collaborate with the school to identify children who will be in years 1‐5 (aged 5‐9 years old) at the start of the intervention, and who are already on the SLT caseload, or for whom there are concerns about language development. The parents of these children will be sent an information sheet and consent form. For children whose parents consent, the SLT will meet with the children to gain their consent and will then administer two standardized assessments (Structured Photographic Expressive Langauge Test ‐ 3; Clinical Evaluation of Language Fundamentals (CELF)‐5, Formulated Sentences subtest) to ensure that grammar is an area of difficulty. Those with a standard score above 90 on the SPELT‐3 or above 6 on the CELF‐5 Formulated Sentences subtest will be excluded from the study, as they are unlikely to benefit from the intervention. The study uses the R package “carat” to carry out adaptive covariate randomisation using Hu and Hu’s randomisation using the command‐line user interface to assign participants to groups sequentially. The study will use a biased coin probability of 0.85 and the following covariates (with double weight assigned to SLT): • Year group (1, 2, 3, 4, 5) • SLT (1, 2, 3, 4, 5, 6, 7, 8, 9, 10) • CELF Formulated Sentences raw score (0‐15, 16‐2 CONDITION: Intervention aiming to improve expressive language in children with language difficulties (including Developmental Language Disorder, DLD) ; Mental and Behavioural Disorders PRIMARY OUTCOME: The creation of a grammar factor is assessed using the following measures at pre‐ and post‐intervention in both the intervention and control groups:; 1. Raw score on the SPELT‐3; 2. ACE narrative syntax raw score; 3. Receptive grammar: TROG‐E blocks passed; 4. Three measures of grammatical accuracy and complexity in narratives (ERRNI – Story B) and ACE narrative combined): ; 4.1. Mean length of utterance (MLU); 4.2. Clausal density (number of clauses/number of utterances); 4.3. Grammatical errors per utterance; SECONDARY OUTCOME: Semantics, morphology, syntax, and pragmatics measured using the CELF‐5 Formulated Sentences raw score at pre‐ and post‐intervention in both the intervention and control groups INCLUSION CRITERIA: 1. Children in school years 1‐5 (aged 5‐9 years old) at the start of the intervention 2. Either already on the SLT caseload or there are concerns about their language development 3. Difficulties with expressive grammar with a standard score below 90 on the SPELT‐3, and a scaled score below 7 on the CELF‐5 Formulated Sentences subtest