This urgent revision will determine the optimal treatment intensity for children with language impairment (LI), provided via telepractice platforms, by systematically manipulating treatment dose and frequency. This study will also investigate the moderating influence of the home environment on children’s outcomes. This study aim is urgent in that over 1 million children with LI are no longer receiving language services in the public schools, as prescribed by their IEPs, due to COVID-19. Children instead are either receiving supplemental resource packets or receiving therapy via telepractice – a grossly understudied platform for service provision for this population.

Preliminary studies of children with LI in the public schools suggest that children with LI who received high frequency/low dose treatment (or low frequency/high dose) made better gains over time than children receiving the extremes (overall low or high intensity of treatment; Schmitt et al., 2017). These preliminary findings are correlational in nature; the current study aims to manipulate both parameters of intensity (dose and frequency) to determine not only the interactive influence of dose and frequency on children’s gains, but also the extent to which factors of the home environment – now a primary learning environment for school age children – influence the dose and frequency required to realize language gains.

The study will utilize the methods used in the parent study of optimal treatment intensity now on a telepractice platform. Participants (60 children with LI recruited from two US states) will be randomized into one of two frequency conditions (massed vs spaced) in which they will receive a word learning intervention previously tested through NIH funding by Holly Storkel and colleagues (e.g., Storkel et al., 2017). The intervention identifies 60 new vocabulary targets which are presented to children within story book readings using rich vocabulary intervention strategies.