Developmental Language DisorderNCT06898671
Language Outcomes, Mechanisms, and Trajectories in Adults With and Without Developmental Language Disorder
An observational study of Developmental Language Disorder, run by University of Iowa at 1 site in United States.
Trial summary
The investigators' overall objective is to characterize the long-term outcomes of Developmental Language Disorder (DLD) in adulthood and to identify specific cognitive mechanisms mediating these outcomes. Read more about this study
- Who is it for?
- Ages 30 to 35 yearsHealthy volunteers can take part
- Conditions the study is for
- Developmental Language Disorder
- What is being tested?
- Eye-Tracking in Visual World Paradigm
- Type of treatment
- Lifestyle or therapy programme
- How many people
- 400 participants
- Where
- 1 siteUnited States
- Study dates
- 17 Apr 2023to Jul 2027
- How long will I take part?
- 2 Days
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 30 to 35 years
- All sexes
- Healthy volunteers accepted
- Adult
Study population: Approximately 150 adults with Developmental Language Disorder (DLD) and 250 adults with typical language (TL) will participate in this project. Participants will be between the ages of 30 and 34 years at time of enrollment. Participants will be drawn from a large cohort of adults with and without DLD who participated in the Iowa Longitudinal Study (an extensive longitudinal follow-up of an epidemiological study of DLD)
Who may be able to join
- Adults with Developmental Language Disorder (DLD) and those with typical language (TL) between the ages of 28 and 40 years who participated in the Iowa Longitudinal Study(NIH-DC-19-90 \& P50 DC002746; IRB# 200106051, "Collaboration on Specific Language Impairment".)
- Aged 30-35
- Normal or corrected to normal vision
- Normal hearing
Who cannot join
- history of brain injury
- history of neural developmental disabilities
- not monolingual
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site, 1 recruiting
- Recruiting
Wendell Johnson Speech and Hearing Center
Iowa City, Iowa, 52245
Emily Phalen, MA, 319-467-0769, emily-phalen@uiowa.edu
Kristi Hendrickson, PhD, 319-335-8701, kristi-hendrickson@uiowa.edu
About this study
The investigators' overall objective is to characterize the long-term outcomes of Developmental Language Disorder (DLD) in adulthood and to identify specific cognitive mechanisms mediating these outcomes. To address their objectives, the investigators utilize a large, pre-existing dataset and participant pool from one of the most comprehensive examinations of DLD to date: the Iowa Longitudinal Study. The investigators will re-recruit subjects with DLD and with typical language from this historic cohort, who are now adults (30-35 years old). In Aim 1, the investigators will use measures from kindergarten through 10th grade and collect new outcome measures in adulthood to characterize the long-term outcomes of DLD. The investigators predict that adults with DLD will diverge from adults with TL in language skills that are more complex and higher-level language skills that are important for communication in the workplace. Further, the investigators predict a fanning effect: some children with DLD will "catch up" to their TL peers in adulthood, some will show evidence of a decline, and others will show stable trajectories. In Aim 2, the investigators measure real-time competition across written and spoken language using eye-tracking. According to speed of processing accounts adults with DLD may be slower than their TL peers to activate competitors and targets. According to working memory accounts adults with DLD will show sustained competitor activation. Further, the investigators predict that measures related to the dynamics of competition (speed of activation and timing of competitor suppression) will account for variation in language outcomes in adults.
Read the detailed description
Aim 1: Characterize individual differences in the developmental trajectory and ultimate attainment of language ability in adults with and without DLD. This proposal directly addresses previous limitations by leveraging existing data and an existing participant pool from one of the most unique, influential, and comprehensive examinations of childhood DLD to date (the Iowa Longitudinal Study). The investigators re-recruit participants with and without DLD from this historic study who are now adults (30-35 years old). The investigators use retrospective oral language measures from kindergarten through 10th grade and collect new measures that capture language comprehensively (receptive and expressive language at the sublexical, lexical, sentence, and discourse/pragmatic levels) in adulthood. The investigators focus on the following two sub-aims:
Aim 1a: Characterize language outcomes in adults with DLD. The proposed measures will capture language abilities that stratify a wide range of language skills in adolescents and adults, differentiate individuals with DLD from their typically developing peers at various stages of development, and are reported to be functional for adults in the workplace. Given documented difficulties with complex language structures and discourse in older children and adolescents with DLD, the investigators expect that adults with DLD may diverge from adults with TL in performance related to language skills that are more linguistically complex (e.g., complex syntax and high lexical density). Further, they predict marked deficits in higher-level language skills (pragmatics and discourse), which are important aspects of communication in the workplace (e.g., language used for negotiating, cooperating, etc.). Given variable profiles of DLD, the investigators also expect that some participants will demonstrate lingering differences related to the consistency of their errors and the phonological complexity of their utterances. The investigators also seek to answer questions about the dimensionality of language ability. This follows from previous work demonstrating that language ability is best captured by a unitary factor in the early school-age years, with vocabulary and grammar becoming differentiated only later in development. Accordingly, the investigators carry out analyses to determine whether this dual-factor approach holds in adulthood or whether the dimensionality has increased yet further, and whether differences in language dimensionality obtain across DLD and TL groups.
Aim 1b: Shape of developmental trajectory. The investigators use retrospective language measures collected from K-10th grade as part of the Iowa Longitudinal Study, combined with new measures the investigators will collect in these same individuals in adulthood to examine the long-term trajectory of DLD. Given that adults with DLD do not typically receive services, the status quo under which the field is implicitly operating is that adults with DLD "catch-up" to their TL peers or that language abilities plateau in the school-age years and no further development is possible. However, research shows that adults with DLD have lower quality of life outcomes, and language abilities continue to grow until the thirties in typical populations, which conflicts with this viewpoint. For this sub-aim, the investigators use latent-trait Bayesian analyses to mediate between two competing hypotheses. The first hypothesis is that the investigators will uncover evidence for the maintenance of the relative stability seen during the school-age years (i.e., children, with remarkable reliability, maintain their standing relative to the rest of the cohort members in longitudinal studies of language ability). However, upon exiting the educational system, adults with DLD rarely receive services, and this may contribute to increased variability in outcomes. Thus, the second, competing hypothesis is that the investigators will uncover a fanning effect: some adults will have improved their language abilities relative to their prior standing in the cohort, while others will show evidence of a decline, with still others showing a relative maintenance of the school-age years trajectory. Such a fanning effect would suggest that trajectories after the school-age years are amenable to intervention.
Aim 2: Identify real-time processes that explain individual differences in language outcomes in adults with and without DLD.
For Aim 2, the investigators offer a mechanistic account of language deficits underlying DLD in adults. Their goal is to refine processing-based theories of DLD by offering a more precise characterization of the computational differences that subserve deficits in language processing in this population. Further, the investigators seek to illuminate individual differences in adult language across the ability spectrum. For this aim, the investigators use well supported models of competition in adults with TL as a theoretical framework for understanding mechanisms that underlie language deficits in adults with DLD. The investigators have developed a research protocol that measures real-time competition in expressive and receptive language at the lexical, sentence, and pragmatic levels. Consistent with working memory accounts, the investigators predict that, compared to adults with TL, adults with DLD will show sustained competition at all levels of language. An alternative-though not mutually exclusive- hypothesis is consistent with speed of processing accounts: group differences will be better reflected in how quickly targets and competitors are initially activated. Further, the investigators predict that measures related to the dynamics of competition will account for variation in language outcomes in adults across the ability spectrum.
- Conditions
- Developmental Language Disorder
- Being tested
- Eye-Tracking in Visual World Paradigm
- Keywords
- Language Profiles, Language Processing, Adult Language Disorders, Typical Adult Language
- Medical subject headings
- Language Development Disorders, Language Disorders
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Eye-Tracking in Visual World ParadigmBehavioural
Participants complete six eye tracking tasks. They see images on a computer screen are tasked with finding a specific picture or saying a specific word (target). We track their eye movements to the visual representations of the target compared with their eye movements to visual representations of items that are similar to the target.
| Study group | Role | What they receive |
|---|---|---|
| Developmental Language Disorder | Adults with below average language skills participate in eye tracking tasks Receives: Behavioral: Eye-Tracking in Visual World Paradigm | |
| Typically Developing | Adults with typical language skills participate in eye tracking tasks Receives: Behavioral: Eye-Tracking in Visual World Paradigm |
What is being measured
The primary outcome is the main question the study is designed to answer.
Eye movements
Participant are presented with images, and here words referring two one of the images while their eye movements are tracked. We measure the proportion fixations to the target image and distractor images over time. The measurement tool we are using is an eye-tracker (EyeLink portable duo)
Note this is BESH, no intervention
Measured: 2 hours
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Mar 2025
- Study start17 Apr 2023
- Primary completionJul 2026 (estimated)
- Study completionJul 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Developmental Language DisorderStudies of the same condition, open and under way.
- More trials run by University of IowaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 400 participants (estimated)
- Target duration
- 2 Days
Sponsor and investigators
- Lead sponsor
- University of Iowa
- Sponsor type
- University, hospital or other
- Collaborators
- National Institutes of Health (NIH), National Institute on Deafness and Other Communication Disorders (NIDCD)
- Responsible party
- Principal investigator, Kristi I. Hendrickson, University of Iowa
- Investigators
- Stewart McCauley, PhD, Principal investigator, University of IowaSi On Yoon, PhD, Principal investigator, University of IowaPhilip Combiths, PhD, Principal investigator, University of IowaJ. Bruce Tomblin, PhD, Principal investigator, University of IowaJacob Oleson, PhD, Principal investigator, University of Iowa
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06898671
- Sponsor's protocol ID
- 202204590
- Other IDs
- 1R01DC020143-01
- Status last verified
- Mar 2025
- First submitted
- 14 Jul 2023
- Last updated
- 27 Mar 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: The data collected from this project will be used only for research and educational purposes. Our proposed research will achieve scientific rigor as defined by NIH. Both experimental details and data will be available to achieve transparency: 1. We will make the detailed procedure of experiments available to other researchers so that the results can be reproduced across different laboratories 2. We will also have the deidentified data (both subject and item level) that protects subject confidentiality posted to the PI's lab website or Co-I's lab Open Science Framework (OSF) website as the results are published, and 3. All statistical models used in the published papers will be posted to the PI's lab website or Co-I's lab OSF website.
Study at a glance
From the registry record, last updated by the sponsor on 27 Mar 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Language Outcomes, Mechanisms, and Trajectories in Adults With and Without Developmental Language Disorder
- ClinicalTrials.gov ID
- NCT06898671
- Acronym / sponsor ID
- 202204590
- Conditions
- Developmental Language Disorder
- Keywords
- Language Profiles, Language Processing, Adult Language Disorders, Typical Adult Language
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 400 participants (estimated)
- Lead sponsor
- University of IowaUniversity, hospital or other
- Collaborators
- National Institutes of Health (NIH), National Institute on Deafness and Other Communication Disorders (NIDCD)
- Study start
- 17 Apr 2023 (actual)
- Primary completion
- Jul 2026 (estimated)
- Study completion
- Jul 2027 (estimated)
- First posted
- 27 Mar 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The investigators' overall objective is to characterize the long-term outcomes of Developmental Language Disorder (DLD) in adulthood and to identify specific cognitive mechanisms mediating these outcomes. To address their objectives, the investigators utilize a large, pre-existing dataset and participant pool from one of the most comprehensive examinations of DLD to date: the Iowa Longitudinal Study. The investigators will re-recruit subjects with DLD and with typical language from this historic cohort, who are now adults (30-35 years old). In Aim 1, the investigators will use measures from kindergarten through 10th grade and collect new outcome measures in adulthood to characterize the long-term outcomes of DLD. The investigators predict that adults with DLD will diverge from adults with TL in language skills that are more complex and higher-level language skills that are important for communication in the workplace. Further, the investigators predict a fanning effect: some children with DLD will "catch up" to their TL peers in adulthood, some will show evidence of a decline, and others will show stable trajectories. In Aim 2, the investigators measure real-time competition across written and spoken language using eye-tracking. According to speed of processing accounts adults with DLD may be slower than their TL peers to activate competitors and targets. According to working memory accounts adults with DLD will show sustained competitor activation. Further, the investigators predict that measures related to the dynamics of competition (speed of activation and timing of competitor suppression) will account for variation in language outcomes in adults.
Detailed description
Aim 1: Characterize individual differences in the developmental trajectory and ultimate attainment of language ability in adults with and without DLD. This proposal directly addresses previous limitations by leveraging existing data and an existing participant pool from one of the most unique, influential, and comprehensive examinations of childhood DLD to date (the Iowa Longitudinal Study). The investigators re-recruit participants with and without DLD from this historic study who are now adults (30-35 years old). The investigators use retrospective oral language measures from kindergarten through 10th grade and collect new measures that capture language comprehensively (receptive and expressive language at the sublexical, lexical, sentence, and discourse/pragmatic levels) in adulthood. The investigators focus on the following two sub-aims:
Aim 1a: Characterize language outcomes in adults with DLD. The proposed measures will capture language abilities that stratify a wide range of language skills in adolescents and adults, differentiate individuals with DLD from their typically developing peers at various stages of development, and are reported to be functional for adults in the workplace. Given documented difficulties with complex language structures and discourse in older children and adolescents with DLD, the investigators expect that adults with DLD may diverge from adults with TL in performance related to language skills that are more linguistically complex (e.g., complex syntax and high lexical density). Further, they predict marked deficits in higher-level language skills (pragmatics and discourse), which are important aspects of communication in the workplace (e.g., language used for negotiating, cooperating, etc.). Given variable profiles of DLD, the investigators also expect that some participants will demonstrate lingering differences related to the consistency of their errors and the phonological complexity of their utterances. The investigators also seek to answer questions about the dimensionality of language ability. This follows from previous work demonstrating that language ability is best captured by a unitary factor in the early school-age years, with vocabulary and grammar becoming differentiated only later in development. Accordingly, the investigators carry out analyses to determine whether this dual-factor approach holds in adulthood or whether the dimensionality has increased yet further, and whether differences in language dimensionality obtain across DLD and TL groups.
Aim 1b: Shape of developmental trajectory. The investigators use retrospective language measures collected from K-10th grade as part of the Iowa Longitudinal Study, combined with new measures the investigators will collect in these same individuals in adulthood to examine the long-term trajectory of DLD. Given that adults with DLD do not typically receive services, the status quo under which the field is implicitly operating is that adults with DLD "catch-up" to their TL peers or that language abilities plateau in the school-age years and no further development is possible. However, research shows that adults with DLD have lower quality of life outcomes, and language abilities continue to grow until the thirties in typical populations, which conflicts with this viewpoint. For this sub-aim, the investigators use latent-trait Bayesian analyses to mediate between two competing hypotheses. The first hypothesis is that the investigators will uncover evidence for the maintenance of the relative stability seen during the school-age years (i.e., children, with remarkable reliability, maintain their standing relative to the rest of the cohort members in longitudinal studies of language ability). However, upon exiting the educational system, adults with DLD rarely receive services, and this may contribute to increased variability in outcomes. Thus, the second, competing hypothesis is that the investigators will uncover a fanning effect: some adults will have improved their language abilities relative to their prior standing in the cohort, while others will show evidence of a decline, with still others showing a relative maintenance of the school-age years trajectory. Such a fanning effect would suggest that trajectories after the school-age years are amenable to intervention.
Aim 2: Identify real-time processes that explain individual differences in language outcomes in adults with and without DLD.
For Aim 2, the investigators offer a mechanistic account of language deficits underlying DLD in adults. Their goal is to refine processing-based theories of DLD by offering a more precise characterization of the computational differences that subserve deficits in language processing in this population. Further, the investigators seek to illuminate individual differences in adult language across the ability spectrum. For this aim, the investigators use well supported models of competition in adults with TL as a theoretical framework for understanding mechanisms that underlie language deficits in adults with DLD. The investigators have developed a research protocol that measures real-time competition in expressive and receptive language at the lexical, sentence, and pragmatic levels. Consistent with working memory accounts, the investigators predict that, compared to adults with TL, adults with DLD will show sustained competition at all levels of language. An alternative-though not mutually exclusive- hypothesis is consistent with speed of processing accounts: group differences will be better reflected in how quickly targets and competitors are initially activated. Further, the investigators predict that measures related to the dynamics of competition will account for variation in language outcomes in adults across the ability spectrum.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Target follow-up
- 2 Days
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Developmental Language Disorder | – | Behavioral: Eye-Tracking in Visual World ParadigmAdults with below average language skills participate in eye tracking tasks |
| Typically Developing | – | Behavioral: Eye-Tracking in Visual World ParadigmAdults with typical language skills participate in eye tracking tasks |
Who may qualify
- Ages
- 30 to 35 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
- Study population
- Approximately 150 adults with Developmental Language Disorder (DLD) and 250 adults with typical language (TL) will participate in this project. Participants will be between the ages of 30 and 34 years at time of enrollment. Participants will be drawn from a large cohort of adults with and without DLD who participated in the Iowa Longitudinal Study (an extensive longitudinal follow-up of an epidemiological study of DLD)
Key inclusion criteria (4 listed)
- Adults with Developmental Language Disorder (DLD) and those with typical language (TL) between the ages of 28 and 40 years who participated in the Iowa Longitudinal Study(NIH-DC-19-90 \& P50 DC002746; IRB# 200106051, "Collaboration on Specific Language Impairment".)
- Aged 30-35
- Normal or corrected to normal vision
- Normal hearing
Key exclusion criteria (3 listed)
- history of brain injury
- history of neural developmental disabilities
- not monolingual
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Eye-Tracking in Visual World ParadigmParticipants complete six eye tracking tasks. They see images on a computer screen are tasked with finding a specific picture or saying a specific word (target). We track their eye movements to the visual representations of the target compared with their eye movements to visual representations of items that are similar to the target. | Behavioural | Developmental Language Disorder, Typically Developing |
Primary outcome
Eye movements
Time frame: 2 hours
Participant are presented with images, and here words referring two one of the images while their eye movements are tracked. We measure the proportion fixations to the target image and distractor images over time. The measurement tool we are using is an eye-tracker (EyeLink portable duo) Note this is BESH, no intervention
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Mar 2025.
- Individual participant dataSharing planned: Yes. The data collected from this project will be used only for research and educational purposes. Our proposed research will achieve scientific rigor as defined by NIH. Both experimental details and data will be available to achieve transparency: 1. We will make the detailed procedure of experiments available to other researchers so that the results can be reproduced across different laboratories 2. We will also have the deidentified data (both subject and item level) that protects subject confidentiality posted to the PI's lab website or Co-I's lab Open Science Framework (OSF) website as the results are published, and 3. All statistical models used in the published papers will be posted to the PI's lab website or Co-I's lab OSF website.
Related trials for Developmental Language Disorder
Not yet recruiting
Hearing Intervention Effects on Brain and Language Development in Children With Bilateral Mild Hearing Loss
Hearing Loss, Bilateral
Recruiting
Personalization of Visual Characters and Text-to-Speech (TTS) to Support Learning in Students With Reading Difficulties
Developmental Dyslexia, Reading Problem
Recruiting
Dynamic Assessment of the Risk for Language and Reading Disorders in Monolingual and Multilingual Children
Developmental Dyslexia, Developmental Language Disorder
Not yet recruiting
Trial of Center-Based Early Start Denver Model vs. Pivotal Response Treatment in Children With Autism
Autism Spectrum Disorder (ASD), Autism
Not yet recruiting
Artificial Grammar Learning in Children Who Are Deaf or Hard-of-Hearing: Stimulus Length Effect
Hearing Impaired Children
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Stewart McCauley, PhD principal investigator
University of Iowa
Si On Yoon, PhD principal investigator
University of Iowa
Philip Combiths, PhD principal investigator
University of Iowa
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Developmental Language Disorder, run by University of Iowa at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 27 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Kristi Hendrickson, PhD (319-335-8701, kristi-hendrickson@uiowa.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Eye movements (time frame: 2 hours). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Mar 2025.