Does Executive Function Performance Predict Treatment Response in Preschoolers With Developmental Language Disorder?

Purpose: The goal of the current study was to examine whether executive function scores predicted response to conversational recast treatment among preschoolers with developmental language disorder (DLD).

Method: Forty-nine preschoolers with DLD who received Enhanced Conversational Recast treatment were included in the analyses. Their response to treatment was indexed by the effect size of their accurate production of a targeted morpheme following treatment relative to their production of the morpheme prior to treatment. Stepwise regression analyses determined whether treatment response was predicted by their standardized language scores and/or by their scores on four executive function tasks that measured selective sustained attention, working memory, inhibition, and attention shifting.

Results: Among the potential predictors included in the model, only Dimensional Change Card Sort (DCCS), which is a measure of attention shifting, was a significant predictor. DCCS scores were positively predictive of treatment outcomes and accounted for 20% of variance in treatment effect among participants.

Conclusions: In addition to considering a child's language abilities when selecting language treatments, clinicians may also take into account their executive function abilities, as children with DLD who had higher DCCS scores tended to have larger positive treatment responses to Enhanced Conversational Recasting. These findings highlight the multifaceted nature of the skills needed for children to succeed in language treatments and provide guidance for selecting treatments that are most appropriate for individual children given their profile of strengths and limitations.