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

Preliminary studies of children with LI in public schools suggested 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 were correlational in nature; the current study aimed 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 – influenced the dose and frequency required to realize language gains.

The study utilized 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) were randomized into one of two frequency conditions (massed vs. spaced) in which they received a word learning intervention previously tested through NIH funding by Holly Storkel and colleagues (e.g., Storkel et al., 2017). The intervention identified 60 new vocabulary targets that were presented to children within storybook readings using rich vocabulary intervention strategies.