Treatment efficiency (Plante et al., 2019)

Purpose: When a behavioral treatment is generally efficacious, the central research questions shift to optimized dose delivery. In this study, we determine whether a validated treatment method can be made more effective or efficient by increasing the dose density employed.
Method: Twenty children were treated with Enhanced Conversational Recast methods to treat morphological errors. Half received 24 doses per session within a half hour (approximately 1 dose/1.25 min), and the other received the same number of doses within 15 min (approximately 1 dose/38 s). Generalization of morpheme use was probed throughout treatment and at a 6-week follow-up. Spontaneous use of treated morphemes was also tracked.
Results: Although the treatment was effective overall, there were no significant differences between treatment conditions on any of the outcome measures. Follow-up performance correlated significantly with performance at the end of the treatment period.
Conclusion: Minimal between-groups differences suggest that performance does not suffer when dose rates are compressed into half the time during treatment, making the high-density dose delivery method a more efficient delivery method. This could make time available within a treatment session to address other goals or allow for more classroom instructional time for the child.

Supplemental Material S1. Number of treatment responders under different classification criteria across studies that have included Enhanced Conversational Recast treatment.

Plante, E., Mettler, H. M., Tucci, A., & Vance, R. (2019). Maximizing treatment efficiency in developmental language disorder: Positive effects in half the time. American Journal of Speech-Language Pathology, 28, 1233–1247. https://doi.org/10.1044/2019_AJSLP-18-0285