Explicit Grammatical Intervention for Developmental Language Disorder: Three Approaches

Authors Catherine H. Balthazar , Susan Ebbels , Rob Zwitserlood
Published in Language, Speech, and Hearing Services in Schools
Publication date 2020
Research groups Speech and Language Therapy: Participation through communication
Type Article


Purpose: This article summarizes the shared principles and evidence underpinning methods employed in the three sentence-level (syntactic) grammatical intervention approaches developed by the authors. We discuss associated clinical resources and map a way forward for clinically useful research in this area. Method: We provide an overview of the principles and perspectives that are common across our three syntactic intervention approaches: MetaTaal (Zwitserlood, 2015; Zwitserlood, Wijnen, et al., 2015), the SHAPE CODING™ system (Ebbels, 2007; Ebbels et al., 2014, 2007), and Complex Sentence Intervention (Balthazar & Scott, 2017, 2018). A description of each approach provides examples and summarizes current evidence supporting effectiveness for children with developmental language disorder ranging in age from 5 to 16 years. We suggest promising directions for future research that will advance our understanding of effective practices and support more widespread adoption of syntactic interventions with school-age children. Conclusion: In each approach to syntactic intervention, careful and detailed analysis of grammatical knowledge is used to support target selection. Intervention targets are explicitly described and presented systematically using multimodal representations within engaging and functional activities. Treatment stimuli are varied within a target pattern in order to maximize learning. Similar intervention intervals and intensities have been studied and proven clinically feasible and have produced measurable effects. We identify a need for more research evidence to maximize the effectiveness of our grammatical interventions, encompassing languages other than English, as well as practical clinical tools to guide target selection, measurement of outcomes, and decisions about how to tailor interventions to individual needs.


  • Rob Zwitserlood | Researcher | Research group Speech and Language Therapy: Participation through communication
    Rob Zwitserlood
    • Researcher
    • Research groups: Speech and Language Therapy: Participation through communication

Language English
Published in Language, Speech, and Hearing Services in Schools
Year and volume 51 2
Key words developmental language disorder, grammatical intervention
Digital Object Identifier https://doi.org/10.1044/2019_LSHSS-19-00046
Page range 226-246