A Randomized Controlled Trial of Computer-Assisted Bilingual Vocabulary Intervention in Emergent Bilinguals with Developmental Language Disorder

About This Grant

Project Summary/Abstract Over 45 million people in the U.S. speak Spanish at home, yet only ~5% of speech-language pathologists provide Spanish-language services. This critical shortage leaves many emergent bilingual children with developmental language disorder (DLD) without access to bilingual interventions, contributing to long-term disparities in communication outcomes. Bilingual intervention supports robust language growth in both Spanish and English with no loss of English gains, but is often unavailable due to the dearth of bilingual clinicians, leaving key aspects of these children's language development unaddressed. To address this gap, we propose a technology-driven solution: the Computer-Assisted Bilingual Vocabulary Intervention (CABVI), an approach that enables monolingual clinicians to deliver standardized, linguistically rich bilingual instruction using Spanish and English strategically to support learning and cross-linguistic transfer. CABVI uses interactive, responsive content to shift the clinician's role from sole language provider to facilitator, empowering SLPs to support dual-language development in emergent bilinguals with DLD. Our long-term goal is to reduce gaps in care for emergent bilinguals DLDs by leveraging such scalable, technology-based strategies to expand access to bilingual intervention. The immediate objective of this R01 is to rigorously evaluate CABVI's efficacy and ecological validity in a randomized controlled trial. Aim 1 will determine whether emergent bilinguals with DLD children receiving bilingual CABVI show greater vocabulary gains in Spanish and English than peers receiving monolingual interventions (either traditional English-only therapy or monolingual CABVI). Aim 2 will compare vocabulary growth in emergent bilinguals with DLD children versus their typically developing bilingual peers after CABVI to understand how developmental language disorder influences response to bilingual intervention. Aim 3 will assess the platform's real-world feasibility by examining monolingual SLPs' fidelity to the intervention protocol, as well as their satisfaction and confidence using CABVI. Preliminary findings underscore CABVI's promise: a pilot school implementation demonstrated that monolingual providers can feasibly deliver CABVI with high fidelity over several months, and children receiving bilingual CABVI achieved significant vocabulary gains in both Spanish and English while maintaining progress in English comparable to monolingual intervention outcomes. By validating this scalable, linguistically tailored intervention, the project will improve access to this population for appropriate therapy, enhance their bilingual communication outcomes, and inform future scalable clinical models that leverage technology to bridge clinician-language gaps - directly aligning with NIDCD priorities to develop evidence-based interventions and improve access to evidence-based care for all Americans.