Therapy Specific Language Impairment with an MLU <2

Clinical Question

In children with Specific Language Impairment with an MLU <2 what therapy approaches are effective?

Critically Appraised Topic

  • Milleu teaching (MT) and recasting are both effective therapy techniques for children with Specific Language Impairment and Mean Length of Utterance (MLU<2)


  • Lower level children may benefit more from MT
    • MLU <1.84 and/or
    • Language ability lower than 22-26 months
  • Higher level children may benefit more from recasting
    • MLU >1.84 and/or
    • Language ability above 33-45 months

CAT PDF Format

Critically Appraised Papers

Camarata, S., Yoder, P. & Camarata, M. (2006) Simultaneous Treatment of Grammatical and Speech Comprehensibility Deficits in Children with Down Syndrome. Down Syndrome Research and Practice, 11 (1), 9-17.

DesJardin, J. & Eisenberg, L. (2007) Maternal Contributions: Supporting Language Development in Young Children with Cochlear Implants. Ear & Hearing, 28, 456-469.

Hassink, J., Leonard, L. (2010) Within-Treatment Factors as Predictors of Outcomes Following Conversational Recasting. American Journal of Speech-Language Pathology, 19, (213-224)

Trent-Stainbrook, A, Kaiser, AP & Frey, JR (2007), ‘Older siblings’ use of responsive interaction strategies and effects on their younger siblings with Down Syndrome’, Journal of Early Intervention, vol. 29, no. 4, pp. 273-286

Tyler, A., Gillon, G., Macrae, T,. & Johnson,. R (2011). Direct and Indirect Effects of Stimulating Phoneme Awareness vs. Other Linguistic Skills in Preschoolers with Co-occuring Speech and Language Impairments. Topics In Language Disorders p128-144

Yoder, P., Camarata, S. & Gardner, E. (2005) Treatment Effects on Speech Intelligibility and Length of Utterance in Children with Specific Language and Intelligibility Impairments. Journal of Early Intervention, 28 (1), 34-49