Distance delivery of a spoken language intervention for school-aged and adolescent boys with fragile X syndrome.

Only 20 boys and their mothers were randomized, and one child in the comparison group did not complete the post-treatment home samples or return for post-treatment assessment. The active group received a package of language coaching, homework, feedback, observation, and behavior support strategies, so the contribution of any single component cannot be separated. The authors did not control for multiple significance testing across the large number of analyses. Session length was not held constant, so some children may have received a more intensive dose than others. Fidelity was not measured for the parent education sessions or the behavior support training. Maintenance and durability of the intervention effects were not measured. The treatment group mean age was 13.92 years and the comparison group mean age was 12.46 years, and the paper described this as a trend. The sample was limited to boys aged 10 to 16 years with confirmed full mutation fragile X syndrome who used at least 3-word utterances and spoke English at home. No gains appeared with an unfamiliar examiner, so the results may not apply to less scaffolded conversations.

The authors reported no conflicts of interest, no financial disclosures, and stated that they alone were responsible for the content and writing of the paper. The supplied text does not state a funding source.

Do not conclude that recasts, WH-questions, or fill-in-the-blank prompts alone improved the boys' spoken language. The treatment also included behavior support plans, visual supports, token reinforcement, coaching, homework, feedback, and observation, and the study cannot separate the contribution of any single component.