AJSLP
Research Article
The Use of Structural Priming and Focused
Recasts to Facilitate the Production
of Subject- and Object-Focused
Relative Clauses by School-Age Children
With and Without Developmental
Language Disorder
Rebekah Wada,a Sandra Laing Gillam,a and Ronald B. Gillama
Purpose: The purpose of this study was to examine the use of
structural priming combined with a focused recasting procedure
to elicit subject- and object-focused, center-embedded
relative clauses from students with developmental language
disorders (DLDs) and typically developing (TD) students.
Method: A total of 26 children (13 DLD, 13 TD), ranging in
age from 6;10 to 10;11 (years;months), participated in this
study. All children completed a priming and recasting task
that targeted subject- and object-focused relatives. The
stimuli were presented in two blocks, which each contained
40 trials for each sentence type.
Results: Children with DLD and their TD peers were
significantly more accurate producing subject-focused than
R
esearch has shown that, after hearing a particular
syntactic structure, a speaker is more likely to use
the same sentence structure (i.e., the target) in
their own subsequent utterances. This phenomenon, often
referred to as “structural or syntactic priming,” has been
documented in studies of adults and children. For example,
in one of the earliest studies of structural priming (Bock,
1986), adults looked at a picture as the experimenter read
a sentence out loud. The participants repeated the sentence
and indicated whether they had heard that same sentence
before. Then, they were shown a second, unrelated picture
a
Department of Communicative Disorders and Deaf Education, Utah
State University, Logan
Correspondence to Ronald B. Gillam: ron.gillam@usu.edu
Editor-in-Chief: Julie Barkmeier-Kraemer
Editor: Stacy Betz
Received September 11, 2019
Revision received December 22, 2019
Accepted May 4, 2020
https://doi.org/10.1044/2020_AJSLP-19-00090
American Journal of Speech-Language Pathology • Vol. 29 • 1883–1895 • November 2020 • Copyright © 2020 The Authors
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object-focused relatives. An analysis of rate of learning
indicated that significantly more trials were required for
subjects in the DLD group to demonstrate consistent
performance on both subject- and object-focused
relatives.
Conclusions: The study supports the feasibility of combining
an implicit priming task with an explicit recasting task for
teaching subject-focused relative clauses to children with
DLD. However, it is likely that additional instruction and/or
more trials will be necessary for children with DLD to attain
consistent performance levels.
Supplemental Material: https://doi.org/10.23641/asha.
12670847
and were asked to describe it. Findings revealed that the
participants’ descriptions of the unrelated pictures were
highly likely to contain the same sentence structure they
had heard the examiner use when they saw the first picture.
This finding has been demonstrated with a number of dif-
ferent syntactic structures, including transitives and datives
(Bock et al., 2007), passives (Messenger et al., 2012), and
relative clauses (Scheepers, 2003).
Studies have also revealed priming effects in typically
developing (TD) children and children with developmental
language disorders (DLDs). However, TD children respond
consistently better to priming for a number of different
sentence types than children with DLDs. This finding is
not surprising given the large body of evidence that shows
children with DLD have difficulty understanding and using
various syntactic forms (Frizelle & Fletcher, 2014; Hestvik
et al., 2010; Schuele & Nicholls, 2000).
A number of language facilitation techniques have
been used successfully to improve the syntactic proficiency
Disclosure: The authors have declared that no competing interests existed at the time
of publication.
1883
of children with DLD. A technique known as “focused
recasting” involves restructuring a child’s utterance in a way
that maintains the meaning of the utterance but increases its
grammatical accuracy or modifies its syntactic structure and
then modeling it aloud for the student (Nelson et al., 1996).
The purpose of this study was to examine the use of struc-
tural priming combined with a focused recasting procedure
to elicit subject- and object-focused, center-embedded rela-
tive clauses from students with DLD and TD students. In
the following section, we will briefly review studies of prim-
ing in adults and children and priming and recasting in chil-
dren with and without DLD. We will also review the types
of sentence structures that have been studied using these
techniques with an emphasis on relative clauses.
Priming
In early syntactic priming studies conducted with
adults, participants were asked to listen to and then repeat
the prime sentences before creating target sentences. Later
studies demonstrated that participants only needed to listen
to the prime sentences to increase the likelihood that they
would produce target sentences that contained the primed
structures; the repetition was not required. For example,
Bock et al. (2007) asked adults to look at pictures and lis-
ten to transitive and dative sentences. Participants were not
asked to repeat the sentences after hearing them. Results
showed that when the participants described unrelated pic-
tures, they were more likely to create a sentence that con-
tained the primed construction.
Studies have shown that priming may occur even at
the level of the clause within a sentence (Branigan et al.,
2006; Pickering & Ferreira, 2008). Branigan et al. (2006)
reported that adults were more likely to use the target verb
phrase if the prime included the verb phrase, regardless of
position in the sentence. This suggests that priming may
not require active attention to the structure of the prime or
active memory of the structure (Bock & Griffin, 2000).
Priming as Implicit Learning
One thought about why priming occurs is that a sen-
tence structure, such as noun phrase–verb–noun phrase–
prepositional phrase, remains active in memory for a short
amount of time after it is heard. As they listen to the first
sentence, listeners may create an abstract representation of
the underlying syntactic form that includes noun phrases,
verb phrases, prepositional phrases, and the phrasal constit-
uents that are constructed from them (Leonard et al., 2002;
Savage et al., 2003; Thothathiri & Snedeker, 2008). Later,
when listeners are asked to create a new sentence about a
second picture, the prior sentence pattern can be quickly
retrieved and modified to fit the second picture, even if the
second picture is minimally related to the first in lexical,
conceptual, or discourse content. The increased likelihood
of using the primed syntactic structure to describe an unre-
lated picture appeared to result from the primed structure be-
ing in an active state in long-term memory. That is, primed
structures were more likely to be retrieved and then modified
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to create a new sentence about the second picture because
they were the most recently activated structures.
Priming may be better conceived of as an implicit
learning process. That is, individuals have cognitive sys-
tems that efficiently and unconsciously learn procedures
for formulating and producing a variety of sentence types.
As children listen to examiners describe pictures with cer-
tain types of sentence structures, these implicit learning
procedures may become fine-tuned to the structure of the
adult production (Bock & Griffin, 2000). As applied to the
current study, repeated priming with center-embedded rela-
tive clauses may strengthen form content mappings of the
subject- and object-focused structures. Evidence supporting
this interpretation relates to the fact that the priming effect
is independent of the speaker’s ability to explicitly recall
the syntactic form on a later recognition task (Bock et al.,
1992, 2007). Furthermore, priming effects occur even when
there are intervening clauses or sentences between the primed
target and the response (Bock & Griffin, 2000). Priming
appears to yield incremental and unconscious changes in
the ability to produce a target sentence form even though
the examiner provides no direct instruction about the struc-
ture of the response sentences (Kidd, 2012).
Priming has been suggested as a mechanism that con-
tributes to language development. There is a body of evi-
dence that has shown that a number of abstract syntactic
patterns are sensitive to priming in adults and children. Ev-
idence for priming of passive sentences was demonstrated by
Messenger et al. (2012) in TD children as young as 3 years
of age. The results showed that both groups (children and
adults) produced more passives when provided with a pas-
sive prime than when provided with an active prime. No
difference in priming was noted between two different verb
types (agent–patient and theme–experience). These results
were replicated in a second experiment with a group of
24 older children (mean age of 4;2 [years;months]) and
24 adults (mean age of 18;8). Messenger et al. argued that
the participants must have created an abstract syntactic
representation of the passive form that did not rely on the
verb type when formulating their responses.
Huttenlocher et al. (2004) demonstrated a syntactic
priming effect for transitive and dative structures in TD chil-
dren between the ages of 4;1 and 5;8 in three experiments.
In Experiment 1, researchers showed children a picture and
described it. The child then repeated the experimenter’s sen-
tence. Another picture was presented, and the child created
an original sentence to describe the second picture. The re-
searchers found that children were able to use the primed
sentence structure even when the lexical features of the sen-
tence differed. In Experiment 2, Huttenlocher et al. (2004)
repeated the same process except that children did not have
to repeat the researcher’s sentences. Children produced the
primed sentences similarly to those produced in the first ex-
periment without needing to repeat the sentences. Finally,
in Experiment 3, Huttenlocher et al. (2004) conducted tests
to see whether the effect of syntactic priming would persist
past one trial. They found that the participants’ use of the
targeted structures increased during the experiment even
with 10 trials interspersed between the primed sentences. This
series of experiments showed that children demonstrated
syntactic priming (a) after hearing one instance of the form
regardless of the lexical features of the sentence, (b) without
the need to repeat the syntactic form after hearing it, and
(c) after listening to multiple examples of the syntactic form
(massed primes) before being asked to produce their own
sentence.
These and other studies have shown priming effects
for a variety of sentence structures. For example, Garraffa
et al. (2012) examined the effect of syntactic priming of sub-
ject relative sentences with TD children and children with
DLD. The researchers found that both groups (TD and
DLD) were more likely to produce a subject relative clause
after hearing a subject relative clause. The children with
DLD performed worse than their TD peers, perhaps because
they had deficient implicit learning mechanisms (Evans
et al., 2009; Hsu & Bishop, 2014; Tomblin et al., 2007).
It is possible that combining other, more explicit types of
language learning experiences, such as recasting, could pos-
itively influence language learning of complex sentences in
children with DLD.
Recasting
Recasting is a more explicit language learning con-
text that involves restructuring a child’s utterance in a way
that maintains the meaning of the utterance but increases
its grammatical accuracy or modifies its syntactic structure
(Nelson et al., 1996). In focused recasting, if a child pro-
duces an utterance that does not contain the grammatical
target, the clinician immediately produces a sentence that
models the grammatical target in a way that retains the
meaning of the sentence that the child produced. Recently,
a systematic review of the effectiveness of recasts in language
intervention was conducted by Cleave et al. (2015). Of the
35 studies included in the systematic review, 20 studies
examined whether a recasting procedure facilitated the
grammatical development of children with language im-
pairments. Though the specific recasting procedure and
the targeted grammatical structure varied across the studies,
18 of the 20 studies supported the use of recasting to increase
child use of the targeted grammatical structures. Overall,
the systematic review found that most evidence suggested
that recasting was an effective technique for increasing lan-
guage ability in children with and without DLD. Cleave
et al. (2015) reported that focused recasts for a specific
grammatical structure were more effective than a broad,
nonspecific recast procedure in which a specific grammati-
cal target is not predetermined.
There have been a number of studies that have com-
pared recasting with other procedures that may impact lan-
guage learning in children. For example, Nelson et al. (1996)
examined the use of recasting in conversational settings with
TD children from the ages of 2–4 years and with children
with DLD aged 4–6 years. Nelson et al. used two different
methods to elicit the selected targets: imitated speech and con-
versational recasts. The researchers found that the children
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(both DLD and TD) produced the target faster in the con-
versational recast condition than the imitated treatment
context.
Prior research has shown that priming and recasting,
particularly focused recasting, are two effective techniques
for eliciting the production of targeted syntactic forms in
children and adults. It is possible that combining an implicit
procedure like priming with an explicit procedure like re-
casting might create a richer learning environment than the
use of either technique alone. In a recent study, Plante et al.
(2018) examined the combined use of auditory bombard-
ment with recasting. In their study, auditory bombardment
was, in essence, a “massed priming” activity, and recasting
was used to target specific grammatical morphemes (e.g.,
past tense –ed or auxiliary “is”). One group of children re-
ceived the auditory bombardment before the recast proce-
dure, and the other group of children received the auditory
bombardment after the recast procedure. Plante et al. found
that the combination of auditory bombardment and re-
casting was effective in increasing child use of the targeted
grammatical morphemes regardless of whether the auditory
bombardment occurred before or after the recast procedure.
Given their results, we reasoned that combining priming
with recasting may also help older children with DLD learn
complex sentence structures. To our knowledge, the impact
of the combined usage of syntactic priming and recasting has
yet to be examined for helping children with DLD produce
subject- and object-focused, center-embedded relative clauses.
Relative Clause Production by Children With DLD
It is well known that students with DLD demonstrate
difficulty learning and using complex sentences in spoken
and written language contexts, with particular difficulty with
relative clauses (Frizelle & Fletcher, 2014; Garraffa et al.,
2012; Nippold et al., 2008; Novogrodsky & Friedmann,
2006; Schuele & Nicholls, 2000; Scott, 2014; Zwitserlood
et al., 2015). For example, Hesketh (2006) found that chil-
dren with DLD between the ages of 6 and 11 years pro-
duced fewer subject relative clauses than their typically
achieving peers. As proposed by Nippold et al. (2008), it
appears that students with DLD may have some knowl-
edge of the subject relative construction, even though they
have difficulty producing relative clauses in narrative retell
or elicited production contexts.
Frizelle and Fletcher (2014) studied the abilities of
84 Irish children with and without DLD to produce sub-
ject relative and object relative clauses in two sentence
contexts. The children were asked to repeat the sentence
types in eight different categories. The children with DLD
scored significantly more poorly on both sentence types
than their peers who were age- or language-matched. In a
similar study of children who spoke Hebrew, Novogrodsky
and Friedmann (2006) examined school-age children’s abil-
ity to produce relative clauses in sentences. Children with
SLI had a more difficult time producing relative clauses (with
object relative being harder than subject relative) than the
TD children. These findings have been reported across
Wada et al.: The Use of Priming and Recasts 1885
numerous languages (Frizelle & Fletcher, 2014; Novogrodsky
& Friedmann, 2006; Zwitserlood et al., 2015).
It is clear that students with DLD across different
languages and cultures have difficulties developing and
mastering the use of relative clauses. It is possible that the
combined use of priming and recasting could be useful as
an intervention procedure to improve production of rela-
tive clauses by children with DLD. This study was designed
to serve as a small-scale test of the feasibility of combining
priming and recasting to support the use of subject- and
object-focused, center-embedded relative clauses. The spe-
cific research questions were as follows:
1. Do children with DLD and TD children perform sim-
ilarly on their use of center-embedded relative clauses
with a subject focus or an object focus in response to
priming combined with recasting?
2. Do TD children and children with DLD require the
same number of trials to demonstrate stable produc-
tion of subject- and object-focused clauses in response
to priming combined with recasting?
3. Do children with DLD and their TD controls make
similar kinds of errors in their off-target responses to
the priming and recasting task?
Method
Participants
A total of 26 children, ranging in age from 6;10 to
10;11 participated in this study. Students were recruited
from local schools in Northern Utah, and all children in
the DLD group had been identified previously by certi-
fied or licensed speech-language pathologists. Thirteen of
the children (seven girls, eight boys) presented with a DLD
as demonstrated by composite standard scores at or below
81 on vocabulary and syntax subtests from global lan-
guage measures, such as the Clinical Evaluation of Language
Table 1. Demographic variables.
Variable
Race/ethnicity
White/non-Hispanic
White/Hispanic
Asian/non-Hispanic
Native Hawaiian/non-Hispanic
Unknown
Age (in months)
CELF Recalling Sentences (raw score)
CELF Recalling Sentences (standard score)
UNIT Symbolic Memory (raw score)
UNIT Symbolic Memory (standard score)
Note. TD = typically developing; DLD = developmental language disorder; CELF = Clinical Evaluation of Language
Fundamentals; UNIT = Universal Nonverbal Intelligence Test.
*p < .05.
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Fundamentals–Fourth Edition (Semel et al., 2003) and the
Test of Language Development–Primary: Fourth Edition
(Newcomer & Hammill, 2008). These tests had been previ-
ously administered. We gave the Clinical Evaluation of
Language Fundamentals–Fourth Edition Recalling Sentences
and the Universal Nonverbal Intelligence Test (Bracken &
McCallum, 1998) Symbolic Memory subtests to all chil-
dren. Table 1 presents descriptive data for the two groups.
There were 13 same-age children (seven girls, eight
boys) in a TD control group who had no history of devel-
opmental delays or remedial services. None of the students
in the study presented with evidence of hearing impairment,
visual impairment, gross neurological impairment, oral
structural anomalies, or emotional/social disorders. Chil-
dren were excluded if parents reported a history of focal
brain lesions, traumatic brain injury, cerebral palsy, seizure
disorders, symptoms of severely impaired reciprocal social
interaction, or severely restricted activities listed in the
Diagnostic and Statistical Manual of Mental Disorders,
Fifth Edition criteria for autism spectrum disorders.
Prior to administration of the experimental task,
all children completed a sentence repetition task consist-
ing of five subject-focused, center-embedded relative and
five object-focused, center-embedded relative sentences.
Ten of the 13 children in the TD group could repeat all
five subject-focused, center-embedded relative sentences
(M = 4.62, SD = 0.77), but only one of the 13 could re-
peat all five object-focused, center-embedded relative sen-
tences (M = 3.23, SD = 1.42) without errors. Five of the
13 children in the DLD group could repeat all five subject-
focused relative sentences without errors (M = 3.46, SD =
1.76), but only one could repeat all five of the object-focused
relative sentences (M = 0.62, SD = 0.96).
Experimental Task
A priming/recasting task was conducted with two
types of center-embedded relative clauses, those with a
TD group (n = 13) DLD group (n = 13)
9 5
1 0
0 1
0 2
3 5
M (SD) M (SD) p
107.23 (17.39) 110 (12.46) .645
59.46 (15.76) 34.08 (14.03) .001*
10.15 (3.05) 4.15 (2.48) .001*
10.92 (4.15) 10.77 (4.02) .924
9.38 (2.5) 9.08 (3.01) .779
subject focus and those with an object focus (de Villiers
et al., 1979). The researchers created 40 paired subject-
focused stimuli (80 total sentences) and 40 paired object-
focused stimuli (80 total sentences), which are available in
Supplemental Material S1. Each paired stimuli included two
sentences that described two separate pictures. All pictures
were obtained from shutterstock.com. The pictures used as
stimuli depicted agents and actions. There was no contextual
information in the pictures that required a relative clause.
For each paired stimuli, the first sentence was the prime sen-
tence that the examiner used to describe the picture. For ex-
ample, one picture showed a girl smiling and sitting at a
table while holding a set of keys. The created sentence de-
scribing this picture was, The girl that held the key above
the table was happy. The paired picture for the participant
to describe showed a man sitting at a table holding a knife
and fork in each hand and frowning at an empty plate.
The targeted sentence for the paired picture was, The man
that held the fork in his hand was sad.
All the sentences contained the desired relative clause
type and an embedded prepositional phrase. Coh-Metrix
(Graesser et al., 2011) was used to compare the complexity
of the two types of sentences. The results from the Coh-
Metrix analysis (see Table 2) demonstrated that the subject-
and object-focused stimulus sentences were similar in length
and complexity. The words across the two sentence types were
similar with respect to age of acquisition, complexity of the
content words, familiarity, concreteness, and imageability.
For each trial, participants were shown one picture
and heard the examiner verbally model the target syntactic
structure (a subject- or object-focused relative clause). The
participant was then shown a second picture that depicted
a related action and was asked to create a sentence that
“sounded like” the sentence that the examiner had produced
for the previous picture. If the participant produced a sen-
tence that contained the target structure, the examiner re-
peated the student’s sentence. If the participant’s utterance
did not contain the target sentence structure, the examiner
recasted the participant’s sentence so that it included the
target syntactic structure and as much of the vocabulary as
possible. There was no other feedback.
To illustrate, in one subject-focused trial, the exam-
iner placed a picture of a bear eating berries in front of the
Table 2. Coh-Metrix analysis of subject- and object-focused stimuli.
SF prime sentence
Variable
No. of words per sentence
No. of modifiers per noun
Age of acquisition content ratings
Familiarity for content words
Concreteness for content words
Imageability for content words
Note. SF = subject-focused, center-embedded relative clause; OF = object-focused, center-embedded relative
clause.
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participant and said, “The bear that ate the berries from
the bush was still hungry.” A corresponding picture (e.g., a
cat drinking milk) was then placed in front of the partici-
pant, and the participant was asked to create a sentence
that went with the picture. If the participant responded
with a sentence that contained a subject-focused relative
clause (e.g., The cat that drank the milk was still thirsty.),
the examiner repeated the child’s utterance. Notice that
the prepositional phrase was not required for the response
to be considered to be “on-target.” If the child’s response
was “off-target” (e.g., The cat drank some milk out of the
bowl.), the examiner recasts the sentence so that it contained
the target structure (e.g., The cat that drank the milk from
a bowl was still thirsty). The sequence of the experiment is
represented in Figure 1.
The task was piloted with two TD children aged 5;5
and 5;9. Neither of the participants produced the target
sentence structures after the prime nor did they repeat the
target structures correctly. We decided not to include a
younger, language-matched group in the study because the
task appeared to be too difficult for children under the age
of 6 years.
The experimental task was also piloted with two TD
children in the desired age range. For the purpose of deter-
mining the feasibility of the task, we used Kidd’s (2012)
criteria of at least one correct production out of six trials. The
pilot demonstrated that both children could complete the
task and the stimuli were minimally appropriate for priming
subject- and object-focused, center-embedded relative clauses.
The order of presentation for the two sentence types
was counterbalanced across participants to control for or-
der effects. Therefore, half of the participants received the
40 subject-focused relative clause trials followed by the
40 object-focused relative clause trials, and half received
the object-focused relative clause trials followed by the
subject-focused relative clause trials. Counterbalancing was
accomplished by randomizing the order of the sentence types
and preassigning them to participant ID numbers. Chil-
dren were randomly assigned to one of two presentation
orders (subject-focused first or object-focused first). Prelimi-
nary analysis of variance (ANOVA) for subject relative
trials to criteria and object relative trials to criteria revealed
nonsignificant main effects for order and nonsignificant
OF prime sentence
M M
11.95 11.08
1.06 1.64
219.96 235.44
538.72 589.76
498.05 485.27
521.51 512.09
Wada et al.: The Use of Priming and Recasts 1887
Figure 1. Sequence of tasks during experiment.
Group × Order interactions. Therefore, subsequent analyses
collapsed across orders.
The first author and a research assistant administered
the assessments and experimental tasks to the participants.
The experimental sessions with participants were video-
recorded. Three of the research assistant’s sessions and three
of the first author’s sessions were randomly chosen for com-
putation of fidelity. Procedural fidelity was calculated by
adding the number of structured primes and focused recasts
produced accurately and dividing by the total number of
structured primes and focused recasts possible. The reliabil-
ity of the presentation of the primes and recasts was 97%.
Scoring
First, the participants’ responses were scored based
on use of the targeted sentence structure. A sentence was
judged to be on-target if it contained the desired center-
embedded structure primed by the experimenter. The sen-
tences were not judged on verb tense agreement or presence
of a prepositional phrase. For example, if the prime sentence
was, The car that hit the tree next to the street was blue, and
the child said, The boy that hit the ball looked mad, in the
subject-focused relative condition, the sentence would be
marked as on-target even though the sentence did not con-
tain a prepositional phrase. Additionally, if the child marked
the relative with “who” instead of “that,” the sentence was
marked as on-target. For example, if the prime sentence was,
The car that hit the tree next to the street was blue, and the
child’s sentence was, The boy who hit the ball into the air was
happy, the child’s sentence would be scored as on-target.
In studies of learning and memory, researchers often
use number of trials to a criterion (e.g., r correct responses
in s consecutive trials) to indicate the consistency with
which participants can perform a task (Runnels et al.,
1968). Kidd (2012) used the criterion of one correct pas-
sive out of six trials in the posttest block as evidence of
priming. In this study, we employed the more stringent
criterion of three correct responses in any four consecutive
trials as indicating the earliest point within a block of 40 tri-
als in which a participant evidenced stable production of
a target form.
Off-target responses that did not contain the desired
center-embedded relative clause structure were coded for
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type of error. Error codes included change in focus, ungram-
matical sentences, simple sentence, right-branching relative
clause, use of multiple simple sentences, and presence of a
subordinating or coordinating conjunction. A change in
focus error occurred when the participant used a center-
embedded relative clause that was not the one primed. For
example, if the participant was primed for a subject-focused,
center-embedded relative clause and produced an object-
focused, center-embedded relative clause, the response
would be marked as a change in focus error. An example
of a change in focus error occurred when the participant
said, The shirt that the man hung up was blue, when the tar-
get sentence was, The shirt that was on the hanger was blue.
In this case, the participant used an object-focused, center-
embedded relative clause instead of the primed subject-
focused relative clause. An ungrammatical sentence was
defined as any sentence that did not follow the grammati-
cal rules. An example of an ungrammatical sentence was,
The boy that is smiling with his fluffy bunny, when the target
sentence was, The boy that held the bunny is his arms was
laughing. A simple sentence error was defined as the use
of one complete, grammatical sentence without a relative
clause. An example of a simple sentence error was, The wie-
ner dog was running away from the horse, when the target
sentence was, The horse that chased the dog in the field was
running. A right-branching relative clause error occurred
when the participant used a right-branching relative clause
instead of the primed center-embedded relative clause struc-
ture. An example of a right-branching relative clause error
was, The boy rode the bike that was red, when the target
sentence was, The boy that rode his bike to school had a
green backpack. Another error pattern was when the par-
ticipant used multiple simple sentences to describe the picture.
An example of the use of multiple simple sentences was,
The dog is happy. And the boy is holding the ball, in re-
sponse to the target sentence, The dog that performed a trick
for the boy sat on the floor. The subordinating or coordinat-
ing conjunction error was defined as the participant response
including a subordinating or coordinating conjunction in-
stead of the primed relative clause structure. An example
of a subordinating or coordinating conjunction error was,
The boy gave fake money to the girl when they were playing
bank, when the target sentence was, The boy that gave the
bills to the girl was short.
Reliability of Scoring
All sessions were audio-recorded using a digital recorder.
The sessions were transcribed from the audio recordings
by two members of the research team using Systematic Anal-
ysis of Language Transcripts software (Miller & Iglesias,
2008). In order to calculate word-by-word reliability for
transcriptions, one researcher retranscribed three partici-
pant sessions. Transcription reliability was 97%.
The transcripts were coded for item accuracy. To es-
tablish intrarater reliability, the first author listened to all
the sessions she conducted and rescored all de-identified
transcriptions. Intrarater reliability was found to be at 99%.
A second examiner also scored six of the transcripts (three
from the TD group and three from the DLD group). Calcu-
lation of interrater reliability was conducted by dividing
the total number of agreements (460) by the total number
of items (480) and then multiplying by 100. Interrater reli-
ability was 95.83%.
Results
Analyses of On-Target Responses
The first research question concerned potential group
differences in children’s ability to respond correctly (on-
target) to subject- and object-focused, center-embedded
relative clause primes. The accuracy for production of each
sentence type for each group is presented in Figure 2. A
two-way mixed ANOVA was conducted to evaluate the
statistical reliability of the group differences on producing
subject- and object-focused, center-embedded relative clauses
following structured primes and/or focused recasts. The
dependent variable was the number of on-target produc-
tions. The between-subjects variable was group (DLD, TD),
and the within-subject variable was prime type (whether the
Figure 2. Total on-target relative clause responses for subject-focused (SF) and object-focused (OF) primes.
TD = typically developing; DLD = developmental language disorder.
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prime was a subject-focused relative or object-focused rela-
tive sentence). Greenhouse–Geisser adjustments to the uni-
variate F tests are reported to control for potential threats to
the sphericity assumption. Effect sizes of significant main
effects and interactions were assessed with partial eta squared
values, which are interpreted as the proportion of variance
of the dependent variable that is related to the main effect
or interaction, excluding all other main effects and interac-
tions. Conventional interpretations of partial eta squared
effect sizes are .01 (small), .06 (moderate), and .14 (large;
Green & Salkind, 2011).
There were significant main effects for prime type,
F(1, 24) = 31.037, p < .001, η2p = .564, and group, F(1, 24) =
6.135, p < .05, η2p = .204. The Prime Type × Group interac-
tion was not significant. The prime type main effect indicated
that both groups were more accurate for subject-focused
sentences than object-focused sentences. The partial eta
squared effect size of .564 is indicative of a very large effect.
The group main effect indicated that, across sentence types,
the children with DLD responded with fewer on-target ut-
terances immediately after the prime than their TD con-
trols. This was interpreted as a large effect as indicated by
the partial eta squared effect size of .204.
Most of the children in both groups reached our rate
of learning criterion (three correct responses out of four
consecutive trials) for the subject-focused prime targets.
Only three of the 14 students with DLD failed to meet the
trials to criterion threshold within 40 total trials for subject
relative sentences; no student in the TD group failed to
meet this criterion. Indications of rate of learning differed
for the object-focused sentences. Eleven of the 14 students
with DLD failed to meet the trials to criterion threshold
for the object-focused relatives as compared to only four
out of 13 students in the TD group. A two-way contin-
gency table analysis was conducted to evaluate whether
Wada et al.: The Use of Priming and Recasts 1889
participants in the TD group were more likely to reach
trials to criterion than participants in the DLD group. The
probability of reaching criteria was significantly different
for the two groups, Pearson χ2(1, N = 26) = 11.09, p = .001.
Participants in the TD group were 1.9 times more likely to
reach criteria during the two priming tasks (40.8%) than
participants in the DLD group (21%).
We assessed rate of learning with a two-way mixed
ANOVA. The dependent variable for rate of learning was
number of trials to criteria (on-target responses to three of
four sequential trials). The between-subjects variable was
group (TD, DLD), and the within-subject variable was re-
sponse type (subject-focused, object-focused). Figure 3 de-
picts the average number of trials required for subjects in
the DLD and TD groups to demonstrate consistent perfor-
mance on both the subject-focused relative clause and ob-
ject-focused relative clause tasks. The number of trials to
criteria for participants who did not reach the criteria within
the administered trials was reported as 40. There were sig-
nificant main effects for group, F(1, 24) = 7.25, p = .013,
ηp2 = .232, and sentence type, F(1, 24) = 23.79, p < .001,
ηp2 = .498. The partial eta squared values for both main
effects were quite large. Across the two conditions, the
children in the DLD group required significantly more tri-
als to reach criteria (M = 26.04, SD = 13.56) than the chil-
dren in the TD group (M = 14.73, SD = 12.27). Across
the two groups, participants needed significantly fewer tri-
als to reach criteria for the subject-focused relative sentences
(M = 13.14, SD = 12.79) than the object-focused relative
sentences (M = 27.62, SD = 15.32). The Group × Sentence
Type interaction was not significant.
Error Analyses
The third research question concerned whether chil-
dren in the two groups responded differentially during the
Figure 3. Mean trials to criteria on the subject- and object-focused relative sentences for the children in the typically
developing (TD) and developmental language disorder (DLD) groups. Error bars represent 95% confidence intervals.
1890 American Journal of Speech-Language Pathology • Vol. 29 • 1883–1895 • November 2020
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priming and recasting task. Error pattern analysis was con-
ducted on all participants’ off-target responses (see Table 3).
We conducted two 2-way contingency table analysis to
determine whether children in the TD and DLD groups
differed for the types of off-target errors. The first analysis
concerned the responses to subject-focused, center-embedded
relative clause primes; the second analysis concerned the
off-target responses to object-focused, center embedded rel-
ative clause primes. For each analysis, the independent var-
iable was group (TD, DLD), and the dependent variable
was error type (changes in focus, ungrammatical sentence,
simple sentence, right-branching relative clause, multiple
sentences, and coordinating/subordinating clauses).
The proportion of off-target errors for the subject-
focused, center-embedded relative primes differed across
the two groups, Pearson χ2(4, N = 437) = 25.077, p < .001,
Cramér’s V = .240. Follow-up pairwise comparisons re-
vealed that the groups differed significantly on the change
in focus, multiple sentences, and the coordinating/subordi-
nating clause error types. The groups did not differ signifi-
cantly for the proportion of ungrammatical errors, simple
sentence errors, or right-branching errors. The participants
in the TD group had a higher percentage of opposite focus
errors (8.6%) than the participants in the DLD group (2.2%).
Multiple-sentence errors accounted for 11.3% of total errors
from participants in the DLD group but only 1.8% of total
errors for participants in the TD group. Lastly, a significantly
higher percentage of total errors produced by participants
in the TD group (10.4%) were from the subordinating/
coordinating error category compared to 5.5% of total
errors produced by participants in the DLD group.
The second two-way contingency table analysis con-
cerned potential group differences for the off-target errors
for the object-focused, center-embedded relative clauses (see
Table 3). As with the subject-focused, center-embedded
relative clauses, the proportion of errors differed across the
 Table 3. Type of error, total number of errors per group, and the number of each type of error for individuals within each group (range) during participant responses.

Change in focus Ungrammatical Simple Right-branching Multiple sentences Sub/coord

Variable Total (range) Percent Total (range) Percent Total (range) Percent Total (range) Percent Total (range) Percent Total (range) Percent

Subject-focused relatives
TD 14 8.6 45 27.6 84 51.5 0 0 3 1.8 17 10.4
(0–8) (0–11) (0–25) 0 (0–2) (0–7)
DLD 6 2.2 68 24.8 154 56.2 0 0 31 11.3 15 5.5
(0–3) (0–15) (0–29) 0 (0–8) (0–5)
Object-focused relatives
TD 105 37 80 28.2 84 29.6 6 2.1 2 0.7 7 2.5
(0–27) (0–16) (0–26) (0–4) (0–2) (0–2)
DLD 128 28.8 133 30 131 29.5 5 1.1 33 7.4 14 3.2
(0–27) (0–24) (0–35) (0–2) (0–12) (0–7)
Wada et al.: The Use of Priming and Recasts

Note. Percentages do not add up to 100 due to rounding. Simple = simple sentence; Sub/coord = subordinating or coordinating conjunction; Total = total number of times error
occurred across all participants; range = number of times an error occurred across individual participants; TD = typically developing; DLD = developmental language disorder.
1891

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two groups, Pearson χ2(5, N = 728) = 21.487, p = .001,
Cramér’s V = .172. Follow-up pairwise comparisons re-
vealed that the groups differed significantly on the change
in focus and multiple-sentence error types. The ungram-
matical errors, simple sentence errors, right-branching errors,
and subordinating/coordinating errors were remarkably
similar for the two groups, as seen in Table 3. The partic-
ipants in the TD group made significantly more change
in focus errors (37%) than participants in the DLD group
(28.8%). While 7.4% of the errors by children in the DLD
group involved multiple sentences, only 0.7% of errors in
the TD group were multiple sentences. When children in
the TD group responded to the primes in an off-target man-
ner, they were more likely than children in the DLD group
to produce utterances that contained multiple clauses.
Discussion
This small-scale study was designed to assess the fea-
sibility of combining syntactic priming and focused recast-
ing to elicit the production of subject- and object-focused,
center-embedded relative syntactic forms by a group of
school-age children with DLD and a group of their same-
age TD peers. Participants saw a picture and listened to a
sentence containing either a subject-focused relative or
object-focused, center-embedded relative clause. They were
then shown a second picture and were asked to generate a
sentence with a syntactic structure similar to the examiner’s
model. After the participant responded, the examiner pro-
vided focused recasts to correct the utterance to contain
the targeted structure or repeated the child’s correct utter-
ance. Children were credited for responding consistently to
a particular structure if they reached the criterion of pro-
ducing the primed sentence structure on three out of four
consecutive trials.
Our results indicated that children in both groups
produced more on-target primed responses and took signif-
icantly fewer trials to reach criteria for the subject-focused
than the object-focused relative sentences. This is consistent
with the findings reported by Novogrodsky and Friedmann
(2006) indicating that object relatives are more difficult than
subject relatives. Not surprisingly, the DLD group performed
more poorly on the prime plus recasting tasks than their
TD peers. Across both types of relative clauses (subject-
focused, object-focused) the children in the TD group pro-
duced more on-target responses and needed fewer trials
to reach our learning criteria than children in the DLD
group. In fact, participants in the TD group were nearly
2 times more likely to reach the criteria for consistency
than participants in the DLD group. Combining an implicit
technique (priming) with an explicit technique (recasting)
was more effective for promoting production of subject-
focused relative clauses than object-focused relative clauses.
However, combining these techniques appeared to be more
effective for the adept language learners in the TD group
than for the children in the DLD group.
The error pattern analysis revealed that the children
in the TD and DLD groups responded differently to the
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subject- and object-focused targets. The children in the DLD
group tended to produce multiple simple sentences when
their responses to the primes were off-target. Consistent
with previous studies that examined the use of relative clauses
by children with DLD, the participants in the DLD group
tended to use simple sentences (The deer was brown.) and
occasionally multiple simple sentences (The deer ate leaves.
He was hungry.) when their responses to the primes were
off-target. Novogrodsky and Friedmann (2006) also reported
that children with DLD were more likely to use simple
sentences to avoid the use of a relative clause. In this case,
difficulties with relative clauses may be compounded by
working memory limitations in which children with DLD
were not as adept at binding the critical structure in the
primed target to their knowledge of complex syntax in long-
term memory (Gillam et al., 2019; Montgomery et al., 2018).
In a somewhat different interpretation, Novogrodsky and
Friedmann (2006) hypothesized that the deficits noted chil-
dren with DLD’s ability to assign thematic roles in relative
clauses could be due to child preference for a canonical
order (subject-verb-object) strategy. Further research into
the processes involved in relative clause production is nec-
essary to determine the specific mechanisms underlying the
difficulties that children with DLD have with producing
relative clauses.
Clinical Implications
A key finding from the study was that children with
DLD were consistently able to create subject-focused rela-
tive sentences about pictures after they were provided with
two different models (syntactic priming and focused recast-
ing) on each item. Eleven of the 14 participants with DLD
were eventually able to meet the criterion for consistency
(three of four consecutive responses) for subject-focused
relative clauses. However, the children with DLD were less
successful at creating object-focused relatives during the
priming/recasting task. Only three out of the 14 participants
with DLD met the criterion for consistency for object-
focused relative clauses. Even when they were provided
with 40 primes and 40 recasts, the participants with DLD
struggled to consistently produce object-focused relative
clauses. Additionally, adding a more explicit strategy (re-
casting) to an implicit strategy (structural priming) did
not facilitate the use of center-embedded relative clauses
for children with DLD to the same extent as their typically
achieving peers. While syntactic priming and recasting
may be effective clinical strategies for teaching grammati-
cal morphemes and simple sentence constructions (Cleave
et al., 2015; Leonard, 2011; Plante et al., 2018) to pre-
school children with DLD, they may not be as effective
for relative clause instruction. Unfortunately, it is difficult
from this small-scale study to make conjectures about the
effectiveness of priming plus recasting for teaching center-
embedded relative clauses, especially since we did not
have pretest data on the children’s knowledge of relative
clauses. Nonetheless, it is likely that children with DLD
will require many more than 40 opportunities to hear and
produce relative clause sentences in order to reach consis-
tency in the use of object-focused relative clause structures.
In order to reduce the cognitive and linguistic load
imposed by the complexity of the syntactic structure, clini-
cians may want to provide graphic organizers and/or visual
cues in addition to priming/recasting. Explicit instruction
through the use of visual/graphic organizers has been em-
pirically validated for vocabulary and comprehension in-
struction and should support the development of syntactic
knowledge as discourse demands increase (Kim et al., 2004).
A graphic organizer to teach object-focused relative clauses
could include symbols that represent the different sentence
elements: the object, the relative marker “that,” the subject,
and the verb phrase. For example, for the sentence, The
carrot that the rabbit ate was orange, the different parts
would be object (The carrot), relative marker (that), subject
(the rabbit ate), and verb phrase (was orange). The clinician
might want to include an arrow to indicate that the verb
phrase is referring to the object. Because of the pattern seen
in this study in which children with DLD avoided the use
of the marker “that,” it should be included as a separate
symbol/word on the graphic organizer. When using the or-
ganizer to teach the structure, the clinician should select
pictures with a clear subject and object in order to make it
easier for the child to see the relationship.
Another potential approach within which to embed
priming and recasting is the use of vertical structuring. In
vertical structuring, the child produces an utterance, and
then the clinician asks a question about the utterance so that
the child must elaborate. The clinician then combines the
child’s utterance into one complex sentence (Schwartz
et al., 1985). For example, if the clinician shows a picture
of a boy eating and asks, “What is the boy doing?” The
child might say, “The boy eats.” The clinician would ask,
“What is the boy eating?” If the child responds, “An ap-
ple,” the clinician would put the two answers together into
a single SVO construction by saying, “The boy eats an ap-
ple.” This technique can be used with more complex sen-
tences such as object-focused relative clauses. For example,
the clinician might present the child with a picture of a
rabbit with a carrot. The child might say, “The carrot is
orange.” The clinician asks, “Who is eating the carrot?”
The child responds, “The rabbit.” The clinician puts the
utterances into an object-focused relative clause by saying,
“The carrot that the rabbit eats is orange.” By combining
the child’s two utterances, the clinician is using the tech-
niques of vertical structuring as well as recasting. This tech-
nique may be more beneficial than priming and recasting
because it provides clear demonstrations of word order and
clause structure meaning that it may be less reliant on im-
plicit learning mechanisms.
Finally, recall that object-focused, center-embedded
relative clauses do not appear often in oral conversations.
Therefore, oral language might be a difficult context for
teaching such complex structures. Clinicians may want to
find or create children’s books that contain multiple exam-
ples of subject- and object-focused relatives. Then, have
children with DLD practice identifying relative clauses in
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text and then use these structures as they retell the stories.
Such multimodal experiences may contribute to learning
and using them consistently.
Limitations
This was a small-scale feasibility study, so it was lim-
ited in size (only 26 participants). The participants also re-
ceived only 40 opportunities for priming and production
for each relative clause type. A larger number of participants
and a longer stimulus set would provide more information,
particularly for those participants who did not reach our
criterion of minimally stable production within the 40 op-
portunities that were provided. Additionally, all of the test-
ing was conducted in one session. This may have impacted
how well the participants could pay attention to the task.
Unfortunately, we have no information about how long the
effects of our priming/recasting input lasted because no fol-
low-up sessions were completed. Lastly, we did not examine
the participants’ use of relative clauses in their spontaneous
speech prior to or after the experimental task. In further re-
search, a language sample for each participant should be
gathered before testing in order to analyze how often the
participants are using subject-focused and object-focused,
center-embedded relative clauses in their spontaneous speech.
Finally, to better understand the mechanisms of change,
future studies could be designed to compare the outcomes
of priming only, priming plus recasting, and recasting only
conditions.
The sentences that were used in this study were 11 or
12 words long and contained a prepositional phrase. The
length of the sentences may have made it more difficult for
children to store the first clause in working memory while
they shifted their focus of attention to the second relative
clause constituent. Sentence length is something clinicians
may want to control for and/or vary when developing stim-
uli for intervention efforts. Future studies may investigate
ways to systematically increase utterance length and com-
plexity in ways that facilitate children’s abilities to pay at-
tention to the syntactic targets they are being asked to learn.
Conclusions
This study assessed the ability of children with DLD
and their TD peers to produce subject- and object-focused,
center-embedded relative syntactic structures in the context
of priming combined with recasting. Children in both groups
were significantly more accurate producing subject-focused
relatives than object-focused relatives. School-age TD chil-
dren required significantly fewer trials to consistently pro-
duce both types of relative clause sentences. In fact, even
after 40 trials, some of the children in the DLD group never
reached the criterion of consistency of three correct responses
on four consecutive trials. These findings suggest that more
explicit instruction about the structure of relative clauses
might be necessary for children with DLD to be able to
learn and use the complex grammatical patterns associated
with subject- and object-focused relative clauses. Further
Wada et al.: The Use of Priming and Recasts 1893
research should examine lasting effects that the strategies
of priming and recasting may have on the production of a
variety of complex sentences in children with DLD.
Acknowledgments
Data collection and analysis were supported by the Lillywhite
endowment to Utah State University.
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