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In the last two decades, several studies have provided evidence that intervention for older school\u2010age children with SLI can be effective. These metalinguistic intervention approaches teach grammatical rules explicitly and use shapes and colours as two\u2010dimensional visual support. Reading or writing activities form a substantial part of these interventions. However, some children with SLI are poor readers and might benefit more from an approach that is less dependent on literacy skills.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To examine the effectiveness of a combined metalinguistic and multimodal approach in older school\u2010age children with SLI. The intervention was adapted to suit poor readers and targeted the improvement of relative clause production, because relative clauses still pose difficulties for older children with SLI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods &amp; Procedures<\/jats:title><jats:p>Participants were 12 monolingual Dutch children with SLI (mean age 11;2). All children visited a special school for children with speech and language disorders in the Netherlands. A quasi\u2010experimental multiple\u2010baseline design was chosen to evaluate the effectiveness of the intervention. A set of tasks was constructed to test relative clause production and comprehension. Two balanced versions were alternated in order to suppress a possible learning effect from multiple presentations of the tasks. After 3 monthly baseline measurements, the children received individual treatment with a protocolled intervention programme twice a week during 5 weeks. The tests were repeated directly post\u2010therapy and at a retention measurement 3 months later. During the intervention programme, the speech therapist delivering the treatment remained blind to the test results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes &amp; Results<\/jats:title><jats:p>No significant changes were found during the baseline measurements. However, measurement directly post\u2010therapy showed that 5 h of intervention produced significant improvement on the relative clause production tasks, but not on the relative clause comprehension task. The gains were also maintained 3 months later.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Implications<\/jats:title><jats:p>The motor and tactile\/kinesthetic dimensions of the \u2018MetaTaal\u2019 metalinguistic intervention approach are a valuable addition to the existing metalinguistic approaches. This study supports the evidence that grammatical skills in older school\u2010age children with SLI can be remediated with direct intervention using a metalinguistic approach. The current tendency to diminish direct intervention for older children with SLI should be reconsidered.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1460-6984.12131","type":"journal-article","created":{"date-parts":[[2015,2,19]],"date-time":"2015-02-19T17:03:26Z","timestamp":1424365406000},"page":"273-297","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["\u2018MetaTaal\u2019: enhancing complex syntax in children with specific language impairment\u2014a metalinguistic and multimodal approach"],"prefix":"10.1111","volume":"50","author":[{"given":"Rob","family":"Zwitserlood","sequence":"first","affiliation":[{"name":"Utrecht Institure of Linguistics (OTS) Utrecht University  Utrecht the Netherlands"},{"name":"Royal Auris Group  Gouda the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Wijnen","sequence":"additional","affiliation":[{"name":"Utrecht Institure of Linguistics (OTS) Utrecht University  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjolijn","family":"van Weerdenburg","sequence":"additional","affiliation":[{"name":"Behavioural Science Institute Radboud University Nijmegen  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludo","family":"Verhoeven","sequence":"additional","affiliation":[{"name":"Behavioural Science Institute Radboud University Nijmegen  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,2,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3109\/13682829009011971"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1044\/jshr.2702.244"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-199606000-00021"},{"key":"e_1_2_7_5_1","volume-title":"Multisensory Teaching of Basic Language Skills","author":"Birsh J. 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