Exercise as Treatment in Children with Communication Impairments - Project Summary/Abstract Communication impairments affect ~10% of children in the US between 3-10 years of age, and fine/gross motor deficits co-occur in an astounding 30-85% of this population. One subpopulation that evidences high rates of co-occurring language and motor deficits is children with developmental language disorder (DLD; a highly common disorder that affects expressive and/or receptive language in 1/13 children). Consequently, millions of children present with these debilitating impairments that require time-consuming and costly therapy, which typically occurs in discipline-specific silos. The siloed approach has limitations as it fails to leverage potentially synergistic effects that may be achieved when we treat the whole child, rather than intervene discipline by discipline. Unfortunately, this status quo siloed approach results in limited, incremental gains. Alternative, ground-shifting interventions that harness neuroplasticity and yield multisystem gains are needed to fill this gap in treatment options for children with co-occurring language and motor deficits. The goal of the proposed research is two-fold. The Aim 1 study will establish motor performance and fitness levels for children with DLD and carefully characterize the motor deficits of children in this population. The Aim 2 study is a Phase 0/Early Phase 1 RCT that tests the efficacy of physical exercise as treatment to promote cognitive-linguistic, motor, and fitness gains in children with DLD. Participants will be randomly assigned to undergo 6 weeks (3x/week) of exercise training (i.e., activities to train cardiovascular fitness, agility, balance, strength, endurance) or to a quiet rest condition (e.g., legos and coloring) on the same schedule. Both interventions will be provided in small groups of 4 children or less. Cognitive-linguistic, motor skills, and fitness will be assessed pre-treatment and again at 1-week, 1-month, and 3-months post treatment to determine treatment and maintenance gains on these measures. This research will gather vital information for a Phase 2 trial of preliminary efficacy and contribute high-quality evidence that will help speech language pathologists and other practitioners make evidence-based clinical decisions. The long-term goal of this research program is to identify the breadth of comorbid impairments in children with communication disorders and develop optimally effective treatments to maximize outcomes and quality of life for the millions of children with communication impairments and their families.