Articlegreen2015

Early Intervention for Toddlers With Language Delays: A Randomized Controlled Trial

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Language Development and Disorders Hearing Impairment and Communication Assistive Technology in Communication and Mobility

Abstract

OBJECTIVE: Early interventions for toddlers with expressive and receptive language delays have not resulted in positive expressive language outcomes. This randomized controlled trial tested the effects on language outcomes of a caregiver-implemented communication intervention targeting toddlers at risk for persistent language delays. METHODS: Participants included 97 toddlers, who were between 24 and 42 months with language scores at least 1.33 SDs below the normative mean and no other developmental delays, and their caregivers. Toddlers were randomly assigned to the caregiver-implemented intervention or a usual-care control group. Caregivers and children participated in 28 sessions in which caregivers were taught to implement the intervention. The primary outcome was the Preschool Language Scale, Fourth Edition, a broad-based measure of language. Outcome measurement was not blinded. RESULTS: Caregivers in the intervention improved their use of all language facilitation strategies, such as matched turns (adjusted mean difference, intervention-control, 40; 95% confidence interval 34 to 46; P < .01). Children in the intervention group had significantly better receptive language skills (5.3; 95% confidence interval 0.15 to 10.4), but not broad-based expressive language skills (0.37, 95% confidence interval -4.5 to 5.3; P = .88). CONCLUSIONS: This trial provides preliminary evidence of the short-term effects of systematic caregiver instruction on caregiver use of language facilitation strategies and subsequent changes in children's language skills. Future research should investigate the ideal dosage levels for optimizing child outcomes and determine which language facilitation strategies are associated with specific child outcomes. Research on adaptations for families from culturally and linguistically diverse backgrounds is needed.

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2007Bayley Scales of Infant Development 2010Peabody Picture Vocabulary Test 2007Peabody Picture Vocabulary Test 1990Parenting Stress Index 2012Expressive One-Word Picture Vocabulary Test 2021Preschool Language Scale – 5 2013THE PARENTING STRESS INDEX 2000Prevalence and natural history of primary speech and language delay: findings from a systematic review of the literature

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2019Association of Parent Training With Child Language Development 2018Parent-Implemented Language and Communication Interventions for Children with Developmental Delays and Disabilities: a Scoping Review 2019A systematic review of language intervention research with low-income families: A word gap prevention perspective 2018Parent-Implemented Communication Treatment for Infants and Toddlers With Hearing Loss: A Randomized Pilot Trial 2017The Longitudinal Effects of Early Language Intervention on Children's Problem Behaviors 2017

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