This report examines 174 young children's language outcomes in the Bucharest Early Intervention Project, the first randomized trial of foster placement after institutional care. Age of foster placement was highly correlated with language outcomes. Placement by 15 months led to similar expressive and receptive language test scores as typical age peers at 30 and 42 months. Placement from 15 to 24 months also led to dramatic language improvement. In contrast, children placed after 24 months had the same severe language delays as children in institutional care. Language samples at 42 months confirmed that placement after 24 months led to lower expressive skill.

The authors discuss cultural influences on clinical interactions when treating late talkers, 2-to 3-year-old children with primary language delays. They use the literature to examine the cultural relevance of core components of early language treatment and propose alternative professional actions in the cases of cultural mismatches. Alternative actions include triadic or multiparty treatments, the inclusion of siblings or others, more structured tasks or group settings for language training, and shaping of culturally congruent directive language techniques. Also discussed is the need for an emphasis on social language use and professional clarity regarding links between early child language ability and later achievements in order to motivate treatment.