Outcomes of a Universal Shared Reading Intervention by 2 Years of Age: The Let's Read Trial

Goldfeld, Sharon; Napiza, Natasha; Quach, Jon; Reilly, Sheena; Ukoumunne, Obioha C; Wake, Melissa

doi:10.1542/peds.2009-3043

Cited by 35 publications

(20 citation statements)

References 23 publications

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“…However, we note that not all parent-reported outcomes favored the intervention group, which suggests that any placebo effect, if positive, operated differentially. In addition, several of our trials in which we used similar designs (eg 44,45 ) have yielded null parent-reported outcomes despite very positive parent evaluations, which argues against any expectation of placebo effects. Parent report, however, is the most costeffective and feasible option for a population-based screening measure compared with objective measures such as overnight polysomnography.…”

Section: Strengths and Limitationsmentioning

confidence: 88%

A Brief Sleep Intervention Improves Outcomes in the School Entry Year: A Randomized Controlled Trial

et al. 2011

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WHAT'S KNOWN ON THIS SUBJECT:Sleep problems are common in school-aged children and might compromise the function of children and parents and contribute to a poor transition to school, which can result in later academic difficulties. Improvement of child sleep through brief behavioral strategies might improve the school transition. WHAT THIS STUDY ADDS:Large-scale screening of new school entrants for sleep problems, followed by a targeted behavioral intervention, was demonstrated to be feasible and was beneficial for short-to medium-term child psychosocial outcomes. Larger effectiveness trials are needed to confirm the public health benefits of these interventions. abstract OBJECTIVE: To determine the feasibility of screening for child sleep problems and the efficacy of a behavioral sleep intervention in improving child and parent outcomes in the first year of schooling. METHODS:A randomized controlled trial was nested in a population survey performed at 22 elementary schools in Melbourne, Australia. Intervention involved 2 to 3 consultations that covered behavioral sleep strategies for children whose screening results were positive for a moderate/severe sleep problem. Outcomes were parent-reported child sleep problem (primary outcome), sleep habits, psychosocial health-related quality of life, behavior, and parent mental health (all at 3, 6, and 12 months) and blinded, face-to-face learning assessment (at 6 months). RESULTS:The screening survey was completed by 1512 parents; 161 (10.8%) reported a moderate/severe child sleep problem, and 108 of 136 (79.2% of those eligible) entered the trial. Sleep problems tended to resolve more rapidly in intervention children. Sleep problems affected 33% of 54 intervention children versus 43% of 54 control children at 3 months (P ϭ .3), 25.5% vs 46.8% at 6 months (P ϭ .03), and 32% vs 33% at 12 months (P ϭ .8). Sustained sleep-habit improvements were evident at 3, 6, and 12 months (effect sizes: 0.33 [P ϭ .03]; 0.51 [P ϭ .003]; and 0.40 [P ϭ .02]; respectively), and there were initial marked improvements in psychosocial scores that diminished over time (effect sizes: 0.47 [P ϭ .02]; 0.41 [P ϭ .09]; and 0.26 [P ϭ .3]; respectively). Better prosocial behavior was evident at 12 months (effect size: 0.35; P ϭ .03), and learning and parent outcomes were similar between groups.CONCLUSIONS: School-based screening for sleep problems followed by a targeted, brief behavioral sleep intervention is feasible and has benefits relevant to school transition. Pediatrics 2011;128:692-701

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Section: Strengths and Limitationsmentioning

confidence: 88%

A Brief Sleep Intervention Improves Outcomes in the School Entry Year: A Randomized Controlled Trial

et al. 2011

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“…It was conducted in 8 of the 31 local government areas (LGAs) comprising greater Melbourne, Australia (population 4.0 million in 2011 14 ). Methods are detailed in the published protocol 15 ; Fig 1 summarizes Participants were re-recruited from 2 previous population-based early childhood trials, Let' s Learn Language 10 and Let' s Read, 16 both with robust null findings and over 88% retention at age 3 years. Let' s Learn Language was conducted within 3 LGAs drawn from the lower, middle, and upper socioeconomic tertiles, respectively, as ranked by the Australian censusderived Socioeconomic Indexes For Areas Index of Disadvantage.…”

Section: Methodsmentioning

confidence: 99%

Randomized Trial of a Population-Based, Home-Delivered Intervention for Preschool Language Delay

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Preschool language delay is associated with poorer academic performance, more limited employment opportunities, and relationship difficulties. Despite its importance within public health, there has been little progress toward effective population-based prevention and intervention approaches to improve outcomes. WHAT THIS STUDY ADDS:It is feasible to identify low language in 4-year-olds on a population basis and deliver a 1-on-1 intervention. By age 5 years, this resulted in better phonological awareness and letter knowledge. There was weak evidence of better expressive, but not receptive, language. abstract OBJECTIVE: Population approaches to lessen the adverse impacts of preschool language delay remain elusive. We aimed to determine whether systematic ascertainment of language delay at age 4 years, followed by a 10-month, 1-on-1 intervention, improves language and related outcomes at age 5 years. METHODS:A randomized trial nested within a cross-sectional ascertainment of language delay. Children with expressive and/or receptive language scores more than 1.25 SD below the mean at age 4 years entered the trial. Children randomly allocated to the intervention received 18 1-hour home-based therapy sessions. The primary outcomes were receptive and expressive language (Clinical Evaluation of Language Fundamentals -Preschool, 2 nd Edition) and secondary outcomes were child phonological skills, letter awareness, pragmatic skills, behavior, and quality of life. RESULTS:A total of 1464 children were assessed for language delay at age 4 years. Of 266 eligible children, 200 (13.6%) entered the trial, with 91 intervention (92% of 99) and 88 control (87% of 101) children retained at age 5 years. At age 5 years, there was weak evidence of benefit to expressive (adjusted mean difference, intervention 2 control, 2.0; 95% confidence interval [CI] 20.5 to 4.4; P = .12) but not receptive (0.6; 95% CI 22.5 to 3.8; P = .69) language. The intervention improved phonological awareness skills (5.0; 95% CI 2.2 to 7.8; P , .001) and letter knowledge (2.4; 95% CI 0.3 to 4.5; P = .03), but not other secondary outcomes. CONCLUSIONS:A standardized yet flexible 18-session language intervention was successfully delivered by non-specialist staff, found to be acceptable and feasible, and has the potential to improve long-term consequences of early language delay within a public health framework. Pediatrics 2013;132:e895-e904 AUTHORS:

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“…Figure 1 shows progress at time of writing. Because it has re-recruited participants from two earlier low-intensity language and literacy promotion trials with null findings, Let’s Learn Language [17] and Let’s Read [31], the trial is taking place predominantly in the same 8 Melbourne local government areas (LGAs) in which these participants continue to reside.…”

Section: Methodsmentioning

confidence: 99%

Improving outcomes of preschool language delay in the community: protocol for the Language for Learning randomised controlled trial

et al. 2012

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BackgroundEarly language delay is a high-prevalence condition of concern to parents and professionals. It may result in lifelong deficits not only in language function, but also in social, emotional/behavioural, academic and economic well-being. Such delays can lead to considerable costs to the individual, the family and to society more widely. The Language for Learning trial tests a population-based intervention in 4 year olds with measured language delay, to determine (1) if it improves language and associated outcomes at ages 5 and 6 years and (2) its cost-effectiveness for families and the health care system.Methods/DesignA large-scale randomised trial of a year-long intervention targeting preschoolers with language delay, nested within a well-documented, prospective, population-based cohort of 1464 children in Melbourne, Australia. All children received a 1.25-1.5 hour formal language assessment at their 4th birthday. The 200 children with expressive and/or receptive language scores more than 1.25 standard deviations below the mean were randomised into intervention or ‘usual care’ control arms. The 20-session intervention program comprises 18 one-hour home-based therapeutic sessions in three 6-week blocks, an outcome assessment, and a final feed-back/forward planning session. The therapy utilises a ‘step up-step down’ therapeutic approach depending on the child’s language profile, severity and progress, with standardised, manualised activities covering the four language development domains of: vocabulary and grammar; narrative skills; comprehension monitoring; and phonological awareness/pre-literacy skills. Blinded follow-up assessments at ages 5 and 6 years measure the primary outcome of receptive and expressive language, and secondary outcomes of vocabulary, narrative, and phonological skills.DiscussionA key strength of this robust study is the implementation of a therapeutic framework that provides a standardised yet tailored approach for each child, with a focus on specific language domains known to be associated with later language and literacy. The trial responds to identified evidence gaps, has outcomes of direct relevance to families and the community, includes a well-developed economic analysis, and has the potential to improve long-term consequences of early language delay within a public health framework.Trial registrationCurrent Controlled Trials ISRCTN03981121.

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Outcomes of a Universal Shared Reading Intervention by 2 Years of Age: The Let's Read Trial

Abstract: This universal literacy-promotion program was not beneficial in relatively disadvantaged communities by the age of 2 years and may be ineffective. Alternative interpretations may relate to program intensity, reach and/or sleeper effects. Definitive outcomes at 4 years are awaited.

Cited by 35 publications

References 23 publications

A Brief Sleep Intervention Improves Outcomes in the School Entry Year: A Randomized Controlled Trial

A Brief Sleep Intervention Improves Outcomes in the School Entry Year: A Randomized Controlled Trial

Randomized Trial of a Population-Based, Home-Delivered Intervention for Preschool Language Delay

Improving outcomes of preschool language delay in the community: protocol for the Language for Learning randomised controlled trial

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