Outcomes of population based language promotion for slow to talk toddlers at ages 2 and 3 years: Let's Learn Language cluster randomised controlled trial

Abstract

Objective To determine the benefits of a low intensity parent-toddler language promotion programme delivered to toddlers identified as slow to talk on screening in universal services.Design Cluster randomised trial nested in a population based survey.Setting Three local government areas in Melbourne, Australia.Participants Parents attending 12 month well child checks over a six month period completed a baseline questionnaire. At 18 months, children at or below the 20th centile on an expressive vocabulary checklist entered the trial.Intervention Maternal and child health centres (clusters) were randomly allocated to intervention (modified “You Make the Difference” programme over six weekly sessions) or control (“usual care”) arms.Main outcome measures The primary outcome was expressive language (Preschool Language Scale-4) at 2 and 3 years; secondary outcomes were receptive language at 2 and 3 years, vocabulary checklist raw score at 2 and 3 years, Expressive Vocabulary Test at 3 years, and Child Behavior Checklist/1.5-5 raw score at 2 and 3 years.Results 1217 parents completed the baseline survey; 1138 (93.5%) completed the 18 month checklist, when 301 (26.4%) children had vocabulary scores at or below the 20th centile and were randomised (158 intervention, 143 control). 115 (73%) intervention parents attended at least one session (mean 4.5 sessions), and most reported high satisfaction with the programme. Interim outcomes at age 2 years were similar in the two groups. Similarly, at age 3 years, adjusted mean differences (intervention−control) were −2.4 (95% confidence interval −6.2 to 1.4; P=0.21) for expressive language; −0.3 (−4.2 to 3.7; P=0.90) for receptive language; 4.1 (−2.3 to 10.6; P=0.21) for vocabulary checklist; −0.5 (−4.4 to 3.4; P=0.80) for Expressive Vocabulary Test; −0.1 (−1.6 to 1.4; P=0.86) for externalising behaviour problems; and −0.1 (−1.3 to 1.2; P=0. 92) for internalising behaviour problems.Conclusion This community based programme targeting slow to talk toddlers was feasible and acceptable, but little evidence was found that it improved language or behaviour either immediately or at age 3 years.Trial registration Current Controlled Trials ISRCTN20953675.

Two-Year Outcomes of a Population-Based Intervention for Preschool Language Delay: An RCT

“…10 Although there is no consensus as to the optimal age for population-based intervention, we chose 4 years because at earlier ages, language delay is both nonspecific and insensitive in predicting later language delay [11][12][13] (ie, low sensitivity), whereas schoolage intervention may be too late. 14 The program was designed to be sufficiently standardized for population-based delivery by nonspecialists, yet flexible enough to meet the varying needs of children at this age.…”

Assessment of swallowing in preterm newborns fed by bottle and cup

“…These 10 studies used approaches which included only the parents (12,13) , the parents and the children (14)(15)(16)(17) , or only the children (18) . The strategies of intervention in language used were programs with both parents, or only with the mother, in order to promote language through shared games (14) , shared reading (14) , interactional video (12,14,15) , guide book on how to stimulate language (12) , workshops (12) , supplies to assist learning (14) , informative brochures (14) , newspapers with specific age appropriate interactive activity (14) , home visits (17) , teaching of mothers on how to deal with your own anxiety and stress signals, facilitating the relationship with their children as well as the development of those (13) , the strengthening of the family bond (16) and group orientations (18) , and the preparation for going to school with the parents. In Table 1 are presented the main characteristics of the studies included in the present review, such as authors, original language, periodical, impact factor, kind of intervention performed, number of participants, and the average age of the sample.…”

“…Inadequate educational practices are related to cognitive and social development in the academic performance of children (20) . Some other studies generated interventions directly with the parents (12)(13)(14) . Pediatricians, psychologists, and speech language therapists made low-cost preventive interventions, as well as oriented the parents of children with language delay risk for presenting reduced vocabulary.…”

“…In one of the studies (12) , through workshops, parents watched videos of themselves interacting with their children, observing positive and negative aspects and getting information on how to contribute to the development of the child. The program had the support of videos, a handbook and workshops, and the duration of six weekly sessions of 2 hours.…”

“…There were preventive interventions in most part of the studies included in this review (12,14,15,17) . The prevention has been recognized and used by most professionals involved in the process of development and the search of the child's quality of life.…”