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PubMed2026

Effectiveness of Caregiver-Mediated Spoken Language Interventions for Children Under Five at Risk of Developmental Language Disorder: A Systematic Review and Meta-Analysis.

BACKGROUND AND AIMS: Caregiver-mediated interventions are commonly used by Speech and Language Therapists to support early language development. Developmental Language Disorder (DLD) is associated with reduced quality of life throughout the lifespan. Understanding factors that predict intervention success is essential for developing appropriate, cost-effective therapy provision for the approximately 12% of preschool children who present with early markers for Developmental Language Disorder (DLD). This systematic review and meta-analysis examined the effectiveness of caregiver-mediated spoken language interventions for under-fives at risk of DLD, and factors influencing intervention effectiveness. METHODS: A systematic review following PRISMA guidelines was conducted. Five electronic databases were searched to identify experimental studies comparing caregiver-mediated spoken language interventions to control conditions in under-fives presenting with risk factors for DLD. Risk factors included prematurity, socioeconomic factors, caregiver language development concerns, and formal or informal language screening or assessment scores. Twenty-six experimental studies with 1407 child participants were included in qualitative synthesis. Meta-analysis was performed on nine Randomised Controlled Trials involving 947 children. RESULTS: Effectiveness was examined for outcomes including child language gains, child wellbeing, inclusion and attainment. Meta-analysis indicated a significant effect of caregiver-mediated spoken language interventions on language outcomes compared to treatment-as-usual, non-language intervention or waitlist control conditions. Non-language outcomes were evaluated via qualitative synthesis. Interventions significantly improved language development trajectories for under-fives presenting with risk factors or early markers for DLD. CONCLUSION AND IMPLICATIONS: This review contributes to the growing evidence base demonstrating that caregiver-mediated interventions can positively impact language development and wellbeing outcomes for children under five at risk of DLD. These findings support the implementation of caregiver-mediated environmental language interventions in clinical practice to maximise accessibility and cost-effectiveness while delivering optimal outcomes for vulnerable populations. WHAT THIS PAPER ADDS: What is already known on this subject Previous research on caregiver-mediated spoken language interventions has highlighted gaps in the evidence regarding the impact of risk factors, demographic characteristics, dosage and intervention components on child language outcomes. Developmental Language Disorder has relatively high population prevalence, estimated at 7%. Prevalence is associated with risk factors including low household socioeconomic status (SES), prematurity and late language emergence. In contrast to its prevalence, there is low public and professional awareness of DLD and a low diagnostic rate. Therefore, a strengthened evidence base and additional insights into the factors affecting success of family-based interventions is important in order to increase the effectiveness of service provision and care planning for this underserved population. Timely and effective intervention with young children presenting with early markers for DLD has the potential to offer lifelong improvement to their wellbeing, inclusion and attainment outcomes. Recent systematic reviews of the effectiveness of caregiver-mediated language interventions had differences in population age range and diagnostic inclusion criteria. What this paper adds to existing knowledge Our review examines the effectiveness of caregiver-mediated early spoken language interventions on child language, attainment and wellbeing, and on caregiver self-efficacy and adherence to language support strategies. Our population was children under five presenting with risk factors for Developmental Language Disorder, in the absence of other neurodevelopmental or genetic conditions such as intellectual disability or autism. This review adds depth and detail to the evidence base supporting the effectiveness of caregiver-mediated spoken language interventions in improving outcomes for this population of young children, and factors that influence their success. What are the potential or actual clinical implications of this work? The high prevalence of Developmental Language Disorder, estimated at around 7% of the population, and the strong association with risk factors including low SES, prematurity and late language emergence, coupled with the low awareness of DLD and low diagnostic rate, mean that a strengthened evidence base and additional insights into the factors affecting success of family-based interventions can increase the effectiveness of service provision and care planning for this population. Timely and effective intervention in this group of young children has the potential to improve wellbeing and attainment outcomes across the lifespan. This review contributes to our understanding of how to implement cost-effective, socially valid and maximally engaging partnership working with families of young children at risk for DLD.

Humans↗
PubMedDate not supplied

[Language disorders in children: diagnostic, pathogenetic and developmental aspects].

Several Authors report the pathogenetic factors of developmental language disorders, some clinical features, the evaluation criteria, the treatment prospects aimed also at learning disorders. 163 children with language disorders have been examined: M98, F65; range 2.8-6.2 ys, mean 5.1 ys. The study of verbal comprehension and production and the evaluation of cognitive level, of language function, of communicative abilities, of handedness was performed. The diagnostic evaluation results: uncomplicated language retardation (31.2%), developmental dysphasia (7.4%), acquired aphasia (0.6%), dysphasia/cognitive retardation (36.8%), language retardation/deafness (10.4%), stuttering (6.8%), relational disorders (6.8%). The pathogenetic features are the following: organic factors (early brain damage 51%, early otopathies 10%), environment factors (24%, partly as joined factors), emotive disorders (11%), familiarity (10%), no determinable etiology (2%). The Author remarks some therapeutic strategies and evolution prospects of the different language disorders. In order to attain early diagnosis and treatment it seems advisable to increase cognitive-linguistic examination in preschool age and to start rehabilitation services at nursery-school.

Age Factors↗
PubMed1989

Memory scanning speed in language-disordered children.

Twelve students from classrooms for children with severe language disorders and 12 age-matched controls were evaluated for short-term memory scanning speed using the Sternberg task. Sets of two, three, and four digits were presented via earphones as memory sets, followed by single-probe digits. Reaction time was measured for a verbal response of "yes" or "no" indicating whether the probe was a member of the initial set. Average per-item scanning speed for the normal children was 66 ms, which was significantly different from the 253-ms average scanning speed of the language-disordered group. Many similarities were noted in the performance of the two groups on the memory scanning task. No differences were found in estimates of encoding and response speed, in percentage of errors or in serial or numerical position effects across groups. Results indicate that children with developmental language disorders may demonstrate reduced processing speed or memory retrieval time, which could contribute to linguistic deficits.

Adolescent↗
PubMed1992

Language disorders in disruptive behavior disordered homicidal youth.

Eight homicidal youths were assessed for language disorders and psychiatric diagnoses using a battery of standardized language tests and the Diagnostic Interview for Children and Adolescents. Both language disorders and Diagnostic and Statistical Manual III-R psychiatric diagnoses were present in all subjects.

Adolescent↗
PubMed1988

Language learning and retention in young language-disordered children.

Simultaneous sign and spoken language training was conducted with young, language-disordered children under standardized training and follow-up conditions with a stringent learning criterion to determine if language learned was stable over time. Twenty-one children between 36 and 86 months with no or nonfunctional language participated in the study. Diagnoses included autism, mental retardation, combined autism and mental retardation, and developmental aphasia. Children completed a mean of 74 signed speech training sessions. Sessions were twice daily, 5 days a week. Follow-up evaluations were made approximately 6 months after training. Of the 21 children, 17 learned at least one word and 7 children learned multiple-word phrases during the training. Most language learned in training was found to be retained at follow-up approximately 6 months later. Gestural imitation, play style, language age, developmental age, and fine motor skills had strong correlations with language learning and retention.

Aphasia↗
PubMed1986

Family history of children with developmental language disorders.

The present study shows the increased incidence of language-related disorders among family members of children with language disorders. The family histories of 74 children with developmental language disorders and 36 normal children were compared. The children with language disorders had significantly more family members who reported speech, stuttering, reading, and language disorders than the normal control group.

Articulation Disorders↗
PubMed1977

A comparative study of infantile autism and specific developmental receptive language disorders. III. Discriminant function analysis.

A psychometric, observational, and interview study was undertaken with 47 boys, aged 4 1/2 to 10 years, with nonverbal IQs of 70+ and a severe developmental disorder of language comprehension. Separate discriminant function analyses, based on behavioral, language, or cognitive features, showed little overlap between clinically defined autistic and dysphasic subgroups. Moreover, the discrimination could be made as clearly on language or cognitive characteristics as on social or behavioral critera. Language abnormalities and behavioral features also intercorrelated within the autistic subgroup. It is concluded that autism and dysphasia differ in important ways and that a cognitive deficit is an essential part of the syndrome of autism.

Autistic Disorder↗
PubMed1986

The study of childhood language disorders: nineteenth century perspectives.

Childhood language disorders have been known and studied at least as far back as the early nineteenth century. The results of the early investigations, however, have essentially been forgotten. The aim of this article is to recall the investigators of the nineteenth century and their findings. Throughout most of that period efforts were directed simply at establishing the existence of mutism without deafness or "idiocy." In the last two decades an "information explosion" took place, authored by a small group of German-speaking physicians. On the basis of their clinical observations they described the disorders, offered theories on their nature and etiology, and devised therapy programs. These findings and theoretical constructions are presented, along with information on the probable sources of the authors' ideas. Although resemblances to modern concepts are often striking, it seems unlikely that the earlier work is the source of the more recent ones.

Child↗
PubMed1985

Development of print awareness in language-disordered preschoolers.

This study examined print awareness and related oral language abilities in language-disordered and normally developing preschoolers. Twenty subjects, ages 3:1 to 6:5 (years:months), were shown high frequency environmental print in four conditions varying in the amount of non-print information present in the print setting. They were asked to match the print to the object that it signified and to provide verbal labels for the same objects. Results indicated that normal-language children were responding meaningfully to print settings that contained reduced non-print cues while the language-disordered subjects were not. General language ability was correlated with print awareness, but knowledge of specific oral lexemes was not necessary for accurate print responses. Parent questionnaire data suggested that group differences did not result from differential prior experience with the print items. Results are discussed with reference to hypothesized relationships between oral and written language.

Awareness↗
PubMed1988

Sentence comprehension strategies in children with autism and specific language disorders.

Two groups of children with language disorders--one group with autism and one with relatively specific language impairment (LI)--and two groups of normal children matched to the disordered groups for mental and receptive language age were asked to act out a series of sentences. Half the experimental sentences were in active voice, and half were the same sentences given in passive voice. Within each set, events described in the sentences were probable, neutral, or improbable. Results revealed that the autistic group made little use of a semantically based probable event strategy for acting out sentences, but were likely to use a syntactically based word order strategy. The LI group was no more likely than the autistic group to use the semantic strategy, and was equally likely to use word order. Both groups resembled normals matched for receptive language age.

Autistic Disorder↗
PubMed1985

Cohesion in the narratives of normal and language-disordered children.

An adaptation of Halliday and Hasan's (1976) description of cohesion in English was applied to the spoken narratives of normal and language-disordered children. Three major questions were addressed: (a) the influence of the nonlinguistic environment on the use of cohesion, (b) the nature of language disorder as displayed in the use of cohesion, and (c) the relationship between comprehension and use of cohesion. Twenty normal and 20 language-disordered children, aged 7:6-10:6, were included in the study. Each child produced two narratives, one for an adult listener who saw a movie with the child and one who had not. Results indicate that both groups of subjects altered their use of cohesion as a function of the listener's needs in the same way. However, the normal and language-disordered subjects differed in their manner of cohesive organization, their cohesive adequacy, and their comprehension of the story.

Child↗
PubMed1978

Experimental acquisition of wh-questions in language-disordered children.

Twenty-four language-disordered children were trained, through modeling with a problem-solving set, to produce a question form involving a wh- word-who, what, or where-in a structure requiring either auxiliary is or auxiliary does. Results indicated the subsequent use of the trained auxiliary across wh- words and, to a lesser extent, the subsequent use of untrained as well as trained wh- words. These results suggest that the training of one multioperation structure may result in the acquisition of two partially independent linguistic operations. Such patterns of acquisition could result in an increase in the efficiency of language training.

Child↗
PubMed1989

A preliminary investigation of the pragmatic abilities of a group of language disordered children.

The communicative acts, conversational acts, and breakdown repair abilities of six language-disordered children with a syntactic age of +/- 3 years old as determined by the LARSP (Crystal, Fletcher, Garman: 1976) were investigated. Sampling of each subject involved two separate naturalistic interactions with a familiar adult and a language disordered peer. The data obtained from the transcriptions were analysed in terms of linguistic and nonlinguistic behaviours on the Communication Profile by Wollner and Geller (1982). Specific patterns of deficit and strengths were observed and these trends were related to recent literature in this area. The study emphasises that there is as much heterogeneity in the pragmatic skills as in the other communication skills of language disordered children, although this is due to some extent to the limitations of assessment in naturalistic settings. It also indicates individual areas of pragmatic deficit that require remediation.

Child, Preschool↗
PubMed1989

Behavioral correlates of developmental expressive language disorder.

The association of behavior problems with preschool language disorders has been documented extensively. However, researchers have typically failed to differentiate subgroups of language-impaired children, to use observational data in documenting the behavior disorders, or to study children at the youngest ages. Using a multimodal assessment, this study examined parent-child interaction and behavior problems in a clearly defined subgroup of language-impaired children, those with developmental expressive language disorder (ELD). These children exhibit a delay in expressive language compared with receptive language and nonverbal cognitive skills. Subjects were identified and studied at the youngest age at which the disorder can be assessed. A group of ELD children, averaging 27 months of age, was contrasted with a group of normally developing children, matched for age, sex, and receptive language ability. Groups were compared on observed parent-child interactions as well as maternal responses on the Parenting Stress Index, the Eyberg Child Behavior Inventory, and a behavior-related structured interview. ELD children, when compared with normally developing children, exhibited higher levels of negative behavior and were perceived as different by their parents.

Child Behavior Disorders↗
PubMed1991

Evaluation for suspected language disorders in preschool children.

Pediatricians can identify a child with a developmental language disorder by expanding a traditional developmental assessment with special screening tests of language skills. They can direct parents to specialists who can define the nature of the language disturbance in more detail and predict its natural history. They must then support the parents as they learn to use the community resources available for remediation of their child. As more is learned about the biologic bases of normal and abnormal language development in children, pediatricians will undoubtedly have an even more central role in identification of patients with language disorders and education of their families.

Child Language↗
PubMed1978

The relationship between perceptual dysfunction and language disorders: a case report.

The acquisition of language is discussed in relation to two specific perceptual processes: first, identification and discrimination of recurring aspects of an experience, and second, integration of the language form with the specific aspect of the event being represented. The analysis of the language of a child with perceptual and integrative deficits revealed expressive use of language without comprehension and limited knowledge of concepts. Explanations of these behaviors are presented in light of the child's perceptual and integrative dysfunctions. Implications for clinical management of a perceptually based language disorder are discussed.

Child↗
PubMed1989

Prevalence of unsuspected language disorders in a child psychiatric population.

Nonretarded 5- to 12-year-old consecutive referrals to a child psychiatric outpatient clinic underwent a routine systematic language assessment. The assessment battery comprised standardized measures of the receptive and expressive components of syntax, semantics, and phonology. Standardized behavior rating scales also were completed by parents. Of the children referred solely for a psychiatric problem, 28% had a moderate or severe language disorder that previously had not been suspected or diagnosed. These children differed from a comparison group of children with both psychiatric and language disorders in that they were younger and more likely to have an externalizing behavioral problem. The findings indicate that there is a sizeable proportion of children whose language disorders are overlooked possibly because of their disruptive behavior. This suggests the need for routine screening of language in child psychiatric populations.

Child↗