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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↗
PubMed1990

An update on the CHILDES/BIB (formerly ISU/CHILDES) database.

A description is given of the CHILDES/BIB database, its contents, and its relationship to the CHILDES database. CHILDES is a depository of child language corpora, and the publisher of CHAT (a transcription manual), and CLAN (an electronic package for child language research). CHILDES/BIB is an electronic bibliographic database that is an autonomous unit of CHILDES.

Bibliographies as Topic↗
PubMed1999

Language sample analysis in the 21st century.

Time requirements inherent in transcription and analysis of spontaneous language samples represent a significant barrier to the regular use of language sample analysis in clinical settings. Taking advantage of the options provided by new large, fast, and affordable personal microcomputers, two language analysis programs, the Systematic Analysis of Language Transcripts and The Child Language Data Exchange System have been developed to provide automated analysis of a wide range of language indices, as well as tools designed to reduce and simplify the time-intensive process of transcribing and analyzing children's language samples from both typical and clinical populations. In this article we provide a historical context for the development of these language analysis programs and a brief introduction to the transcription editors and language sample databases for both systems. In addition, a case study highlighting the interactive use of both analysis systems is provided.

Child↗
PubMed2003

The development of inversion in wh-questions: a reply to Van Valin.

Van Valin (Journal of Child Language 29, 2002, 161-75) presents a critique of Rowland & Pine (Journal of Child Language 27, 2000, 157-81) and argues that the wh-question data from Adam (in Brown, A first language, Cambridge, MA, 1973) cannot be explained in terms of input frequencies as we suggest. Instead, he suggests that the data can be more successfully accounted for in terms of Role and Reference Grammar. In this note we re-examine the pattern of inversion and uninversion in Adam's wh-questions and argue that the RRG explanation cannot account for some of the developmental facts it was designed to explain.

Child Language↗
PubMed1993

Lexical segmentation and vocabulary growth in early language acquisition.

The identification of appropriate lexical segmentations of the speech signal constitutes a problem for the language learner and the child language researcher alike. Articulatory precision and fluency criteria for identifying formulaic expressions, sub-lexical forms and target lexemes in linguistic productions are defined and applied to the analysis of two Danish children's language development between the ages of 1;0 and 2;0. The results of this analysis are compared to the results of applying standard distributional and frequency criteria in the tabulation of mean length of utterance and vocabulary profiles for both standard and non-standard lexical segmentations. It is argued that although the two methods yield converging profiles of development during the latter part of the period studied, articulatory precision and fluency criteria offer a more powerful tool for identifying alternative segmentation strategies in early language acquisition. Profiles of vocabulary development for these two children suggest that the solution to the segmentation problem may be an important trigger for their vocabulary spurts.

Child Language↗
PubMedDate not supplied

Assessing the comprehension and production of language in young children: an account of the Reynell Developmental Language Scales III.

The Reynell Developmental Language Scales III have been designed to test the language abilities of children from 18 months to 7 years. They have been standardized on a large, representative sample of children in the United Kingdom and thereby provide a robust measure of language achievement. These Scales provide clinicians with the means of comparing the performance of children who have been referred for therapy, or who are in therapy, with the performance of a large group of normally developing children. The Scales reflect the developmental progression of normal child language in the early years, focusing on key features of child language acquisition at different stages as well as on features which are known to distinguish language impaired-children from language-normal children. While not claiming that the tests are fully comprehensive, the authors maintain that they afford the clinician with a means of looking at components of language while also gaining some insights into the child's ability to integrate vocabulary and grammar. It is recognized that no test can fully assess every aspect of language; essentially a test must be practical in terms of design and, for screening purposes, sufficiently comprehensive to be used with a large section of children referred. In addition to fulfilling these criteria, the Scales have been designed to provide some diagnostic indicators of areas of difficulty. The aims of the original Scales were to provide a measure of verbal ability that could be compared with mental age, and to provide separate scores for production and comprehension. These aims have also been realized in the new version. Additionally a test has been provided that is consonant with information gained from the intensive research in the field of child language that has taken place since the original Scales were devised. The Scales can reveal information about a child's language abilities not readily available from observation and serve a useful function in both identifying disorder and evaluating therapy. Clinicians are increasingly being asked to demonstrate effectiveness of therapy but are hampered by inappropriate outcome measures (Law 1997). It is hoped that the RDLS III provides a test that is valid and reliable and one that can contribute to both the characterization of speech and language disorders and the measurement of treatment efficacy.

Child↗
PubMed2004

Sampling children's spontaneous speech: how much is enough?

There has been relatively little discussion in the field of child language acquisition about how best to sample from children's spontaneous speech, particularly with regard to quantitative issues. Here we provide quantitative information designed to help researchers make decisions about how best to sample children's speech for particular research questions (and/or how confident to be in existing analyses). We report theoretical analyses in which the major parameters are: (1) the frequency with which a phenomenon occurs in the real world, and (2) the temporal density with which a researcher samples the child's speech. We look at the influence of these two parameters in using spontaneous speech samples to estimate such things as: (a) the percentage of the real phenomenon actually captured, (b) the probability of capturing at least one target in any given sample, (c) the confidence we can have in estimating the frequency of occurrence of a target from a given sample, and (d) the estimated age of emergence of a target structure. In addition, we also report two empirical analyses of relatively infrequent child language phenomena, in which we sample in different ways from a relatively dense corpus (two children aged 2;0 to 3;0) and compare the different results obtained. Implications of these results for various issues in the study of child language acquisition are discussed.

Child↗
PubMed1987

Medical profile of the language-delayed child: otitis-prone versus otitis-free.

Delay in language development may be associated with an underlying anatomical, neurosensory, or psychological disorder such as: deafness, cerebral palsy, cleft palate, autism, or mental retardation. A condition called specific developmental language delay may occur in children devoid of any other identifiable disorder or developmental delay. Language delay associated with early onset, severe-to-profound hearing impairment has been well documented. Controversial studies have also appeared in the communicative disorders' literature suggesting that fluctuating conductive hearing loss in early childhood can significantly affect the development of language and related academic skills. Some authors have claimed that these deleterious effects can be irreversible. This study focuses on 3 groups of preschool children, in whom hearing acuity has been documented: One group with recurrent otitis and language delay; a second group with an equally well documented otitis history but without language delay; and a third group with documented language delay in the absence of any known predisposing conditions, including early-onset, recurrent otitis media. Prenatal, birth and developmental histories of the children in each group were compared in detail to identify any factors which may enhance or ameliorate the effects of fluctuating conductive hearing loss on language development. In a population of 1864 children (ages 9-59 months) referred for otolaryngologic and/or communicative evaluation, 480 otherwise normal children (67.6% males; 32.4% females) were found to have a history of early-onset, recurrent otitis media and/or delayed speech and language development on the basis of an extensive evaluation battery. This population was further subdivided into 3 groups (I = otitis-positive/normal language; II = otitis-positive/language delay; and III = otitis-free/language delay). Among the 329 children with positive histories for early otitis media (Groups I & II), a significantly higher percentage of those demonstrating language delay were from homes in the lower socio-economic category. Race and sex showed no significant relationship to language delay among the otitis-positive groups, although males were twice as numerous as females in the over-all study population. Articulation errors on speech measures and borderline delays in other developmental milestones (standing, walking, and toilet training) were also significantly greater in the language-delayed group when compared with otitis-positive children whose language was age-appropriate.(ABSTRACT TRUNCATED AT 400 WORDS)

Child Development↗
PubMedDate not supplied

A fluent language disorder following antepartum left-hemisphere brain injury.

This article describes the development of language in a left-handed girl with a left middle cerebral artery infarction. Seven language samples of parent-child interaction, obtained when she was between 36 and 60 months of age, were transcribed and analyzed using the Child Language Data Exchange System. At 36 months of age, only 42 (20%) of the child's 214 utterances contained words; the other 80% were composed of jargon or interactional markers such as "uh-huh" and "uhn-uhn." Jargon incorporated familiar intonational contours and prosodic features to convey emotional states and communicative functions. Between 36 and 45 months of age, her jargon became differentiated into increasing approximations of English sentences. Simultaneously, her use of words and word combinations increased. By 54 months of age, no jargon was heard. The pattern of development observed in this child can be described as a transient jargon or fluent aphasia. It may have resulted from initial reliance on an uninjured right hemisphere. However, given the similarity between this pattern and the expressive or gestalt style of learning seen in some normal children, the pattern may also be related to other variables including characteristics of the parental input.

Adult↗
PubMed1991

'Can I put--I want a slippers to put on': young children's development of request forms in a code-switching environment.

This paper concerns the development of semi-modal want/want to, and modals may, can and could in two Trinidadian children, whose Verb Phrase development was studied in naturalistic settings, between the ages of 2;3 and 4;1, and 2;4 and 4;9. The similarities and differences in development between the two are important for underlining a number of key factors in the acquisition process. Accepting the salience of requests/demands in early child language, the study draws attention to the child's propensity for using the means most readily available to him/her in the input, for expression of this function. Additionally, there is evidence of the child's ability to make stylistic discriminations at a very early age and of the propensity for making semantic distinctions among forms. The study indicates that work on the development of grammatical features is incomplete without consideration of sociolinguistic aspects of usage as integral to grammatical acquisition from the outset.

Child↗
PubMed1988

Topic manipulation and conversational participation as a function of familiarity in school-age language-impaired and normal language peers.

This study investigated the topic manipulation skills and conversational participation of school-age language-impaired children (LI) in interactions with normal language peers. The subjects consisted of eight dyads of a normal language child and a language-impaired child balanced for approximate age and sex. They ranged in age from 5.11 to 7.11 years of age. The subjects participated in two conversations in order to explore the effects of familiarity on conversational participation. The subjects were unfamiliar with each other before the study began. Fifteen to twenty minutes of discourse were taped, transcribed, and analyzed for the number and proportion of topics maintained, topics introduced, topics reintroduced, topics shaded, and the number and proportion of back channel responses produced in Session 1 and Session 2. A behavioral measure was included to clarify whether conversational nonassertiveness was related to a behavioral style of interaction. No significant differences were found between the LI children and the normal children for the number and proportion of topics maintained, topics introduced, or topics shaded. However, the LI subjects did produce significantly more topic reintroductions than the normal subjects. The number and proportion of back channel responses was not found to differ significantly between the two groups. A familiarity effect was demonstrated by a reduction in the number of utterances produced in Session 2 as compared to Session 1 as the children interacted less in the second conversation. Several interpretations of the results are discussed.

Child↗
PubMed2001

Learning a morphological system without a default: the Polish genitive.

The acquisition of the English past tense inflection is the paradigm example of rule learning in the child language literature and has become something of a test case for theories of language development. This is unfortunate, as the idiosyncratic properties of the English system of marking tense make it a rather unrepresentative example of morphological development. In this paper, I contrast this familiar inflection with a much more complex morphological subsystem, the Polish genitive. The genitive case has three different markers, each restricted to a different subset of nouns, in both the singular and the plural. Analysis of the spontaneous speech of three children between the ages of 1;4 and 4;11 showed that they generalized, and overgeneralized, all three singular endings. However, error rates were extremely low and there is no evidence that they treated any one ending as the 'default'. The genitive plural, on the other hand, showed a strikingly different pattern of acquisition, similar to that seen in English-speaking children learning the past tense. It is argued that in the latter two cases, the default-like character of one of the affixes is attributable to the properties of the relevant inflectional subsystems, not to the predispositions that children bring to the language-learning task.

Child Language↗
PubMed1992

The wheat and the chaff: or four confusions regarding CHILDES.

Edwards (1992) presents a set of examples from the Child Language Data Exchange System (CHILDES) as prototypes of bad transcription practice. Her discussion is based upon four basic confusions. First, Edwards confuses old and discarded versions of CHAT with current CHAT. Second, she confuses the relation between CHAT standards with the implementation of these standards during the process of reformatting older corpora. Third, she confuses transcription for automatic analysis with transcription for documentation. Fourth, she confuses the CHAT guidelines with the larger CHILDES system. We argue that these confusions have misled Edwards into developing an overly rigid set of principles for data analysis which, if followed literally, could choke off progress in the analysis of spontaneous language samples.

Archives↗
PubMedDate not supplied

Relations between maternal input and theory of mind understanding in deaf children.

This study investigates the relationship between theory of mind (ToM) skills in deaf children and input from their hearing mothers. Twenty-two hearing mothers and their deaf children (ages 4-10 years) participated in tasks designed to elicit talk about the mind. The mothers' mental state talk was compared with that of 26 mothers with hearing children (ages 4-6 years). The frequency of mothers' mental talk was correlated with deaf children's performance on ToM tasks, after controlling for effects of child language and age. Maternal sign proficiency was correlated with child language, false belief, and mothers' talk about the mind. Findings are discussed in relation to experiential accounts of ToM development and roles of maternal talk in children's social understanding.

Child↗
PubMed2000

Directiveness in teachers' language input to toddlers and preschoolers in day care.

Five subtypes of directiveness were examined in the interactions of day care teachers with toddler and preschooler groups. The instructional context (book reading, play dough) yielded significant differences across all five subtypes of directiveness, indicating that these two activities elicited different types of teacher-child discourse. Book reading was characterized by significantly more behavior and response control and less conversation control in comparison with the play-dough activity. Correlations between teachers' directiveness and child language productivity indicated that behavior control and turn-taking control were associated with low levels of productivity, whereas conversation control was associated with the highest levels of productivity. The results of this study confirm that instructional context is an important mediator of teachers' directiveness and suggest that subtypes of directiveness have differential effects on child language output.

Child Day Care Centers↗