Early intervention for toddlers with language delays: a randomized controlled trial.
OBJECTIVE
Early interventions for toddlers with expressive and receptive language delays have not resulted in positive expressive language outcomes. This randomized controlled trial tested the effects on language outcomes of a caregiver-implemented communication intervention targeting toddlers at risk for persistent language delays.


METHODS
Participants included 97 toddlers, who were between 24 and 42 months with language scores at least 1.33 SDs below the normative mean and no other developmental delays, and their caregivers. Toddlers were randomly assigned to the caregiver-implemented intervention or a usual-care control group. Caregivers and children participated in 28 sessions in which caregivers were taught to implement the intervention. The primary outcome was the Preschool Language Scale, Fourth Edition, a broad-based measure of language. Outcome measurement was not blinded.


RESULTS
Caregivers in the intervention improved their use of all language facilitation strategies, such as matched turns (adjusted mean difference, intervention-control, 40; 95% confidence interval 34 to 46; P < .01). Children in the intervention group had significantly better receptive language skills (5.3; 95% confidence interval 0.15 to 10.4), but not broad-based expressive language skills (0.37, 95% confidence interval -4.5 to 5.3; P = .88).


CONCLUSIONS
This trial provides preliminary evidence of the short-term effects of systematic caregiver instruction on caregiver use of language facilitation strategies and subsequent changes in children's language skills. Future research should investigate the ideal dosage levels for optimizing child outcomes and determine which language facilitation strategies are associated with specific child outcomes. Research on adaptations for families from culturally and linguistically diverse backgrounds is needed.
Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, School of Communication, Northwestern University, Evanston, Illinois; and megan.y.roberts@northwestern.edu.
Megan Y
MY
Roberts
Department of Special Education, Peabody College, Vanderbilt University, Nashville, Tennessee.
Ann P
AP
Kaiser
D002675:Child, Preschool; D032882:Comprehension; D061345:Early Medical Intervention; D004505:Education, Nonprofessional; D005260:Female; D006801:Humans; D007223:Infant; D007805:Language Development Disorders / Q000175:diagnosis*; D007807:Language Tests; D007808:Language Therapy / Q000379:methods*; D008297:Male; D013067:Speech Perception
early intervention; language; randomized controlled trial