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Pinstock E, Schramm SA. Vocabulary trajectories in German-speaking children from 18 months to three years: a growth mixture model. JOURNAL OF CHILD LANGUAGE 2024:1-18. [PMID: 39696932 DOI: 10.1017/s0305000924000503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2024]
Abstract
Children acquire vocabulary at different growth rates. The aim of this study was to identify subgroups of different vocabulary trajectories in a community sample of L1 German-speaking children aged 1;6 to 3;0 to enlarge the understanding of vocabulary trajectories. Parents filled out vocabulary checklists at four measurement times, each six months apart. Growth mixture modelling was used to naturally determine latent classes of observed vocabulary growth curve patterns. Six distinct trajectories of vocabulary growth were identified and characterised. Children's (N=198) vocabulary abilities were divided into the following subgroups: "far above average" (2.0%), "above average" (6.6%), "typical" (70.2%), "below average" (14.1%), "early below average" but caught up with their peers over time (5.6%), and "far below average" (1.5%). Socioeconomic status differed significantly between subgroups.
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Kang VY, Kim S, Gregori EV, Maggin DM, Chow JC, Zhao H. Systematic Review and Meta-Analysis of Enhanced Milieu Teaching. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024:1-23. [PMID: 39666897 DOI: 10.1044/2024_jslhr-24-00260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2024]
Abstract
PURPOSE Early language intervention is essential for children with indicators of language delay. Enhanced milieu teaching (EMT) is a naturalistic intervention that supports the language development of children with emerging language. We conducted a systematic review and meta-analysis of all qualifying single-case and group design studies that evaluate the experimental effects of EMT on child outcomes. METHOD We evaluated the risk of bias in the included studies and conducted a descriptive analysis of study quality, effect sizes, and demographics. We reviewed a total of 29 single-case and 17 group design studies in which 1,590 children participated. RESULTS Out of 46 studies, 39 met the What Works Clearinghouse standards without reservations, showing low levels of risk of bias. The effects were comparable when EMT was implemented alone and when it was implemented with another intervention component, and EMT was more effective when implemented by caregivers than when implemented by therapists. Most studies did not report sufficient participant demographics. CONCLUSIONS The EMT research literature published thus far is of high study quality; the effects across studies are comparable; and the intervention has been studied via a wide range of delivery modalities, contexts, implementers, and samples. Future research could systematically examine the effects of EMT and explore these varying intervention delivery, implementer, and learner characteristics as moderators.
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Affiliation(s)
- Veronica Y Kang
- Department of Counseling, Higher Education, and Special Education, University of Maryland, College Park
| | - Sunyoung Kim
- Department of Special Education, University of Illinois Chicago
| | - Emily V Gregori
- Department of Special Education, University of Illinois Chicago
| | - Daniel M Maggin
- Department of Special Education, University of Illinois Chicago
| | - Jason C Chow
- Department of Special Education, Vanderbilt University, Nashville, TN
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Bjork J, Kenley JK, Gardner C, Latham A, Smyser TA, Miller JP, Shimony JJ, Neil JJ, Warner B, Luby J, Barch DM, Rogers CE, Smyser CD, Lean RE. Associations between prenatal adversity and neonatal white matter microstructure on language outcomes at age 2 years. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.08.02.24311434. [PMID: 39211873 PMCID: PMC11361255 DOI: 10.1101/2024.08.02.24311434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Background Early life adversity is associated with microstructural alterations in white matter regions that subserve language. However, the mediating and moderating pathways between adversities experienced in utero and key neonatal white matter tracts including the corpus callosum (CC), superior longitudinal fasciculus (SLF), arcuate fasciculus (AF), inferior fronto- occipital fasciculus (IFOF), and uncinate on early language outcomes remains unknown. Methods This longitudinal study includes 160 neonates, oversampled for prenatal exposure to adversity, who underwent diffusion MRI (dMRI) in the first weeks of life. dMRI parameters were obtained using probabilistic tractography in FSL. Maternal Social Disadvantage and Psychosocial Stress was assessed throughout pregnancy. At age 2 years, the Bayley Scales of Infant and Toddler Development-III evaluated language outcomes. Linear regression, mediation, and moderation assessed associations between prenatal adversities and neonatal white matter on language outcomes. Results Prenatal exposure to Social Disadvantage (p<.001) and Maternal Psychosocial Stress (p<.001) were correlated with poorer language outcomes. When Social Disadvantage and maternal Psychosocial Stress were modeled simultaneously in relation to language outcomes, only Social Disadvantage was significant (p<.001). Independent of Social Disadvantage (p<.001), lower neonatal CC fractional anisotropy (FA) was related to poorer global (p=.02) and receptive (p=.02) language outcomes. CC FA did not mediate the association between Social Disadvantage and language outcomes (indirect effect 95% CIs -0.96-0.15), and there was no interaction between Social Disadvantage and CC FA on language outcomes (p>.05). Bilateral SLF/AF, IFOF, and uncinate were not significant (p>.05). Conclusions Prenatal exposure to Social Disadvantage and neonatal CC FA were independently related to language problems by age 2, with no evidence of mediating or moderating associations with language outcomes. These findings elucidate the early neural underpinnings of language development and suggest that the prenatal period may be an important time to provide poverty- reducing support to expectant mothers to promote offspring neurodevelopmental outcomes.
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Calder SD, Boyes M, Brennan‐Jones CG, Whitehouse AJO, Robinson M, Hill E. Do parent-reported early indicators predict later developmental language disorder? A Raine Study investigation. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:396-412. [PMID: 37743609 PMCID: PMC10952803 DOI: 10.1111/1460-6984.12950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/28/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Developmental language disorder (DLD) is one of the most common neurodevelopmental conditions. Due to variable rates of language growth in children under 5 years, the early identification of children with DLD is challenging. Early indicators are often outlined by speech pathology regulatory bodies and other developmental services as evidence to empower caregivers in the early identification of DLD. AIMS To test the predictive relationship between parent-reported early indicators and the likelihood of children meeting diagnostic criteria for DLD at 10 years of age as determined by standardized assessment measures in a population-based sample. METHODS Data were leveraged from the prospective Raine Study (n = 1626 second-generation children: n = 104 with DLD; n = 1522 without DLD). These data were transformed into 11 predictor variables that reflect well-established early indicators of DLD from birth to 3 years, including if the child does not smile or interact with others, does not babble, makes only a few sounds, does not understand what others say, says only a few words, says words that are not easily understood, and does not combine words or put words together to make sentences. Family history (mother and father) of speech and language difficulties were also included as variables. Regression analyses were planned to explore the predictive relationship between this set of early indicator variables and likelihood of meeting DLD diagnostic criteria at 10 years. RESULTS No single parent-reported indicator uniquely accounted for a significant proportion of children with DLD at 10 years of age. Further analyses, including bivariate analyses testing the predictive power of a cumulative risk index of combined predictors (odds ratio (OR) = 0.95, confidence interval (CI) = 0.85-1.09, p = 0.447) and the moderating effect of sex (OR = 0.89, CI = 0.59-1.32, p = 0.563) were also non-significant. CONCLUSIONS Parent reports of early indicators of DLD are well-intentioned and widely used. However, data from the Raine Study cohort suggest potential retrospective reporting bias in previous studies. We note that missing data for some indicators may have influenced the results. Implications for the impact of using early indicators as evidence to inform early identification of DLD are discussed. WHAT THIS PAPER ADDS What is already known on the subject DLD is a relatively common childhood condition; however, children with DLD are under-identified and under-served. Individual variability in early childhood makes identification of children at risk of DLD challenging. A range of 'red flags' in communication development are promoted through speech pathology regulatory bodies and developmental services to assist parents to identify if their child should access services. What this paper adds to the existing knowledge No one parent-reported early indicator, family history or a cumulation of indicators predicted DLD at 10 years in the Raine study. Sex (specifically, being male) did not moderate an increased risk of DLD at 10 years in the Raine study. Previous studies reporting on clinical samples may be at risk of retrospective reporting bias. What are the potential or actual clinical implications of this work? The broad dissemination and use of 'red flags' is well-intentioned; however, demonstrating 'red flags' alone may not reliably identify those who are at later risk of DLD. Findings from the literature suggest that parent concern may be complemented with assessment of linguistic behaviours to increase the likelihood of identifying those who at risk of DLD. Approaches to identification and assessment should be considered alongside evaluation of functional impact to inform participation-based interventions.
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Affiliation(s)
- Samuel D. Calder
- Health Sciences, College of Health and MedicineUniversity of TasmaniaLauncestonTASAustralia
| | - Mark Boyes
- Curtin School of Population Health, Faculty of Health SciencesCurtin UniversityPerthWAAustralia
- enAble InstituteCurtin UniversityPerthWAAustralia
| | - Christopher G. Brennan‐Jones
- Telethon Kids InstituteThe University of Western AustraliaPerthWAAustralia
- School of Allied Health, Faculty of Health SciencesCurtin UniversityPerthAustralia
| | | | - Monique Robinson
- Telethon Kids InstituteThe University of Western AustraliaPerthWAAustralia
| | - Elizabeth Hill
- enAble InstituteCurtin UniversityPerthWAAustralia
- School of Allied Health, Faculty of Health SciencesCurtin UniversityPerthAustralia
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Hill E, Calder S, Candy C, Truscott G, Kaur J, Savage B, Reilly S. Low language capacity in childhood: A systematic review of prevalence estimates. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:124-142. [PMID: 37563793 DOI: 10.1111/1460-6984.12944] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/25/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND AND AIMS Epidemiological studies have provided invaluable insight into the origin and impact of low language skills in childhood and adolescence. However, changing terminology and diagnostic guidelines have contributed to variable estimations of the prevalence of developmental language difficulties. The aim of this review was to profile the extent and variability of low language prevalence estimates through a systematic review of epidemiological literature. METHODS A systematic review of the empirical research (August 2022) was undertaken to identify studies that aimed to estimate the prevalence of low language skills in children (<18 years). A total of 19 studies published between 1980-2022 met inclusion criteria for review. RESULTS Studies reported prevalence estimates of low language skills in children between 1 and 16 years. Estimated rates varied from 0.4% to 25.2%. More stable estimations were observed in studies of children aged 5 years and older and those that applied updated diagnostic criteria to performance on standardised assessments of receptive and expressive language. CONCLUSIONS AND IMPLICATIONS The estimated prevalence of low language skills in childhood varies considerably in the literature. Application of updated diagnostic criteria, including the assessment of functional impact, is critical to inform advocacy efforts and govern social, health and educational policies. WHAT THIS PAPER ADDS What is already known on the subject Epidemiological research has informed our understanding of the origin and impact of low language capacity in childhood. Childhood language disorder is met with a rich history of evolving terminology and diagnostic guidelines to identify children with low language skills. Inconsistent definitions of and methods to identify low language in children have resulted in variable prevalence estimates in population-based studies. Variability in prevalence estimates impacts advocacy efforts to inform social, health and educational policy for child language disorder. What this study adds A total of 19 studies published at the time of this review aimed to provide estimates of the proportion of children who experience low language skills. Prevalence estimates varied between 0.4% and 25.2%, with more stable estimates reported in studies of older school-age children and those which utilised standardised assessments of both expressive and receptive language. Few studies utilised assessments of functional impact of language difficulties, which is misaligned with updated diagnostic criteria for child language disorder. What are the clinical implications of this work? This review reports substantial variability in estimates of the proportion of children and adolescents who live with low language skills. This variability underscores the importance of applying updated diagnostic criteria to identify the prevalence low language in childhood. Efforts to estimate the prevalence of low language must include measures of functional impact of low language skills. This aligns with clinical recommendations, which call for routine assessment of functional outcomes. To this end, we require a unified understanding of the term 'functional impact' in the context of low language, including the development and evaluation of measures that assess impact across emotional, social and academic domains.
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Affiliation(s)
- E Hill
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- enAble Institute, Curtin University, Perth, Australia
| | - S Calder
- Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - C Candy
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - G Truscott
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - J Kaur
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - B Savage
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - S Reilly
- Health Group, Griffith University, Gold Coast, Queensland, Australia
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Hatherly K, Glista D, Testani D, Brunton L, Cunningham BJ. A scoping review of virtual synchronous intervention studies in preschool rehabilitation. Disabil Rehabil 2024; 46:232-240. [PMID: 36546349 DOI: 10.1080/09638288.2022.2157054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE To summarize the available evidence for the delivery of synchronous virtual rehabilitation intervention services for preschoolers and to identify key factors associated with virtual intervention. METHODS Five databases were searched to identify peer-reviewed articles that assessed virtual interventions for preschoolers delivered by rehabilitation health professionals including physical therapists, occupational therapists, speech-language pathologists, audiologists, and their associated assistants. Relevant data regarding demographics, technology, mode of service delivery, timing, engagement, and measurement data were extracted, and charted. Data were then summarized quantitatively using frequency counts, and qualitatively using descriptive summaries. RESULTS Sixteen studies were identified. Virtual interventions primarily targeted language difficulties or disorders, therefore most services were delivered by a speech-language pathologist or audiologist. Most interventions were delivered using Skype or Zoom on a weekly basis. Various technological features (e.g., phonology software, 'e-helpers') were included, and multiple activities (e.g., playdough, bubbles) and strategies were used to support engagement. CONCLUSION This scoping review provides current knowledge about the delivery of virtual rehabilitation interventions for preschoolers to help guide best practices for clinicians. Future research could assess the validity of existing outcome measures in the virtual environment, and outline optimal session length and frequency for virtual preschool interventions.
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Affiliation(s)
- Kathryn Hatherly
- School of Communication Sciences and Disorders, Elborn College, Western University, London, Canada
| | - Danielle Glista
- School of Communication Sciences and Disorders, Elborn College, Western University, London, Canada
- National Centre for Audiology, Elborn College, Western University, London, Canada
| | - Daniela Testani
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Laura Brunton
- School of Physical Therapy, Elborn College, Western University, London, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - Barbara Jane Cunningham
- School of Communication Sciences and Disorders, Elborn College, Western University, London, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
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Cheung RW, Willan K, Dickerson J, Bowyer-Crane C. Risk factors for early language delay in children within a minority ethnic, bilingual, deprived environment (Born in Bradford's Better Start): a UK community birth cohort study. BMJ Paediatr Open 2023; 7:e001764. [PMID: 36927864 PMCID: PMC10030670 DOI: 10.1136/bmjpo-2022-001764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/24/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Preschool language skills and language delay predict academic and socioemotional outcomes. Children from deprived environments are at a higher risk of language delay, and both minority ethnic and bilingual children can experience a gap in language skills at school entry. However, research that examines late talking (preschool language delay) in an ethnically diverse, bilingual, deprived environment at age 2 is scarce. METHODS Data from Born in Bradford's Better Start birth cohort were used to identify rates of late talking (≤10th percentile on the Oxford-Communicative Development Inventory: Short) in 2-year-old children within an ethnically diverse, predominantly bilingual, deprived UK region (N=712). The relations between known demographic, maternal, distal and proximal child risk factors, and language skills and language delay were tested using hierarchical linear and logistic regression. RESULTS A total of 24.86% of children were classified as late talkers. Maternal demographic factors (ethnicity, born in UK, education, financial security, employment, household size, age) predicted 3.12% of the variance in children's expressive vocabulary. Adding maternal language factors (maternal native language, home languages) and perinatal factors (birth weight, gestation) to the model predicted 3.76% of the variance. Adding distal child factors (child sex, child age) predicted 11.06%, and adding proximal child factors (receptive vocabulary, hearing concerns) predicted 49.51%. Significant risk factors for late talking were male sex (OR 2.07, 95% CI 1.38 to 3.09), receptive vocabulary delay (OR 8.40, 95% CI 4.99 to 14.11) and parent-reported hearing concerns (OR 7.85, 95% CI 1.90 to 32.47). Protective factors were increased household size (OR 0.85, 95% CI 0.77 to 0.95) and age (OR 0.82, 95% CI 0.70 to 0.96). CONCLUSIONS Almost one in four children living in an ethnically diverse and deprived UK area have early language delay. Demographic factors explained little variance in early vocabulary, whereas proximal child factors held more predictive value. The results indicate further research on early language delay is warranted for vulnerable groups.
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Affiliation(s)
- Rachael W Cheung
- Department of Health Sciences, University of York, York, UK
- Better Start Bradford Innovation Hub, Born in Bradford, Bradford Institute for Health Research, Bradford, UK
| | - Kathryn Willan
- Better Start Bradford Innovation Hub, Born in Bradford, Bradford Institute for Health Research, Bradford, UK
| | - Josie Dickerson
- Better Start Bradford Innovation Hub, Born in Bradford, Bradford Institute for Health Research, Bradford, UK
| | - Claudine Bowyer-Crane
- National Institute of Economic and Social Research, London, UK
- Department of Education, University of Sheffield, Sheffield, UK
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Calder SD, Brennan‐Jones CG, Robinson M, Whitehouse A, Hill E. The prevalence of and potential risk factors for Developmental Language Disorder at 10 years in the Raine Study. J Paediatr Child Health 2022; 58:2044-2050. [PMID: 35922883 PMCID: PMC9804624 DOI: 10.1111/jpc.16149] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/22/2022] [Accepted: 07/20/2022] [Indexed: 01/07/2023]
Abstract
AIM This study sought to determine the prevalence of Developmental Language Disorder (DLD) in Australian school-aged children and associated potential risk factors for DLD at 10 years. METHODS This study used a cross-sectional design to estimate the prevalence of DLD in Generation 2 of the prospective Raine Study. Participants included 1626 children aged 10 years with available language data. Primary outcomes included variables matching diagnostic criteria for DLD. Associations of other potential prenatal and environmental variables were analysed as secondary outcomes. RESULTS The prevalence of DLD in this sample was 6.4% (n = 104) at 10 years. This sub-cohort comprised 33.7% (n = 35) with expressive language deficits, 20.2% (n = 21) with receptive language deficits, and 46.2% (n = 48) with receptive-expressive deficits. No significant difference in sex distribution was observed (52.9% male, p = 0.799). Children who were exposed to smoke in utero at 18 weeks gestation were at increased risk of DLD at 10 years (OR = 2.56, CI = 1.23-5.35, p = 0.012). CONCLUSIONS DLD is a relatively prevalent condition in Australian children, even when assessed in middle childhood years. These findings can inform future research priorities, and public health and educational policy which account for the associations with potential risk factors.
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Affiliation(s)
- Samuel D Calder
- School of Allied Health, Faculty of Health SciencesCurtin UniversityPerthWestern AustraliaAustralia,Health Sciences, College of Health and MedicineUniversity of TasmaniaLauncestonTasmaniaAustralia
| | - Christopher G. Brennan‐Jones
- School of Allied Health, Faculty of Health SciencesCurtin UniversityPerthWestern AustraliaAustralia,Telethon Kids Institute, The University of Western AustraliaPerthWestern AustraliaAustralia
| | - Monique Robinson
- Telethon Kids Institute, The University of Western AustraliaPerthWestern AustraliaAustralia
| | - Andrew Whitehouse
- Telethon Kids Institute, The University of Western AustraliaPerthWestern AustraliaAustralia
| | - Elizabeth Hill
- School of Allied Health, Faculty of Health SciencesCurtin UniversityPerthWestern AustraliaAustralia
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Kautto A, Mainela‐Arnold E. Procedural learning and school-age language outcomes in children with and without a history of late talking. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2022; 57:1255-1268. [PMID: 35761759 PMCID: PMC9796386 DOI: 10.1111/1460-6984.12751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 05/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND 'Late talkers' (LTs) are toddlers with late language emergence that cannot be explained by other impairments. It is difficult to predict which of these children continue to present long-term restrictions in language abilities and will later be identified as having a developmental language disorder. Procedural memory weaknesses have been suggested to underlie developmental language disorders, but have not been investigated in LTs. AIMS We investigated the relationships between aspects of procedural memory and school-age language abilities in children with and without a history of LT. We hypothesized that children with a history of LT exhibit (1) restrictions in procedural memory when compared with children with typical early development (TED); and (2) a positive association between procedural memory and school-age language abilities. METHODS & PROCEDURES We recruited 79 children (7;5-10;5), 43 of whom had a history of LT. Aspects of procedural memory, procedural learning and motor planning were assessed using the serial reaction time and the end-state comfort tasks. School-age language abilities were measured using standardized tests. OUTCOMES & RESULTS Counter to expectations, motor planning was not associated with a history of LT or school-age language abilities, and the children with TED did not show stronger procedural learning as compared with peers with a history of LT. However, weaker school-age language abilities were associated with weak procedural learning in TED group. CONCLUSIONS & IMPLICATIONS Factors other than deficits in procedural memory are likely to underlie LT. Procedural learning shows promise as a potential predictor of language development in children that are not identified as LTs. WHAT THIS PAPER ADDS What is already known on the subject Poor procedural learning has been associated with developmental language disorders and suggested to underlie language difficulties. However, to our knowledge, this study is the first to investigate procedural learning and its associations with language outcomes in LTs. What this paper adds to existing knowledge Consistent with prior research, we found an association between language abilities and procedural learning in school-aged children, but found no evidence for poor procedural learning in children with a history of LT. Furthermore, the school-age language outcomes were only associated with procedural learning in children with no history of LT. What are the potential or actual clinical implications of this work? Our findings suggest that factors other than limitations in procedural learning underlie LT. However, procedural learning could be a useful predictor for school-aged language outcomes in children not identified as LTs.
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Affiliation(s)
- Anna Kautto
- Department of Psychology and Speech–Language PathologyUniversity of TurkuTurkuFinland
| | - Elina Mainela‐Arnold
- Department of Psychology and Speech–Language PathologyUniversity of TurkuTurkuFinland
- Department of Speech–Language PathologyUniversity of TorontoTorontoONCanada
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Cunningham BJ, Cermak C, Head J, Oram Cardy J. Clinical feasibility, utility, and usability of the Profile of Preschool Communication: A pilot test in community settings. JOURNAL OF COMMUNICATION DISORDERS 2022; 98:106232. [PMID: 35689872 DOI: 10.1016/j.jcomdis.2022.106232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 04/20/2022] [Accepted: 06/03/2022] [Indexed: 06/15/2023]
Abstract
AIM . This study aimed to pilot test, assess usability and utility of, and identify barriers to implementation for the Profile of Preschool Communication (PPC) - a new data collection tool designed to support outcome monitoring in preschool speech-language programs and practice-based research. METHODS . This pilot study was conducted with three sites in the Ontario Preschool Speech and Language (PSL) program. Twenty-three speech-language pathologists used the PPC for all outcome monitoring assessments for 2-3-months and provided feedback about their experience using it in practice. Then, 18 of the 23 speech-language pathologists completed online surveys to rate usability and utility, and report their perceived implementation barriers and facilitators. RESULTS . Speech-language pathologists reported difficulties completing some sections of the PPC, most notably obtaining data related to maternal education and family history of mental health concerns. Usability and utility were generally rated favorably with some items rated as neutral. Barriers to implementation included the paper format, completion time, requirement to ask personal questions, and the perception by some that data were useful for outcome monitoring but not practice. Facilitators included ease of use, an improvement over the existing tool, and the collection of data to support service planning. CONCLUSIONS . The PPC shows potential as an outcome monitoring data collection tool in preschool speech-language pathology programs. Findings will be of interest to researchers engaged in practice-based research and those interested in engaging end users to develop clinically meaningful tools.
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Affiliation(s)
- Barbara Jane Cunningham
- School of Communication Sciences and Disorders, Western University, Elborn College, 1201 Western Road, London, ON, N6G 1H1, Canada; CanChild Centre for Childhood Disability Research, McMaster University, Hamilton ON, L8S1C7, Canada.
| | - Carly Cermak
- School of Communication Sciences and Disorders, Western University, Elborn College, 1201 Western Road, London, ON, N6G 1H1, Canada
| | - Julianna Head
- School of Health Studies, Western University, 1151 Richmond Street, London, ON, N6A 3K7, Canada
| | - Janis Oram Cardy
- School of Communication Sciences and Disorders, Western University, Elborn College, 1201 Western Road, London, ON, N6G 1H1, Canada
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So KKH, To CKS. Systematic Review and Meta-Analysis of Screening Tools for Language Disorder. Front Pediatr 2022; 10:801220. [PMID: 35281230 PMCID: PMC8904415 DOI: 10.3389/fped.2022.801220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/13/2022] [Indexed: 11/13/2022] Open
Abstract
Language disorder is one of the most prevalent developmental disorders and is associated with long-term sequelae. However, routine screening is still controversial and is not universally part of early childhood health surveillance. Evidence concerning the detection accuracy, benefits, and harms of screening for language disorders remains inadequate, as shown in a previous review. In October 2020, a systematic review was conducted to investigate the accuracy of available screening tools and the potential sources of variability. A literature search was conducted using CINAHL Plus, ComDisCome, PsycInfo, PsycArticles, ERIC, PubMed, Web of Science, and Scopus. Studies describing, developing, or validating screening tools for language disorder under the age of 6 were included. QUADAS-2 was used to evaluate risk of bias in individual studies. Meta-analyses were performed on the reported accuracy of the screening tools examined. The performance of the screening tools was explored by plotting hierarchical summary receiver operating characteristic (HSROC) curves. The effects of the proxy used in defining language disorders, the test administrators, the screening-diagnosis interval and age of screening on screening accuracy were investigated by meta-regression. Of the 2,366 articles located, 47 studies involving 67 screening tools were included. About one-third of the tests (35.4%) achieved at least fair accuracy, while only a small proportion (13.8%) achieved good accuracy. HSROC curves revealed a remarkable variation in sensitivity and specificity for the three major types of screening, which used the child's actual language ability, clinical markers, and both as the proxy, respectively. None of these three types of screening tools achieved good accuracy. Meta-regression showed that tools using the child's actual language as the proxy demonstrated better sensitivity than that of clinical markers. Tools using long screening-diagnosis intervals had a lower sensitivity than those using short screening-diagnosis intervals. Parent report showed a level of accuracy comparable to that of those administered by trained examiners. Screening tools used under and above 4yo appeared to have similar sensitivity and specificity. In conclusion, there are still gaps between the available screening tools for language disorders and the adoption of these tools in population screening. Future tool development can focus on maximizing accuracy and identifying metrics that are sensitive to the dynamic nature of language development. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=210505, PROSPERO: CRD42020210505.
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Affiliation(s)
| | - Carol K. S. To
- Academic Unit of Human Communication, Development, and Information Sciences, Faculty of Education, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Wilson P, Rush R, Charlton J, Gilroy V, McKean C, Law J. Universal language development screening: comparative performance of two questionnaires. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2021-001324. [PMID: 36053598 PMCID: PMC8739429 DOI: 10.1136/bmjpo-2021-001324] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/16/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Low language ability in early childhood is a strong predictor of later psychopathology as well as reduced school readiness, lower educational attainment, employment problems and involvement with the criminal justice system. Assessment of early language development is universally offered in many countries, but there has been little evaluation of assessment tools. We planned to compare the screening performance of two commonly used language assessment instruments. METHODS A pragmatic diagnostic accuracy study was carried out in five areas of England comparing the performance of two screening tools (Ages and Stages Questionnaire (ASQ) and Sure Start Language Measure (SSLM)) against a reference test (Preschool Language Scale, 5th edition). RESULTS Results were available for 357 children aged 23-30 months. The ASQ Communication Scale using optimal cut-off values had a sensitivity of 0.55, a specificity of 0.95 and positive and negative predictive values of 0.53 and 0.95, respectively. The SSLM had corresponding values of 0.83, 0.81, 0.33 and 0.98, respectively. Both screening tools performed relatively poorly in families not using English exclusively in the home. CONCLUSION The very widely used ASQ Communication Scale performs poorly as a language screening tool, missing over one-third of cases of low language ability. The SSLM performed better as a screening tool.
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Affiliation(s)
- Philip Wilson
- Centre for Rural Health, Institute of Applied Health Sciences, University of Aberdeen, Inverness, UK
| | - Robert Rush
- Independent statistical consultant, Edinburgh, UK
| | - Jenna Charlton
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
| | | | - Cristina McKean
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - James Law
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
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13
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Caglar-Ryeng Ø, Eklund K, Nergård-Nilssen T. School-entry language outcomes in late talkers with and without a family risk of dyslexia. DYSLEXIA (CHICHESTER, ENGLAND) 2021; 27:29-49. [PMID: 32181543 DOI: 10.1002/dys.1656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 02/18/2020] [Accepted: 03/02/2020] [Indexed: 06/10/2023]
Abstract
Children with familial risk (FR) of dyslexia and children with early language delay are known to be at risk for later language and literacy difficulties. However, research addressing long-term outcomes in children with both risk factors is scarce. This study tracked FR and No-FR children identified as late talkers at 2 years of age and reports development from 4;6 through 6 years. We examined the possible effects of FR-status and late talking (LT) status, respectively, on language skills at school entry, and whether FR-status moderated the associations between 4;6-year and 6-year language scores. Results indicated an effect of LT status on language at both ages, while FR status affected language skills at 6 years only. The interaction between LT and FR statuses was not significant, implying that LT status affected language skills independently of the child's FR status. A proportion of late talkers developed typical language at 6 years of age, while some FR children with typical vocabulary skills in toddlerhood had emerging developmental language disorder by school entry. FR status had a moderating effect on the association between expressive grammar at ages 4;6 and 6 years. Possible explanations for the effect of FR status on language skills are discussed. We highlight limitations in the study size and suggest how these preliminary findings can inform future research.
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Affiliation(s)
- Ømur Caglar-Ryeng
- Department of Education, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Kenneth Eklund
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
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14
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Visser-Bochane MI, van der Schans CP, Krijnen WP, Reijneveld SA, Luinge MR. Validation of the Early Language Scale. Eur J Pediatr 2021; 180:63-71. [PMID: 32533257 PMCID: PMC7782443 DOI: 10.1007/s00431-020-03702-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 05/19/2020] [Accepted: 05/22/2020] [Indexed: 11/29/2022]
Abstract
The aim of this study was to assess the criterion validity of a new screening instrument, the Early Language Scale (ELS), for the identification of young children at risk for developmental language disorder (DLD), and to determine optimal age-adjusted cut-off scores. We recruited a community-based sample of 265 children aged 1 to 6 years of age. Parents of these children responded on the ELS, a 26-item "yes-no" questionnaire. The children were assessed with extended language tests (language comprehension, word production, sentence production, communication). A composite score out of these tests (two tests below - 1 SD or one below - 1.5 SD) was used as reference standard. We assessed the validity of the ELS, measured by sensitivity, specificity, predictive values, and AUC. The optimal sensitivity/specificity age-dependent cut-off ELS score was at 15th percentile. Sensitivity and specificity were 0.62 and 0.93, respectively. Positive predictive value was moderate (0.53), negative predictive value was high (0.95), the positive likelihood ratio was 9.16, and negative likelihood ratio was 0.41. The area under the ROC curve was 0.88. The items covered the increasing language development for the ages from 1 to 6.Conclusion: The ELS is a valid instrument to identify children with DLD covering an age range of 1 to 6 years in community-based settings. What is Known: • Early identification and treatment of developmental language disorders can reduce negative effects on children's emotional functioning, academic success, and social relationships. • Short, validated language screening instruments that cover the full age range of early childhood language development lack. What is New: • The 26-item Early Language Scale (ELS) is a valid instrument to identify children at risk for developmental language disorder in well-child care and early educational settings among Dutch children aged 1-6 years.
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Affiliation(s)
- Margot I. Visser-Bochane
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University Groningen, University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands
| | - Cees P. van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University Groningen, University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Health Psychology Research, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Wim P. Krijnen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University Groningen, University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands
| | - Sijmen A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Margreet R. Luinge
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University Groningen, University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands
- Department of Otorhinolaryngology, Head & Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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15
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Brennan-Jones CG, Whitehouse AJO, Calder SD, Costa CD, Eikelboom RH, Swanepoel DW, Jamieson SE. Does Otitis Media Affect Later Language Ability? A Prospective Birth Cohort Study. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:2441-2452. [PMID: 32539591 DOI: 10.1044/2020_jslhr-19-00005] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose The aim of the study was to examine whether otitis media (OM) in early childhood has an impact on language development in later childhood. Methods We analyzed data from 1,344 second-generation (Generation 2) participants in the Raine Study, a longitudinal pregnancy cohort established in Perth, Western Australia, between 1989 and 1991. OM was assessed clinically at 6 years of age. Language development was measured using the Peabody Picture Vocabulary Test-Revised (PPVT-R) at 6 and 10 years of age and the Clinical Evaluation of Language Fundamentals-Third Edition at 10 years of age. Logistic regression analysis accounted for a wide range of social and environmental covariates. Results There was no significant relationship between bilateral OM and language ability at 6 years of age (β = -0.56 [-3.78, 2.66], p = .732). However, while scores were within the normal range for the outcome measures at both time points, there was a significant reduction in the rate of receptive vocabulary growth at 10 years of age (PPVT-R) for children with bilateral OM at 6 years of age (β = -3.17 [-6.04, -0.31], p = .030), but not for the combined unilateral or bilateral OM group (β = -1.83 [-4.04, 0.39], p = .106). Conclusions Children with OM detected at 6 years of age in this cohort had average language development scores within the normal range at 6 and 10 years of age. However, there was a small but statistically significant reduction in the rate of receptive vocabulary growth at 10 years of age (on the PPVT-R measure only) in children who had bilateral OM at 6 years of age after adjusting for a range of sociodemographic factors.
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Affiliation(s)
- Christopher G Brennan-Jones
- Telethon Kids Institute, The University of Western Australia, Perth
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth
- Department of Audiology, Perth Children's Hospital, Western Australia
| | | | - Samuel D Calder
- Faculty of Health Sciences, Curtin University, Perth, Western Australia
| | - Cheryl Da Costa
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth
| | - Robert H Eikelboom
- Ear Science Institute Australia, Perth, Western Australia
- Ear Sciences Centre, The University of Western Australia, Perth
- Department of Speech Language Pathology and Audiology, University of Pretoria, South Africa
| | - De Wet Swanepoel
- Ear Science Institute Australia, Perth, Western Australia
- Ear Sciences Centre, The University of Western Australia, Perth
- Department of Speech Language Pathology and Audiology, University of Pretoria, South Africa
| | - Sarra E Jamieson
- Telethon Kids Institute, The University of Western Australia, Perth
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O'Toole C, Lyons R, Ó'Doibhlín D, O'Farrell F, Houghton C. Stage 1 Registered Report: The experiences and perceptions of parent-child interaction therapy for parents of young children with communication difficulties: A qualitative evidence synthesis protocol. HRB Open Res 2020; 2:36. [PMID: 32566893 PMCID: PMC7281664 DOI: 10.12688/hrbopenres.12974.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2020] [Indexed: 12/22/2022] Open
Abstract
Background: Parent-child interaction therapy refers to a group of interventions mediated by trained parents to address areas of developmental difficulties in children. In the field of speech and language therapy it is used in early intervention for children with speech, language and communication difficulties. The intervention involves training parents and caregivers on the importance of responsivity and language input in daily interactions and coaches them on strategies to implement these with the children. As the success of the intervention is heavily influenced by caregiver engagement, understanding and acceptance, it is important to consider their views. However, to date there has been limited work on synthesising parental views of this intervention. Methods: This is a protocol for a qualitative evidence synthesis of peer-reviewed qualitative papers addressing the experiences and perceptions of parent-child interaction therapy for parents of children with communication difficulties. We will complete a systematic search of 11 databases, review the reference lists and complete a cited reference search of all included studies. Two authors will independently screen tests for inclusion, initially by title and abstract, with full-text screening as necessary. Thematic synthesis will be used for all included studies. We will appraise the quality of included studies using CASP and confidence in the review findings using GRADE CERQual. Discussion: As the views of parents are pivotal in the success of this intervention, the findings from this synthesis should help to guide best practice and policy for the future implementation of parent child interaction therapy for children with communication difficulties..
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Affiliation(s)
- Ciara O'Toole
- Department of Speech and Hearing Sciences, University College Cork, Cork, Ireland
| | - Rena Lyons
- Discipline of Speech and Language Therapy, National University of Ireland, Galway, Galway, Ireland
| | - Donna Ó'Doibhlín
- Boston Scientific Library, University College Cork, Cork, Ireland
| | | | - Catherine Houghton
- School of Nursing and Midwifery, National University of Ireland, Galway, Galway, Ireland
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17
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Morgan L, Delehanty A, Dillon JC, Schatschneider C, Wetherby AM. Measures of Early Social Communication and Vocabulary Production to Predict Language Outcomes at Two and Three Years in Late-Talking Toddlers. EARLY CHILDHOOD RESEARCH QUARTERLY 2020; 51:366-378. [PMID: 32863566 PMCID: PMC7455001 DOI: 10.1016/j.ecresq.2019.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Late talkers are a heterogeneous group of toddlers and reliable predictors of persistent language delay have been elusive. The purpose of this study was to determine the extent to which early social communication and vocabulary production predicted variance in language outcomes at 2 and 3 years of age. METHODS Participants were 408 typically developing and late-talking toddlers who completed the Communication and Symbolic Behavior Scales Caregiver Questionnaire and Behavior Sample (CSBS CQ and CSBS BS) at a mean of 20 months, the Language Development Survey (LDS) at a mean of 24 months, and the Mullen Scales of Early Learning (MSEL) at a mean of 25 months. A subgroup of 198 children completed a second MSEL at 3 years of age. Associations among the LDS, CSBS CQ, CSBS BS, and MSEL were examined using correlational and hierarchical linear regression analyses. Logistic regression was used to examine each measure's contribution to predicting language delay at 2 and 3 years. RESULTS Moderate to large correlations were observed among all variables. The LDS, CSBS CQ, and CSBS BS added unique contributions to the prediction of 2- and 3-year expressive and receptive language outcomes. Measures of speech and vocabulary production were the strongest predictors of language outcomes at age 2. At age 3, social and symbolic communication played a more significant role in accounting for variance in expressive and receptive language outcome. A similar pattern emerged for the categorical prediction of language delay. CONCLUSIONS Measures of social communication between 18-21 months added important information to predicting language outcomes at 2 and 3 years, above and beyond parent-reported expressive vocabulary production measured at 24 months, with small effect sizes overall. Implications for identifying younger children who are at risk for continued language delay and recommendations for referral to early intervention programs are discussed.
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Affiliation(s)
- Lindee Morgan
- Marcus Autism Center, School of Medicine, Department of Pediatrics, Emory University, 1920 Briarcliff Rd., Atlanta, GA 30320
| | - Abigail Delehanty
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA 15282
| | | | | | - Amy M Wetherby
- Autism Institute, College of Medicine, Department of Clinical Sciences, Florida State University, Tallahassee, FL 32312
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18
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O'Toole C, Lyons R, Ó’Doibhlín D, O’Farrell F, Houghton C. Stage 1 Registered Report: The experiences and perceptions of parent-child interaction therapy for parents of young children with communication difficulties: A qualitative evidence synthesis protocol. HRB Open Res 2019; 2:36. [DOI: 10.12688/hrbopenres.12974.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2019] [Indexed: 11/20/2022] Open
Abstract
Background: Parent-child interaction therapy is an early intervention for children with speech, language and communication difficulties. It involves training parents and caregivers on the importance of responsivity and language input in daily interactions and coaches them on strategies to implement this with the children. As the success of the intervention is heavily influenced by caregiver engagement, understanding and acceptance, it is important to consider their views. However, to date there has been limited work on synthesizing parental views of this intervention. Methods: This is a protocol for a qualitative evidence synthesis of peer-reviewed papers addressing the experiences and perceptions of parent-child interaction therapy for parents of young children with communication difficulties. We will complete a systematic search of 11 databases, review the reference lists and complete a cited reference search of all included studies. Two authors will independently screen tests for inclusion, initially by title and abstract, with full-text screening as necessary. Thematic synthesis will be used for all included studies. We will appraise the quality of included studies using CASP and confidence in the review findings using GRADE CERQual. Discussion: The findings from this synthesis will help to guide best practice and policy for the implementation of parent child interaction therapy by considering the views of parents.
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19
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Whitworth A, Claessen M. Making waves in our profession: Using research to drive clinical practice. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 19:205-207. [PMID: 28521560 DOI: 10.1080/17549507.2017.1322144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Anne Whitworth
- a School of Psychology and Speech Pathology, Curtin University , Perth , Western , Australia
| | - Mary Claessen
- a School of Psychology and Speech Pathology, Curtin University , Perth , Western , Australia
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