The efficacy of early language intervention in mainstream school settings: a randomized controlled trial

Early Intervention, Regular Education, and Family: Reciprocal Influences on Communication and Language Disorders

Families are the primary caregivers and the main source of support for their children. Family resilience involves coping and adapting to stressful situations. This study explored the impact of previous treatment experience on parental resilience, in families, as well as the relationship between family history of communication and language disorders and parental stress. These variables were assessed through the Resilience Scale and the Parental Stress Index in parents of 220 children aged 3 to 6 years attending mainstream schools and early intervention (EI) centers in Caceres (Spain). The results revealed significant differences in resilience between parents who had received previous treatments and those who had not (p = 0.11). Furthermore, a significant association was found between having no family history of communication and language disorders and the Dysfunctional Parent-Child Interaction subscale from the Parental Stress Index (U = -2.079, p = 0.038). These findings highlight the relevance of previous experience in EI to build family resilience as resilient parents are more likely to be actively involved in their children's education and create a supportive environment. Thus, promoting resilience in educational settings may have positive effects on children's and families' quality of life during the EI process.

Impact of school SES on literacy development

Effective literacy skills are essential to actively participate in today's society. However, little research has been conducted that examined the impact of contextual variables on literacy development. The present paper addressed whether and how the socioeconomic status of the school (S-SES) children attend affects their literacy achievements. Eight-hundred and seventy-eight 2nd and 4th grade children participated in the study. Data were collected in low-SES (vulnerable) and in mid-high-SES (non-vulnerable) schools. Children completed a large battery of language, cognitive, and literacy tasks in Catalan, a language spoken in a region in Spain where virtually all children are at least bilingual (they also speak Spanish) and it is the main language of instruction. Results showed that children in vulnerable schools were outperformed by children in non-vulnerable schools across all literacy competencies, but particularly affected higher order skills; that is, text quality and reading comprehension. Differences with their non-vulnerable peers remained, even after controlling for context-level covariates, including familial SES. However, S-SES ceased to exert significant influence once children's cognitive and, especially, linguistic skills were considered. The study adds to previous research claiming that school SES has an effect on students' literacy skills, above and beyond children's home SES. However, our findings also suggest that literacy performance is ultimately mostly dependent on educationally actionable, subject-level skills. Educational implications are discussed.

Creating the conditions for robust early language development for all: Part two: Evidence informed public health framework for child language in the early years

BACKGROUND

One of the most significant developmental accomplishments is the emergence of language in early childhood. Whilst this process is effortless for most children, others can face significant hurdles. Identifying, in the early years, which children will go on to have developmental language disorder is, however, fraught with several well-documented challenges. In the preceding paper we described and linked new research evidence about factors that influence language development in the early years, noting that exposure to some may be time sensitive and that these influences cluster together and can accumulate over time. We demonstrated that risk profiles were associated with and characterised low language trajectories, and we considered how this information could be integrated into a concept that moves beyond screening at single time points in the early years. We argue that this evidence might be used to build an improved early years framework for language thereby creating a more equitable surveillance system that does not leave children living in less advantageous circumstances behind. Underpinning this thinking was a bioecological framework that incorporates the social, environmental and family factors in the child's ecosystem known to influence language development in the early years.

AIMS

To develop a proposal for the design and implementation of an early language public health framework based on current best evidence METHODS: We synthesised the findings from the companion paper (Reilly & McKean 2023) regarding early language trajectories, inequalities and clustering of risks with key public health concepts, relevant intervention evidence and implementation theories to develop a new framework for language surveillance and preventative interventions in the early years.

MAIN CONTRIBUTION

An evidence informed early language public health framework is presented. Describing in turn (1) essential components; (2) relevant interventions; (3) essential qualities for implementation ((i) probabilistic, (ii) proportionate, (iii) developmental and sustained and (iv) codesigned); (4) system-level structures and (5) processes required to adopt and embed an early language public health framework in an existing Local Government Area's child health surveillance and early prevention-intervention systems.

CONCLUSIONS

Children's language development influences their life chances across the life course and language difficulties are unfairly distributed across society. Current evidence points to the need for whole systems approaches to early child language and enables a blueprint for such a framework to be described.

WHAT THIS PAPER ADDS

What is already known on the subject Early child language development sets the stage for a child's life chances and language difficulties can have profound long-term consequences. Such difficulties are unfairly distributed across society and the reach of preventative services is not universal or equitable.

WHAT THIS STUDY ADDS

Several effective primary and secondary preventative interventions exist but their successful implementation is not straightforward. An early language public health framework of surveillance and intervention is described to provide equitable and effective early interventions to children from 0-4 years. We detail the essential components, interventions and qualities of that framework and describe system-level structures and processes required to adopt and embed an early language public health framework in a given locality. WHAT ARE THE CLINICAL IMPLICATIONS OF THIS WORK?: A whole systems approach to early child language is required and should be co-designed through local collaboration with family, community and children's services stakeholders. A public health speech and language therapist role could catalyse the implementation of such approaches and support continuous improvement.

Consensus Paper: Situated and Embodied Language Acquisition

Theories of embodied cognition postulate that perceptual, sensorimotor, and affective properties of concepts support language learning and processing. In this paper, we argue that language acquisition, as well as processing, is situated in addition to being embodied. In particular, first, it is the situated nature of initial language development that affords for the developing system to become embodied. Second, the situated nature of language use changes across development and adulthood. We provide evidence from empirical studies for embodied effects of perception, action, and valence as they apply to both embodied cognition and situated cognition across developmental stages. Although the evidence is limited, we urge researchers to consider differentiating embodied cognition within situated context, in order to better understand how these separate mechanisms interact for learning to occur. This delineation also provides further clarity to the study of classroom-based applications and the role of embodied and situated cognition in the study of developmental disorders. We argue that theories of language acquisition need to address for the complex situated context of real-world learning by completing a "circular notion": observing experimental paradigms in real-world settings and taking these observations to later refine lab-based experiments.

A randomized controlled trial of the effectiveness of teacher continued professional development on student language outcomes

BACKGROUND

Continued professional development (CPD) is required for updated skills and knowledge. This study evaluates the efficacy of a CPD programme for mainstream school teachers.

AIMS

In an 11-week intervention programme, speech-language therapists (SLTs) presented the participating teachers with whole-class teaching techniques aimed at creating a language and communication-supporting classroom environment. The effects of the intervention on the language development of the students in the teachers' classes were assessed.

METHODS & PROCEDURES

A total of 211 first- and second-year students (M_age = 7;6, range = 6;5-8;9) underwent standardized language assessments of receptive and expressive language abilities before and after their teachers' participation in the CPD. The students were divided into intervention and delayed intervention groups to enable randomized intervention allocation. Linear mixed modelling was used to estimate the individual and interaction effects of group, time and demographic factors.

OUTCOMES & RESULTS

Significant effects of time, group and school, respectively, but no interaction between time and group indicates that while all students advanced between assessments, the progress was not attributable to the teachers' participation in the CPD.

CONCLUSIONS & IMPLICATIONS

Results are discussed in light of those of recent studies of universal services to support optimal language development.

WHAT THIS PAPER ADDS

What is already known on this subject Although inconclusive, previous research indicates that intervention delivered to teachers by SLTs has the potential to improve the language abilities of the students in the teachers' classrooms. What this paper adds to existing knowledge This study explored the language development of first- and second-year mainstream school students whose teachers took part in a CPD programme aimed at establishing language and communication-supporting teaching techniques. Results indicate that the development of the students' language abilities could not be attributed to the teachers' participation in the CPD. What are the potential or actual implications of the work? SLTs are often asked to guide teachers and teaching staff rather than themselves conduct individual assessments and interventions. The results of this trial can be used to inform the discussion on how to prioritize between tasks.

Investigating the Measurement Invariance and Method-Trait Effects of Parent and Teacher SNAP-IV Ratings of Preschool Children

The Swanson, Nolan, and Pelham scale version IV (SNAP-IV) is widely used to assess symptoms of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) in children and adolescents. Nevertheless, there is insufficient data to support its use in preschool children. The study had three goals: First, to test the factorial validity of the three correlated-factors model of ADHD and ODD items of the SNAP-IV. Second, to investigate the measurement invariance of the items over time (6-month longitudinal interval) and by sex. Third, to investigate the convergent validity and method-specific influences on ADHD/ODD assessments with respect to multiple raters (parents/teachers) of children's symptoms. Participants were 618 preschool children (3.5-6 years) at baseline and 6-month follow-up. For model testing, we used confirmatory factor analysis for categorical observed variables. Method and trait effects were examined using the CT-C(M-1) model. The analyses showed partial measurement invariance over time and according to sex. Moreover, strong rater-specific effects were detected. The implication of the results for construct validation of the instrument and clinical assessment of ADHD and ODD traits are discussed.

Development and norming of the Hungarian CDI-III: A screening tool for language delay

BACKGROUND

Difficulties in language development are related to social and emotional problems, lower academic outcomes, and lower quality of life from childhood to adolescence. These grave consequences might be significantly reduced by timely identification and professional support. The introduction of systematic screening for language delay (LD) in 3-year-old children in Hungary was based on the recent adaptation of the MacArthur-Bates CDI-III (HCDI-III).

AIMS

To explore the relevant psychometric properties of the HCDI-III; to identify factors characteristic of the families and children influencing language development at the age group under investigation; and to evaluate the adequacy of the tool for the purpose of screening LD in kindergarten at the age of 3 years.

METHODS & PROCEDURES

The norming study of the HCDI-III was conducted in a collaborative research project with the Metropolitan Pedagogical Services in Budapest. HCDI-III parent report forms along with a demographic survey form were distributed to parents of all Hungarian-speaking children between the ages of 2;0 and 4;2 without special education needs. The normative sample comprised data from 1424 children aged 2;0-4;2 with 51.1% boys and 48.9% girls. The data set contained information including language skills, basic demographics, birth conditions, health issues and socio-economic status (SES).

OUTCOMES & RESULTS

In the HCDI-III form, six outcome variables were created to cover the domains of expressive vocabulary, morphosyntax and language use. Statistical analyses revealed appropriate psychometric properties of five outcome variables that showed a normal distribution and were strongly correlated to age. Outcomes of girls were slightly (but significantly) higher on scales corresponding to vocabulary, syntax, language use and productivity. Most variables were highly correlated with one another even with age partialled out. Multiple regression analyses revealed significant effect of age, gender and parental education on all main outcome variables. Neither one of the other eight predictors, including familial and birth-related factors, affected linguistic outcomes in our sample.

CONCLUSIONS & IMPLICATIONS

The results are consistent with the majority of Communicative Development Inventory (CDI) studies, and support the psychometric eligibility of the instrument for screening purposes between 30 and 50 months. As certain regions of Hungary are characterised by a high prevalence of low-SES families, more research is needed to adapt the screening procedure and subsequent measures to their needs.

WHAT THIS PAPER ADDS

What is already known on the subject Difficulties in language development are related to lower social and academic outcomes and lower quality of life from childhood to adolescence. These grave consequences might be significantly reduced by timely identification and professional support. Structured parent report forms such as the MacArthur-Bates CDI are widely accepted methods for screening children with LD. What this paper adds to existing knowledge This study reports the Hungarian adaptation and norming of the CDI-III form. Statistical analyses revealed appropriate psychometric properties of most of its sections. Language outcomes were affected by age, gender and parental education on all main outcome variables in children between 2 and 4 years of age. What are the potential or actual clinical implications of this work? The results support the psychometric eligibility of the HCDI-III instrument for screening purposes. The introduction of the screening procedure in clinical practice is expected to improve early support of children with language difficulties and reduce risks of developmental problems related to language disorders.

Early language screening and intervention can be delivered successfully at scale: evidence from a cluster randomized controlled trial

BACKGROUND

It is well established that oral language skills provide a critical foundation for formal education. This study evaluated the effectiveness of the Nuffield Early Language Intervention (NELI) programme in ameliorating language difficulties in the first year of school when delivered at scale.

METHODS

We conducted a cluster randomized controlled trial (RCT) in 193 primary schools (containing 238 Reception classrooms). Schools were randomly allocated to either a 20-week oral language intervention or a business-as-usual control group. All classes (N = 5,879 children) in participating schools were screened by school staff using an automated App to assess children's oral language skills. Screening identified 1,173 children as eligible for language intervention: schools containing 571 of these children were allocated to the control group and 569 to the intervention group.

RESULTS

Children receiving the NELI programme made significantly larger gains than the business-as-usual control group on a latent variable reflecting standardized measures of language ability (d = .26) and on the school-administered automated assessment of receptive and expressive language skills (d = .32). The effects of intervention did not vary as a function of home language background or gender.

CONCLUSIONS

This study provides strong evidence for the effectiveness of a school-based language intervention programme (NELI) delivered at scale. These findings demonstrate that language difficulties can be identified by school-based testing and ameliorated by a TA delivered intervention; this has important implications for educational and social policy.

Does Early Child Language Predict Internalizing Symptoms in Adolescence? An Investigation in Two Birth Cohorts Born 30 Years Apart

Language is vital for social interaction, leading some to suggest early linguistic ability paves the way for good adolescent mental health. The relation between age-5 vocabulary and adolescent internalizing symptoms was examined in two U.K. birth cohorts that are nationally representative in terms of sex, ethnicity, and socioeconomic status: the 1970 British Cohort Study (BCS; N = 11,640) and the Millennium Cohort Study (MCS born ~2001; N = 14,754). In the BCS, no relation between receptive vocabulary and age-16 self-reported symptoms was observed (β = 0.00 [-0.03; 0.03]). In the MCS, better expressive vocabulary was associated with more age-14 self-reported symptoms (β = 0.05 [0.02; 0.07]). The direction of this effect was reversed for parent-reported symptoms. All effect sizes were small. The relation between childhood vocabulary and internalizing symptoms varies by generation and reporter.

Portuguese Early Literacy Screening Tool- RaLEPE: Pilot Study

Early literacy development is an indicator of a child’s overall cognitive-linguistic development and affects their academic, social, emotional and behavioural skills. Research suggests that early detection in preschool years can have an important role in the prevention of academic failure. There is a lack of early literacy screening tools for Portuguese preschool children. This study aims to present preliminary data results of the development and validation of the Preschool Early Literacy Screening Tool (Rastreio de Literacia Emergente Pré-escolar- RaLEPE). A pilot study was carried out with a sample of 128 screenings, answered by the parents/caregivers of the Portuguese children in the target age groups. The analysis of results shown the reliability of the tool, with a very good internal consistency for RaLEPE total scale and the different sections. Therefore, preliminary results of this study indicate internal validity of the RaLEPE and confirm this as screening tool usefulness for early intervention childhood, to provide early diagnosis and contribute to early intervention for children with language and learning disorders.

Children’s Language Skills Can Be Improved: Lessons From Psychological Science for Educational Policy

Oral language is crucial for social interaction and for learning in the classroom; it also provides the foundation for reading comprehension. It follows that children with language difficulties are at high risk of educational failure. Recently, a number of studies have demonstrated that it is possible to produce small but significant improvements in children’s oral language through targeted language interventions ( d = 0.16) and, furthermore, that studies with high-quality implementation show larger effects ( d = 0.24). There is also evidence that effects of language intervention can generalize to produce improvements in reading comprehension. Although further research examining the long-term effects of language interventions are needed, current findings have important implications for educational policy and practice.

Can inferencing be trained in preschoolers using shared book-reading? A randomised controlled trial of parents' inference-eliciting questions on oral inferencing ability

The ability to make inferences is essential for effective language comprehension. While inferencing training benefits reading comprehension in school-aged children (see Elleman, 2017, for a review), we do not yet know whether it is beneficial to support the development of these skills prior to school entry. In a pre-registered randomised controlled trial, we evaluated the efficacy of a parent-delivered intervention intended to promote four-year-olds' oral inferencing skills during shared book-reading. One hundred children from socioeconomically diverse backgrounds were randomly assigned to inferencing training or an active control condition of daily maths activities. The training was found to have no effect on inferencing. However, inferencing measures were highly correlated with children's baseline language ability. This suggests that a more effective approach to scaffolding inferencing in the preschool years might be to focus on promoting vocabulary to develop richer and stronger semantic networks.

Oral language comprehension interventions in 1-8-year-old children with language disorders or difficulties: A systematic scoping review

BACKGROUND AND AIMS

The most severe problems in language manifest as difficulties in comprehending oral language. These difficulties are persistent and expose individuals to several risk factors. There is a lack of intervention research in the area of oral language comprehension, and no reviews have focused solely on oral language comprehension interventions in young children. The aim of this review was to identify interventions targeting oral language comprehension in children 8 years or younger with language disorders or difficulties. The review also examined the possible intervention foci, efficacy, and level of evidence of these interventions.

METHODS

A systematic scoping review of eight databases was carried out. Twenty of 2399 articles met the inclusion criteria and a further six articles were identified through reference lists of sourced articles. These 26 articles described 25 studies. Altogether 2460 children aged 1-8 years participated in the 25 studies. The data from these studies were extracted and analysed, and the intervention foci, efficacy, and level of evidence were evaluated.Main contribution: The reviewed interventions focused on three aspects: modifying the communicative environment of the child; targeting aspects of the child's language; or targeting the child's language processing. Of the included studies, 80% indicated positive effects on participants' oral language comprehension. The level of evidence of the included studies varied. With few exceptions, researchers and practitioners can have moderate confidence in the results of the included studies indicating that it is possible to ameliorate difficulties in oral language comprehension.

CONCLUSIONS

This review summarises the existing evidence on oral language comprehension interventions in young children with language disorders or difficulties. The evidence base is still limited, and more research is urgently needed. The results suggest that though not all interventions seem to provide desired outcomes, there are several interventions indicating efficacy to target problems in oral language comprehension in 1-8-year-old children with language disorders or difficulties. A careful choice of therapy technique and collaboration with people in the child's environment is required to maximize outcomes.Implications: The results suggest that young children's oral language comprehension skills can be improved by guiding parents and clinicians in their communication strategies, and by clinician-implemented interventions targeting aspects of the child's language. The research on interventions targeting children's language processing is limited, and the results mixed. The present study provides information on different oral language comprehension interventions and their outcomes. The findings are readily applicable for clinical use.

Improving storytelling and vocabulary in secondary school students with language disorder: a randomized controlled trial

BACKGROUND

Although language and communication difficulties are common in secondary school students, there has been limited research into the efficacy of interventions for adolescents with language and communication difficulties.

AIMS

To investigate the efficacy of teaching assistant (TA)-delivered narrative and vocabulary interventions to mainstream secondary school-aged students with language disorder.

METHODS & PROCEDURES

A randomized controlled trial (RCT) of a language and communication intervention was used to evaluate the efficacy of vocabulary and narrative interventions to improve the vocabulary and narrative performance of adolescents (mean age = 12.8 years) with language disorder. The language and communication programmes (narrative, vocabulary and combined narrative and vocabulary) were delivered by TAs in the classroom, three times per week, for 45-60 min each, over 6 weeks, totalling 18 sessions. Standardized and intervention-specific measures were used as outcomes.

OUTCOMES & RESULTS

Twenty-one schools with 358 eligible participants were recruited. The three intervention groups showed significant improvements (d = .296) on a narrative latent variable defined by a standardized narrative assessment (the Expression, Reception and Recall of Narrative Instrument-ERRNI), but there were no significant improvements on an overall vocabulary latent variable compared with the waiting control group. Differential effects were found on some non-standardized intervention-specific measures with the narrative group making significantly more progress on narrative tasks compared with the waiting control group, the vocabulary group showing the same pattern on specific vocabulary tasks, and the combined narrative and vocabulary group making significantly more progress on some of the intervention-specific narrative, and all the intervention-specific vocabulary outcomes compared with the waiting control group.

CONCLUSIONS & IMPLICATIONS

It is possible to improve narrative but not vocabulary skills, as assessed by standardized measures, in secondary school students with a relatively brief group TA-delivered intervention. There were differential effects for both narrative and vocabulary with intervention-specific measures. Future work is required to explore whether more intensive and longer lasting interventions would be more effective and to identify which students in this age group are most likely to benefit from such interventions.

Academic Outcomes in Bilingual Children With Developmental Language Disorder: A Longitudinal Study

Previous studies have shown that most English-speaking children with language difficulties show academic difficulties during their schooling. The present study aimed to describe the academic achievement of children speaking Spanish and Catalan with developmental language disorder (DLD) during their primary education and to predict their academic outcomes using several processing skills assessed at the beginning of their schooling. To this end, we followed 28 children during their schooling (6–12 years of age). Participants were divided into two groups, one with DLD (n = 14) and a control group (n = 14) paired by age, gender, socio-economic status (SES), family language (L1), and classroom. All participants were assessed through different processing skills with the Spanish version of the NEPSY at the beginning of their schooling (age 6): attention (visual attention, auditory attention, and response set), phonological awareness, verbal short-term memory (sentence repetition, and narrative memory), access to language (semantic verbal fluency and rapid naming), and language comprehension (comprehension of verbal commands). At the end of primary education, schools reported the official academic marks at the 1st cycle (6–8 years), 2nd cycle (8–10 years) and 3rd cycle (10–12 years). Direct scores of the processing skills and academic results were used for statistical analyses. Results showed that children with DLD had more frequent grade retention, and their academic marks were significantly lower than those of their peers in all the cycles and for all academic subjects with a high language dependency (all except physical education and mathematics). Those subjects with lower language dependence did not show significant differences (physical education and mathematics). Rapid naming accounted for most of the variance of academic outcomes, followed by phonological awareness, and language comprehension when both groups were taken together. Only rapid naming accounted for academic results in the DLD group and phonological awareness did so for the control group. In sum, children with DLD experienced more academic difficulties during their primary education. Those children (with and without DLD) who experienced difficulties not only with rapid naming but also with phonological awareness and oral language comprehension at the beginning of their schooling showed a higher probability of academic failure.

Evidence-based pathways to intervention for children with language disorders

BACKGROUND

Paediatric speech and language therapist (SLT) roles often involve planning individualized intervention for specific children, working collaboratively with families and education staff, providing advice, training and coaching and raising awareness. A tiered approach to service delivery is currently recommended whereby services become increasingly specialized and individualized for children with greater needs.

AIMS

To stimulate discussion regarding delivery of SLT services by examining evidence regarding the effectiveness of (1) intervention for children with language disorders at different tiers and (2) SLT roles within these tiers; and to propose an evidence-based model of SLT service delivery and a flowchart to aid clinical decision-making.

METHODS & PROCEDURES

Meta-analyses and systematic reviews, together with controlled, peer-reviewed group studies where recent systematic reviews were not available, of interventions for children with language disorders are discussed, alongside the differing roles SLTs play in these interventions. Gaps in the evidence base are highlighted.

MAIN CONTRIBUTION

The service-delivery model presented resembles the tiered model commonly used in education services, but divides individualized (Tier 3) services into Tier 3A: indirect intervention delivered by non-SLTs, and Tier 3B: direct intervention by an SLT. We report evidence for intervention effectiveness, which children might best be served by each tier, the role SLTs could take within each tier and the effectiveness of these roles. Regarding universal interventions provided to all children (Tier 1) and those targeted at children with language weaknesses or vulnerabilities (Tier 2), there is growing evidence that approaches led by education services can be effective when staff are highly trained and well supported. There is currently limited evidence regarding additional benefit of SLT-specific roles at Tiers 1 and 2. With regard to individualized intervention (Tier 3), children with complex or pervasive language disorders can progress following direct individualized intervention (Tier 3B), whereas children with milder or less pervasive difficulties can make progress when intervention is managed by an SLT, but delivered indirectly by others (Tier 3A), provided they are well trained and supported, and closely monitored.

CONCLUSIONS & IMPLICATIONS

SLTs have a contribution to make at all tiers, but where prioritization for clinical services is a necessity, we need to establish the relative benefits and cost-effectiveness at each tier. Good evidence exists for SLTs delivering direct individualized intervention and we should ensure that this is available to children with pervasive and/or complex language disorders. In cases where service models are being provided which lack evidence, we strongly recommend that SLTs investigate the effectiveness of their approaches.

Evaluation of a parent-delivered early language enrichment programme: evidence from a randomised controlled trial

BACKGROUND

It is widely believed that increasing parental involvement can improve children's educational outcomes although we lack good evidence for such claims. This study evaluated the effectiveness of a parent-delivered early language enrichment programme.

METHODS

We conducted a randomised controlled trial (RCT) with 208 preschool children and their parents living in socially diverse areas in the United Kingdom. Families were allocated to an oral language programme (N = 103) or an active control programme targeting motor skills (N = 105). Parents delivered the programmes to their child at home in daily 20-min sessions over 30 weeks of teaching.

RESULTS

Children receiving the language programme made significantly larger gains in language (d = .21) and narrative skills (d = .36) than children receiving the motor skills programme at immediate posttest. Effects on language were maintained 6 months later (d = .34), and at this point, the language group also scored higher on tests of early literacy (d values=.35 and .42). There was no evidence that the movement programme improved motor skills.

CONCLUSIONS

This study provides evidence for the effectiveness of a parent-delivered language enrichment programme. Further large-scale evaluations of the programme are needed to confirm and extend these findings.

Commentary: So was it worth it? A commentary on Fricke et al. and Hagen et al. (2017)

Fricke et al. and Hagen et al. (2017) each report on large-scale pragmatic randomised controlled trials delivered in schools or nurseries, investigating language interventions for vulnerable children and showing moderate positive effect sizes. Such research is part of a recent development of 'what works' research in England, and the number of 'what works' trials continues to increase, largely through funding from the Sutton Trust, who are concerned with disadvantaged children, to the Educational Endowment Foundation (EEF). 'What works' research is not firmly accepted by all educationalists, however, results of trials are now available quickly and presented in a manner intended to be accessible to practitioners. This development may facilitate principled decisions on the adoption of interventions by schools, as trials and their outcomes may be interrogated to support decisions on whether the anticipated impact is worth the cost of implementation.