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Improving outcomes of preschool language delay in the community : protocol for the Language for Learning randomised controlled trial

Wake, Melissa, Levickis, Penny, Tobin, Sherryn, Zens, Naomi, Law, James, Gold, Lisa, Ukoumunne, Obioha C., Goldfeld, Sharon, Le, Ha ND, Skeat, Jemma and Reilly, Sheena 2012, Improving outcomes of preschool language delay in the community : protocol for the Language for Learning randomised controlled trial, BMC Pediatrics, vol. 12, no. 96, pp. 1-11.

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Title Improving outcomes of preschool language delay in the community : protocol for the Language for Learning randomised controlled trial
Author(s) Wake, Melissa
Levickis, Penny
Tobin, Sherryn
Zens, Naomi
Law, James
Gold, Lisa
Ukoumunne, Obioha C.
Goldfeld, Sharon
Le, Ha ND
Skeat, Jemma
Reilly, Sheena
Journal name BMC Pediatrics
Volume number 12
Issue number 96
Start page 1
End page 11
Total pages 11
Publisher BioMed Central
Place of publication London, England
Publication date 2012-07
ISSN 1471-2431
Keyword(s) Language development
Population characteristics
Randomized controlled trial
Child development
Outcome assessment
Early intervention
Language development disorders
Mass screening
Summary Background

Early language delay is a high-prevalence condition of concern to parents and professionals. It may result in lifelong deficits not only in language function, but also in social, emotional/behavioural, academic and economic well-being. Such delays can lead to considerable costs to the individual, the family and to society more widely. The Language for Learning trial tests a population-based intervention in 4 year olds with measured language delay, to determine (1) if it improves language and associated outcomes at ages 5 and 6 years and (2) its cost-effectiveness for families and the health care system.

Methods/Design

A large-scale randomised trial of a year-long intervention targeting preschoolers with language delay, nested within a well-documented, prospective, population-based cohort of 1464 children in Melbourne, Australia. All children received a 1.25-1.5 hour formal language assessment at their 4th birthday. The 200 children with expressive and/or receptive language scores more than 1.25 standard deviations below the mean were randomised into intervention or ‘usual care’ control arms. The 20-session intervention program comprises 18 one-hour home-based therapeutic sessions in three 6-week blocks, an outcome assessment, and a final feed-back/forward planning session. The therapy utilises a ‘step up-step down’ therapeutic approach depending on the child’s language profile, severity and progress, with standardised, manualised activities covering the four language development domains of: vocabulary and grammar; narrative skills; comprehension monitoring; and phonological awareness/pre-literacy skills. Blinded follow-up assessments at ages 5 and 6 years measure the primary outcome of receptive and expressive language, and secondary outcomes of vocabulary, narrative, and phonological skills.

Discussion

A key strength of this robust study is the implementation of a therapeutic framework that provides a standardised yet tailored approach for each child, with a focus on specific language domains known to be associated with later language and literacy. The trial responds to identified evidence gaps, has outcomes of direct relevance to families and the community, includes a well-developed economic analysis, and has the potential to improve long-term consequences of early language delay within a public health framework.
Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Language eng
Field of Research 111403 Paediatrics
Socio Economic Objective 920501 Child Health
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2012 Wake et al.
Persistent URL http://hdl.handle.net/10536/DRO/DU:30046186

Document type: Journal Article
Collections: Population Health
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.