Randomized trial of a population-based, home-delivered intervention for preschool language delay

Wake, Melissa, Tobin, Sherryn, Levickis, Penny, Gold, Lisa, Ukoumunne, Obioha C., Zens, Naomi, Goldfeld, Sharon, Le, Ha, Law, James and Reilly, Sheena 2013, Randomized trial of a population-based, home-delivered intervention for preschool language delay, Pediatrics : official journal of the American academy of pediatrics, vol. 132, no. 4, pp. e895-e905.

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Title Randomized trial of a population-based, home-delivered intervention for preschool language delay
Author(s) Wake, Melissa
Tobin, Sherryn
Levickis, Penny
Gold, Lisa
Ukoumunne, Obioha C.
Zens, Naomi
Goldfeld, Sharon
Le, Ha
Law, James
Reilly, Sheena
Journal name Pediatrics : official journal of the American academy of pediatrics
Volume number 132
Issue number 4
Start page e895
End page e905
Total pages 11
Publisher American Academy for Pediatrics
Place of publication Grove Village, Illinois
Publication date 2013-10
ISSN 0031-4005
1098-4275
Keyword(s) language
early intervention
randomised controlled trial
health services
child development
Summary OBJECTIVE
Population approaches to lessen the adverse impacts of preschool language delay remain elusive. We aimed to determine whether systematic ascertainment of language delay at age 4 years, followed by a 10-month, 1-on-1 intervention, improves language and related outcomes at age 5 years.

METHODS:
A randomized trial nested within a cross-sectional ascertainment of language delay. Children with expressive and/or receptive language scores more than 1.25 SD below the mean at age 4 years entered the trial. Children randomly allocated to the intervention received 18 1-hour home-based therapy sessions. The primary outcomes were receptive and expressive language (Clinical Evaluation of Language Fundamentals – Preschool, 2nd Edition) and secondary outcomes were child phonological skills, letter awareness, pragmatic skills, behavior, and quality of life.

RESULTS:
A total of 1464 children were assessed for language delay at age 4 years. Of 266 eligible children, 200 (13.6%) entered the trial, with 91 intervention (92% of 99) and 88 control (87% of 101) children retained at age 5 years. At age 5 years, there was weak evidence of benefit to expressive (adjusted mean difference, intervention − control, 2.0; 95% confidence interval [CI] −0.5 to 4.4; P = .12) but not receptive (0.6; 95% CI −2.5 to 3.8; P = .69) language. The intervention improved phonological awareness skills (5.0; 95% CI 2.2 to 7.8; P < .001) and letter knowledge (2.4; 95% CI 0.3 to 4.5; P = .03), but not other secondary outcomes.

CONCLUSIONS:
A standardized yet flexible 18-session language intervention was successfully delivered by non-specialist staff, found to be acceptable and feasible, and has the potential to improve long-term consequences of early language delay within a public health framework.
Language eng
Field of Research 111403 Paediatrics
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2013, American Academy for Pediatrics
Persistent URL http://hdl.handle.net/10536/DRO/DU:30060669

Document type: Journal Article
Collection: Population Health
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