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Two-year outcomes of a population-based intervention for preschool language delay : an RCT

Wake, Melissa, Levickis, Penny, Tobin, Sherryn, Gold, Lisa, Ukoumunne, Obioha C., Goldfeld, Sharon, Zens, Naomy, Le, Ha N.D., Law, James and Reilly, Sheena 2015, Two-year outcomes of a population-based intervention for preschool language delay : an RCT, Pediatrics, vol. 136, no. 4, pp. e838-e847, doi: 10.1542/peds.2015-1337.

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Title Two-year outcomes of a population-based intervention for preschool language delay : an RCT
Author(s) Wake, Melissa
Levickis, Penny
Tobin, Sherryn
Gold, Lisa
Ukoumunne, Obioha C.
Goldfeld, Sharon
Zens, Naomy
Le, Ha N.D.
Law, James
Reilly, Sheena
Journal name Pediatrics
Volume number 136
Issue number 4
Start page e838
End page e847
Total pages 10
Publisher American Academy of Pediatrics
Place of publication Grove Village, Ill.
Publication date 2015-10
ISSN 1098-4275
Summary OBJECTIVE: We have previously shown short-term benefits to phonology, letter knowledge, and possibly expressive language from systematically ascertaining language delay at age 4 years followed by the Language for Learning intervention. Here, we report the trial's definitive 6-year outcomes. METHODS: Randomized trial nested in a population-based ascertainment. Children with language scores >1.25 SD below the mean at age 4 were randomized, with intervention children receiving 18 1-hour home-based therapy sessions. Primary outcome was receptive/expressive language. Secondary outcomes were phonological, receptive vocabulary, literacy, and narrative skills; parent-reported pragmatic language, behavior, and health-related quality of life; costs of intervention; and health service use. For intention-to-treat analyses, trial arms were compared using linear regression models. RESULTS: Of 1464 children assessed at age 4, 266 were eligible and 200 randomized; 90% and 82% of intervention and control children were retained respectively. By age 6, mean language scores had normalized, but there was little evidence of a treatment effect for receptive (adjusted mean difference 2.3; 95% confidence interval [CI] -1.2 to 5.7; P = .20) or expressive (0.8; 95% CI -1.6 to 3.2; P = .49) language. Of the secondary outcomes, only phonological awareness skills (effect size 0.36; 95% CI 0.08-0.65; P = .01) showed benefit. Costs were higher for intervention families (mean difference AU$4276; 95% CI: $3424 to $5128). CONCLUSIONS: Population-based intervention targeting 4-year-old language delay was feasible but did not have lasting impacts on language, possibly reflecting resolution in both groups. Long-term literacy benefits remain possible but must be weighed against its cost.
Language eng
DOI 10.1542/peds.2015-1337
Field of Research 111799 Public Health and Health Services not elsewhere classified
Socio Economic Objective 920299 Health and Support Services not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, American Academy of Pediatrics
Persistent URL http://hdl.handle.net/10536/DRO/DU:30079053

Document type: Journal Article
Collection: Population Health
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