In this section
7-15% of preschool children have language delay, so are vulnerable to poor lifelong academic, social and economic outcomes. Trials suggest that intervention helps, but these are mainly in children presenting to clinicians for care. It's still not known whether screening all preschoolers for language delay and offering treatment to all those detected leads to better outcomes, or at what cost.
Language for Learning aimed to find out the population costs and benefits of screening 4 year olds and then offering a one-on-one standardized intervention program in the community. It followed the Let's Read and Let's Learn
Language trials and involved many of the same children. Because we have studied the 1400 participants since infancy, the trial could also shed light on why some children respond better than others to treatment.
Language for Learning had 3 stages:
From March 2010-April 2011, the Language for Learning team assessed the language skills of over 1400 four-year old children. Around 900 children had previously taken part in Let's Learn Language and around 500 children had taken part in Let's Read. The assessments were
completed in the family's homes and the researchers had lots of fun meeting the children, their siblings, families, pets and favourite toys!
During the four year visit we assessed children's language in two main areas. "Expressive language" looks at how a child uses words to communicate with others. "Receptive language" looks at how much children can understand words and phrases that are of increasing length and
complexity. Of the 1464 children that we visited, we found that around 18% of children scored lower in expressive and/or receptive language than what we would expect for 4-year-olds. All of these families were invited into Stage 2.
200 children and their families were invited into Stage 2 of L4L, and 196 families agreed to take part. Of these, 97 families were allocated to the intervention group and 99 families were allocated to the control group. We followed up on all the children around the fifth and sixth
birthdays, to see how their language was developing down the track.
Children allocated to the intervention group were offered 20 one-to-one sessions in the family home. The therapy comprised 18 weekly therapy sessions in three 6-week blocks; the five-year-old assessment and an exit/feedback/planning session in the following month. The therapy sessions ended in December
2011. A majority of the parents reported that the therapy was very useful and would recommend it to a friend.
We received some great feedback from parents who took part in the intervention. For example:
A repeat language assessment was offered to all of the Language for
Learning families- both intervention and controls- around their child's fifth birthday. As of February 2012 we completed the last five year assessment. We had a great response to the visits, over 90% of the 200 families invited, took part in a five year assessment. Parents reported that they were pleased to receive written feedback about their child's performance after the assessment.
In March 2012, we got back in touch with all of the 196 families, to book in the final face-to-face language assessment around their child's sixth birthday. As of February 2013 we completed the last six year assessment. Again, we had fantastic involvement from families and were able to see 86% of the 200 invited families.
We are pleased about the results which show that children who received the intervention showed better scores at 5 and 6 years of age on phonological skills, i.e. children’s ability to hear the sounds that make up words, an important skill for learning to read and spell. While results did not show that children who received the intervention scored better on the language assessment (i.e. receptive and expressive language), it was promising that on average children in both the intervention and control groups continued to improve on their language scores to age 6 years.
We are excited to announce that we have received funding to complete a follow-up with all of the children who took part in Let’s
Learn Language, Let’s Read and Language
for Learning, as the children turn nine years old in 2015. For more details. See Language for Learning
Follow-Up 2015-2016 section below.
Dr Penny Levickis
Phone: 03 8341 6454
Professor Melissa Wake
We’re delighted that we now have funding from the Victorian Department of Education & Training to see the children again now that they are nine years old.
The last eight years have seen big changes in understanding how language develops. Researchers used to think that most pre-schoolers with language delay were late talkers as toddlers. Now we know that many of these children actually start talking at the usual age. Finding them and offering help could make for a better start to school. But at the moment, 4 year olds aren’t screened for low language, and there are no standard programs to help them. This could change if we could find an approach that helps.
The Language for Learning
Follow-Up study aims to find out:
This could help health and education professionals focus on the children who are most at risk of later problems.
In 2015 we will contact the 1400 families who took part in Let’s Learn Language, Let’s
Read and Language for Learning, as the children turn nine years old, and invite families into the Language for Learning Follow-Up. As part of the follow-up, we will complete a detailed language assessment with the children at their school. We will also ask the children, parents and classroom
teachers to complete a brief survey.
Victorian Department of Education & Training; and
Murdoch Childrens Research Institute
Wake M, Tobin S, Levickis P, Gold L, Ukoumunne OC, Zens N, Goldfeld S, Le H, Law J, Reilly S. Randomized trial of a population-based home-delivered intervention for preschool language delay. Pediatrics2013;132(4):e895-e904
Wake M, Levickis P, Tobin S, Zens N, Law J, Gold L, Ukoumunne OC, Goldfeld S, Le, HND, Skeat J, Reilly S. Improving outcomes of preschool language delay in the community: Protocol for the Language for
Learning randomised controlled trial. BMC Pediatrics, 2012;12:96(1-11)
The Centre for Community Child Health is a department of The Royal Children’s Hospital and a research group of Murdoch Childrens Research Institute.