How much of a long-term impact does parent-implemented speech–language therapy have on late talkers? That’s an important question. Most studies have focused on short- or medium-term outcomes and have not looked into long-term follow-up results.
These researchers wanted to know the medium- and long-term effects of a low-dosage parent program for late talkers. To do this, they provided the Hanen’s Target Word program to 30 parents of 24-month-old late talkers, and followed a different set of 30 parents–child pairs that did not receive the program. The program included five group sessions and two individual video-feedback sessions over the span of three months. They then tested parents’ use of the strategies at 36 months, and language skills at 36 and 48 months.
They found that the program accelerated the vocabulary growth for the late talkers, but by age 4, there were no longer any differences between the two groups’ expressive vocabularies and both had reached age-appropriate scores. Both groups, however, continued to fall behind their peers in syntax and grammar.
The parents who participated in the study followed their child’s lead more and put less communicative pressure on their child; however, the parents did not significantly improve in how often they responded to their child’s communication or in how much linguistic stimulation they provided their child. Through analysis, the researchers found the strategy of reducing communicative pressure to be specifically associated with children’s language growth.
Here are some important considerations and takeaways from the study:
Null long-term results don’t mean that the intervention wasn’t worthwhile. As we know, increasing two year olds’ vocabularies can help ease the frustration of not being able to communicate which is an important goal of early intervention.
Dosage and coaching style play an important role in treatment outcomes. The authors discuss how the parent results of this study differed sharply from the Roberts and Kaiser (2015) study in which the researchers taught parents Enhanced Milieu Teaching (EMT) strategies, and parents were able to learn all of them. One of the reasons why is that the intervention dosage was much higher for the EMT study (four workshops and 24 hour-long sessions, compared to two), giving parents more opportunity for practice and feedback. Adjusting the dosage or coaching style of the Target Word program may be one option for increasing its long-term effectiveness.
Reducing communicative pressure may be an especially important strategy for parents. This is a simple strategy to teach parents, and these results demonstrate how powerful it can be for supporting language growth in toddlers.
Ongoing monitoring is important for late-talkers. Nearly one third of the children who participated still had language scores below the normal range at four years of age, but fewer than half of those children received speech–language therapy after the study. Monitoring is important to ensure that these children don’t fall through the cracks when language demands as they grow older.
One final note: this isn’t a replication study of Hanen’s Target Word program, but rather it’s a study that tested its effectiveness in real-world contexts. That’s awesome for two reasons: (1) authors aren’t tied to Hanen, which helps eliminate bias, and (2) real-world contexts = more like what we SLPs face = more clinically applicable!
Want more? These authors also published a study of Hanen’s Target Word program (so popular!) This retrospective study (looking back at client charts) similarly showed gains in communicative participation and vocabulary for children who participated in the program.
Kruythoff-Broekman, A., Wiefferink, C., Rieffe, C., Uilenburg, N. (2019). Parent-implemented early language intervention programme for late talkers: parental communicative behaviour change and child language outcomes at 3 and 4 years of age. International Journal of Language & Communication Disorders. doi: 10.1111/1460-6984.12451