Melissa Wake1, Penny Levickis2, Sherryn Tobin2, Lisa Gold3, Obioha C Ukoumunne4, Sharon Goldfeld5, Naomi Zens2, Ha N D Le3, James Law6, Sheena Reilly7. 1. Centre for Community Child Health, Royal Children's Hospital, Parkville, Melbourne, Australia; Murdoch Childrens Research Institute, Parkville, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Australia; melissa.wake@rch.org.au. 2. Centre for Community Child Health, Royal Children's Hospital, Parkville, Melbourne, Australia; Murdoch Childrens Research Institute, Parkville, Melbourne, Australia; 3. Deakin Health Economics, Deakin University, Burwood, Australia; 4. National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, South West Peninsula (PenCLAHRC), University of Exeter Medical School, University of Exeter, Exeter, United Kingdom; and. 5. Centre for Community Child Health, Royal Children's Hospital, Parkville, Melbourne, Australia; Murdoch Childrens Research Institute, Parkville, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Australia; 6. Institute of Health and Society, School of Education, Communication and Language Sciences, University of Newcastle, United Kingdom. 7. Murdoch Childrens Research Institute, Parkville, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Australia;
Abstract
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.
RCT Entities:
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.
Authors: Kristine M Jensen de López; Jelena Kuvač Kraljević; Emilie L Bang Struntze Journal: Int J Lang Commun Disord Date: 2022-04-20 Impact factor: 2.909
Authors: Sara Rinaldi; Maria Cristina Caselli; Valentina Cofelice; Simonetta D'Amico; Anna Giulia De Cagno; Giuseppina Della Corte; Maria Valeria Di Martino; Brigida Di Costanzo; Maria Chiara Levorato; Roberta Penge; Tiziana Rossetto; Alessandra Sansavini; Simona Vecchi; Pierluigi Zoccolotti Journal: Brain Sci Date: 2021-03-23