Intervention to tackle language delay in preschoolers ineffective; researchers

Approximately eight per cent of preschool children have a delay in their language development that persists throughout the school years and into adulthood. Persistent language delay is associated with poorer school and academic performance, more limited employment opportunities, and difficulties with social interactions and relationships.

But experts differ as to the solution. Should we try to detect language delay very early, when intervention could still change a child's course for the better? Or should we give children time to 'grow out of it', and offer intervention later? Answering this question would help policymakers know where to spend their money most effectively.

In a trial published in the British Medical Journal, Murdoch Childrens Research Institute researchers have tackled this thorny question. They found that a parent language-promotion group program for slow-to-talk 18 month old toddlers didn't improve their language skills or behaviour. But most importantly, almost all the children had normal language by the age of 3 years - whether they received the intervention or not.

To be sure the trial was relevant to children in the general community, the researchers screened over a thousand healthy Melbourne 18 month olds to find those who were saying few or no spoken words, so were considered to be 'at risk' for language delay. These 300 toddlers then took part in the trial. Half of them attended a parent language promotion group for two hours a week over 6 weeks, while for the others it was business as usual.

Despite the fact parents rated the sessions highly, the program had little impact on improving vocabulary, language or behavioural outcomes for toddlers and preschoolers, either immediately or at age three.

Lead author Professor Melissa Wake said the trial has two major implications. Firstly, it should reassure parents whose toddlers aren't talking by age 18 months, that unless there are other development concerns, a 'wait and see' approach is likely to be best for most children.

Secondly, it answers a major question as to when and whether countries screen for language delay, a subject for which she says stronger evidence is sorely needed.

"Studies with both positive and null findings need to be considered in making informed decisions about the effectiveness of prevention strategies, particularly given the public pressure to respond earlier to a range of language concerns in young children," she said.

"This study shows the wisdom of rigorous trials not only to get the right answer but to avert the considerable waste of governments' and families' resources that may otherwise occur.

"It's clear that very early screening, under the age of 2 years, for spoken vocabulary isn't going to solve childhood language delay. But it's such an important problem that we need to look at all the options for older children - and research them properly."