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A Randomised Controlled Trial of the Effectiveness of Parent-Based Models of Language Intervention for 2- to 3-Year-Old Children with Speech, Language and Communication Needs (SLCN) in Areas of Social Disadvantage

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Title: A Randomised Controlled Trial of the Effectiveness of Parent-Based Models of Language Intervention for 2- to 3-Year-Old Children with Speech, Language and Communication Needs (SLCN) in Areas of Social Disadvantage
Language: English
Authors: Deborah Gibbard (ORCID 0000-0002-6252-8690), Sue Roulstone, Ngianga II Kandala (Shadrack), Lydia Morgan (ORCID 0000-0001-9011-8544), Sam Harding, Clare Smith, Chris Markham
Source: International Journal of Language & Communication Disorders. 2024 59(4):1517-1537.
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 21
Publication Date: 2024
Document Type: Journal Articles
Reports - Research
Descriptors: Toddlers, Delayed Speech, Language Acquisition, Speech Language Pathology, Disadvantaged Environment, Disadvantaged Youth, Communication Disorders, Language Impairments, Individual Needs, Intervention, Parent Participation
DOI: 10.1111/1460-6984.13016
ISSN: 1368-2822
1460-6984
Abstract: Background: Early language delay is exacerbated by social disadvantage. Factors such as parents' low levels of literacy, confidence and self-perception can affect the capacity to act on advice received, critical to empowerment. Methods used to achieve successful health outcomes in socially disadvantaged clinical populations may need enhancing. Aims: To compare the impact of standard parent-based intervention (PBI) to enhanced PBI for young children with speech, language and communication needs (SCLN) and their families living in more socially disadvantaged populations. Methods and Procedures: A multicentre clustered blind randomised controlled trial was used to compare the effect of parent-based group interventions to improve early language development with children (mean age 27.5 months) from more socially disadvantaged populations with an expressive vocabulary of 40 or less single words. Intervention sessions were delivered by a speech and language therapist, over a 20-week period. Participants received one of two interventions: (1) Standard Care - indirect group PBI - (PBI); (2) Enhanced Care: indirect group enhanced PBI - (EPBI). Both standardised and non-standardised measures were used as outcomes. Parent engagement in the intervention was captured through analysis of attendance and the Parent Activation Measure - Speech & Language Therapy (PAM-SLT) (Insignia Health, 2014). The PAM measures a person's knowledge, skills and confidence to manage their own health and well-being (NHS England, 2018). In this study, activation referred to parents' knowledge, skills and confidence to manage their child's language development. Outcomes and Results: One hundred fifty-five participants were randomised at baseline. Children in both groups made significant improvements in the outcome on MacArthur-Bates Communicative Development Inventories Sentence Length, from pre-intervention to post-intervention and 6 months post-intervention (p < 0.05). Changes in vocabulary and expressive language skills were more equivocal, showing wide variation in confidence intervals for both groups. Where parents attended at least one intervention session almost all effect sizes were in favour of the EPBI intervention. Parents' activation levels significantly increased for both groups (EPBI p < 0.001, PBI p = 0.003), with a moderate effect size in favour of EPBI (Hedges' G 0.37, confidence interval -0.02 to 0.76), although wide variation was found. Conclusions and Implications: This trial provides some evidence of facilitating the language development of children with SLCN from more socially disadvantaged areas through supporting caregivers. However, we found variation in outcomes; some children made excellent progress, whilst others did not. Further exploration of parent engagement and its relationship to child language outcomes will be valuable to understanding more about mechanisms of change in interventions that involve parents.
Abstractor: As Provided
Entry Date: 2024
Accession Number: EJ1431155
Database: ERIC
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  Data: A Randomised Controlled Trial of the Effectiveness of Parent-Based Models of Language Intervention for 2- to 3-Year-Old Children with Speech, Language and Communication Needs (SLCN) in Areas of Social Disadvantage
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Deborah+Gibbard%22&quot;&gt;Deborah Gibbard&lt;/searchLink&gt; (ORCID &lt;externalLink term=&quot;https://orcid.org/0000-0002-6252-8690&quot;&gt;0000-0002-6252-8690&lt;/externalLink&gt;)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Sue+Roulstone%22&quot;&gt;Sue Roulstone&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ngianga+II+Kandala+%28Shadrack%29%22&quot;&gt;Ngianga II Kandala (Shadrack)&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Lydia+Morgan%22&quot;&gt;Lydia Morgan&lt;/searchLink&gt; (ORCID &lt;externalLink term=&quot;https://orcid.org/0000-0001-9011-8544&quot;&gt;0000-0001-9011-8544&lt;/externalLink&gt;)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Sam+Harding%22&quot;&gt;Sam Harding&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Clare+Smith%22&quot;&gt;Clare Smith&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Chris+Markham%22&quot;&gt;Chris Markham&lt;/searchLink&gt;
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  Data: Wiley. Available from: John Wiley &amp; Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
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  Data: 10.1111/1460-6984.13016
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  Data: 1368-2822&lt;br /&gt;1460-6984
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  Data: Background: Early language delay is exacerbated by social disadvantage. Factors such as parents&#39; low levels of literacy, confidence and self-perception can affect the capacity to act on advice received, critical to empowerment. Methods used to achieve successful health outcomes in socially disadvantaged clinical populations may need enhancing. Aims: To compare the impact of standard parent-based intervention (PBI) to enhanced PBI for young children with speech, language and communication needs (SCLN) and their families living in more socially disadvantaged populations. Methods and Procedures: A multicentre clustered blind randomised controlled trial was used to compare the effect of parent-based group interventions to improve early language development with children (mean age 27.5 months) from more socially disadvantaged populations with an expressive vocabulary of 40 or less single words. Intervention sessions were delivered by a speech and language therapist, over a 20-week period. Participants received one of two interventions: (1) Standard Care - indirect group PBI - (PBI); (2) Enhanced Care: indirect group enhanced PBI - (EPBI). Both standardised and non-standardised measures were used as outcomes. Parent engagement in the intervention was captured through analysis of attendance and the Parent Activation Measure - Speech &amp; Language Therapy (PAM-SLT) (Insignia Health, 2014). The PAM measures a person&#39;s knowledge, skills and confidence to manage their own health and well-being (NHS England, 2018). In this study, activation referred to parents&#39; knowledge, skills and confidence to manage their child&#39;s language development. Outcomes and Results: One hundred fifty-five participants were randomised at baseline. Children in both groups made significant improvements in the outcome on MacArthur-Bates Communicative Development Inventories Sentence Length, from pre-intervention to post-intervention and 6 months post-intervention (p &lt; 0.05). Changes in vocabulary and expressive language skills were more equivocal, showing wide variation in confidence intervals for both groups. Where parents attended at least one intervention session almost all effect sizes were in favour of the EPBI intervention. Parents&#39; activation levels significantly increased for both groups (EPBI p &lt; 0.001, PBI p = 0.003), with a moderate effect size in favour of EPBI (Hedges&#39; G 0.37, confidence interval -0.02 to 0.76), although wide variation was found. Conclusions and Implications: This trial provides some evidence of facilitating the language development of children with SLCN from more socially disadvantaged areas through supporting caregivers. However, we found variation in outcomes; some children made excellent progress, whilst others did not. Further exploration of parent engagement and its relationship to child language outcomes will be valuable to understanding more about mechanisms of change in interventions that involve parents.
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