Effects in language development of young children with language delay during early intervention.

INTRODUCTION: In the Netherlands, early language intervention is offered to young children with Language Delay (LD). The intervention combines groupwise language intervention, individual speech and language therapy and parent-implemented language intervention. This study tests the hypothesis that children with LD show progress in their receptive and expressive language during intervention. Differences in language progress between age groups (< 36 months and ≥ 36 months at intervention start) were expected in favour of the younger group, which might be due to an earlier intervention start, a longer treatment duration or the potential presence of late talkers. METHODS: The study included 183 children with LD (45 children < 3 years of age at intervention start; mean age 32 months, 138 children ≥ 3 years; mean age 40 months). Receptive and expressive language was assessed with norm-referenced tests at intervention start and ending using Routine Outcome Monitoring. A repeated measures MANOVA was carried out to examine language progress and to compare the age groups on receptive syntax, receptive vocabulary, expressive syntax and expressive vocabulary. The Reliable Change Index was used to study individual progress. RESULTS: On average, children in both age groups showed significant improvement in all four language domains. The younger children showed more language progress than the older children in all four domains. When examining individual progress, most of the children displayed reliable improvement for expressive vocabulary. Most children developed in the same pace as their typically developing peers for receptive syntax, receptive vocabulary, and expressive syntax. CONCLUSIONS: Children stabilized or even improved language proficiency during the intervention, indicating that the language gap between these children and typically developing children did not widen further. Younger children displayed more language progress than older children in all four domains, but it is unclear what might explain this difference.

Language development and behaviour problems in toddlers indicated to have a developmental language disorder.

BACKGROUND: There is empirical evidence that a developmental language disorder (DLD) in early childhood leads to behaviour problems. However, it is still not clear how changes in language proficiency in these children influence the presence of behaviour problems. AIMS: The aim of this study is to examine if changes in language proficiency are related to changes in behaviour problems in toddlers indicated to have DLD. METHODS & PROCEDURES: This study included 185 toddlers indicated to have DLD (mean age 38 months at pretest). Scores on receptive and expressive language domains and internalizing and externalizing behaviour were gathered on Wave 1 and Wave 2 using Routine Outcome Monitoring. The Reliable Change Index was used to categorize children into two groups: children improving in receptive and expressive language domains and children not improving. OUTCOMES & RESULTS: For receptive syntax, receptive vocabulary and expressive syntax, 30% or less of the children improved. Only for expressive vocabulary, most children improved (63%). Behaviour problems were present in 17% (internalizing) and 23% (externalizing) of the children. Changes in language proficiency did not lead to changes in internalizing or externalizing behaviour problems, not for the total sample, nor for children displaying behaviour problems at Wave 1. CONCLUSIONS & IMPLICATIONS: Professionals working with toddlers indicated to have DLD need to be aware of the co-occurrence of language problems and behaviour problems, and have to realize that behaviour problems might not immediately decrease when language proficiency improves. If behaviour problems are present in toddlers indicated to have DLD, interventions should not only focus on language, but also on behaviour problems. WHAT THIS PAPER ADDS: What is already known on the subject There is empirical evidence that a developmental language disorder (DLD) in early childhood leads to behaviour problems. However, it is still not clear how changes in language proficiency in children with DLD influence the presence of behaviour problems. What this paper adds to existing knowledge This study addresses if a change in language proficiency is related to changes in child behaviour problems in toddlers indicated to have DLD. The results of our study showed that most of the children did not show a positive reliable change in receptive syntax, receptive vocabulary and expressive syntax at this young age, but most of the children did in expressive vocabulary. Furthermore, changes in language proficiency did not lead to changes in the presence of internalizing or externalizing behaviour problems. What are the potential or actual clinical implications of this work? Therefore, professionals working with toddlers indicated to have DLD should be aware of the co-occurrence of language problems and behaviour problems, and have to realize that behaviour problems might not decrease as a result of improved language proficiency. If behaviour problems are present and need to be treated, other interventions, apart from the language intervention, might be necessary.

Association of language, behavior, and parental stress in young children with a language disorder.

BACKGROUND: Several studies show that language problems, child behavior problems, and parental stress can co-occur in children. Still, little is known about how these domains are related in toddlers with a language disorder (LD). AIMS: This study examined relations between language problems, child behaviour problems, and parental stress in toddlers with LD and if these relations differ for children with different types of LD. METHOD: Data of 185 children with LD (mean age 38 months) were collected using Routine Outcome Monitoring. Children were divided into two groups: presence of receptive and expressive problems (REP) and expressive problems only (EP). Relations were analyzed using Structural Equation Modeling. RESULTS: A better receptive language was associated with less teacher-reported internalizing and externalizing problems. A better expressive vocabulary was associated with more parent-reported internalizing problems and more teacher-reported externalizing problems. No relation was found between language and parental stress. Associations between language, behavior, and parental stress did not differ for children with REP or children with EP. CONCLUSIONS: Our study shows that when specific language domains are examined, the pattern of associations between language and behavior becomes more complex, because relations exist between specific language domains and behavior, but not between all of them.

Family counseling in the Netherlands for Turkish-origin parents of deaf children with a cochlear implant.

Cultural elements such as language, beliefs about health, and family context play important roles in the uptake of rehabilitation and treatment of deafness. Because of cultural issues, minority groups often do not receive optimal care. Focusing on the Netherlands, the researchers explored how the rehabilitation and counseling of deaf children of Turkish-origin parents can be improved. The most important findings were that (a) most parents initially did not believe their child was deaf and regretted later that they did not start hearing rehabilitation earlier; (b) parents had little confidence in the Dutch health care system and sought a second opinion from a medical doctor of their own national origin; (c) parents did not know how to be actively involved in the care of their deaf child. Implications for practice aimed at improving rehabilitation and counseling for these children are described.