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Rosemary Greenwood - One of the best experts on this subject based on the ideXlab platform.
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twins as a natural experiment to study the causes of mild Language Delay i design twin singleton differences in Language and obstetric risks
Journal of Child Psychology and Psychiatry, 2003Co-Authors: Michael Rutter, Karen Thorpe, Kate Northstone, Rosemary Greenwood, Jean GoldingAbstract:Background: Twins tend to lag behind singletons in their Language development, but the causes were unknown. The possibilities suggested include obstetric complications, twin-specific features, and postnatal differences in family interaction. The present study was designed to pit these alternatives against one another as possible causal influences. Method: The Avon Longitudinal Study of Parents and Children (ALSPAC) was used to identify the 116 twin pairs (of whom 96 participated) and 114 pairs of singletons (of whom 98 participated) whose ages were no more than 30 months apart. The McArthur Communicative Development Inventory was completed at 20 months, and the Pre-School Language Scales (PLS-3), and the McCarthy Scales of Children’s Abilities at 36 months. Obstetric and perinatal complications were assessed on the basis of detailed systematic parental reports, together with a systematic coded abstraction of all medical records dealing with pregnancy and the neonatal period. Family background details were assessed from parental reports, and the primary carer’s verbal functioning was assessed by the Mill Hill Vocabulary Scale. Congenital anomalies were assessed using the method of Waldrop and Halverson. Results: The Language of twins was 1.7 months below that of singletons at 20 months and 3.1 months at 3 years. The verbal cognitive score of twins was about half a standard deviation lower than that of singletons. The twin‐singleton differences in Language level were found to be unassociated with obstetric/perinatal features as assessed from both parental reports and medical records, to birthweight or gestation, to birthweight discrepancy within the twin pair, or to congenital anomalies. Conclusions: It is concluded that obstetric/perinatal features do not account for the slower Language development in twins as compared with singletons, within a sample born after at least 33 weeks gestation. Keywords: Twins, singletons, Language Delay, obstetric/perinatal complications, congenital anomalies. It has long been known that, compared with singletons, twins are on average Delayed in their Language development by some 3 months during the first 3 years of life (Rutter & Redshaw, 1991) and that this verbal deficit seems to persist to some degree through the primary school years at least. There are three rather separate reasons for seeking to understand the causes of this Language disparity between twins and singletons. First, there is a need to understand the challenges faced by twins in their psychological development. Being slow in Language development is a common cause of concern among the parents of twins and is a frequent cause of referral to developmental clinics of one kind or another. At present, we know very little about
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twins as a natural experiment to study the causes of mild Language Delay ii family interaction risk factors
Journal of Child Psychology and Psychiatry, 2003Co-Authors: Karen Thorpe, Michael Rutter, Rosemary GreenwoodAbstract:Background: Twins tend to lag behind singletons in their Language development, but the causes were unknown. Method: Ninety-six twin pairs from the Avon Longitudinal Study of Parents and Children (ALSPAC), for whom birth was after at least 33 weeks of gestation, were compared with 98 pairs of singletons, no more than 30 months apart in age. Parental qualities and family interaction were assessed through standardised questionnaires and interviews and both structured and unstructured observations in the home at 20 months and 36 months. The possible causal role of postnatal family influences was assessed through five criteria: i) the feature had to differ between twins and singletons; ii) individual differences in that feature had to relate to individual differences in Language level within the sample of singletons and of twins; iii) the feature as measured at 20 months had to predict Language as assessed at 36 months; iv) that had to apply after controlling for Language level at 20 months; and v) introduction of the predictive feature into an overall model had to obliterate the twin‐singleton difference in Language level. Results: Patterns of parent‐child interaction and communication met these five criteria. The maternal factors all concerned aspects of interaction that were broadly concerned with communication: encouraging the child to speak, providing elaborating comments, engaging in reading to the child and talking about the story and its illustrations. The HOME inventory findings provided similar findings with respect to responsiveness, involvement and level of experiences involved. Family features that might have been influential, but which were not, included parental depression, breastfeeding, family size, and style of sibling interaction. Conclusion: Patterns of parent‐child interaction and communication within the normal range have environmentally mediated effects on Language and account for twin‐singleton differences in Language developmently. The results indicate the value of a natural experiment in testing competing causal hypotheses, and show the role of environmental factors as influences on Language variations within the normal range, for both twins and singletons. Keywords: Twins, singletons, parent‐child interaction, parent‐child communication, Language Delay, parental depression, breastfeeding, family size, sibling interaction, natural experiment. Twins provide a different parenting task from that presented by singletons (Rutter & Redshaw, 1991). Moreover, the family constellation, with two young children at the same developmental stage, also provides a different Language environment that could have implications for the communicative development of the children. The burden on parents during the infancy period is clearly greater ‐ not only because there are two babies to look after, but also because their feeding and sleeping patterns are quite likely not to coincide. It is not surprising, therefore, that the mothers of twins have been found to have higher rates of depression than the mothers of sin
James Law - One of the best experts on this subject based on the ideXlab platform.
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two year outcomes of a population based intervention for preschool Language Delay an rct
Pediatrics, 2015Co-Authors: Melissa Wake, James Law, Sherryn Tobin, Penny Levickis, Lisa Gold, Obioha C Ukoumunne, Naomi Zens, Sharon Goldfeld, Sheena ReillyAbstract: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.
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randomized trial of a population based home delivered intervention for preschool Language Delay
Pediatrics, 2013Co-Authors: Melissa Wake, Sherryn Tobin, Penny Levickis, Lisa Gold, Obioha C Ukoumunne, Naomi Zens, Sharon Goldfeld, James LawAbstract:OBJECTIVE: Population approaches to lessen the adverse impacts of preschool Language Delay remain elusive. We aimed to determine whether systematic ascertainment of Language Delay at age 4 years, followed by a 10-month, 1-on-1 intervention, improves Language and related outcomes at age 5 years. METHODS: A randomized trial nested within a cross-sectional ascertainment of Language Delay. Children with expressive and/or receptive Language scores more than 1.25 SD below the mean at age 4 years entered the trial. Children randomly allocated to the intervention received 18 1-hour home-based therapy sessions. The primary outcomes were receptive and expressive Language (Clinical Evaluation of Language Fundamentals – Preschool, 2nd Edition) and secondary outcomes were child phonological skills, letter awareness, pragmatic skills, behavior, and quality of life. RESULTS: A total of 1464 children were assessed for Language Delay at age 4 years. Of 266 eligible children, 200 (13.6%) entered the trial, with 91 intervention (92% of 99) and 88 control (87% of 101) children retained at age 5 years. At age 5 years, there was weak evidence of benefit to expressive (adjusted mean difference, intervention − control, 2.0; 95% confidence interval [CI] −0.5 to 4.4; P = .12) but not receptive (0.6; 95% CI −2.5 to 3.8; P = .69) Language. The intervention improved phonological awareness skills (5.0; 95% CI 2.2 to 7.8; P < .001) and letter knowledge (2.4; 95% CI 0.3 to 4.5; P = .03), but not other secondary outcomes. CONCLUSIONS: A standardized yet flexible 18-session Language intervention was successfully delivered by non-specialist staff, found to be acceptable and feasible, and has the potential to improve long-term consequences of early Language Delay within a public health framework. * Abbreviations: CELF-P2 — : Clinical Evaluation of Language Fundamentals – Preschool, 2nd Edition CI — : confidence interval LGA — : local government area
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improving outcomes of preschool Language Delay in the community protocol for the Language for learning randomised controlled trial
BMC Pediatrics, 2012Co-Authors: James Law, Melissa Wake, Sherryn Tobin, Penny Levickis, Lisa Gold, Naomi Zens, Obioha C UkoumunneAbstract:Background: Early Language Delay is a high-prevalence condition of concern to parents and professionals. It may result in lifelong deficits not only in Language function, but also in social, emotional/behavioural, academic and economic well-being. Such Delays can lead to considerable costs to the individual, the family and to society more widely. The Language for Learning trial tests a population-based intervention in 4 year olds with measured Language Delay, to determine (1) if it improves Language and associated outcomes at ages 5 and 6 years and (2) its cost-effectiveness for families and the health care system. Methods/Design: A large-scale randomised trial of a year-long intervention targeting preschoolers with Language Delay, nested within a well-documented, prospective, population-based cohort of 1464 children in Melbourne, Australia. All children received a 1.25-1.5 hour formal Language assessment at their 4 th birthday. The 200 children with expressive and/or receptive Language scores more than 1.25 standard deviations below the mean were randomised into intervention or ‘usual care’ control arms. The 20-session intervention program comprises 18 one-hour home-based therapeutic sessions in three 6-week blocks, an outcome assessment, and a final feed-back/forward planning session. The therapy utilises a ‘step up-step down’ therapeutic approach depending on the child’s Language profile, severity and progress, with standardised, manualised activities covering the four Language development domains of: vocabulary and grammar; narrative skills; comprehension monitoring; and phonological awareness/pre-literacy skills. Blinded follow-up assessments at ages 5 and 6 years measure the primary outcome of receptive and expressive Language, and secondary outcomes of vocabulary, narrative, and phonological skills. Discussion: A key strength of this robust study is the implementation of a therapeutic framework that provides a standardised yet tailored approach for each child, with a focus on specific Language domains known to be associated with later Language and literacy. The trial responds to identified evidence gaps, has outcomes of direct relevance to families and the community, includes a well-developed economic analysis, and has the potential to improve long-term consequences of early Language Delay within a public health framework.
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speech and Language therapy interventions for children with primary speech and Language Delay or disorder
Cochrane Database of Systematic Reviews, 2003Co-Authors: James Law, Zoe Garrett, Chad NyeAbstract:Primary speech and Language Delay/disorder is a common developmental difficulty which, if unresolved, can cause difficulties of both learning and socialisation lasting into adolescence and beyond. This review examines the effectiveness of speech and Language therapy interventions for children with primary speech and Language Delay/disorder. The review concludes that whilst there may be some support for the effectiveness of speech and Language therapy for children with expressive phonological and expressive vocabulary difficulties, the evidence concerning the effectiveness of interventions for expressive syntax is mixed, and no evidence is available concerning interventions for children with receptive Language difficulties.
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prevalence and natural history of primary speech and Language Delay findings from a systematic review of the literature
International Journal of Language & Communication Disorders, 2000Co-Authors: James Law, James Boyle, Frances Harris, Avril Harkness, Chad NyeAbstract:The prevalence and the natural history of primary speech and Language Delays were two of four domains covered in a systematic review of the literature related to screening for speech and Language Delay carried out for the NHS in the UK. The structure and process of the full literature review is introduced and criteria for inclusion in the two domains are specified. The resulting data set gave 16 prevalence estimates generated from 21 publications and 12 natural history studies generated from 18 publications. Results are summarized for six subdivisions of primary speech and Language Delays: (1) speech and/or Language, (2) Language only, (3) speech only, (4) expression with comprehension, (5) expression only and (6) comprehension only. Combination of the data suggests that both concurrent and predictive case definition can be problematic. Prediction improves if Language is taken independently of speech and if expressive and receptive Language are taken together. The results are discussed in terms of the need to develop a model of prevalence based on risk of subsequent difficulties.
Michael Rutter - One of the best experts on this subject based on the ideXlab platform.
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twins as a natural experiment to study the causes of mild Language Delay i design twin singleton differences in Language and obstetric risks
Journal of Child Psychology and Psychiatry, 2003Co-Authors: Michael Rutter, Karen Thorpe, Kate Northstone, Rosemary Greenwood, Jean GoldingAbstract:Background: Twins tend to lag behind singletons in their Language development, but the causes were unknown. The possibilities suggested include obstetric complications, twin-specific features, and postnatal differences in family interaction. The present study was designed to pit these alternatives against one another as possible causal influences. Method: The Avon Longitudinal Study of Parents and Children (ALSPAC) was used to identify the 116 twin pairs (of whom 96 participated) and 114 pairs of singletons (of whom 98 participated) whose ages were no more than 30 months apart. The McArthur Communicative Development Inventory was completed at 20 months, and the Pre-School Language Scales (PLS-3), and the McCarthy Scales of Children’s Abilities at 36 months. Obstetric and perinatal complications were assessed on the basis of detailed systematic parental reports, together with a systematic coded abstraction of all medical records dealing with pregnancy and the neonatal period. Family background details were assessed from parental reports, and the primary carer’s verbal functioning was assessed by the Mill Hill Vocabulary Scale. Congenital anomalies were assessed using the method of Waldrop and Halverson. Results: The Language of twins was 1.7 months below that of singletons at 20 months and 3.1 months at 3 years. The verbal cognitive score of twins was about half a standard deviation lower than that of singletons. The twin‐singleton differences in Language level were found to be unassociated with obstetric/perinatal features as assessed from both parental reports and medical records, to birthweight or gestation, to birthweight discrepancy within the twin pair, or to congenital anomalies. Conclusions: It is concluded that obstetric/perinatal features do not account for the slower Language development in twins as compared with singletons, within a sample born after at least 33 weeks gestation. Keywords: Twins, singletons, Language Delay, obstetric/perinatal complications, congenital anomalies. It has long been known that, compared with singletons, twins are on average Delayed in their Language development by some 3 months during the first 3 years of life (Rutter & Redshaw, 1991) and that this verbal deficit seems to persist to some degree through the primary school years at least. There are three rather separate reasons for seeking to understand the causes of this Language disparity between twins and singletons. First, there is a need to understand the challenges faced by twins in their psychological development. Being slow in Language development is a common cause of concern among the parents of twins and is a frequent cause of referral to developmental clinics of one kind or another. At present, we know very little about
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twins as a natural experiment to study the causes of mild Language Delay ii family interaction risk factors
Journal of Child Psychology and Psychiatry, 2003Co-Authors: Karen Thorpe, Michael Rutter, Rosemary GreenwoodAbstract:Background: Twins tend to lag behind singletons in their Language development, but the causes were unknown. Method: Ninety-six twin pairs from the Avon Longitudinal Study of Parents and Children (ALSPAC), for whom birth was after at least 33 weeks of gestation, were compared with 98 pairs of singletons, no more than 30 months apart in age. Parental qualities and family interaction were assessed through standardised questionnaires and interviews and both structured and unstructured observations in the home at 20 months and 36 months. The possible causal role of postnatal family influences was assessed through five criteria: i) the feature had to differ between twins and singletons; ii) individual differences in that feature had to relate to individual differences in Language level within the sample of singletons and of twins; iii) the feature as measured at 20 months had to predict Language as assessed at 36 months; iv) that had to apply after controlling for Language level at 20 months; and v) introduction of the predictive feature into an overall model had to obliterate the twin‐singleton difference in Language level. Results: Patterns of parent‐child interaction and communication met these five criteria. The maternal factors all concerned aspects of interaction that were broadly concerned with communication: encouraging the child to speak, providing elaborating comments, engaging in reading to the child and talking about the story and its illustrations. The HOME inventory findings provided similar findings with respect to responsiveness, involvement and level of experiences involved. Family features that might have been influential, but which were not, included parental depression, breastfeeding, family size, and style of sibling interaction. Conclusion: Patterns of parent‐child interaction and communication within the normal range have environmentally mediated effects on Language and account for twin‐singleton differences in Language developmently. The results indicate the value of a natural experiment in testing competing causal hypotheses, and show the role of environmental factors as influences on Language variations within the normal range, for both twins and singletons. Keywords: Twins, singletons, parent‐child interaction, parent‐child communication, Language Delay, parental depression, breastfeeding, family size, sibling interaction, natural experiment. Twins provide a different parenting task from that presented by singletons (Rutter & Redshaw, 1991). Moreover, the family constellation, with two young children at the same developmental stage, also provides a different Language environment that could have implications for the communicative development of the children. The burden on parents during the infancy period is clearly greater ‐ not only because there are two babies to look after, but also because their feeding and sleeping patterns are quite likely not to coincide. It is not surprising, therefore, that the mothers of twins have been found to have higher rates of depression than the mothers of sin
Karen Thorpe - One of the best experts on this subject based on the ideXlab platform.
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twins as a natural experiment to study the causes of mild Language Delay i design twin singleton differences in Language and obstetric risks
Journal of Child Psychology and Psychiatry, 2003Co-Authors: Michael Rutter, Karen Thorpe, Kate Northstone, Rosemary Greenwood, Jean GoldingAbstract:Background: Twins tend to lag behind singletons in their Language development, but the causes were unknown. The possibilities suggested include obstetric complications, twin-specific features, and postnatal differences in family interaction. The present study was designed to pit these alternatives against one another as possible causal influences. Method: The Avon Longitudinal Study of Parents and Children (ALSPAC) was used to identify the 116 twin pairs (of whom 96 participated) and 114 pairs of singletons (of whom 98 participated) whose ages were no more than 30 months apart. The McArthur Communicative Development Inventory was completed at 20 months, and the Pre-School Language Scales (PLS-3), and the McCarthy Scales of Children’s Abilities at 36 months. Obstetric and perinatal complications were assessed on the basis of detailed systematic parental reports, together with a systematic coded abstraction of all medical records dealing with pregnancy and the neonatal period. Family background details were assessed from parental reports, and the primary carer’s verbal functioning was assessed by the Mill Hill Vocabulary Scale. Congenital anomalies were assessed using the method of Waldrop and Halverson. Results: The Language of twins was 1.7 months below that of singletons at 20 months and 3.1 months at 3 years. The verbal cognitive score of twins was about half a standard deviation lower than that of singletons. The twin‐singleton differences in Language level were found to be unassociated with obstetric/perinatal features as assessed from both parental reports and medical records, to birthweight or gestation, to birthweight discrepancy within the twin pair, or to congenital anomalies. Conclusions: It is concluded that obstetric/perinatal features do not account for the slower Language development in twins as compared with singletons, within a sample born after at least 33 weeks gestation. Keywords: Twins, singletons, Language Delay, obstetric/perinatal complications, congenital anomalies. It has long been known that, compared with singletons, twins are on average Delayed in their Language development by some 3 months during the first 3 years of life (Rutter & Redshaw, 1991) and that this verbal deficit seems to persist to some degree through the primary school years at least. There are three rather separate reasons for seeking to understand the causes of this Language disparity between twins and singletons. First, there is a need to understand the challenges faced by twins in their psychological development. Being slow in Language development is a common cause of concern among the parents of twins and is a frequent cause of referral to developmental clinics of one kind or another. At present, we know very little about
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twins as a natural experiment to study the causes of mild Language Delay ii family interaction risk factors
Journal of Child Psychology and Psychiatry, 2003Co-Authors: Karen Thorpe, Michael Rutter, Rosemary GreenwoodAbstract:Background: Twins tend to lag behind singletons in their Language development, but the causes were unknown. Method: Ninety-six twin pairs from the Avon Longitudinal Study of Parents and Children (ALSPAC), for whom birth was after at least 33 weeks of gestation, were compared with 98 pairs of singletons, no more than 30 months apart in age. Parental qualities and family interaction were assessed through standardised questionnaires and interviews and both structured and unstructured observations in the home at 20 months and 36 months. The possible causal role of postnatal family influences was assessed through five criteria: i) the feature had to differ between twins and singletons; ii) individual differences in that feature had to relate to individual differences in Language level within the sample of singletons and of twins; iii) the feature as measured at 20 months had to predict Language as assessed at 36 months; iv) that had to apply after controlling for Language level at 20 months; and v) introduction of the predictive feature into an overall model had to obliterate the twin‐singleton difference in Language level. Results: Patterns of parent‐child interaction and communication met these five criteria. The maternal factors all concerned aspects of interaction that were broadly concerned with communication: encouraging the child to speak, providing elaborating comments, engaging in reading to the child and talking about the story and its illustrations. The HOME inventory findings provided similar findings with respect to responsiveness, involvement and level of experiences involved. Family features that might have been influential, but which were not, included parental depression, breastfeeding, family size, and style of sibling interaction. Conclusion: Patterns of parent‐child interaction and communication within the normal range have environmentally mediated effects on Language and account for twin‐singleton differences in Language developmently. The results indicate the value of a natural experiment in testing competing causal hypotheses, and show the role of environmental factors as influences on Language variations within the normal range, for both twins and singletons. Keywords: Twins, singletons, parent‐child interaction, parent‐child communication, Language Delay, parental depression, breastfeeding, family size, sibling interaction, natural experiment. Twins provide a different parenting task from that presented by singletons (Rutter & Redshaw, 1991). Moreover, the family constellation, with two young children at the same developmental stage, also provides a different Language environment that could have implications for the communicative development of the children. The burden on parents during the infancy period is clearly greater ‐ not only because there are two babies to look after, but also because their feeding and sleeping patterns are quite likely not to coincide. It is not surprising, therefore, that the mothers of twins have been found to have higher rates of depression than the mothers of sin
Jean Golding - One of the best experts on this subject based on the ideXlab platform.
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twins as a natural experiment to study the causes of mild Language Delay i design twin singleton differences in Language and obstetric risks
Journal of Child Psychology and Psychiatry, 2003Co-Authors: Michael Rutter, Karen Thorpe, Kate Northstone, Rosemary Greenwood, Jean GoldingAbstract:Background: Twins tend to lag behind singletons in their Language development, but the causes were unknown. The possibilities suggested include obstetric complications, twin-specific features, and postnatal differences in family interaction. The present study was designed to pit these alternatives against one another as possible causal influences. Method: The Avon Longitudinal Study of Parents and Children (ALSPAC) was used to identify the 116 twin pairs (of whom 96 participated) and 114 pairs of singletons (of whom 98 participated) whose ages were no more than 30 months apart. The McArthur Communicative Development Inventory was completed at 20 months, and the Pre-School Language Scales (PLS-3), and the McCarthy Scales of Children’s Abilities at 36 months. Obstetric and perinatal complications were assessed on the basis of detailed systematic parental reports, together with a systematic coded abstraction of all medical records dealing with pregnancy and the neonatal period. Family background details were assessed from parental reports, and the primary carer’s verbal functioning was assessed by the Mill Hill Vocabulary Scale. Congenital anomalies were assessed using the method of Waldrop and Halverson. Results: The Language of twins was 1.7 months below that of singletons at 20 months and 3.1 months at 3 years. The verbal cognitive score of twins was about half a standard deviation lower than that of singletons. The twin‐singleton differences in Language level were found to be unassociated with obstetric/perinatal features as assessed from both parental reports and medical records, to birthweight or gestation, to birthweight discrepancy within the twin pair, or to congenital anomalies. Conclusions: It is concluded that obstetric/perinatal features do not account for the slower Language development in twins as compared with singletons, within a sample born after at least 33 weeks gestation. Keywords: Twins, singletons, Language Delay, obstetric/perinatal complications, congenital anomalies. It has long been known that, compared with singletons, twins are on average Delayed in their Language development by some 3 months during the first 3 years of life (Rutter & Redshaw, 1991) and that this verbal deficit seems to persist to some degree through the primary school years at least. There are three rather separate reasons for seeking to understand the causes of this Language disparity between twins and singletons. First, there is a need to understand the challenges faced by twins in their psychological development. Being slow in Language development is a common cause of concern among the parents of twins and is a frequent cause of referral to developmental clinics of one kind or another. At present, we know very little about
