Predicting Language Outcomes at 4 Years of Age: Findings From Early Language in Victoria Study

Reilly, Sheena; Wake, Melissa; Ukoumunne, Obioha C; Bavin, Edith L.; Prior, Margot; Cini, Eileen; Conway, Laura; Eadie, Patricia; Bretherton, Lesley

doi:10.1542/peds.2010-0254

Cited by 315 publications

(391 citation statements)

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“…Further research is needed to replicate these findings using a full assessment of language. The prevalence of language problems in our control group was however, similar to other population-based studies, 29,30 suggesting a screen may be sufficient for estimating language problems. The participation …”

Section: Discussionsupporting

confidence: 88%

Language Problems in Children With ADHD: A Community-Based Study

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: Children with attentiondeficit/hyperactivity disorder (ADHD) have poorer academic and social functioning and more language problems than typically developing peers. However, it is unknown how language problems impact the academic and social functioning of these children.WHAT THIS STUDY ADDS: Language problems are common in children with ADHD and are associated with markedly poorer academic functioning independent of ADHD symptom severity and comorbidities. There was little evidence that language problems were associated with poorer social functioning for children with ADHD.abstract OBJECTIVES: To examine the prevalence of language problems in children with attention-deficit/hyperactivity disorder (ADHD) versus non-ADHD controls, and the impact of language problems on the social and academic functioning of children with ADHD.METHODS: Children (6 to 8 years) with ADHD (n = 179) and controls (n = 212) were recruited through 43 Melbourne schools. ADHD was assessed by using the Conners 3 ADHD Index and the Diagnostic Interview Schedule for Children IV. Oral language was assessed by using the Clinical Evaluation of Language Fundamentals, fourth edition, screener. Academic functioning was measured via direct assessment (Wide Range Achievement Test 4) and teacher report (Social Skills Improvement System). Social functioning was measured via parent and teacher report (Strengths and Difficulties Questionnaire; Social Skills Improvement System). Logistic and linear regression models were adjusted for sociodemographic factors and child comorbidities. RESULTS:Children with ADHD had a higher prevalence of language problems than controls after adjustment for sociodemographic factors and comorbidities (odds ratio, 2.8; 95% confidence interval [CI], 1.5 to 5.1). Compared with children with ADHD alone, those with language problems had poorer word reading (mean difference [MD], 211.6; 95% CI, 216.4 to 26.9; effect size, 20.7), math computation (MD, 211.4; 95% CI, 215.0 to 27.7; effect size, 20.8), and academic competence (MD, 210.1; 95% CI, 214.0 to 26.1; effect size, 20.7). Language problems were not associated with poorer social functioning. CONCLUSIONS:Children with ADHD had a higher prevalence of language problems than controls, and language problems in children with ADHD contributed to markedly poorer academic functioning. Pediatrics 2014;133:793-800

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Section: Discussionsupporting

confidence: 88%

Language Problems in Children With ADHD: A Community-Based Study

et al. 2014

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“…8,19,20 21 Previous publications detail the recruitment processes. 8,19,20 Briefly, infants were recruited from the Victorian Maternal and Child Health service, which is a state government nursing service for families with children aged 0 to 6 years, supplemented by recruitment from 7-to 9-month hearing screening sessions and local newspaper publicity. We excluded children with a serious disability or developmental delay, such as Down syndrome or cerebral palsy.…”

Section: Overview Of the Early Language In Victoria Studymentioning

confidence: 99%

“…8 We have repeatedly collected data about communication, language development, and stuttering from those children. 8,19,20 We aimed to document the natural history of stuttering in those children: (1) cumulative incidence of stuttering onset, (2) 12-month recovery status, (3) predictors of onset and recovery, and (4) potential comorbidities.…”

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confidence: 99%

Natural History of Stuttering to 4 Years of Age: A Prospective Community-Based Study

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Stuttering is extremely common, with 8.5% of children affected by age 3 years in a prospective community-ascertained cohort of Australian children. The natural history and comorbidities of early stuttering are uncertain at the population level.WHAT THIS STUDY ADDS: The cumulative incidence of stuttering was 11% by 4 years. Stuttering children were similar in temperament and social-emotional development but had better verbal and nonverbal skills than their peers. Recovery from stuttering was low; 6.3% 12 months after onset. abstract OBJECTIVES: To document the natural history of stuttering by age 4 years, including (1) cumulative incidence of onset, (2) 12-month recovery status, (3) predictors of stuttering onset and recovery, and (4) potential comorbidities. The study cohort was a prospective community-ascertained cohort (the Early Language in Victoria Study) from Melbourne, Australia, of 4-year-old children (n = 1619; recruited at age 8 months) and their mothers. METHODS:Outcome was stuttering onset by age 4 years and recovery within 12 months of onset, defined using concurrent monthly parent and speech pathologist ratings. Potential predictors: child gender, birth weight, birth order, prematurity, and twinning; maternal mental health and education; socioeconomic status; and family history of stuttering. Potential comorbidities: preonset and concurrent temperament, language, nonverbal cognition, and health-related quality of life.RESULTS: By age 4 years, the cumulative incidence of stuttering onset was 11.2% (95% confidence interval [CI]: 9.7% to 12.8%). Higher maternal education (P = .004), male gender (P = .02), and twinning (P = .005) predicted stuttering onset. At outcome, stuttering children had stronger language (mean [SD]: 105.0 [13.0] vs 99.6 [14.6]; mean difference 5.5, 95% CI: 3.1 to 7.8; P , .001) and nonverbal cognition (mean [SD]: 106.5 [11.4] vs 103.9 [13.7], mean difference 2.6, 95% CI: 0.4 to 4.8; P = .02) and better health-related quality of life but were otherwise similar to their nonstuttering peers. Only 9 of 142 children (6.3%; 95% CI: 2.9% to 11.7%) recovered within 12 months of onset. CONCLUSIONS:Although stuttering onset is common in preschoolers, adverse affects are not the norm in the first year after onset. Pediatrics 2013;132: [460][461][462][463][464][465][466][467]

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“…10 Although there is no consensus as to the optimal age for population-based intervention, we chose 4 years because at earlier ages, language delay is both nonspecific and insensitive in predicting later language delay [11][12][13] (ie, low sensitivity), whereas schoolage intervention may be too late. 14 The program was designed to be sufficiently standardized for population-based delivery by nonspecialists, yet flexible enough to meet the varying needs of children at this age.…”

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confidence: 99%

Two-Year Outcomes of a Population-Based Intervention for Preschool Language Delay: An RCT

et al. 2015

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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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Predicting Language Outcomes at 4 Years of Age: Findings From Early Language in Victoria Study

Abstract: Measures of social disadvantage helped explain more variation in outcomes at 4 years than at 2 years, but ability to predict low language status and SLI status remained limited.

Cited by 315 publications

References 23 publications

Language Problems in Children With ADHD: A Community-Based Study

Language Problems in Children With ADHD: A Community-Based Study

Natural History of Stuttering to 4 Years of Age: A Prospective Community-Based Study

Two-Year Outcomes of a Population-Based Intervention for Preschool Language Delay: An RCT

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