Group Members Research Articles

Stimulating the capacity to govern the commons.

The ability to strengthen governance institutions and fisheries restrictions and laws is needed to improve conservation and management of common-pool resources. We evaluated the potential for stimulating change with modest interventions by studying fishing village households before and after a 27-month intervention period in a high-priority coral reef conservation area. Interventions included training in catch monitoring, stock assessment, mapping fishing grounds, microcredit, gender inclusion, theatrical skills, fuel efficient stoves, and participation in the planning of a conservation proposal. There was a background increase in reported formal education, household size, group membership, and household wealth but a decrease in fish consumption and public services. Of conservation importance, the perceived strength of 13 governance institutions and benefits of 6 fisheries restrictions increased over the intervention period. Finally, correspondence between knowledge of and agreement with recent national fisheries laws was moderate to high and positively correlated. The intervention period was stronger than demographic factors that often influence perceptions, such as village, government services, gender, household size, membership in community groups, and age responses. In general, perceptions of strengths of governance and benefits of restrictions increased more among women and youth than adult men respondents. The largest changes in perceptions of increased benefits were among strict restrictions initially ranked low, specifically fisheries closures, parks, and species restrictions. Consequently, capacity building overrode demographic factors common to poor people with limited employment capacity that can have negative perceptions of strict conservation.

“I Cannot Tell Anyone:” There are Many Reasons

ABSTRACT Purpose: The purpose of this study was to investigate variables associated with difficulty disclosing past trauma. Across several prevalence studies, 26% of adults never disclosed childhood abuse until adulthood when they were asked in a research survey or interview question. In this Institutional Review Board approved study, group differences were examined (ability and inability to disclose a traumatic event) as well as predictors for difficulty disclosing past trauma. Method: A non-clinical population (N = 693) was examined to determine prevalence rates and group differences between participants unable to tell someone about a past traumatic event (10%) compared to those who could disclose past traumatic events (90%). Variables included pathological dissociative processing, internalized shame, coping strategies (task, emotion, avoidance), and cumulative trauma exposure. Logistic regression analyses were conducted to determine predicting variables for disclosure difficulties. Findings: The group that had difficulty disclosing a past traumatic event had more cumulative trauma, pathological dissociative processing, emotion-oriented coping, and shame. In the first logistic regression analyses, interpersonal traumatic events were predictors for the inability to disclose a traumatic event (classified 90% of group membership). In the second logistic regression, shame and cumulative traumatic exposure were predicting factors (classified 90% of group membership). Conclusion: Difficulty speaking about a traumatic event was associated with interpersonal adult and childhood traumatic events, more internalized shame, and cumulative trauma exposure. It is recommended that clinicians working with patients with substantial traumatic exposure address shame, pathological dissociative processing, and emotion-oriented coping strategies if they detect trauma disclosure difficulties.

Caries trajectories from childhood to adolescence: Analysis of data from a nationwide school dental service.

The aim of the study was to assess patterns of longitudinal changes in caries status among school-going children in Singapore. Dental records for a single cohort of students who received dental examinations in six standard examination years between 2009 and 2017 were analysed (n = 24 699). Group-based trajectory modelling with a zero-inflated Poisson distribution was carried out to determine dental caries trajectories in the permanent dentition. Associations between sociodemographic factors and trajectory group membership were assessed using multinomial logistic regression. The predicted population distribution across the four caries trajectory groups identified was 65.0% ('none'), 16.8% ('low'), 14.8% ('medium') and 3.4% ('high'). The 'none' trajectory group had a decayed, missing and filled teeth (DMFT) score of 0 throughout the 8 years. Higher baseline DMFT counts and nonlinear increases in DMFT scores were noted for the 'low', 'medium' and 'high' trajectory groups. The correlation coefficient between DMFT counts in years 6 and 8 was 0.91, as compared to 0.77 between baseline and year 1. Factors associated with the 'high' caries trajectory include lower socio-economic status, female gender, Chinese race (compared to the Indian race), enrolment in primary schools in the Eastern and Western regions of Singapore, and enrolment in public secondary schools. Under a nationwide school dental service, four trajectory patterns of caries counts in the permanent dentition were identified over 8 years. Among students in the 'low', 'medium' and 'high' trajectory groups, greater caries increment was noted during the transition from primary to secondary school. The correlation between DMFT counts in successive examinations was stronger in older than younger ages.

Friendship Network and School Socialization Correlates of Adolescent Ethnic-Racial Identity Development.

Ethnic-racial identity (ERI) development is consequential for youth adjustment and includes exploration, resolution, and affect about the meaning of one's ethnic-racial group membership. Little is known about how identity-relevant experiences, such as ethnic-racial socialization and discrimination in peer relationships and school contexts, catalyze adolescent ERI development. The present study examines how identity-relevant experiences in friend and school contexts (i.e., proportion of same-ethnoracial friends, cultural socialization among friends, friends' ERI dimensions, friends' experiences of ethnoracial discrimination, and school promotion of cultural competence and critical consciousness) are associated with ERI development. A multivariate path model with a sample from four southwestern U.S. schools (N = 717; 50.5% girls; Mage = 13.76; 32% Latinx, 31.5% Multiethnic, 25.7% White, 11% other) was used to test these associations. Findings showed that friend and school predictors of ERI did not differ between early and middle adolescents, but significant differences and similarities emerged in some of these associations between ethnoracially minoritized and White youth. Specifically, friend cultural socialization was positively associated with ERI exploration for ethnoracially minoritized youth only, whereas school critical consciousness socialization was positively linked with ERI exploration only for White youth. Friend cultural socialization and friend network's levels of ERI resolution were positively associated with ERI resolution across both ethnoracial groups. These friend and school socialization associations were documented above and beyond significant contributions of personal ethnoracial discrimination to ERI exploration and negative affect for both ethnoracially minoritized and White youth. These findings expand our understanding of how friend and school socialization mechanisms are associated with adolescent ERI development, which is vital to advancing developmental theory and fostering developmental competences for youth to navigate their multicultural yet socially stratified and inequitable world.

When saying sorry is not enough: The paradox of a political apology offered to Irish mother and baby home survivors

AbstractWhile political apologies cannot undo what has been done, they are often perceived as highly relevant for healing and reconciliation. However, these apologies are often mired in controversy and highly political. While research on political apologies has focused on the role of intergroup relations, limited research has explored the intragroup dynamics involved. The present article explores how the paradoxical features of a political apology to ingroup members have their source in partisanship. The analysis used methods derived from discursive psychology. Using data from six parliamentary statements that were given in response to the political apology offered to Irish mother and baby home survivors, we demonstrated how these speakers constructed and understood the apology and how these constructions relate to their own political positions. Specifically, the apology to mothers and babies is used for political purpose, allowing majority members of government to position the wrongdoings experienced by mothers and babies in the past and to encourage the national collective to move on. Others seeking progressive social change—a parliamentary minority—use the apology to shape a political narrative that demands national collective action. Our work highlights the important role that identity‐based power relations play in confronting historical injustice, and how this may result in a dual schism with people within a nation becoming divided over both the apology and the appropriate response.

A social identity approach to understanding sustainability and environmental behaviours in South Africa

ABSTRACT In recent years, change in behaviour towards the environment has gained prominence as a policy tool to influence positive environmental value. Simultaneously, the role played by social identity in promoting pro-environmental action is gaining recognition. Within this work, the intersection between collective group identity and environmental behaviour has received very little attention. Group norms are considered a strong predictor of pro-environmental behaviour, yet the influence of social identity and collective action on environmental action has not been adequately investigated in a multi-ethnic setting. Within this context, this study examines the affective component of social identity influence on pro-environmental action. More succinctly, this study demonstrates how outgroups and in-groups’ relations and broader sociocultural structures, values, interest, and norms impact environmental and sustainability transitions behaviours. Through interviews with participants across the four dominant social groups in South Africa, this study provides compelling evidence that country-wide expressions of social identity and ingroup dynamics shapes the individual behaviour regarding environmental and sustainability concerns and further strengthen the individual’s perspective for social environmental transformation. This study advances the need for a social-identity centred approach to foster pro-environmental and sustainability outcomes. Highlights The influence that social contexts and social group memberships have on individual perception and behaviour provide important insights to build an empirical base for an inclusive environmental and sustainable action. We applied the theory of social identity to explore these processes and how normative group values and group interest shape environmental behaviour.

Factors influencing nursing student satisfaction in aged care placements: An Australian cross-sectional study

AimThis study aimed to investigate factors influencing nursing students’ satisfaction with aged care placements. BackgroundProviding positive clinical experiences in aged care is crucial for students to learn safe, quality care and to foster a sustainable workforce. DesignCross-sectional study MethodsNursing students in nursing degrees participated in the national placement evaluation survey. A total of 2378 responses were extracted from the national clinical placement evaluation survey in 2023. Using multinomial logistic regression, demographics, academic, placement characteristics and placement education quality (clinical environment and learning support) were investigated in relation to three different levels of students' overall satisfaction (low, moderate, high). ResultsStudents reported overall satisfaction with their clinical placement, with a mean score of 7.9 (SD=2.1) on a 10-point scale. While most students agreed that they had achieved their learning objectives (90.0 %), they reported limited opportunities to interact with the multidisciplinary team (80.0 %). Further, students reported a relatively negative experience with staff, such as willingness to work with students (78.9 %) and being positive role models (78.9 %). Comparing the low satisfaction group to the moderate satisfaction group, male gender, identifying as an indigenous student and higher academic years increased the odds of being ‘least satisfied’, whereas international students, whose first language was not English and those with higher perceived placement education quality scores had lower odds of low satisfaction group membership. Conversely, compared with the moderate satisfaction group, those with the highest satisfaction with their clinical placement had a greater odds of being older, an international student and having higher scores in placement quality for the clinical environment and learning support. This model predicted 58.7 % of students' overall satisfaction. ConclusionsPositive learning experiences in aged care may promote the importance of practice in this area to new graduates. Despite students’ overall positive satisfaction with aged care placements, it is clear there are areas to address: a need to develop a structured approach to enhance aged care clinical experiences, progressive development of learning objectives, enhancing student career preparation and increasing participation in interprofessional collaboration may be useful approaches.

The mediating role of systemic inflammation and moderating role of racialization in disparities in incident dementia

BackgroundExposure to systemic racism is linked to increased dementia burden. To assess systemic inflammation as a potential pathway linking exposure to racism and dementia disparities, we investigated the mediating role of C-reactive protein (CRP), a systemic inflammation marker, and the moderating role of the racialization process in incident dementia.MethodsIn the US Health and Retirement Study (n = 6,908), serum CRP was measured at baseline (2006, 2008 waves). Incident dementia was classified by cognitive tests over a six-year follow-up. Self-reported racialized categories were a proxy for exposure to the racialization process. We decomposed racialized disparities in dementia incidence (non-Hispanic Black and/or Hispanic vs. non-Hispanic white) into 1) the mediated effect of CRP, 2) the moderated portion attributable to the interaction between racialized group membership and CRP, and 3) the controlled direct effect (other pathways through which racism operates).ResultsThe 6-year cumulative incidence of dementia is 12%. Among minoritized participants (i.e., non-Hispanic Black and/or Hispanic), high CRP levels ( ≥ 75th percentile or 4.73μg/mL) are associated with 1.26 (95%CI: 0.98, 1.62) times greater risk of incident dementia than low CRP ( < 4.73μg/mL). Decomposition analysis comparing minoritized versus non-Hispanic white participants shows that the mediating effect of CRP accounts for 3% (95% CI: 0%, 6%) of the racial disparity, while the interaction effect between minoritized group status and high CRP accounts for 14% (95% CI: 1%, 27%) of the disparity. Findings are robust to potential violations of causal mediation assumptions.ConclusionsMinoritized group membership modifies the relationship between systemic inflammation and incident dementia.

Long-term trajectories of low back pain in older men: A prospective cohort study with 10-year analysis of the MrOS Study.

While low back pain (LBP) may persist or recur over time, few studies have evaluated the individual course of LBP over a long-term period, particularly among older adults. Based on data from the longitudinal Osteoporotic Fractures in Men (MrOS) study, we aimed to identify and describe different LBP trajectories in older men and characterize members in each trajectory group. A total of 5,976 community-dwelling men (mean age=74.2) enrolled at six US sites were analyzed. Participants self-reported LBP (yes/no) every 4 months during a maximum of 10 years. Latent class growth modelling was performed to identify unique LBP trajectory groups that explained variation in the LBP data. The association of baseline characteristics with trajectory group membership was assessed using univariable and multivariable multinominal logistic regression. A five-class solution was chosen; no/rare LBP (n=2442/40.9%), low frequency-stable LBP (n=1040/17.4%), low frequency-increasing LBP (n=719/12%), moderate frequency-decreasing LBP (n=745/12.5%) and high frequency-stable LBP (n=1030/17.2%). History of falls (OR=1.52), history of LBP (OR=6.37), higher physical impairment (OR=1.51-2.85) and worse psychological function (OR=1.41-1.62) at baseline were all associated with worse LBP trajectory groups in this sample of older men. These findings present an opportunity for targeted interventions and/or management to older men with worse or increasing LBP trajectories and associated modifiable risk factors, to reduce the impact of LBP and improve quality of life.

Childhood trauma and treatment resistance in first-episode psychosis: Investigating the role of premorbid adjustment and duration of untreated psychosis

BackgroundEarly identification of treatment non-response in first-episode psychosis (FEP) is essential to outcome. Despite indications that exposure to childhood trauma (CT) can have adverse effects on illness severity, its impact on treatment non-response and the interplay with other pre-treatment characteristics is sparsely investigated. We use a lack of clinical recovery as an early indicator of treatment resistance to investigate the relationship between CT and treatment resistance status at one-year follow-up and the potential mediation of this effect by other pre-treatment characteristics. MethodsThis prospective one-year follow-up study involved 141 participants recruited in their first year of treatment for a schizophrenia-spectrum disorder. We investigated clinical status, childhood trauma (CT), premorbid adjustment (PA), and duration of untreated psychosis (DUP) at baseline and clinical status at one-year follow-up. Ordinal regression analyses were conducted to investigate how PA and DUP affected the relationship between CT and one-year outcome in FEP. Results45 % of the FEP sample reported moderate to severe CT, with significantly higher levels of CT in the early treatment resistant group compared to participants with full or partial early recovery. Ordinal regression analysis showed that CT was a significant predictor of being in a more severe outcome group (OR = 4.59). There was a partial mediation effect of PA and a full mediation effect of DUP on the effect of CT on outcome group membership. DiscussionOur findings indicate that reducing treatment delays may mitigate the adverse effects of CT on clinical outcomes and support the inclusion of broad trauma assessment in FEP services.

The role of group membership and culture in interpersonal distance regulation

AbstractThe current study aims to examine the influence of group membership and cultural conceptions on the regulation of interpersonal distance (IPD) among Chinese and Italian adolescents. Two‐hundred forty participants completed an online computerized version of the Interpersonal Visual Analogue Scale to assess their preferred IPD. A greater distance was found in Chinese than Italian participants. Chinese participants also chose a larger distance from outgroup than ingroup members, whereas no such tendencies were found among Italian participants. Moreover, in the Chinese group, a larger distance from the male target was chosen by females compared to male participants. Finally, all participants maintained greater distance when outgroup members approached from the back than from the front. These findings not only provide evidence that nationality and group membership impact on how individuals regulate spatial boundaries, but also offer a new lens to understand intergroup dynamics shaping social interactions among individuals from diverse cultural backgrounds.

The role of group membership and culture in interpersonal distance regulation

AbstractThe current study aims to examine the influence of group membership and cultural conceptions on the regulation of interpersonal distance (IPD) among Chinese and Italian adolescents. Two‐hundred forty participants completed an online computerized version of the Interpersonal Visual Analogue Scale to assess their preferred IPD. A greater distance was found in Chinese than Italian participants. Chinese participants also chose a larger distance from outgroup than ingroup members, whereas no such tendencies were found among Italian participants. Moreover, in the Chinese group, a larger distance from the male target was chosen by females compared to male participants. Finally, all participants maintained greater distance when outgroup members approached from the back than from the front. These findings not only provide evidence that nationality and group membership impact on how individuals regulate spatial boundaries, but also offer a new lens to understand intergroup dynamics shaping social interactions among individuals from diverse cultural backgrounds.

Using artificial agents to nudge outgroup altruism and reduce ingroup favoritism in human-agent interaction

Ingroup favoritism and intergroup discrimination can be mutually reinforcing during social interaction, threatening intergroup cooperation and the sustainability of societies. In two studies (N = 880), we investigated whether promoting prosocial outgroup altruism would weaken the ingroup favoritism cycle of influence. Using novel methods of human-agent interaction via a computer-mediated experimental platform, we introduced outgroup altruism by (i) nonadaptive artificial agents with preprogrammed outgroup altruistic behavior (Study 1; N = 400) and (ii) adaptive artificial agents whose altruistic behavior was informed by the prediction of a machine learning algorithm (Study 2; N = 480). A rating task ensured that the observed behavior did not result from the participant’s awareness of the artificial agents. In Study 1, nonadaptive agents prompted ingroup members to withhold cooperation from ingroup agents and reinforced ingroup favoritism among humans. In Study 2, adaptive agents were able to weaken ingroup favoritism over time by maintaining a good reputation with both the ingroup and outgroup members, who perceived agents as being fairer than humans and rated agents as more human than humans. We conclude that a good reputation of the individual exhibiting outgroup altruism is necessary to weaken ingroup favoritism and improve intergroup cooperation. Thus, reputation is important for designing nudge agents.

Using artificial agents to nudge outgroup altruism and reduce ingroup favoritism in human-agent interaction

Ingroup favoritism and intergroup discrimination can be mutually reinforcing during social interaction, threatening intergroup cooperation and the sustainability of societies. In two studies (N = 880), we investigated whether promoting prosocial outgroup altruism would weaken the ingroup favoritism cycle of influence. Using novel methods of human-agent interaction via a computer-mediated experimental platform, we introduced outgroup altruism by (i) nonadaptive artificial agents with preprogrammed outgroup altruistic behavior (Study 1; N = 400) and (ii) adaptive artificial agents whose altruistic behavior was informed by the prediction of a machine learning algorithm (Study 2; N = 480). A rating task ensured that the observed behavior did not result from the participant’s awareness of the artificial agents. In Study 1, nonadaptive agents prompted ingroup members to withhold cooperation from ingroup agents and reinforced ingroup favoritism among humans. In Study 2, adaptive agents were able to weaken ingroup favoritism over time by maintaining a good reputation with both the ingroup and outgroup members, who perceived agents as being fairer than humans and rated agents as more human than humans. We conclude that a good reputation of the individual exhibiting outgroup altruism is necessary to weaken ingroup favoritism and improve intergroup cooperation. Thus, reputation is important for designing nudge agents.

Clubs and networks

A recurring theme in the study of society is the concentration of influence and power that is driven through unequal membership of groups and associations. In some instances, these bodies constitute a small world while in others they are fragmented into distinct cliques. This paper presents a new model of clubs and networks to understand the sources of individual marginalization and the origins of small and large worlds.

Nudging (dis)trust in science: Exploring the interplay of social norms and scientific trust during public health crises

AbstractIn times of public health crisis, such as the COVID‐19 pandemic, there is a critical need for interventions that emphasize group unification. Such interventions may motivate individuals to adhere personally and collectively to health advice, enhance national solidarity, and reduce conspiratorial beliefs among members—particularly among those who may express skepticism or distrust towards science. Across three experimental studies (Ntotal = 1604) conducted online (Experiments 1 &amp; 3) and in a real‐world setting (Experiment 2) in Ireland and Kosovo, we assessed participants' trust in science (i.e., the extent to which they trust in science and scientists) and exposed them to one of three conditions regarding COVID‐19 health advice: compliance (i.e., the majority of ingroup members comply with the health advice), non‐compliance (i.e., the majority of ingroup members do not comply with the health advice), or no advice (i.e., control condition with no health advice information). Overall, the results showed that participants with low (vs. high) trust in science, intending to adhere to health advice and expecting ingroup members to do the same, experienced greater national solidarity and reduced their conspiracy beliefs in the compliance condition compared to noncompliance or control conditions. Participants' feelings of national solidarity explained the observed effects. In sum, this set of experimental studies shows that compliance with health advice during a health crisis not only enhances national solidarity but also promotes adherence to health behaviors and reduces conspiracy beliefs, especially among those initially skeptical of science.

Nudging (dis)trust in science: Exploring the interplay of social norms and scientific trust during public health crises

AbstractIn times of public health crisis, such as the COVID‐19 pandemic, there is a critical need for interventions that emphasize group unification. Such interventions may motivate individuals to adhere personally and collectively to health advice, enhance national solidarity, and reduce conspiratorial beliefs among members—particularly among those who may express skepticism or distrust towards science. Across three experimental studies (Ntotal = 1604) conducted online (Experiments 1 &amp; 3) and in a real‐world setting (Experiment 2) in Ireland and Kosovo, we assessed participants' trust in science (i.e., the extent to which they trust in science and scientists) and exposed them to one of three conditions regarding COVID‐19 health advice: compliance (i.e., the majority of ingroup members comply with the health advice), non‐compliance (i.e., the majority of ingroup members do not comply with the health advice), or no advice (i.e., control condition with no health advice information). Overall, the results showed that participants with low (vs. high) trust in science, intending to adhere to health advice and expecting ingroup members to do the same, experienced greater national solidarity and reduced their conspiracy beliefs in the compliance condition compared to noncompliance or control conditions. Participants' feelings of national solidarity explained the observed effects. In sum, this set of experimental studies shows that compliance with health advice during a health crisis not only enhances national solidarity but also promotes adherence to health behaviors and reduces conspiracy beliefs, especially among those initially skeptical of science.

Persistent vocal learning in an aging open-ended learner reflected in neural FoxP2 expression

BackgroundMost vocal learning species exhibit an early critical period during which their vocal control neural circuitry facilitates the acquisition of new vocalizations. Some taxa, most notably humans and parrots, retain some degree of neurobehavioral plasticity throughout adulthood, but both the extent of this plasticity and the neurogenetic mechanisms underlying it remain unclear. Differential expression of the transcription factor FoxP2 in both songbird and parrot vocal control nuclei has been identified previously as a key pattern facilitating vocal learning. We hypothesize that the resilience of vocal learning to cognitive decline in open-ended learners will be reflected in an absence of age-related changes in neural FoxP2 expression. We tested this hypothesis in the budgerigar (Melopsittacus undulatus), a small gregarious parrot in which adults converge on shared call types in response to shifts in group membership. We formed novel flocks of 4 previously unfamiliar males belonging to the same age class, either “young adult” (6 mo − 1 year) or “older adult” (≥ 3 year), and then collected audio-recordings over a 20-day learning period to assess vocal learning ability. Following behavioral recording, immunohistochemistry was performed on collected neural tissue to measure FoxP2 protein expression in a parrot vocal learning center, the magnocellular nucleus of the medial striatum (MMSt), and its adjacent striatum.ResultsAlthough older adults show lower vocal diversity (i.e. repertoire size) and higher absolute levels of FoxP2 in the MMSt than young adults, we find similarly persistent downregulation of FoxP2 and equivalent vocal plasticity and vocal convergence in the two age cohorts. No relationship between individual variation in vocal learning measures and FoxP2 expression was detected.ConclusionsWe find neural evidence to support persistent vocal learning in the budgerigar, suggesting resilience to aging in the open-ended learning program of this species. The lack of a significant relationship between FoxP2 expression and individual variability in vocal learning performance suggests that other neurogenetic mechanisms could also regulate this complex behavior.

How Partisanship Can Moderate the Influence of Communicated Information on the Beliefs of Agents Aiming to Form True Beliefs

ABSTRACT Partisan epistemology – individuals granting greater credibility to co-partisan sources in evaluating information – is often taken to be evidence of directionally motivated reasoning in which concerns about group membership override concerns about accuracy. Against this dominant view, I outline a novel accuracy-based account of this mode of reasoning. According to this account, partisan epistemology stems from the inference that co-partisans are more likely to be right as they have superior epistemic access to the relevant facts and seek to realize the correct values. I argue that this theory fits better with relevant findings than motivated-reasoning theories of partisan epistemology. Finally, I suggest it has adequate explanatory power vis-à-vis patterns of misinformation belief.

Outcomes of Aural Rehabilitation Provided in Person or by Telehealth Among Deaf/Hard of Hearing Young Children with Cochlear Implants or Hearing Aids.

Background: Cochlear implants and hearing aids may facilitate the development of listening and spoken language (LSL) in deaf/hard of hearing young children, but they require aural rehabilitation therapy-often unavailable outside urban areas-for optimal outcomes. This trial assessed the relative effectiveness of LSL therapy delivered either in person or by interactive video. The hypothesis was that telehealth service delivery would be noninferior to in-person therapy. Methods: Most parents refused randomization of their children to telehealth or in-person conditions; therefore, randomization was impossible. In consultation with the funder (NIDCD), the study design was modified. Parents were allowed to select their preferred study condition, and the study team was blinded to group membership. Forty-two families were in the in-person group and 35 in telehealth (40 and 30, respectively, after attrition). Primary endpoints were total score, auditory comprehension, and expressive communication on the Preschool Language Scale, 5th edition. There were several secondary speech, hearing, and language outcome measures. Assessments occurred at baseline and at follow-up after 6 months of LSL therapy. Results: Propensity scores were used to create two matched groups. At baseline, groups did not differ on PLS-5 scores. Change from baseline to F/U on age-equivalents for all three scores was nearly identical for both groups, although the telehealth group was younger, on average, than the in-person group. Discussion: Telehealth was noninferior to in-person services for all primary endpoints. For secondary outcomes, neither group demonstrated a significant advantage. Magnitudes of estimated group differences were small, suggesting nonsignificant differences not predominantly because of sample size. The telehealth group showed greater improvement on 15/24 of secondary language outcome measures. The findings provide evidence that telehealth is equivalent to in-person care for providing LSL therapy to young children with cochlear implants and hearing aids.