Language Outcomes In Children Research Articles

Pathways between family SES, parent characteristics, early experiences, and child language outcomes in South Korea: A combined analysis of the family stress model and the family investment model.

Whereas previous research has examined the role that parenting and home environments play in explaining the relation between family socioeconomic status and children's language development in the United States, relatively little is known about the associations between these constructs in other cultures. This study tested an integrated model of language development within a longitudinal data set of 1,894 socioeconomically diverse Korean children (48.35% girls; > 99% native-born Korean citizens) from the first year of life (age 3-8 months) to ages 3 and 6 years. A model integrating parent and environmental characteristics from the family stress model and the family investment model that also included maternal self-efficacy and knowledge of child development was shown to adequately explain the associations between family socioeconomic status and children's language development. Implications for applying similar integrated models in international contexts are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Joint attention episodes during interactions with fathers but not mothers at age 2 years is associated with expressive language at 3 years

Joint Attention (JA) in parent–infant interaction has been demonstrated to contribute to infants’ language outcomes. A limited number of studies have investigated the characteristics of JA episodes during parent–toddler interaction in relation to toddlers’ language development. The majority of these studies were conducted with mothers, whereas JA with fathers remains understudied. The current study investigated JA episodes during interactions with mothers and fathers separately as well as longitudinal associations with child language outcomes. A total of 31 toddlers (18 girls) and their mothers and fathers participated in the study at ages 2 years (M = 24.07 months, SD = 1.45) and 3 years (M = 37.44 months, SD = 1.72). JA episodes were observed during free play interactions at age 2 and were coded microanalytically; receptive and expressive language skills were assessed by Bayley Scales of Infant and Toddler Development–Third Edition at ages 2 and 3. No significant differences in JA episodes were found between mother–toddler and father–toddler dyads. Whereas JA characteristics with mothers were not found to be significantly associated with toddlers’ language outcomes, multiple linear regression analyses showed that paternal education and parent-followed JA episodes during father–toddler interaction at age 2 explained a significant amount of variance in toddlers’ expressive language skills at age 3. Findings suggest that JA episodes during interactions with fathers might benefit toddlers’ expressive language development.

Children with cochlear implant and additional disabilities benefit from consistent device use.

Although the prevalence of additional disabilities (AD) in children with a cochlear implant (CI) is high, children with such disabilities are often excluded from clinical studies, or their specific characteristics are only partially included. The literature shows that several factors need to be considered in evaluating auditory and language development in CI children with AD, including demographic variables as well as the severity and type of disability. Current findings on device use in children show correlations with auditory and language outcome, but little is known about device use specifically in children with AD. The purpose of this study was to determine the auditory and language outcome of CI children with AD and to analyse their datalogging-based daily device use, both 1 year and 2 years after implantation. In addition, any potential correlations between outcome and device use were to be identified. A cohort of 32 CI children with 5 different types of AD were included in this retrospective analysis. The children's auditory and language outcome was assessed by the parental questionnaires LittlEARS and ELFRA and by the professional observation tool CAP (Categories of Auditory Performance) 1 and 2 years after implantation. Longitudinal device use was analysed by using the CI system-integrated data-logging; daily duration of CI use, number of coil disconnections and exposure to different listening scenes were recorded. Overall, the cohort's auditory and language performance showed significant progress over time, while reduced abilities became more obvious after 2 years of CI experience. The mean daily duration of CI use increased significantly from 7.8±2.8 to 8.2±2.7h after 2 years. High numbers of daily coil disconnections were detected, with a significant mean decrease from 83.4±73.1 to 66.3±54.6 whereas the percentage exposure to different listening environments was widely stable over time. Significant rank correlations were identified between outcomes measured by ELFRA and CAP with daily duration of CI use, numbers of coil disconnections and percentage of exposure to speech-characterised listening scenes. The auditory and language outcome in CI children with AD is variable, but it progresses over time. Children benefit from a consistent daily device use as well as from a high exposure to speech-characterised environments. Device use should be monitored constantly, with particular focus on daily duration of CI use and, in particular, on the number of coil disconnections if children have a severe motor impairment. Objective data-logging is an important addition to outcome assessment by testing, observations and parental questionnaires. Although assessment in children with AD is a major challenge for professionals, comprehensive assessment is needed to improve cochlear implant services with special adaption to children with AD, and this should include audiological, development-related and psychosocial information. A unified system to classify types of disabilities could help to improve procedures for analysing different outcomes.

Family and Caregiver Characteristics Contribute to Caregiver Change in Use of Strategies and Growth in Child Spoken Language in a Parent-Implemented Language Intervention in Fragile X Syndrome.

This study examined relationships among family characteristics, caregiver change in use of strategies, and child growth in spoken language over the course of a parent-implemented language intervention (PILI) that was developed to address some of the challenges associated with the fragile X syndrome (FXS) phenotype. Participants were 43 parent-child dyads from two different PILI studies, both of which taught parents various language facilitation strategies to support child language. Before starting the intervention, parents reported on their mental health, parenting stress, and parenting competence. This study focused on potential barriers to treatment gains by examining correlations between the measures of parent well-being and (a) parent change in use of intervention strategies taught in the PILI and (b) changes in child language outcomes from preto post-intervention. Parents in this study had elevated mental health symptoms across several domains and increased rates of parenting stress. Furthermore, although PILI resulted in treatment gains for both parents and children, a variety of parent mental health symptoms were found to be significantly and negatively associated with change in use of strategies and growth in child language over the course of the intervention. Some inconsistent findings also emerged regarding the relationships between parenting stress and competence and change in parent strategy use and growth in child language. This study provides preliminary evidence that parents who are experiencing significant mental health challenges may have a more difficult time participating fully in PILIs and that there may be subsequent effects on child outcomes. Future PILIs could benefit from addressing parent well-being as a substantial part of the intervention program.

Pre-linguistic social communication skills and post implant language outcomes in deaf children with cochlear implants.

PurposeThis study investigates the relationship between pre-linguistic social communication skills and age of cochlear implant for future language outcomes in a large sample of deaf children. MethodA retrospective cohort study of records from 75 children. Pre-implant data included Age at Implant, pre-linguistic communication (social, symbolic and speech) skills, and non-verbal ability. Receptive and expressive language development data at 1 year, 2 years and 4 years post implant were analysed to investigate the relationships between pre-implant factors and language outcomes, in particular pre-linguistic social communication skills in early and late implanted children. ResultsAge at Implant was the strongest correlate of post implant expressive and receptive language outcomes. The sample was divided into early implanted (<18 month) and late implanted (>18 months) children. In the early implanted group, pre-linguistic social communication skills were the strongest pre-implant correlate of language outcomes four years post-implant. In the late implanted group, there were no significant pre-implant correlates of language outcomes. ConclusionsLong term language outcomes after cochlear implantation are the product of a set of communicative, cognitive and environmental factors. Early pre-implant social communication skills are an important consideration for clinicians who guide parents as to likely long-term outcomes post cochlear implantation. Social communication skills are particularly important for children who receive implants before the age of 18 months.

Early Identification of Hearing Loss and Language Development at 32 Months of Age.

This study examines the relationship between the early identification of hearing loss and language outcomes for deaf/hard of hearing (D/HH) children, with bilateral or unilateral hearing loss and with or without additional disabilities. It was hypothesized that hearing loss identified by 3 months of age would be associated with better language outcomes. Using a prospective, longitudinal design, 86 families completed developmental instruments at two time points: at an average age of 14.8 months and an average age of 32.1 months. Multiple regression examined how hearing loss identified by 3 months of age contributed to later language outcomes while controlling for developmental level at the first time point. Hearing loss identified by 3 months of age was positively associated with better language outcomes for D/HH children at 32 months of age; however, D/HH children still exhibited language delays, compared to normative scores for same-aged hearing peers for reported measures. Language outcomes of children with unilateral hearing loss were not better than those of children with mild-to-moderate bilateral hearing loss. Children with additional disabilities and more severe bilateral hearing loss had lower language scores than those without.

Immersion in dual-language programs does not impede children's native language processing.

The benefits of dual-language immersion (DLI) versus English-only classrooms for minority-language speakers' acquisition of English have been well documented. However, less is known about the effect(s) of DLI on majority-language speakers' native English skills. Prior studies largely used accuracy-focused measures to index children's language skills; it is possible that processing-based tasks are more sensitive to the effects of DLI experience. Thirty-three monolingual native English-speaking children attending English-only classrooms and thirty-three English-speaking children attending English-Spanish DLI matched in age, gender, nonverbal IQ, and socio-economic status were tested twice, 1 year apart, on standardized and processing-based measures of English vocabulary and morphosyntax. We ran linear mixed-effects models to examine the extent to which group and time would predict scores on knowledge-based measures of vocabulary and morphosyntactic knowledge, as well as accuracy and reaction times on processing-based measures of English vocabulary and morphosyntax. Results revealed comparable levels of growth in English for both groups. A subtle effect of DLI was observed on a lexical-decision task: bilinguals were slower in Year 1 but both groups were equally efficient in Year 2. These results indicate that DLI programs have minimal impact on majority-language speakers' native-language skills in the age-range tested. This study is the first to longitudinally examine processing-based native language outcomes in bilingual children in DLI classrooms. We do not find evidence that DLI exposure carries a cost to native language development, even when indexed by processing measures. This should reassure parents, educators, and policymakers in that there are no downsides to DLI.

Early predictors of language outcomes in Down syndrome: A mini-review.

As children with Down syndrome (DS) typically manifest significant delays in language development, the research has pointed out the predictors of later language skills for this clinical population. The purpose of this study was to systematically explore the evidence for early predictors of language outcomes in infants and toddlers with DS from studies published between 2012 and 2022. After the search, nine studies met the inclusion criteria. The results indicated that maternal educational level, adaptive level of functioning, cognitive function, attention skills, communicative intent of the child, early vocalizations, gestures, baby signs, parents’ translation of their children’s gestures into words, and vocabulary level are significant predictors of language outcomes in children with DS. These findings provide a timely and warranted summary of published work that contributes to current understanding of the development of language and communication in DS. They are therefore useful to researchers, clinicians, and families.

Specific parenting behaviors link maternal education to toddlers' language and social competence.

Maternal sensitive parenting behavior has been shown to account, at least partially, for the relation between family background and children's language and behavioral outcomes. Yet, as previous studies often used a rather global or domain-general measure of maternal sensitivity, it remains an open question whether different domains of child development are influenced by the different facets of maternal sensitivity. Thus, this study investigated whether specific parenting behaviors differentially mediated the association between maternal education and children's language and social competence. Drawing on 2,478 mother-child dyads from the German National Educational Panel Study, we distinguished mothers' sensitive parenting behavior as cognitive-verbally stimulating and socioemotionally supportive parenting behaviors. These two observed specific parenting behaviors at 26 months were modeled as separate pathways linking maternal education and children's language outcomes at 26 months as well as children's social competence at 38 months. All analyses controlled for family net income, single parenthood, migration background, mother's depressive feelings, and child's negative affectivity. The results indicated that the mother's cognitive-verbally stimulating parenting behavior was specifically related to the children's language skills, whereas mother's socioemotionally supportive parenting behavior specifically predicted children's later social competence. Furthermore, these two separable parenting behaviors differentially mediated the association between maternal education and toddler's language and social competence. Most notably, children's language additionally mediated the relation between maternal education and children's social competence. The findings suggest that domain-specific intervention programs have the potential to promote early language and social development efficiently. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Cross-Modal Reorganization From Both Visual and Somatosensory Modalities in Cochlear Implanted Children and Its Relationship to Speech Perception.

We hypothesized that children with cochlear implants (CIs) who demonstrate cross-modal reorganization by vision also demonstrate cross-modal reorganization by somatosensation and that these processes are interrelated and impact speech perception. Cross-modal reorganization, which occurs when a deprived sensory modality's cortical resources are recruited by other intact modalities, has been proposed as a source of variability underlying speech perception in deaf children with CIs. Visual and somatosensory cross-modal reorganization of auditory cortex have been documented separately in CI children, but reorganization in these modalities has not been documented within the same subjects. Our goal was to examine the relationship between cross-modal reorganization from both visual and somatosensory modalities within a single group of CI children. We analyzed high-density electroencephalogram responses to visual and somatosensory stimuli and current density reconstruction of brain activity sources. Speech perception in noise testing was performed. Current density reconstruction patterns were analyzed within the entire subject group and across groups of CI children exhibiting good versus poor speech perception. Positive correlations between visual and somatosensory cross-modal reorganization suggested that neuroplasticity in different sensory systems may be interrelated. Furthermore, CI children with good speech perception did not show recruitment of frontal or auditory cortices during visual processing, unlike CI children with poor speech perception. Our results reflect changes in cortical resource allocation in pediatric CI users. Cross-modal recruitment of auditory and frontal cortices by vision, and cross-modal reorganization of auditory cortex by somatosensation, may underlie variability in speech and language outcomes in CI children.

Interactive Effects of Temperament and Family-Related Environmental Confusion on Spoken Language in Children Who Are Deaf and Hard of Hearing.

The aim of this study was to examine the influence of caregivers' reports of family-related environmental confusion-which refers to the level of overstimulation in the family home environment due to auditory and nonauditory (i.e., visual and cognitive) noise-on the relation between child temperament and spoken language outcomes in children who are deaf and hard of hearing (DHH) in comparison to age-matched children with typical hearing (TH). Two groups of families with children between 3 and 7 years of age (TH = 59, DHH = 58) were sequentially recruited from a larger longitudinal study on developmental outcomes in children who are DHH. Caregivers (all TH) completed questionnaires measuring three dimensions of child temperament (i.e., effortful control, negative affectivity, and surgency-extraversion) and family-related environmental confusion. A norm-referenced language measure was administered to children. Testing took place within the families' homes. For children who are DHH, effortful control was positively related to spoken language outcomes, but only when levels of family-related environmental confusion were low to moderate. Family-related environmental confusion did not interact with temperament to influence spoken language in children with TH. Homes with low-to-moderate levels of environmental confusion provide an environment that supports DHH children with better effortful control to harness their self-regulatory skills to achieve better spoken language comprehension than those with lower levels of effortful control. These findings suggest that efforts to minimize chaos and auditory noise in the home create an environment in which DHH children can utilize their self-regulatory skills to achieve optimal spoken language outcomes.

Word reading in monolingual and bilingual children with developmental language disorder

Many children with developmental language disorder (DLD) are reported to have word reading difficulties. However, previous research has focused mostly on monolingual children. The present study used two existing datasets to assess word reading outcomes of bilingual children with DLD. In Study 1, we compared word reading outcomes of monolingual and bilingual children with and without DLD (n = 93 monolingual DLD; n = 33 bilingual DLD, n = 42 monolingual TD; n = 74 bilingual TD). In Study 2, we compared those of monolingual (n = 91) and bilingual children with DLD (n = 51) on the basis of school record data. Findings from both studies show mean poor word reading outcomes and a high incidence of poor readers in the groups of children with DLD. Despite lower oral language outcomes of bilingual children in the mainstream language, reading outcomes of monolingual and bilingual children (with/without DLD) did not differ or outcomes were even better for the bilingual children. Overall, these findings indicate that DLD is a risk factor for word reading difficulties, while bilingualism is not.

Intersensory matching of faces and voices in infancy predicts language outcomes in young children.

Parent language input is a well-established predictor of child language development. Multisensory attention skills (MASks; intersensory matching, shifting and sustaining attention to audiovisual speech) are also known to be foundations for language development. However, due to a lack of appropriate measures, individual differences in these skills have received little research focus. A newly established measure, the Multisensory Attention Assessment Protocol (MAAP), allows researchers to examine predictive relations between early MASks and later outcomes. We hypothesized that, along with parent language input, multisensory attention to social events (faces and voices) in infancy would predict later language outcomes. We collected data from 97 children (predominantly White and Hispanic, 48 males) participating in an ongoing longitudinal study assessing 12-, 18-, and 24-month MASks (MAAP) and parent language input (quality, quantity), and 18- and 24-month language outcomes (child speech production, vocabulary size). Results revealed 12-month intersensory matching (but not maintaining or shifting attention) of faces and voices in the presence of a distractor was a strong predictor of language. It predicted a variety of 18- and 24-month child language outcomes (expressive vocabulary, child speech production), even when holding traditional predictors constant: parent language input and SES (maternal education: 52% bachelor's degree or higher). Further, at each age, parent language input predicted just one outcome, expressive vocabulary, and SES predicted child speech production. These novel findings reveal infant intersensory matching of faces and voices in the presence of a distractor can predict which children might benefit most from parent language input and show better language outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A mediation analysis to disentangle relations between maternal education and early child development

Maternal education is associated with early child outcomes. However, the several mechanisms that may explain this relationship remain underexplored. Using data from 1,097 children aged 12–15 months in Chile, we estimate the maternal education gap across child cognitive and language outcomes. Following a bioecological perspective, we explore potential pathways by which maternal education might influence child development, such as child characteristics, the quantity and quality of mother–child interactions, and the availability of home stimulation. We found an average maternal education gap between children with mothers with the lowest and the highest educational levels of 0.36, 0.31, and 0.25 standard deviation in child cognition, expressive language, and receptive language, respectively. The mediational analysis showed that maternal stress and depression and the quality of the home environment mediated the relation between maternal education and child language and cognitive development.

Predictors of Early Language Outcomes in Children with Connexin 26 Hearing Loss across Three Countries.

GJB2-associated hearing loss (GJB2-HL) is the most common genetic cause of hearing loss in children. However, little is known about the clinical characteristics and early language outcomes in population-oriented samples including children with different degrees of hearing loss. Insight into these characteristics are relevant for the counselling of parents. Our sample consisted of 66 children at approximately 2 years of age (17–32 months) with bilateral hearing loss due to GJB2 from three population-based cohorts in Austria, Australia and the Netherlands. Predictors of early vocabulary, including demographic, audiological, genetic and intervention variables and the role of medical comorbidities and nonverbal cognition were examined. The vocabulary scores of children with GJB2-HL were approximately 0.7 standard deviations (SDs) below the norms of children with typical hearing. Age at access to family-centered early intervention and first-born position among siblings predicted language outcomes, whereas the degree of hearing loss and genetic subtype were not significantly correlated with expressive vocabulary. In children with GJB2-HL, early access to family-centered early intervention significantly affected language outcomes at the age of two.

Early home learning environment profiles and their contribution to child development in Chile

The home learning environment (HLE) is a significant factor in children's development. This study uses the Chilean Early Childhood Longitudinal Survey of children 6 months to 5 years old (n = 12,898) to address the role of the home learning environment. Factor scores from factor analysis were used in latent profile analysis to identify HLE profiles and predict children's general development, language and socio-emotional outcomes. Four home learning environment profiles were revealed: a low-interaction and low-resources group (Inattentive), a high-interaction and high-resources group (Nurturing), an average-interaction but low-resources group (Warm), and a low-interaction and high-resources group (Instructional). Very high and very low profiles yielded different child development results, but in mixed profiles, vulnerabilities in one dimension seemed to be compensated by strengths in another. Controlling for pretest scores and demographics, the profiles predicted a small portion of variance in children's development skills two years later.

Procedural learning and school-age language outcomes in children with and without a history of late talking.

'Late talkers' (LTs) are toddlers with late language emergence that cannot be explained by other impairments. It is difficult to predict which of these children continue to present long-term restrictions in language abilities and will later be identified as having a developmental language disorder. Procedural memory weaknesses have been suggested to underlie developmental language disorders, but have not been investigated in LTs. We investigated the relationships between aspects of procedural memory and school-age language abilities in children with and without a history of LT. We hypothesized that children with a history of LT exhibit (1) restrictions in procedural memory when compared with children with typical early development (TED); and (2) a positive association between procedural memory and school-age language abilities. We recruited 79 children (7;5-10;5), 43 of whom had a history of LT. Aspects of procedural memory, procedural learning and motor planning were assessed using the serial reaction time and the end-state comfort tasks. School-age language abilities were measured using standardized tests. Counter to expectations, motor planning was not associated with a history of LT or school-age language abilities, and the children with TED did not show stronger procedural learning as compared with peers with a history of LT. However, weaker school-age language abilities were associated with weak procedural learning in TED group. Factors other than deficits in procedural memory are likely to underlie LT. Procedural learning shows promise as a potential predictor of language development in children that are not identified as LTs. What is already known on the subject Poor procedural learning has been associated with developmental language disorders and suggested to underlie language difficulties. However, to our knowledge, this study is the first to investigate procedural learning and its associations with language outcomes in LTs. What this paper adds to existing knowledge Consistent with prior research, we found an association between language abilities and procedural learning in school-aged children, but found no evidence for poor procedural learning in children with a history of LT. Furthermore, the school-age language outcomes were only associated with procedural learning in children with no history of LT. What are the potential or actual clinical implications of this work? Our findings suggest that factors other than limitations in procedural learning underlie LT. However, procedural learning could be a useful predictor for school-aged language outcomes in children not identified as LTs.

Children With Unilateral Hearing Loss After Newborn Hearing Screening in Taiwan.

We explored the intervention characteristics and language outcomes of children with unilateral hearing loss (UHL) in Taiwan after the implementation of universal newborn hearing screening (UNHS) to highlight changes in attitudes and actions toward hearing-related treatments. Data of 132 children with UHL in birth cohorts from 2012 to 2019 were included. This retrospective study examined differences in age at identification, hearing aid (HA) fitting, and seeking supportive services. Commonly requested attributes of services, reasons for HA rejection, and children's language performance were investigated. The age at identification decreased from 50.3 months in 2012 to 2.6 months in 2019. Similar trends of declining age were obtained for the age at HA fitting and age at first service contact. In addition, 40% of the parents did not seek support until the child became older (M = 30.5 months) and showed more noticeable behaviors related to hearing loss, and only 64% of the children were consistent HA users. Children with UHL enrolled in the intervention programs approximated the average language performance of the assessment norm; however, they showed depressed language levels when compared to the norm group at the 75th percentile. UNHS had a positive impact on early identification and intervention in children with UHL. Compared to parents of children with all types of hearing loss, parents of children with UHL seemed to be more uncertain about aural habilitation at the early stage.

Outcome of language therapy in bimodal-fit children versus unilateral cochlear implant children in bilateral sensorineural hearing impairment: a case-control study

BackgroundTreating hearing-impaired children aims not only to improve their hearing but also to enhance language acquisition capability. In our community, the CI usually performed on one side because of financial issues at least for a period of time. Consequently, the brain may neglect the unfitted ear. Contralateral hearing aid is an alternative solution when bilateral CI is unavailable. Our purpose is to evaluate the language outcome in bimodal-fit children who using cochlear implant (CI) and contralateral hearing aid (HA) compared to children using unilateral cochlear implant only.ResultsIn this case-control study, 15 children who are using binaural-bimodal stimulation by unilateral CI and contralateral HA and 15 children using monaural cochlear implant received auditory training and language therapy. All participants have been assigned randomly from the Phoniatrics and Audiology clinics. Filtering of patients was made to get the two groups matched regarding age, sex, family motivation, age of implantation, and age of hearing impairment. Evaluation and language therapy were performed in the Phoniatrics clinic. Language progress in each group was compared over different time-points. Also, it was compared between the two groups in each time-point. Both groups revealed significant language improvement over time with intensive auditory training and language therapy. In addition, the bimodal-fit children showed better language and speech outcomes than the unilateral CI children in receptive semantics, expressive semantics, word class, mean length of utterance, and speech intelligibility. The differences were significant with P-values 0.047, 0.034, 0.03, 0.016, and 0.028, respectively, after 9 months of rehabilitation.ConclusionBimodal-fit children showed better improvement in language than the unilateral CI group. The contralateral hearing aid may be complementary to the unilateral cochlear implant by covering wider speech frequency range. Also, it prevents auditory deprivation and enables binaural hearing with positive impact on language outcome.

Evaluating the dose–response relationship of the number of sessions of “It Takes Two to Talk®” in young children with language delay

Purpose To evaluate the dose–response relationship between the number of It Takes Two to Talk® (ITTT) sessions attended and the language outcomes of young children with language delay and their parent’s responsivity in a multicultural clinical population. Method A clinical caseload of 273 early language delayed children (mean age 29.2 months, SD 7.8) and their families participated in parent group workshops and individual coaching sessions of the parent responsivity program ITTT. The children’s vocabulary and early syntax, collected using the MacArthur-Bates Communicative Development Inventories and mean length of the three longest utterances respectively, were collated from pre- and post-intervention from pre-existing clinical data. Parental responsivity was evaluated utilising the Parent–Child Interaction checklist at three time points. Multilevel regression was used to determine the relationship between the number of sessions attended and outcomes, while accounting for covariates such as age and language spoken. Result ITTT dosage did not predict child language outcomes. Rather, vocabulary and early syntax outcomes were predicted by age, pre-scores and parent responsivity at the beginning of treatment. A higher dosage of ITTT did however positively predict parent responsivity, as did speaking only English at home. Socioeconomic status, gender and presence of receptive language difficulties did not contribute significantly to either child or parent outcomes. Conclusion A lower dosage of the intervention may be considered for parents and children with fewer known risk factors without significant implications.