Milieu Teaching Research Articles

Delivering Enhanced Milieu Teaching to Toddlers With Down Syndrome via Hybrid Telepractice: A Single-Case Experimental Design.

This pilot study investigated delivering enhanced milieu teaching tailored for children with Down Syndrome (EMT-DS) through hybrid telepractice. In this multiple-baseline design across behaviors study, a speech-language pathologist (SLP) taught EMT-DS to three caregivers and their children with DS (22-40 months) using a hybrid service delivery model. Sessions were conducted in person and via telepractice. The SLP taught caregivers EMT-DS, emphasizing the use of (a) four target EMT strategies: matched turns, expansions, time delays, and milieu teaching episodes; (b) augmentative and alternative communication (AAC; manual signs, speech-generating device); and (c) aided AAC modeling. The SLP provided caregiver instruction following the teach-model-coach-review approach. Caregiver outcomes were the accuracy (primary) and frequency (secondary) of EMT strategy use. Child outcomes were exploratory and included the rate of symbolic communication acts, weighted number of communication acts, and number of different words (NDW). There was a functional relation between the intervention and the accuracy and frequency of EMT strategy use for all three caregivers. All caregivers showed an increase in the accuracy for all four target strategies. Caregivers also increased the frequency of the three EMT strategies: expansions, time delays, and milieu teaching episodes. There were no changes in the frequency of matched turns. Caregiver use of EMT strategies maintained for 6 weeks post-intervention. After caregivers learned EMT strategies, gradual increases in the rate of symbolic communication acts and NDW occurred for all three children. Results demonstrate the preliminary efficacy of using a hybrid service delivery model to teach caregivers EMT-DS. https://doi.org/10.23641/asha.27115252.

The effect of teacher education supported through consultation on acquisition communication skills in children with autism spectrum disorder

The purpose of this paper is to measure the effects of the consultation method that includes teaching and practicing the mand-modelling technique to teachers and parents to improve the communication skills of children with autism. Multiple probe design, which is one of the single-case research designs, was used in the study. The findings of this research show that families with children with autism can be successful in improving their children’s limited verbal communication skills through receiving training in milieu teaching techniques that parents receive from their children’s teachers and perform in parallel with their teachers. The results showed that using the consultation method to teach the mand-modelling technique to special education teachers by ensuring that the family participates in the education is effective in developing pragmatic language in children with autism.

Does Gestural Communication Influence Later Spoken Language Ability in Minimally Verbal Autistic Children?

The current study examined the predictive role of gestures and gesture-speech combinations on later spoken language outcomes in minimally verbal (MV) autistic children enrolled in a blended naturalistic developmental/behavioral intervention (Joint Attention, Symbolic Play, Engagement, and Regulation [JASPER] + Enhanced Milieu Teaching [EMT]). Participants were 50 MV autistic children (40 boys), ages 54-105 months (M = 75.54, SD = 16.45). MV was defined as producing fewer than 20 spontaneous, unique, and socially communicative words. Autism symptom severity (Autism Diagnostic Observation Schedule-Second Edition) and nonverbal cognitive skills (Leiter-R Brief IQ) were assessed at entry. A natural language sample (NLS), a 20-min examiner-child interaction with specified toys, was collected at entry (Week 1) and exit (Week 18) from JASPER + EMT intervention. The NLS was coded for gestures (deictic, conventional, and representational) and gesture-speech combinations (reinforcing, disambiguating, supplementary, other) at entry and spoken language outcomes: speech quantity (rate of speech utterances) and speech quality (number of different words [NDW] and mean length of utterance in words [MLUw]) at exit using European Distributed Corpora Project Linguistic Annotator and Systematic Analysis of Language Transcripts. Controlling for nonverbal IQ and autism symptom severity at entry, rate of gesture-speech combinations (but not gestures alone) at entry was a significant predictor of rate of speech utterances and MLUw at exit. The rate of supplementary gesture-speech combinations, in particular, significantly predicted rate of speech utterances and NDW at exit. These findings highlight the critical importance of gestural communication, particularly gesture-speech (supplementary) combinations in supporting spoken language development in MV autistic children.

The impact of enhanced Milieu teaching with phonological emphasis (EMT + PE) on the speech and language outcomes for toddlers with cleft palate in Brazil and the United States of America

Purpose The purpose of this study was to compare the speech and language outcomes of children with cleft palate with or without cleft lip (CP+/-L) in the USA to children with CP+/-L in Brazil who underwent intervention with enhanced Milieu teaching with phonological emphasis (EMT + PE), as there are few cross-country intervention comparisons for children with CP+/-L. Method This is a retrospective analysis of 29 participants from the USA and 24 participants from Brazil who were matched on age. The US participants were between the ages of 13–35 months (M = 23.76), spoke Standard American English in the home, and were recruited from East Tennessee State University and Vanderbilt University. The Brazilian participants were between the ages of 20–34 months (M = 25.04), spoke Brazilian Portuguese in the home, and were recruited from the Hospital de Reabilitação de Anomalias Craniofaciais–Universidade de São Paulo. All treatment participants received EMT + PE from trained speech-language pathologists in hospital-university clinics. Result The treatment groups demonstrated greater gains than comparison groups in percent consonants correct, number of different words, and expressive/receptive vocabulary. There was no main effect nor interaction by country. Conclusion The application of EMT + PE in a second culture and language is a viable early intervention option for participants with CP+/-L.

Telepractice Parent Training of Enhanced Milieu Teaching With Phonological Emphasis (EMT+PE) For Persian-Speaking Toddlers With Nonsyndromic Cleft Palate: Protocol for a Randomized Controlled Trial.

Children born with a cleft palate with or without a cleft lip (CP/L) are at increased risk for delayed language development and speech sound disorders. Enhanced Milieu Teaching with Phonological Emphasis (EMT+PE) is a recommended naturalistic intervention for toddlers with CP/L. The parents' role in providing naturalistic interventions is critical and they need training based on learning principles to implement these interventions. Telepractice is an appropriate method for training parents and children with various speech-related disorders. This study aims to determine and compare the effectiveness of telepractice and the parent-implemented EMT+PE intervention on language and speech measures in toddlers with CP/L with usual interventions and determine the effectiveness maintenance of the intervention. A randomized controlled trial (RCT) will assess the efficacy of telepractice and the parent-implemented EMT+PE intervention in enhancing speech and language measures in toddlers with CP/L. Eligible participants will be randomly assigned to one of 2 groups: the conventional intervention group and the EMT+PE intervention group. Participants' speech and language measures will be evaluated remotely by trained raters before and after the intervention and 2 months after the intervention. Parents of participants in the intervention group will receive 3 months of training in speech and language supportive strategies from trained therapists using telehealth fidelity scales. Parents of participants in the control group will receive the conventional speech and language intervention by cleft team therapists. Study outcomes will include language variables (mean length of utterance) and speech production variables (percent correct consonants). The protocol was approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences in February 2022. The selection process of participants, as well as training therapists and raters, commenced in January 2022, the therapy and follow-up period ended in June 2023, and pre- and postintervention assessments have been conducted. Data analysis is ongoing, and we expect to publish our results by the summer of 2024. Funding is yet to be received. The results of this study may help us develop a speech and language intervention with a different delivery model for toddlers with CP/L, and the cleft team care can use these results in service delivery. Consistent with our hypothesis, speech and language measures are expected to improve. DERR1-10.2196/54426.

Enhanced Milieu Teaching in resource-constrained settings: Stakeholder-informed adaptation guidelines.

Enhanced Milieu Teaching (EMT) is an evidence-based naturalistic developmental behavioural intervention (NDBI) for children with developmental disabilities. Little is known about the EMT's fit or what adaptations might be needed to improve its applicability within a resource-constrained setting. To explore stakeholders' perceptions of the contextual fit of EMT for young children with developmental disabilities in a resource-constrained context and to identify adaptations to improve EMT's contextual fit. We conducted a descriptive qualitative study using semi-structured interviews and focus groups. Participants included 5 speech and language therapists and 11 caregivers of children with developmental disabilities who speak English and Afrikaans or isiXhosa. Using thematic analysis, data were coded into 10 subthemes and grouped according to the Adaptome framework components. Overall, stakeholders view EMT as an appropriate intervention in the South African context. They indicated that certain intervention components may need to be modified. Specifically, clinicians may need to adapt intervention materials and activities to be sensitive to families' available resources, preferred activity routines and priorities. From these data, we provide guidelines to improve the fit of EMT in South Africa. Enhanced Milieu Teaching is an appropriate intervention in the South African context, although some adaptations can enhance its fit.Contribution:This article highlights the importance of engaging with stakeholders to determine the fit of NDBIs, like EMT, as they are implemented in new contexts. Based on these insights, stakeholder-informed adaptation guidelines are provided for improving the contextual fit of EMT in resource-constrained settings.

Just-in-Time: A Caregiver-Mediated Intervention for Toddlers With Autism.

We investigated effects of an adaptive telehealth coaching model on caregiver implementation of enhanced milieu teaching (EMT) with newly diagnosed toddlers with autism. Three caregiver-child dyads participated in a multiple-baseline-across-behaviors, single-case design. Caregivers were taught EMT via telehealth using the teach-model-coach-review approach. EMT strategies were taught sequentially in four components corresponding to design tiers. Caregivers reported their needs for support and adaptation via weekly surveys. Primary outcomes were measures of caregiver's implementation, including (a) a fidelity checklist for wholistic use of EMT and (b) a percentage of correct use of a subset of key EMT strategies (e.g., matched turns, target talk, expansions, play actions, milieu episodes). Generalization and maintenance of caregiver strategy use in uncoached home activities were measured. The number of different words used by children was measured as a secondary, descriptive outcome. Social validity data were collected through ratings and interviews at the end of the study. There was a functional relation between the intervention and caregiver's implementation of EMT for all dyads. Caregiver's use of EMT strategies often generalized and maintained post-intervention. Child response to intervention was variable. Social validity data indicated that the model was beneficial to caregivers and children. An adaptive telehealth coaching model is effective for teaching caregivers of toddlers with autism to implement EMT and potentially helps to bridge the gap between diagnosis and comprehensive intervention. Further exploration of the relation between caregiver fidelity and dosage of active ingredients and child spoken language outcomes is needed. https://doi.org/10.23641/asha.25156223.

Language and drawing development after a combined intervention: A single‐subject case study

AbstractLanguage and drawing each have their own sets of symbols that they use to convey messages. It is still unclear whether the development of these two expression mechanisms is similar or distinct. There are various approaches to supporting language and communication skills, including structured and naturalistic methods. The goal of this in‐depth case study is to find out how a combined intervention affects the language and drawing abilities of a three‐year‐old girl with developmental delay. Structured implementations and milieu teaching strategies were used in the same session, but not simultaneously. The participant's language and communication skills improved at the end of the programme. Interestingly, even though there was no drawing‐related goal, her drawings evolved too. Even though this is a single‐subject case study, it suggests that if a child's cognitive and language skills develop, his/her drawing skills do as well.

Aided Enhanced milieu teaching to develop symbolic and social communication skills in children with autism spectrum disorder

Children who lack functional spoken language are candidates for augmentative and alternative communication (AAC). Aided AAC and naturalistic interventions offer the potential to extend the communication functions demonstrated by children with autism spectrum disorder (ASD) who are nonspeaking. Related intervention research, however, has been limited, in that interventions have generally targeted a limited range of communication functions taught in highly structured, decontextualized environments. The aim of this study was to investigate the efficacy of an intervention that combined aided AAC with a naturalistic intervention – enhanced milieu teaching (AEMT) - to increase symbolic communication in children with autism spectrum disorder. Three children with autism spectrum disorder participated in a multiple probe design, in which a range of communication functions were targeted using the AEMT. Results showed increases in the use of symbolic communication from baseline to intervention phases, which were found to be statistically significant for two of the three children (phi 0.7–0.81; p < .001). Intervention outcomes were generalized to a communication partner not involved in the intervention and maintained over time for all children. The study provides preliminary evidence that communication functions beyond object requests could be taught using a systematic, multi-element approach implemented across activities.

“They aren’t waiting for an SLP, they think ‘what can I as a parent do now?’” course leaders’ perceptions of AAC interventions targeting parents

Parental interventions can help parents use strategies to support their child’s language and communication development. The ComAlong courses are parental interventions that focus on responsive communication, enhanced milieu teaching, and augmentative and alternative communication. This interview study aimed to investigate the course leaders’ perceptions of the three ComAlong courses, ComAlong Habilitation, ComAlong Developmental Language Disorder, and ComAlong Toddler, and to evaluate their experiences of the implementation of the courses. Qualitative content analysis was used to analyze the interview data. Thereafter, three categories resulted from the findings: Impact on the Family, A Great Course Concept, and Accessibility of the Courses. The results indicate that participants perceived that the courses had positive effects on both parents and themself. Furthermore, it was described that parents gained knowledge about communication and strategies in how to develop their child’s communication; however, the courses were not accessible to all parents. The collaboration between the parents and course leaders improved, and course leaders viewed the courses as an important part of their work. The following factors had an impact on the implementation: several course leaders in the same workplace, support from colleagues and management, and recruitment of parents to the courses.

Enhanced milieu teaching with phonological emphasis: A pilot, telepractice study for parent training in early intervention

Purpose This pilot study evaluated enhanced milieu teaching with phonological emphasis (EMT + PE) parent training intervention delivered through telepractice and its impact on parent implementation, child speech outcomes, and child language outcomes. Method A multiple baseline design across behaviours was used to assess response to parent training and child outcomes. The intervention was delivered to four parents and their young children with repaired cleft palate. Speech production, receptive language, and expressive language were assessed prior to intervention. EMT + PE strategies including matched turns, modelling and expansions, and prompting/speech recasting were taught to parents using the teach-model-coach-review model. Social validity questionnaires were administered pre- and post-intervention to assess parents’ rating of competence and confidence for managing their child’s early development. Reliability and procedural fidelity were conducted. Result All parents increased their use of modelling and expansions, and prompting and speech recasting in response to training, as evidenced by large effect sizes. Children also responded positively to these strategies by increasing percentage of consonants correct (PCC) and target vocabulary, although PCC gains were less than observed in a prior hybrid telepractice and face-to-face intervention. Social validity measures indicated parents increased their confidence to provide intervention for their children. Conclusion This pilot study indicated that effective parent training in EMT + PE strategies can be delivered through telepractice.

The Effects of Virtual Caregiver Coaching in Antigua & Barbuda on the Implementation of EMT Language Support Strategies in Naturalistic Environments.

This single-case multiple baseline design investigation set out to determine the effectiveness of using a telepractice service delivery model to coach caregivers in Antigua & Barbuda in the use of Enhanced Milieu Teaching (EMT) language support strategies with a child with language impairment. A slightly modified version of the Teach-Model-Coach-Review (TMCR) method was used during virtual instruction to train a caregiver on the language support strategies of environmental arrangement, matched turns, expansions, and time delay with milieu prompting. The caregiver attended sessions three times a week for up to 45 minutes for four weeks. The results of this study indicated a positive relationship between the intervention and caregiver use of strategies. The caregiver demonstrated increased responsiveness to the child's communication attempts and exhibited the use of language support strategies across activities. This study suggests that telepractice can be an effective service delivery model for providing coaching to caregivers.

Development and application effect of enhanced milieu teaching program using augmented reality -Focusing on infants from multicultural families who are late talkers-

본 연구는 증강현실을 활용한 강화된 환경중심 언어중재 프로그램을 개발하고, 이를 말늦은 다문화가정 영아에게 적용하여 언어발달(어휘력, 언어능력, 의사소통기능)에 미치는 효과를 검증하고자 하였다. 이에 관련 문헌 및 선행연구들을 분석하고 보육현장 교직원의 요구조사를 기초로 프로그램을 구성하였다. 이후 관련 분야의 전문가 협의를 통해 최종 프로그램을 확정하였다. 본 연구에서 개발된 프로그램의 효과를 측정하기 위해 S시 G구에 소재한 어린이집에 재원하고 있는 만 2세 영아 총 30명을 대상으로 실험을 실시하였다. 이중 10명은 말늦은 다문화가정의 영아(실험집단)이며 10명은 말늦음이 없는 다문화가정의 영아(비교집단 1) 그리고 단일문화가정의 영아(비교집단 2)이다. 연구기간은 주 2회, 8주간으로 총 16회기이다. 연구도구는 수용·표현 어휘력검사(REVT)와 영·유아 언어발달 검사도구(SELSI)이며 통계방법은 Kruskal-Wallis, Mann-Whitney U 검정을 실시한 후, 유의 수준은 Bonferroni correction을 통해 검증하였다. 그 결과는 다음과 같다. 첫째, 실험집단이 비교집단 1, 2보다 유의한 수용어휘 변화량을 나타냈다. 둘째, 실험집단이 비교집단 1, 2보다 유의한 언어능력 변화량을 나타냈다. 셋째, 교사들의 저널을 바탕으로, 다양한 의사소통 기능을 습득하였음이 밝혀졌다. 이와 같은 결과는 다문화가정이 급증하고 있는 현 대한민국의 보육현장에서 증강현실을 활용한 강화된 환경중심 프로그램이 말늦은 다문화가정 영아의 언어발달을 향상시킬 수 있음을 밝혀냈다는 점에서 의미를 갖는다.

A Preliminary Study of Telepractice Prelinguistic Milieu Teaching for Children with Autism Spectrum Disorders

Background: Autism Spectrum Disorder (ASD) is a developmental neurological disorder characterized by impaired social interactions. The aim of study was to examine the telepractice Prelinguistic Milieu Teaching (PMT) for ASD children.&#x0D; Methods: This study followed a pretest–posttest design. 11 mothers of children with ASD aged 26-71 months (mean=47.09 months, SD=14) were included. Mothers were given the necessary training on the PMT for 12 one-hour weekly sessions, through the WhatsApp software. The self-reported McArthur-Bates communication development inventories (CDIs) was the main outcome measure. The data were analyzed using Wilcoxon test.&#x0D; Results: Mean scores of expressive and perceptive words significantly improved after treatment with large effects sizes (Cohen’s d &gt;0.8). The activity and gestures section scores showed significant improvements after treatment in the areas of communication gestures, play and routines, working with objects and imitation of adult activities (Cohen’s d &gt;0.8).&#x0D; Conclusion: This study provides preliminary evidence that the telepractice of PMT is effective for children with autism spectrum disorder. Further study with a rigours design is warranted.

책 읽기를 활용한 강화된 환경중심 언어중재가 발달장애 유아의 의사소통 능력에 미치는 영향

The purpose of this study was to determine the effects of Enhanced Milieu Teaching with Book Reading(EMT-BR) on the communication ability, the level of support required, and maintenance of two young children with Developmental Disabilities(DD). Participants in the study were two young children with DD at kindergarten special class in G city. A multiple probe design across settings was used to investigate functional relationship between EMT-BR and the communication ability .The results of this study indicated that two participants with DD learned and used their language targets as a result of EMT-BR. First of all, two participants did not communicate with the experimenter during baseline. However, two participants with DD learned and used language targets with assistance with the experimenter as a results of EMT-BR. In addition, during the intervention the most frequently used level of support was time delay and open questions. Finally, they maintained acquired language targets after two or three weeks after the intervention was terminated. This study meaningful that EMT-BR for children with disabilities have been used to communicate using words that were not often used by children with disabilities.&#x0D;

A Study on the Use of Milieu Teaching to Promote Overseas Marketers' Communication Skills and Confidence in Language Learning.

Language plays an extremely important role for people in terms of engaging in various learning activities. Due to the progress of network technologies, it is an immediate goal for enterprises to take a completely new development direction with the application of network technology. Nevertheless, they encounter many difficulties in carrying out overseas marketing such as localization transformation, jet lag, lack of professional marketers, problems with sellers’ product quality, problems with customers’ credit checks, international payment problems, and logistics and delivery problems. These problems mainly result from a difference in language families. The current study was conducted as an experimental study with the participation of overseas marketers in Hebei province. Milieu teaching was implemented with an experimental group and traditional teaching was maintained in the control group for a 20-week (3 h per week) experimental procedure. The research results revealed significantly positive effects of (1) milieu teaching on communication skills, (2) milieu teaching on language learning confidence, and (3) communication skills on language learning confidence. Based on the results, it can be stated that the study is expected to help effectively enhance the communication skills and language learning confidence of overseas marketers to achieve the goals of promoting oral expression and language-use skills.

Effects of Enhanced Milieu Teaching and Book Reading on the Target Word Approximations of Young Children With Language Delay

Teaching vocabularies to young children is critical as vocabulary is related to long-term language, literacy, and academic skills. The current study used a multiple probe design to examine the effects of enhanced milieu teaching with book reading on the use of word approximations in four 2- to 4-year-old females with language delay. The first author implemented the intervention in families’ homes for 3 to 5 days a week over 3 months. Through visual analysis and the calculation of effect sizes, the results showed that there was a functional relation between the intervention and the number and frequency of targeted word approximations. After six to 25 intervention sessions, participants used all five targeted word approximations, and the improvements were maintained up to 15 weeks. In addition, the total frequency of targeted word approximations used after prompts and the proportions of prompts used to elicit the targeted word approximations were measured and analyzed. Parents reported high social validity of the intervention via an anonymous questionnaire. Implications for practice and research of family-centered early intervention are discussed.

Perceptions of Thai Parents Regarding Child Language Development and Parent-Implemented Intervention

This phenomenology study was conducted to explore the parents’ perceptions of the language development of children with language impairment (LI) before and after participation in parent-implemented enhanced milieu teaching (EMT) using the teach-model-coach-review (TMCR) model and the parents’ suggestions for improvement in language development of children with LI. Thirteen parents of children with LI participated in semi-structured interview. A thematic analysis was used to analyze the content. The findings of the study show that before participation in the intervention, parents perceived that requesting and asking someone to do something was important for their children, and they expected that their children would reach language development milestones. Parents also expected that speech therapy was clinician-directed therapy. After an eight-week parent training program, parents felt empowered and learned the EMT language strategies and implemented these strategies in the clinical and home settings. They were satisfied with the language outcomes of their children. In addition, the findings of the study show that parents suggest that parent-child interaction and the home language environment play an important role in their child’s language development.

Conducting a Community Engagement Studio to Adapt Enhanced Milieu Teaching.

Barriers to implementing evidence-based practices occur at various levels. Stakeholder input is required to identify challenges specific to clinical practice settings, client populations, and service delivery approaches. The purpose of this project was to solicit feedback from stakeholders on the telepractice service delivery and implementation strategies proposed for a future study of enhanced milieu teaching (EMT) in rural counties. A Community Engagement Studio was conducted with 11 caregivers of children with language delays living in rural counties. Caregivers and the researchers discussed early intervention service delivery for children with language delays in rural Oregon and the proposed telepractice EMT procedures. Researchers gathered feedback on three intervention components: session frequency and schedule, implementation strategies to encourage caregivers' use of EMT, and performance feedback techniques to teach caregivers. Findings from the Community Engagement Studio led to four primary modifications to the telepractice EMT study protocol. The principal investigator increased available days and times for intervention sessions and added text-message reminders for parents. A survey was also added for caregivers to identify their preferences for additional implementation strategies (e.g., tip sheets, checklist, e-mailed session summaries) and graphic representations of performance feedback (e.g., bar graph, radial graph, mountain climber infographic). Community Engagement Studios are a promising method for increasing community engagement in clinical research and soliciting stakeholder feedback on evidence-based intervention adaptations. https://doi.org/10.23641/asha.17774819.

A systematic review of early speech interventions for children with cleft palate.

Children with cleft palate with or without cleft lip (CP±L) are at high risk of problems with early speech sound production, and these difficulties can persist into later childhood. Early intervention could help to reduce the number of children whose problems become persistent. However, much research in the field to date has focused on older children. There is a need to determine if providing intervention during the phase of early typical speech development leads to better outcomes. To review the evidence for the effectiveness of interventions targeting speech, delivered in the first 3 years of life for children with CP±L, and discuss factors such as intervention type, facilitator, dosage, outcome measures and the age of the child. The systematic review was registered with PROSPERO (CRD42019121964). Eight bibliographic databases including CINAHL and MEDLINE were searched in August 2018. Studies were included if participants received speech and language interventions before 37 months and if they reported outcomes for speech. Two reviewers independently completed inclusion reviews, quality analysis and data extraction. The review included seven papers: one pilot randomized controlled trial, one controlled trial, four cohort studies and one case series report. Interventions largely took a naturalistic approach, namely focused stimulation and milieu teaching. The findings provide preliminary support for naturalistic interventions and suggest that these interventions can be delivered by parents with suitable training. Studies included in the review provided low-strength evidence with variation in both the type of intervention, the manner of delivery and in the risk of bias in the designs used. The papers included in this review suggest that early naturalistic interventions can have positive impacts on the speech development of children with CP±L. However, the reported methodological quality of the publications overall was weak, and the current evidence lacks clarity and specificity in terms of therapy technique, delivery and optimum age of delivery. Future research should use more robust methodological designs to determine whether early speech interventions are beneficial for children born with CP±L. What is already known on the subject Children with CP±L show difficulties with early speech development and often have restricted speech sound inventories. They may reach the canonical babbling stage later than children without CP±L and studies have shown that 20% of children with CP±L have speech which is considered unintelligible or barely intelligible at age 5. It has been proposed that early intervention can lessen the impact of CP±L on speech development. However, currently, the evidence for early interventions for children with CP±L is limited, with the majority of studies focusing on children aged 3 years and older. What this paper adds to existing knowledge This paper reviews the evidence for different types of early interventions for speech provided to children born with CP±L and whether these interventions are effective in supporting speech sound development. In this review, early intervention is defined as intervention provided to children in the first 3 years of life. This review describes intervention approaches and how they are delivered for this population. What are the potential or actual clinical implications of this work? In the UK, children born with CP±L and their families are supported by National Health Service (NHS) services over a 20-year period and speech and language therapy sessions may take place over many weeks and months. If providing early intervention in the first 3 years of life is effective, there is the potential for improved speech outcomes in early childhood and a reduced burden of care on children, families and services. This review considers the evidence for early speech intervention for children with CP±L in the first 3 years of life and identifies areas for future research.