Parent-implemented Language Intervention Research Articles

Empowering Hong Kong Chinese families with autism: A preliminary study of the online Hanen More Than Words Program.

Parent involvement is crucial for tailored early intervention programs. The Hanen More Than Words (HMTW) program is a parent-implemented language intervention for autistic children. The current study examined the effectiveness of the HMTW program delivered online among Chinese families. Using a randomized controlled trial design, 22 Chinese families of autistic children in Hong Kong completed the trial. Baseline and post-intervention assessments were conducted to measure changes in parent-child interaction, parents' use of linguistic facilitation techniques (LFTs), and children's communication skills. Additionally, the influence of parental self-efficacy and parenting stress on treatment outcomes was explored. The intervention group demonstrated significant improvements in parent-child attention synchrony. Although the treatment effect on children's spontaneous communication was not significant, the intervention group showed a larger effect size compared to the controls. The treatment outcomes were mainly influenced by the parents' initial levels of self-efficacy but not by parenting stress. These findings provide preliminary evidence of the effectiveness of the online-delivered HMTW program for Chinese parents of autistic children. Further research involving a larger sample and focusing on long-term effects is needed.

Effect of online parent training in promoting language development of children with language delay in Hubei province, China.

Training parents to implement language and communication intervention strategies is an effective approach to promote language development for children with language delay. This study introduces an online parent training program conducted in Hubei province, China, which was designed to help parents of language-delayed children with a diagnosis of autism spectrum disorder (ASD), developmental language disorder (DLD) or global developmental delay (GDD) apply language intervention strategies into daily interactions and promote their children's language development at home. The Bethel Hearing and Speaking Training Center Family Training for Early Communication & Language Development (Bethel Family Training Program, BFT) (Bethel HSTC, 2020) was designed to improve the language and communication skills for children with language delay in a naturalistic way. The caregivers (including parents, grandparents and other main caregivers) participated in an 8-h online program, including lectures on milestones in child language development, common misunderstandings of child language development, and three basic family language intervention strategies ('Looking together, playing together, and talking together') incorporating active learning through video analysis and discussion. Tongji Hospital in Hubei then continued with 3 months of online home intervention monitoring to all the caregivers via weekly online Q&As led by BFT certified speech therapists' team. The Gesell Developmental Schedules (GDS) was carried out before the online parent training program and after the 3-month online home intervention monitoring. 146 families whose children aged 12-68 months with language delay participated in the online training program. The results of the GDS assessments conducted before and after the program showed that not only did the developmental quotient (DQ) of language improve, but so did the DQ of social behaviour and adaptive behaviour (p < 0.001). There is no between-group difference in the application of three strategies between the ASD group and the DLD or GDD group (p > 0.05). Furthermore, both caregivers' ability to apply 'looking together, playing together, talking together' strategies and the effective interaction time played important roles in improving the child's language abilities. The online parent training focusing on improving daily interaction with children through speech-language stimulation strategies promoted the development of language skills. It is an economic and practical approach for children with language delay who have limited access to local language intervention programs. What is already known on the subject Parent-implemented language intervention is an effective approach at improving children's language development. Telepractice is an appropriate model of service delivery for audiologists and speech-language therapists and may be the primary mode of service delivery or may supplement in-person services. What this paper adds to the existing knowledge This paper explores the effectiveness of an online parent training program and provides new evidence that online training on language support strategies (looking together, playing together, talking together) followed by home intervention monitoring works for Mandarin-speaking children and it is equally effective for children with ASD and non-ASD diagnosis. What are the potential or actual clinical implications of this work? Developmental behavioural paediatricians and speech-language therapists in countries and areas that lack sufficient training resource for every child will have the option to deliver parent training and home intervention monitoring online, which will save time and cost considerably while offering convenience.

Effects in language development of young children with language delay during early intervention

IntroductionIn the Netherlands, early language intervention is offered to young children with Language Delay (LD). The intervention combines groupwise language intervention, individual speech and language therapy and parent-implemented language intervention. This study tests the hypothesis that children with LD show progress in their receptive and expressive language during intervention. Differences in language progress between age groups (< 36 months and ≥ 36 months at intervention start) were expected in favour of the younger group, which might be due to an earlier intervention start, a longer treatment duration or the potential presence of late talkers. MethodsThe study included 183 children with LD (45 children < 3 years of age at intervention start; mean age 32 months, 138 children ≥ 3 years; mean age 40 months). Receptive and expressive language was assessed with norm-referenced tests at intervention start and ending using Routine Outcome Monitoring. A repeated measures MANOVA was carried out to examine language progress and to compare the age groups on receptive syntax, receptive vocabulary, expressive syntax and expressive vocabulary. The Reliable Change Index was used to study individual progress. ResultsOn average, children in both age groups showed significant improvement in all four language domains. The younger children showed more language progress than the older children in all four domains. When examining individual progress, most of the children displayed reliable improvement for expressive vocabulary. Most children developed in the same pace as their typically developing peers for receptive syntax, receptive vocabulary, and expressive syntax. ConclusionsChildren stabilized or even improved language proficiency during the intervention, indicating that the language gap between these children and typically developing children did not widen further. Younger children displayed more language progress than older children in all four domains, but it is unclear what might explain this difference.

Parent-Implemented Language Intervention for Late Talkers: A Scoping Review

Parent-implemented language intervention (PILI) is one of the intervention approaches used in managing late talkers (LTs). Yet, there are few evidence-based PILI programs available for parents of LTs. This scoping review aimed to (a) assess the characteristics of participants depicted in the literature related to PILI programs for parents of LTs, (b) provide an overview of the structure and design of the available PILI programs for parents of LTs, and (c) explore the effectiveness of the programs in relation to the characteristics of reviewed studies. The scoping review was performed by adhering to the general principles prescribed by Arksey and O’Malley (2005). Articles that fulfilled the inclusion criteria and were published from 1980 to 2018 were selected. Two reviewers independently charted the information from the identified articles. A total of 15 articles were selected. The results were reviewed in terms of participant characteristics, intervention characteristics, and effectiveness of PILI programs. Most adult participants in PILI studies were mothers and included child participants with either expressive language delay or receptive and expressive language delay. Moreover, there were different structures and designs of PILI programs for parents of LTs. Preliminary evidence indicated that PILI was more effective than no/delayed intervention and could be as effective as direct therapy provided by clinicians. A discussion related to the findings was also presented. Keywords:parent-implemented language intervention, late talkers, parent training, language intervention

Predictors in language proficiency of young children with presumed developmental language disorder within the setting of early language intervention

IntroductionIn the Netherlands, early language intervention is offered to children with presumed Developmental Language Disorder (DLD). The intervention is a combination of group language intervention, individual speech and language therapy and parent-implemented language intervention. During the intervention, some children show more language progress than others. It is unclear what might explain this variation. In this study, we therefore explored to what extent child, parental, and treatment factors were predictive for receptive and expressive language outcomes of young children with presumed DLD during early language intervention.MethodsFour multiple regression analyses were conducted with four child factors [pre-test receptive syntax, behavior (internalizing and externalizing), non-verbal cognitive ability and gender], one parental factor (parental stress) and one treatment factor (treatment duration) as predictors and receptive and expressive language post-test scores as outcomes. For each language post-test, the corresponding pre-test language measure was also added. Data of 183 children with presumed DLD were included.ResultsReceptive syntax problems were an important predictor of expressive language outcomes. Findings also showed a longer treatment duration to be a predictor of progress in expressive vocabulary. Internalizing behavior, externalizing behavior, non-verbal cognitive ability, gender and parental stress did not contribute to predicting language outcomes. Lower pre-intervention language scores led to lower corresponding post-intervention language scores.ConclusionsProfessionals may need to be aware that children with receptive problems may be indicative of more pervasive impairment and that it can be more difficult to improve their language problems. In fact, children with receptive language problems may need both more and different approaches. The finding that the level of the pre-intervention score has an essential influence on language outcomes underlines the importance of early diagnosis and early intervention, to prevent language problems increasing.

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.

Impacts of a Parent-Implemented Language Intervention on Children's Language Development Within Home Visiting

The purpose of this study was to conduct a pilot randomized controlled trial to evaluate the efficacy of an intervention for enhancing the language development of young children enrolled in home visiting programs. The participants were 59 children (18–30 months old) enrolled in one of three types of home visiting programs. Children's language skills were assessed pre- and post-intervention with the Preschool Language Scale. To estimate the impacts of the intervention on children's language scores, we conducted a two-level hierarchical linear model. Results from this model provide promising evidence for the benefits of using systematic parent-implemented language interventions.

Effects of Parent-Implemented Language Intervention on Communication Skills of Iranian Toddlers: A Pilot Randomized Control Trial

Introduction: In recent years, some studies have indicated that some aspects of language performance of children from low socioeconomic status (SES) families are lower in language tests. Appropriate and timely interventions can partially prevent communication problems in these children. This study aimed to investigate the effect of a parental education program on word acquisition rates in Iranian toddlers from low SES families.&#x0D; Materials and Methods: Sixty-six mothers (toddlers aged 12-14 months) participated in this randomized controlled trial study. These mothers were allocated to the experimental group and control group using the randomization method of the permuted block (each block=6). After baseline assessments, mothers in the experimental group received parental education program aimed at enriching the mother-child interactions and mothers’ knowledge of communication development for 9 weeks. The control group did not receive any education. The outcome measures were children’s scores on the Persian version of the McArthur-Bates communicative development inventories and mothers’ scores in multiple-choice exams regarding workshops’ contents. Data were analyzed using of Chi-square test, independent t test and paired samples t-test, Mann-Whitney U-test, and Wilcoxon signed-rank test.&#x0D; Results: Both groups had a significant increase in vocabulary size, while changes in the experimental group were more than double that of the control group (P&lt;0.001). Other aspects of communicative behaviors, such as imitation, naming, and intentionality were changed only in the experimental group according to the course of typical development (P&lt;0.001). Mothers significantly got higher scores after the workshops in a multiple-choice exam regarding children’s communication, language, and interaction (P&lt;0.001).&#x0D; Conclusion: The results demonstrate that mothers’ knowledge of communication development is malleable and probably has positive effects on the communication behaviors of toddlers from low SES backgrounds.

Parent Implemented Language Intervention through Bluetooth Enabled Device: A Preliminary Investigation in Three Pediatric Patients

Parent Implemented Language Intervention through Bluetooth Enabled Device: A Preliminary Investigation in Three Pediatric Patients

The Effects of a Parent-Implemented Language Intervention on Late-Talkers' Expressive Skills: The Mediational Role of Parental Speech Contingency and Dialogic Reading Abilities.

Several qualitative and quantitative features of parental speech input support children’s language development and may play a critical role in improving such process in late talkers. Parent-implemented interventions targeting late-talkers have been developed to promote children’s language outcomes by enhancing their linguistic environment, i.e., parental speech input. This study investigated the effect of a parent-implemented intervention in increasing late talkers’ expressive skills through modifications in structural and functional features of parental speech input. Forty-six thirty-one-month-old late talkers differing in their birth condition (either low-risk preterm or full-term) participated in the study with a parent; 24 parent-child dyads received a parent-implemented intervention centered on dialogic reading and focused stimulation techniques, whereas the other 22 dyads constituted the control group. At pre- and post-intervention, dyads took part in a parent-child shared book-reading session and both parental and child’s speech measures were collected and examined. Results showed that the intervention positively affected parents’ use of responses and expansions of children’s verbal initiatives, as well as the parental amount of talking over reading, whereas no structural features of parental input resulted modified. Mediation analyses pointed out that the intervention indirectly enhanced late-talkers’ use of verbal types and tokens through changes in parental use of expansions and amount of talking over reading. As birth status was entered as a covariate in the analysis, these findings can be extended to children with different gestational age. We conclude that the parent-implemented intervention was effective in supporting late-talkers’ gains in language development as a cascade result of the improvements in parental contingency and dialogic reading abilities. These promising findings suggest to examine not only children and parental outcomes but also the intervention mechanisms promoting changes in late-talkers’ language development as a clearer view on such process can inform the development of feasible, ecological and effective programs.

Parent-Implemented Hanen Program It Takes Two to Talk®: An Exploratory Study in Spain.

Parent-implemented interventions are a highly common approach for enhancing communication and linguistic abilities of late talkers, involving a population that shows a small expressive vocabulary in the absence of other deficits that could explain it. This study aimed to compare the outcomes of a parent-implemented language intervention, It Takes Two to Talk®—The Hanen Program® for Parents (ITTT), to a clinician-directed therapy. Participants were 17 families and their late-talking children: 10 families took part in ITTT and 7 in the clinician-directed modality. The outcomes in the social communication domain were more favorable for the ITTT group, but there were no significant differences between groups as regards vocabulary and syntax. In terms of parents, the research focused on examining if there were significant changes in parents’ stress and their perceptions of their children’s communication abilities. No differences were observed in the level of stress. In contrast, the group that received the ITTT program significantly altered their perceptions of their children’s communication difficulties in comparison with the clinician-directed therapy. These results have implications in the clinical management of late-talking children, and they are discussed in terms of evidence-based practice.

Spoken Vocabulary Outcomes of Toddlers With Developmental Delay After Parent-Implemented Augmented Language Intervention.

Purpose Early intervention using augmentative and alternative communication (AAC) supports both receptive and expressive language skills. However, many parents and clinicians still worry that augmented language intervention might delay or impair speech development. This study aimed to (a) characterize and analyze the speech sound development of toddlers with developmental delay who participated in a parent-implemented language intervention; (b) examine the accuracy of speech sounds among toddlers who participated in an augmented language intervention using speech-generating devices and toddlers who participated in a traditional, spoken language intervention; and (c) examine the relationship between baseline factors (i.e., receptive and expressive language skills, vocal imitation, and number of unintelligible utterances) and the number of spoken target vocabulary words after intervention. Method This study used extant data from two randomized control trials of parent-implemented language interventions using AAC or spoken language. Out of 109 children who completed the intervention, 45 children produced spoken target vocabulary words at the end of the intervention. We identified and phonetically transcribed spoken target vocabulary words for each child and then classified them based on Shriberg and Kwiatkowski's (1982) developmental sound classes. Results Children's speech sound accuracy was not significantly different across intervention groups. Overall, children who produced more words had more speech sound errors and higher baseline language scores. Intervention group and baseline receptive and expressive language skills significantly predicted the number of spoken target vocabulary words produced at the end of intervention. Conclusions Participation in AAC intervention resulted in significantly more spoken target vocabulary words and no statistically significant differences in speech sound errors when compared to children who received spoken language intervention without AAC. Results support using AAC interventions for very young children without the fear that it will delay speech or spoken language development. Supplemental Material https://doi.org/10.23641/asha.14265365.

Presidential Address, 2020-Using Technology to Deliver Services and Supports in Homes, Neighborhoods, and Communities: Evidence and Promise.

Presidential Address, 2020-Using Technology to Deliver Services and Supports in Homes, Neighborhoods, and Communities: Evidence and Promise.

Controlled trial of lovastatin combined with an open-label treatment of a parent-implemented language intervention in youth with fragile X syndrome

BackgroundThe purpose of this study was to conduct a 20-week controlled trial of lovastatin (10 to 40 mg/day) in youth with fragile X syndrome (FXS) ages 10 to 17 years, combined with an open-label treatment of a parent-implemented language intervention (PILI), delivered via distance video teleconferencing to both treatment groups, lovastatin and placebo.MethodA randomized, double-blind trial was conducted at one site in the Sacramento, California, metropolitan area. Fourteen participants were assigned to the lovastatin group; two participants terminated early from the study. Sixteen participants were assigned to the placebo group. Lovastatin or placebo was administered orally in a capsule form, starting at 10 mg and increasing weekly or as tolerated by 10 mg increments, up to a maximum dose of 40 mg daily. A PILI was delivered to both groups for 12 weeks, with 4 activities per week, through video teleconferencing by an American Speech-Language Association-certified Speech-Language Pathologist, in collaboration with a Board-Certified Behavior Analyst. Parents were taught to use a set of language facilitation strategies while interacting with their children during a shared storytelling activity. The main outcome measures included absolute change from baseline to final visit in the means for youth total number of story-related utterances, youth number of different word roots, and parent total number of story-related utterances.ResultsSignificant increases in all primary outcome measures were observed in both treatment groups. Significant improvements were also observed in parent reports of the severity of spoken language and social impairments in both treatment groups. In all cases, the amount of change observed did not differ across the two treatment groups. Although gains in parental use of the PILI-targeted intervention strategies were observed in both treatment groups, parental use of the PILI strategies was correlated with youth gains in the placebo group and not in the lovastatin group.ConclusionParticipants in both groups demonstrated significant changes in the primary outcome measures. The magnitude of change observed across the two groups was comparable, providing additional support for the efficacy of the use of PILI in youth with FXS.Trial registrationUS National Institutes of Health (ClinicalTrials.gov), NCT02642653. Registered 12/30/2015.

A Systematic and Quality Review of Parent-Implemented Language and Communication Interventions Conducted via Telepractice

The purpose of this study was to systematically review the literature researching telepractice and parent-implemented language and communication interventions. A total of 12 studies met inclusion criteria and comprise the final study sample. A majority of the included articles were single-case research studies, and two were randomized controlled trials. We analyzed participant characteristics, intervention types, outcomes, and research quality in all 12 studies. All telepractice-based parent-implemented interventions reported improvements in parent and/or child outcomes. We evaluated the rigor of the studies against single-case research and group design quality indicators as well as What Works Clearinghouse standards. Of the 10 single-case research studies, one met single-case research design standards and six met standards with reservations, and of the two group design studies, only one met all quality indicators and standards. Results are discussed and future directions are provided.

Parent-Implemented Language Intervention for Teaching Enhanced Milieu Teaching Strategies to Parents of Low-Socioeconomic Status

In this study, the authors examined the effects of training four parents from low-socioeconomic environments to use Enhanced Milieu Teaching (EMT) with their young children with language delay. Parents were taught to use the following EMT strategies during eight to 10 individualized, home-based sessions: matched turns, expansions, time delays, and milieu teaching prompts. A single-case, multiple-baseline design across behaviors replicated across four parent/child dyads was used to evaluate the parents’ use of the EMT strategies. Child language outcomes were also assessed using pre- and post-intervention language samples. All parents learned and demonstrated use of each language support strategy to set criterion levels. Results from this study indicated a functional relationship between the brief parent-implemented language intervention training and parents’ use of language support strategies. In addition, all four children demonstrated gains in expressive language. Additional research is needed to assess fidelity and dosage of parents’ use of strategies on specific child language outcomes and to determine how to facilitate maintenance of parents’ use of strategies over time.

The It Takes Two to Talk® – The Hanen Program® for Parents: impacts on child behaviour and social-emotional functioning

ABSTRACT This study aimed to explore outcomes of a parent-implemented language intervention for children with language difficulties with respect to child behaviour and social-emotional functioning. A single group, quasi-experimental pre–post design was used. Participants were 121 parent–child dyads. The children with language difficulties were aged between 18 months and 4 years. Outcome measures were completed pre- and post-participation in the It Takes Two to Talk® (ITTT) – The Hanen Program® for Parents. Parents reported positive changes (p = <0.01) across four of 10 child behaviours explored in the current study. This study also identified that approximately half of the children who participated (n = 56, 46.3%) were at risk for social-emotional difficulties pre-program and that there was a significant reduction (p = 0.004) in this number post-program. Given the positive outcomes with respect to overall social-emotional functioning in this community-based sample of more than 100 children, this study has highlighted the importance of measuring outcomes of parent-implemented speech-language pathology beyond child language and parent–child interactions. In addition, findings have highlighted a need for further research related to child behaviour outcomes in order to establish if language intervention focused on improving parent–child interactions is also effective in reducing specific disruptive behaviours.

The effects of parent-implemented language interventions on child linguistic outcomes: A meta-analysis

Intervening early is important to minimize persistent difficulties in language and related domains in young children with or at-risk for language impairment (LI; Rescorla, 2009). Because language is first learned in caregiver–child interactions, parent-implemented interventions are potentially an important early intervention for children with or at-risk for LI. Previous meta-analyses have examined outcomes of parent-implemented interventions for children with primary and secondary LI, but have not included children at-risk for LI due to low SES. A systematic review of the literature identified 25 randomized controlled trials of parent-implemented language interventions examining linguistic outcomes for young children. Studies included 1734 participants (M = 3.7 years) with or at-risk for LI due to low SES. Results of these meta-analyses indicated modest improvements in expressive vocabulary and small improvements in expressive language for children with or at-risk for LI. The effect size for expressive vocabulary outcomes was significant for shared book reading interventions (g = 0.37, 95% CI [0.15–0.59]) and interventions implemented in play and/or routines (g = 0.50, 95% CI [0.05–0.95]). The effect size for expressive language was significant (g = 0.42, 95% CI [0.19–0.65]), but not for receptive language (g = 0.07, ns), and the effect size for receptive vocabulary was not significant (g = 0.18, ns). Sub-group analyses for expressive vocabulary and expressive language indicated moderate to large significant effects for children with or at-risk for primary LI and smaller, non-significant effects for children with Autism Spectrum Disorder. Findings are generally consistent with a previous meta-analysis (Roberts & Kaiser, 2011), indicating parent-implemented language interventions may have positive effects on linguistic outcomes for young children with or at-risk for LI. Limited measures of parent training procedures and varied measures of parent outcomes limited the analysis of how child outcomes were achieved.

Parent-implemented language intervention delivered by therapy assistants for two-year-olds at risk of language difficulties: A case series

The aims of this small-scale study were to explore the feasibility and outcomes of a parent-implemented intervention for two-year-olds at risk of language difficulties, and to explore the implications for the public health model of speech and language therapy (SLT). This adds to limited research into targeted SLT public health interventions. It is the first study to investigate early language intervention delivered by trained therapy assistants (TAs) rather than clinicians. Nine children aged between 26 and 31 months took part. Seven (78%) completed the six-session intervention. The outcome measure was the Words subscale of the Language Use Inventory. The gross motor subscale of the Ages and Stages Questionnaire was used as a control measure. Children’s skills were assessed twice before intervention and once afterwards. At baseline, six participants had expressive language delay and no wider speech, language and communication needs (SLCNs). Five of this subgroup showed language use skills within the typical range following intervention. At baseline, three participants had expressive language delay and previously undetected receptive language and/or social interaction difficulties. None of this sub-group showed improved age-adjusted language use skills following intervention. All nine participants had gross motor skills in the typical range at each time point. These exploratory findings suggest this targeted intervention is feasible. This study presents no evidence of short-term impact of this intervention for two-year-olds with expressive language delay and wider SLCNs. These findings suggest this targeted language intervention for two-year-olds may be associated with accelerated language development for some two-year-olds at risk of language difficulties because of expressive language delay; and may help identify two-year-olds with previously undetected wider SLCNs, and therefore facilitate early access to specialist support. We highlight limitations in the study size, design and outcome measures, and identify how these preliminary findings can inform future research.

Effectiveness of a parent-implemented language intervention for late-to-talk children: a real-world retrospective clinical chart review

Purpose: This study aimed to: (1) evaluate the effectiveness of Target WordTM – The Hanen Program® for Parents of Children Who are Late Talkers for improving the real-world communicative participation skills of children who are late-to-talk, and (2) explore predictors of change in children’s communicative participation skills.Method: We conducted a retrospective clinical chart review for 76 families who participated in the Target Word programme at a publicly-funded clinic. Families completed the Focus on the Outcomes of Communication Under Six (FOCUS) at pre-intervention, post-intervention, and after a 3-month consolidation period and scores were compared across the three assessment points. Regression analysis was then used to explore the relation between changes in children’s communicative participation skills and potential predictors of change identified by 25 Target Word certified speech-language pathologists.Result: At the end of intervention, 75% of children had made a clinically significant change in communicative participation skills. Clinicians proposed verbal imitation, language development stagnation and parent interaction style as the top predictors of change in communicative participation skills. Of these, only verbal imitation at pre-intervention predicted change in communicative participation following the intervention.Conclusion: The Target Word programme can facilitate the development of communicative participation skills in late-to-talk children. Modifications to the intervention may be needed in order to maximise outcomes for children with limited verbal imitation.