Objective To determine the benefits of a low intensity
parent-toddler language promotion programme delivered to toddlers identified as
slow to talk on screening in universal services.
Design Cluster randomised trial nested in a population based
Setting Three local government areas in Melbourne, Australia.
Participants Parents attending 12 month well child checks over a six
month period completed a baseline questionnaire. At 18 months, children at or
below the 20th centile on an expressive vocabulary checklist entered the
Intervention Maternal and child health centres (clusters) were
randomly allocated to intervention (modified “You Make the Difference” programme
over six weekly sessions) or control (“usual care”) arms.
Main outcome measures The primary outcome was expressive language
(Preschool Language Scale-4) at 2 and 3 years; secondary outcomes were receptive
language at 2 and 3 years, vocabulary checklist raw score at 2 and 3 years,
Expressive Vocabulary Test at 3 years, and Child Behavior Checklist/1.5-5 raw
score at 2 and 3 years.
Results 1217 parents completed the baseline survey; 1138 (93.5%)
completed the 18 month checklist, when 301 (26.4%) children had vocabulary
scores at or below the 20th centile and were randomised (158 intervention, 143
control). 115 (73%) intervention parents attended at least one session (mean 4.5
sessions), and most reported high satisfaction with the programme. Interim
outcomes at age 2 years were similar in the two groups. Similarly, at age 3
years, adjusted mean differences (intervention−control) were −2.4 (95%
confidence interval −6.2 to 1.4; P=0.21) for expressive language; −0.3 (−4.2 to
3.7; P=0.90) for receptive language; 4.1 (−2.3 to 10.6; P=0.21) for vocabulary
checklist; −0.5 (−4.4 to 3.4; P=0.80) for Expressive Vocabulary Test; −0.1 (−1.6
to 1.4; P=0.86) for externalising behaviour problems; and −0.1 (−1.3 to 1.2;
P=0. 92) for internalising behaviour problems.
Conclusion This community based programme targeting slow to talk
toddlers was feasible and acceptable, but little evidence was found that it
improved language or behaviour either immediately or at age 3 years.
Trial registration Current Controlled Trials ISRCTN20953675.