Improving Children's Expressive Language and Auditory Comprehension Through Responsive Caregiving: Evidence from a Randomized Controlled Trial of a Strength-Based Video-Coaching Intervention.

Young children from low-SES backgrounds are at higher risk for delayed language development, likely due to differences in their home language environment and decreased opportunities for back and forth communicative exchange. Intervention strategies that encourage reciprocal caregiver-child interactions may effectively promote young children's language development and enhance optimal language outcomes. The Filming Interactions to Nurture Development (FIND) program is a brief strength-based video-coaching intervention designed to promote increased back and forth ("serve and return") interactions between caregivers and their children. The current study used data from a randomized controlled trial (RCT) to examine the effectiveness of the FIND program in improving auditory comprehension and expressive communication skills among children from low-SES backgrounds. The current study used a pretest-posttest design to evaluate intervention effects from an RCT with 91 low-SES families. Families with children aged 4 to 36 months old (41.8% female) were randomly assigned to an active control or FIND intervention group. Children's auditory comprehension and expressive communication were assessed using the Preschool Language Scales, Fifth Edition (PLS-5) during both pre- and post-intervention sessions. Children in the FIND intervention group showed significantly increased expressive communication skills and a non-significant increase in auditory comprehension skills across the intervention period. In contrast, children in the active control group showed non-significant changes in expressive communication and a statistically significant decline in auditory comprehension abilities between pre- and post-intervention assessments. All analyses controlled for sex, age, and home language. This study provides preliminary evidence that the FIND intervention promotes the development of expressive and receptive language skills among young children in high-stress, low-SES environments.

A randomized controlled trial of the effectiveness of teacher continued professional development on student language outcomes.

BACKGROUND: Continued professional development (CPD) is required for updated skills and knowledge. This study evaluates the efficacy of a CPD programme for mainstream school teachers. AIMS: In an 11-week intervention programme, speech-language therapists (SLTs) presented the participating teachers with whole-class teaching techniques aimed at creating a language and communication-supporting classroom environment. The effects of the intervention on the language development of the students in the teachers' classes were assessed. METHODS & PROCEDURES: A total of 211 first- and second-year students (Mage = 7;6, range = 6;5-8;9) underwent standardized language assessments of receptive and expressive language abilities before and after their teachers' participation in the CPD. The students were divided into intervention and delayed intervention groups to enable randomized intervention allocation. Linear mixed modelling was used to estimate the individual and interaction effects of group, time and demographic factors. OUTCOMES & RESULTS: Significant effects of time, group and school, respectively, but no interaction between time and group indicates that while all students advanced between assessments, the progress was not attributable to the teachers' participation in the CPD. CONCLUSIONS & IMPLICATIONS: Results are discussed in light of those of recent studies of universal services to support optimal language development. WHAT THIS PAPER ADDS: What is already known on this subject Although inconclusive, previous research indicates that intervention delivered to teachers by SLTs has the potential to improve the language abilities of the students in the teachers' classrooms. What this paper adds to existing knowledge This study explored the language development of first- and second-year mainstream school students whose teachers took part in a CPD programme aimed at establishing language and communication-supporting teaching techniques. Results indicate that the development of the students' language abilities could not be attributed to the teachers' participation in the CPD. What are the potential or actual implications of the work? SLTs are often asked to guide teachers and teaching staff rather than themselves conduct individual assessments and interventions. The results of this trial can be used to inform the discussion on how to prioritize between tasks.

Parental Beliefs, Language Practices and Language Outcomes in Spanish-English Bilingual Children.

As the U.S. population who speaks a language other than English at home continues to grow, few studies have focused on the effect of parental beliefs on the importance of bilingualism have on language outcomes of their children. In this study, we surveyed families raising Spanish-English bilingual children on their beliefs concerning both languages, language practices they implement at home, at school, and in the community, and language outcomes of their children. Using a single mediator model, this study aimed to understand the impact of parental beliefs on language outcomes in Spanish and English and the mediating effects of language practices. We then examined the individual mediating effects of language practices at home, school, and community on the relationship between parental beliefs and language outcomes for each language using a multiple mediator model. Our results suggest that parental beliefs in Spanish predict Spanish language outcomes and parental beliefs in English predict English outcomes and that practices in each language mediated this effect. In particular, we found that Spanish practices at home mediated the effect of language outcomes in Spanish and that English practices at home and in the community mediated English language outcomes.

Speech and Language Outcomes in Low-SES Spanish-English Bilingual Preschoolers: The Role of Maternal Education.

This paper presents a longitudinal examination of Spanish and English phonological, lexical, and morpho-syntactic abilities in 20 low-SES bilingual preschoolers with mothers who had either completed primary or secondary education in Spanish in their country of origin, Mexico. We focused on the link between maternal education and the following spontaneous production measures: 1) phonological accuracy as measured by Percent of Consonants Correct-Revised, 2) lexical variety as measured by Number of Different Words, and 3) utterance length as measured by Mean Length of Utterance in words; the relation between maternal education and spontaneous production was examined both a) at preschool entry, when children were on average 3;6 and dominant in Spanish, and b) a year later, after one year of exposure to the majority language (English) and culture. The results showed that although children of more educated mothers performed significantly better on all English measures than children of less educated mothers, maternal education was not related to Spanish outcomes. The same differences persisted a year later. These results suggest that maternal education may play a different, but long-lasting role in English compared to Spanish development possibly due to language input differences attributable to distinct cultural values and practices associated with different languages.

Early Phonological Predictors of Toddler Language Outcomes.

PURPOSE: Several studies have explored relationships between children's early phonological development and later language performance. This literature has included a more recent focus on the potential for early phonological profiles to predict later language outcomes. METHODS: The present study longitudinally examined the nature of phonetic inventories and syllable structure patterns of 48 typically developing children at 7, 11, and 18 months, and related them to expressive language outcomes at 2 years of age. RESULTS: Findings provide evidence that as early as 11 months, phonetic inventory and mean syllable structure level are related to 24-month expressive language outcomes, including mean length of utterance and vocabulary diversity in spontaneous language samples, and parent-reported vocabulary scores. Consonant inventories in particular differed at 11 and 18 months for 2-year-olds with lower versus higher language skills. CONCLUSION: Limited inventories and syllable repertoires may add to risk profiles for later language delays.

Measures of Early Social Communication and Vocabulary Production to Predict Language Outcomes at Two and Three Years in Late-Talking Toddlers.

BACKGROUND: Late talkers are a heterogeneous group of toddlers and reliable predictors of persistent language delay have been elusive. The purpose of this study was to determine the extent to which early social communication and vocabulary production predicted variance in language outcomes at 2 and 3 years of age. METHODS: Participants were 408 typically developing and late-talking toddlers who completed the Communication and Symbolic Behavior Scales Caregiver Questionnaire and Behavior Sample (CSBS CQ and CSBS BS) at a mean of 20 months, the Language Development Survey (LDS) at a mean of 24 months, and the Mullen Scales of Early Learning (MSEL) at a mean of 25 months. A subgroup of 198 children completed a second MSEL at 3 years of age. Associations among the LDS, CSBS CQ, CSBS BS, and MSEL were examined using correlational and hierarchical linear regression analyses. Logistic regression was used to examine each measure's contribution to predicting language delay at 2 and 3 years. RESULTS: Moderate to large correlations were observed among all variables. The LDS, CSBS CQ, and CSBS BS added unique contributions to the prediction of 2- and 3-year expressive and receptive language outcomes. Measures of speech and vocabulary production were the strongest predictors of language outcomes at age 2. At age 3, social and symbolic communication played a more significant role in accounting for variance in expressive and receptive language outcome. A similar pattern emerged for the categorical prediction of language delay. CONCLUSIONS: Measures of social communication between 18-21 months added important information to predicting language outcomes at 2 and 3 years, above and beyond parent-reported expressive vocabulary production measured at 24 months, with small effect sizes overall. Implications for identifying younger children who are at risk for continued language delay and recommendations for referral to early intervention programs are discussed.

Language and speech outcomes of children with hearing loss and additional disabilities: identifying the variables that influence performance at five years of age.

OBJECTIVE: This study examined language and speech outcomes in young children with hearing loss and additional disabilities. DESIGN: Receptive and expressive language skills and speech output accuracy were evaluated using direct assessment and caregiver report. Results were analysed first for the entire participant cohort, and then to compare results for children with hearing aids (HAs) versus cochlear implants (CIs). STUDY SAMPLE: A population-based cohort of 146 five-year-old children with hearing loss and additional disabilities took part. RESULTS: Across all participants, multiple regressions showed that better language outcomes were associated with milder hearing loss, use of oral communication, higher levels of cognitive ability and maternal education, and earlier device fitting. Speech output accuracy was associated with use of oral communication only. Average outcomes were similar for children with HAs versus CIs, but their associations with demographic variables differed. For HA users, results resembled those for the whole cohort. For CI users, only use of oral communication and higher cognitive ability levels were significantly associated with better language outcomes. CONCLUSIONS: The results underscore the importance of early device fitting for children with additional disabilities. Strong conclusions cannot be drawn for CI users given the small number of participants with complete data.

Impact of Hearing Aids on Language Outcomes in Preschool Children With Mild Bilateral Hearing Loss.

This study aimed to investigate the role of hearing aid (HA) usage in language outcomes among preschool children aged 3-5 years with mild bilateral hearing loss (MBHL). The data were retrieved from a total of 52 children with MBHL and 30 children with normal hearing (NH). The association between demographical, audiological factors and language outcomes was examined. Analyses of variance were conducted to compare the language abilities of HA users, non-HA users, and their NH peers. Furthermore, regression analyses were performed to identify significant predictors of language outcomes. Aided better ear pure-tone average (BEPTA) was significantly correlated with language comprehension scores. Among children with MBHL, those who used HA outperformed the ones who did not use HA across all linguistic domains. The language skills of children with MBHL were comparable to those of their peers with NH. The degree of improvement in audibility in terms of aided BEPTA was a significant predictor of language comprehension. It is noteworthy that 50% of the parents expressed reluctance regarding HA use for their children with MBHL. The findings highlight the positive impact of HA usage on language development in this population. Professionals may therefore consider HAs as a viable treatment option for children with MBHL, especially when there is a potential risk of language delay due to hearing loss. It was observed that 25% of the children with MBHL had late-onset hearing loss. Consequently, the implementation of preschool screening or a listening performance checklist is recommended to facilitate early detection.

The association between statistical learning and language development during childhood: A scoping review.

The statistical account of language acquisition asserts that language is learned through computations on the statistical regularities present in natural languages. This type of account can predict variability in language development measures as arising from individual differences in extracting this statistical information. Given that statistical learning has been attested across different domains and modalities, a central question is which modality is more tightly yoked with language skills. The results of a scoping review, which aimed for the first time at identifying the evidence of the association between statistical learning skills and language outcomes in typically developing infants and children, provide preliminary support for the statistical learning account of language acquisition, mostly in the domain of lexical outcomes, indicating that typically developing infants and children with stronger auditory and audio-visual statistical learning skills perform better on lexical competence tasks. The results also suggest that the relevance of statistical learning skills for language development is dependent on sensory modality.

Impact of Sociodemographic Disparities on Language Outcomes After Cochlear Implantation in a Diverse Pediatric Cohort.

OBJECTIVE: We examined how sociodemographic and audiologic factors affect receptive and expressive language outcomes in children with cochlear implantation. STUDY DESIGN: Retrospective cohort study. SETTING: A hearing loss (HL) clinic at a tertiary center. METHODS: Sociodemographic variables, HL characteristics, age at implantation, and receptive language scores (Preschool Language Scale and the Clinical Evaluation of Language Fundamentals) were collected from patients with congenital HL who received their first implant by 4 years old after January 1, 2007. t Tests, linear regression, Mann-Whitney, Cohen's d, and mediation analysis were used for descriptive statistics and hypothesis testing. RESULTS: Among 79 patients, 42 (53%) were females, 44 (56%) under-represented minorities, and 56 (71%) had public insurance. At least 1 year after implantation, the median receptive language score was 69 (range 50-117). Females (p = .005), having private insurance (p = .00001), having a Cochlear Implant Profile score below 4 (p = .0001), and receiving their implant at or before 12 months of age (p = .0009) were significantly associated with improved receptive language outcomes. Insurance type had a significant effect on receptive language outcomes, independent from age at first implantation (total effect: coef = -13.00, p = .02; direct effect: coef = -12.26, p = .03; indirect effect: coef = -0.75, p = .47). Sociodemographic variables had large effect sizes, with the Cochlear Implant Profile score having the largest effect size (d = 1.3). CONCLUSION: Sociodemographic factors have a large impact on receptive language outcomes. Public insurance is associated with worse receptive language, not mediated by later age at implantation, suggesting that other factors primarily impact language outcomes in publicly insured children with cochlear implants.

Associations between social adversity, caregiver psychological factors, and language outcomes in 9.5-year-old children born to women with opioid use disorder.

We describe the language ability of children at age 9.5 years who were born to women with an opioid use disorder and examine the associations between prenatal opioid exposure, sex, social adversity, caregiver psychological factors, and child language. Data were drawn from the regional prospective longitudinal Canterbury Methadone in Pregnancy study. At the 9.5-year wave, 80 children who were born to mothers in Methadone Maintenance Treatment and their caregivers, and 98 non-exposed comparison children were assessed using a comprehensive standardized measure of language. Information related to social adversity and caregiver psychological factors was obtained from comprehensive caregiver interviews. At age 9.5 years, opioid-exposed children had lower language scores than the non-exposed children, however their group average was within the normal range on the CELF-4 norms. A series of multivariate hierarchical regression models predicting low language at 9.5 years showed sex and opioid-exposure status predicted low language in the first step. The addition of social adversity factors significantly improved the model. The further addition of caregiver psychological factors did not improve prediction. Only sex was a significant predictor throughout. In this sample, children prenatally exposed to opioids were at higher risk of low language outcomes. However, the child being male and social adversity were important influencing factors. This suggests early language support services are indicated for opioid-exposed children, particularly boys and those in socially adverse circumstances.

Children then, adults now: long-term outcomes-performance at 15, 20, and 25 years of cochlear implant use.

Motivation: Severe to profound sensorineural hearing loss interferes with a child's development at the cognitive, linguistic, academic, and social levels. Since the beginning of the pediatric auditory rehabilitation program through cochlear implantation in the Ear, Nose, and Throat (ENT) Service of the Coimbra Hospital and University Center (CHUC), Portugal, its mentors defended the early diagnosis of hearing loss followed by timely intervention, and this was considered the starting point to optimize (re)habilitation through this method. Three decades or so later, recently we conducted this study to evaluate the performance of patients implanted in the initial phase of the cochlear implantation program. Objectives: The study aimed to evaluate the performance of individuals with severe to profound congenital hearing loss who underwent pediatric cochlear implantation and have used the cochlear implant for at least 25 years, to analyze the beneficial effect of early intervention in improving performance results. Methods: The study sample is composed of 31 individuals with severe to profound congenital hearing loss and no other comorbidities, divided into two groups (Group 1: age at implantation was under 3 years; Group 2: age at implantation was over 3 years). All 31 subjects were evaluated at 15, 20, and 25 years of cochlear implant (CI) use with a comprehensive set of tests. In addition, data were collected regarding the academic level of each participant. The results of both groups were compared to find out if there is an effect of age at implantation on auditory performance, and if there is an improvement in the performance with CI over time (15, 20, and 25 years of use). Results: The results show that there is a positive effect, with statistical significance, of early implantation on auditory performance, and telephone use. In both groups, there is an increase in performance over time, but it tends to stabilize after 20 years of CI use. Discussion and conclusion: The results obtained in this work support the importance of early intervention in patients with severe to profound hearing loss who are cochlear implant users and show that CI is an effective and reliable method in the treatment of these patients, contributing to their improved socio-educational integration, and that the benefits last over time.

Language and health-related quality of life outcomes of children early-detected with unilateral and mild bilateral hearing loss.

Introduction: We aimed to describe the language and health-related quality of life (HRQoL) outcomes of children early-identified with unilateral or mild bilateral permanent hearing loss. This was a cross-sectional community-based study of children with mild bilateral or unilateral permanent hearing loss (including unilateral auditory neuropathy spectrum disorder (ANSD)), drawn from a population-based databank in Victoria, Australia. Methods: Enrolment in this databank is independent of early intervention and amplification approaches. Language and caregiver-reported HRQoL outcomes are described by type and degree of loss at three timepoints across child development: at age 2 years (n = 255), 5-7 years (n = 173) and 9-12 years (n = 45). Results: Across all age groups, average language outcomes were poorer than population normative scores by between a half to two thirds of a standard deviation. Children with mild bilateral hearing loss demonstrated poorer average language outcomes than children with unilateral hearing loss, particularly at younger ages. Children with unilateral ANSD showed language outcomes comparable to their peers with unilateral profound hearing loss. Children had poorer HRQoL psychosocial scores compared to physical scores, without obvious patterns of outcomes linked to degree or type of hearing loss. Discussion: This study demonstrates children with early-identified unilateral or mild bilateral hearing loss have average language and HRQoL outcomes poorer than population normative expectations from an early age. These outcomes are observed at later ages across childhood. These findings provide a contemporary description of language and quality of life outcomes for children identified but not targeted by universal newborn hearing screening and raise questions of how to provide better support for these populations of children and their families.

Language Development in the Second Year of Life: The Case of Children with Sex Chromosome Trisomies Diagnosed before Birth.

Many individual factors, such as early communicative skills, could play a role in explaining later linguistic outcomes. The detection of predictive variables is fundamental to identifying early the children who need intervention. The present study focuses on children with sex chromosome trisomies (SCTs), genetic conditions with an increased risk of developing language delays or impairments. The aims are to analyse their communicative skills at 18 months of age, and identify significant predictors of their later vocabulary size. Participants were 76 18-month-old children (38 with SCTs, and 38 typically-developing (TD) children). Their communicative skills were assessed during a parent-child play session, and parents filled in a report on their vocabulary development at 18 and 24 months. Children with SCTs showed significantly poorer linguistic skills at 18 months in both preverbal (babbling and gestures) and verbal abilities. A high percentage (nearly 70%) of toddlers with SCTs were late-talking children at 24 months, and those toddlers showed a lower frequency of babbling utterances at 18 months. Early lexical skills, children's developmental quotient, and being part of the group of toddlers with SCTs were significant predictors of children's vocabulary size six months later. These variables should be considered when assessing the linguistic competence of a child with SCTs to detect possible early risk factors of future language impairment.

Outcome measures following tele-rehabilitation and conventional face to face rehabilitation in paediatric cochlear implant users during COVID-19 pandemic: A pilot study in a tertiary care setup.

BACKGROUND: Following the COVID-19 pandemic, majority of paediatric cochlear implantees (CI) lost follow ups for rehabilitation and tele-therapy was initiated. Present study thus compared the outcome measures of paediatric CI users on tele-therapy versus conventional face to face therapy following COVID-19 pandemic. METHOD: Twenty seven unilateral paediatric cochlear implantees in the age range of 2-11 years were divided into two groups based on the therapy modality, viz, tele- and face-to-face therapy. Based on the hearing age, participants were further divided into three groups, viz, 0-2, 2-4, and greater than four years. A complete the test battery comprising Integrated Scales of Development, Speech Intelligibility Rating scale, and Revised Categorical Auditory Perception were administered. The speech & language test battery was performed prior to initiating the rehabilitation and post 12 months of rehabilitation. RESULTS: Results of the present study revealed that conventional rehabilitation had better outcomes compared to teletherapy. The rate of progress after one year of rehabilitation with respect to hearing-age showed a significant difference for the hearing-age group of 0-2 years across the domains of audition, speech and language. CONCLUSION: The present study indicates that conventional method of the speech-language and auditory rehabilitation is far better compared to the tele rehabilitation services especially for those visiting tertiary care hospitals as most of them belong to lower and middle socioeconomic status. From the results, it can be delineated that with lesser hearing experience, paediatric CI users always need to initially enroll for conventional therapy for better speech-language and auditory outcomes.

Bilingual Language Development in Infancy: What Can We Do to Support Bilingual Families?

Many infants and children around the world grow up exposed to two or more languages. Their success in learning each of their languages is a direct consequence of the quantity and quality of their everyday language experience, including at home, in daycare and preschools, and in the broader community context. Here, we discuss how research on early language learning can inform policies that promote successful bilingual development across the varied contexts in which infants and children live and learn. Throughout our discussions, we highlight that each individual child's experience is unique. In fact, it seems that there are as many ways to grow up bilingual as there are bilingual children. To promote successful bilingual development, we need policies that acknowledge this variability and support frequent exposure to high-quality experience in each of a child's languages.

A Virtual, Randomized, Control Trial of a Digital Therapeutic for Speech, Language, and Cognitive Intervention in Post-stroke Persons With Aphasia.

Background: Post-stroke aphasia is a chronic condition that impacts people's daily functioning and communication for many years after a stroke. Even though these individuals require sustained rehabilitation, they face extra burdens to access care due to shortages in qualified clinicians, insurance limitations and geographic access. There is a need to research alternative means to access intervention remotely, such as in the case of this study using a digital therapeutic. Objective: To assess the feasibility and clinical efficacy of a virtual speech, language, and cognitive digital therapeutic for individuals with post-stroke aphasia relative to standard of care. Methods: Thirty two participants completed the study (experimental: average age 59.8 years, 7 female, 10 male, average education: 15.8 years, time post-stroke: 53 months, 15 right handed, 2 left handed; control: average age 64.2 years, 7 female, 8 male, average education: 15.3 years, time post-stroke: 36.1 months, 14 right handed, 1 left handed). Patients in the experimental group received 10 weeks of treatment using a digital therapeutic, Constant Therapy-Research (CT-R), for speech, language, and cognitive therapy, which provides evidence-based, targeted therapy with immediate feedback for users that adjusts therapy difficulty based on their performance. Patients in the control group completed standard of care (SOC) speech-language pathology workbook pages. Results: This study provides Class II evidence that with the starting baseline WAB-AQ score, adjusted by -0.69 for every year of age, and by 0.122 for every month since stroke, participants in the CT-R group had WAB-AQ scores 6.43 higher than the workbook group at the end of treatment. Additionally, secondary outcome measures included the WAB-Language Quotient, WAB-Cognitive Quotient, Brief Test of Adult Cognition by Telephone (BTACT), and Stroke and Aphasia Quality of Life Scale 39 (SAQOL-39), with significant changes in BTACT verbal fluency subtest and the SAQOL-39 communication and energy scores for both groups. Conclusions: Overall, this study demonstrates the feasibility of a fully virtual trial for patients with post-stroke aphasia, especially given the ongoing COVID19 pandemic, as well as a safe, tolerable, and efficacious digital therapeutic for language/cognitive rehabilitation. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT04488029.

Language Development for the New Generation of Children with Hearing Impairment.

A new generation of children with hearing impairment (HI) has emerged due to the introduction of universal neonatal hearing screening, medical-surgical/technical and educational advances. AIM: Investigation of long-term development of vocabulary and social well-being of children with HI, including children with HI and additional disability. METHOD AND MATERIAL: The project design was prospective, longitudinal, and comparative. Level of receptive vocabulary was compared to children with normal hearing, type of hearing technology, gender, additional disability, diagnosis of HI, level of social well-being, and start age for use of hearing technology. A total of 231 children participated. Intervention included early start of hearing technology and three years of auditory-verbal therapy (AVT) at the preschool level, followed by 3 years of AV guidance at the school level. RESULTS: Children with HI scored within the norm for receptive vocabulary but were outperformed by the control group. Children with HI and a diagnosed additional disability scored lower than children without additional disability, in terms of parental assessments of social well-being. Children with additional disabilities showed positive progression in terms of receptive vocabulary development. CONCLUSIONS: New generations with HI possess the potential to succeed academically in accordance with individual abilities and become active participants in the working market.

Frequency of Early Intervention Sessions and Vocabulary Skills in Children with Hearing Loss.

BACKGROUND: A primary goal of early intervention is to assist children in achieving age-appropriate language skills. The amount of intervention a child receives is ideally based on his or her individual needs, yet it is unclear if language ability impacts amount of intervention and/or if an increased frequency of intervention sessions results in better outcomes. The purpose of this study was to determine the relationship between the frequency of early intervention sessions and vocabulary outcomes in young children with hearing loss. METHODS: This was a longitudinal study of 210 children 9 to 36 months of age with bilateral hearing loss living in 12 different states. Expressive vocabulary skills were evaluated using the MacArthur-Bates Communicative Development Inventories. RESULTS: A higher number of intervention sessions reported at the first assessment predicted better vocabulary scores at the second assessment, and more sessions reported at the second assessment predicted better scores at the third assessment. For each increase in the number of sessions reported, there was a corresponding, positive increase in vocabulary quotient. In contrast, children's vocabulary ability at an earlier time point did not predict intervention session frequency at a later point in time. CONCLUSIONS: A significant prospective effect was apparent with more therapy sessions resulting in improved vocabulary scores 9 months later. These findings underscore the importance of early intervention. Pediatricians and other health care professionals can help apply these findings by counseling parents regarding the value of frequent and consistent participation in early intervention.

Therapeutic approaches to early intervention in audiology: A systematic review.

Babies born with a congenital sensorineural hearing impairment or acquire early-onset permanent bilateral hearing impairment are at risk for delayed speech and language development and poor scholastic outcomes. Auditory Verbal Therapy (AVT) has become the primary intervention approach for developing spoken language in children with hearing impairment, and South Africa also has adopted this approach. The outcomes of AVT within the South African context have not been thoroughly investigated. As part of a larger study, the objective of this systematic review was to describe the speech, language and scholastic outcomes of hearing-impaired children enrolled in AVT as a therapeutic approach to early intervention. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Electronic databases searched included Google Scholar, Science Direct and PubMed. Selected studies were published in English and focused on the outcomes of early intervention for children with hearing impairment. The selected date range of the included articles ensured that the latest research was reviewed. Due to the limited evidence base, the review cannot conclude definitively that AVT yields positive speech, language, and scholastic outcomes in children with hearing impairment. Of the reviewed articles, only one study compares the outcomes of therapeutic intervention approaches, an important consideration, particularly in Low- and Middle-Income countries (LMICs). Current findings provide a strong rationale for the larger study by highlighting that further research comparing AVT to standard speech-language habilitation is required. Research in contexts with linguistic and cultural diversity in countries such as South Africa is required.