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Language is an extremely complex cognitive function that, in situations of typical development, i.e. in the absence of deficits or environmental risk, is generally acquired with apparent ease and naturalness (Kuhl, 2010).
The first 1,000 days of life are considered a key time window in which children's developmental trajectories and future outcomes are shaped. During this period, it is crucial to provide children with nurturing experiences such as responsive care and appropriate learning opportunities (Britto et al., 2017).
Most children learn communication skills (e.g., pointing, gesturing) and language skills (e.g., saying words, following instructions) from high-quality interactions with parents and caregivers. However, some children may have language learning difficulties for a variety of reasons, including genetic, neurological and environmental.
Not all children necessarily follow the stages outlined: some present delayed language development. The early identification and diagnosis of the language disorder is therefore very important as this deficit can have a negative impact on the child's subsequent development of skills, the way he/she relates and subsequent acquisition skills in primary school.
This research aims to assess whether parents, guided and monitored by the speech therapist and psychologist through parental training, can try out specific and effective strategies that enable them to become a facilitating model for the child's communicative-linguistic learning, thereby also improving their quality of life.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Assisted speech therapy intervention + parent training | Experimental | The treatment group consists of 20 children diagnosed with DLD (Language Development Disorder). The participants were randomly assigned and will undergo a structured rehabilitation programme of parent training + speech therapy |
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| Standard Speech Therapy | Active Comparator | The control group consisted of 20 children diagnosed with DLD (Language Development Disorder). Participants were randomly assigned and were subjected to standard therapy approaches, which included traditional speech therapy provided by qualified therapists. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Assisted speech therapy intervention + parent training | Behavioral | The intervention was tailored to individual needs and aimed at improving verbal expression, communicative initiative, and social engagement. Each child receives therapy for a period of 16 weeks, for a total of 32 sessions, twice a week, with each session lasting 45 minutes and in addition 16 sessions of parent traning once a week for 45 minutes.Intervention sessions included tasks designed to engage the child in verbal and social interactions, (such as naming objects, answering questions and performing gestures) to improve verbal expression communicative intention and social engagement, in parallel the parents once a week participate in a parent training session with the aim of supporting and directing them to learn strategies to improve interaction with the child and facilitate communicative-linguistic development |
| Measure | Description | Time Frame |
|---|---|---|
| Language Development Level Test (TVL) | The Test of Verbalization and Language Development is a standardized tool designed to assess various aspects of language development, including verbal production, comprehension, sentence construction, phonological accuracy, and morphosyntactic abilities. The weighted score ranges from 0 to 10, with higher scores indicating better language development. | T0 (baseline)- T1 (6months) |
| The Child Behavior Checklist (CBCL) | The Child Behavior Checklist (CBCL) is a caregiver-reported questionnaire used to identify emotional and behavioral problems in children. It measures multiple domains, including emotional reactivity, anxiety, attention problems, and social difficulties. The T-scores do not have a specific range, but values between 50 and 70 are considered within the normal range, while 70 to 100 indicates clinical significance. Higher scores indicate greater behavioral problems. | T0(baseline)-T1(6months) |
| Questionnaire on Parenting Styles (QSP) | This instrument consists of different forms that consider the three fundamental domains of parent-child interaction: a) the social domain: assessed through 8 items; b) the educational domain: assessed through 7 items; c) the disciplinary domain: assessed through 2 items. In this study, each parent completed four forms of the questionnaire: one assessing what their parental behaviour is like in reality (real style; Form A), one assessing what they would ideally like their own behaviour to be like (ideal style; Form B), one assessing what their partner's parental behaviour is like in reality (real style; Form C) and one assessing what they would ideally like their partner's parental behaviour to be like (ideal style; Form D). | T0(baseline)-T1(6 months) |
| WHOQOL | It assesses individuals' perceptions of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, norms and standards. The WHOQOL-BRIEF is a 26-item self-report instrument that assesses four domains that are assumed to represent the Quality of Life (QOL) construct: the physical domain, the psychological domain, the social relations domain and the environmental domain, plus two aspects for assessing overall QOL and general health. It provides a multi-dimensional profile of QOL domain and sub-domain scores |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Cucinotta Francesca, CF | IRCCS Centro Neurolesi Bonino Pulejo | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| IRCCS Neurolesi Bonino Pulejo, Messina,, Messina, Messina 98124 | Messina | Messina | 98124 | Italy |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37248804 | Result | Zwitserlood-Nijenhuis MA, Wiefferink CH, Gerrits E. A randomized study of parent- versus child-directed intervention for Dutch toddlers with DLD. Int J Lang Commun Disord. 2023 Sep-Oct;58(5):1768-1782. doi: 10.1111/1460-6984.12901. Epub 2023 May 29. | |
| 24334229 | Result | Hawa VV, Spanoudis G. Toddlers with delayed expressive language: an overview of the characteristics, risk factors and language outcomes. Res Dev Disabil. 2014 Feb;35(2):400-7. doi: 10.1016/j.ridd.2013.10.027. Epub 2013 Dec 14. |
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|
| standard speech therapy | Behavioral | Therapy followed established protocols and was adapted to meet the specific needs of the children. Each child received therapy for a period of 16 weeks (twice a week), for a total of 32 sessions.• Standard therapeutic approaches included exercises to improve verbal communication and social engagement, such as object naming, sentence construction and comprehension tasks. Therapists adapted the intervention to the individual communication goals of each 45-minute session. |
|
| T0(baseline)-T1(6 months) |
| Il Parenting Stress Index | It defines the level of stress (anxiety, discomfort, maladaptive coping, etc.) that a parent is experiencing in their parental role. It is closely linked to personal characteristics of the subject that reverberate in the way he or she performs and experiences this role. The stress components most associated with this subscale are: a negative experience regarding one's parental competence; stress resulting from the restrictions the parental role places on other social roles important to the subject; conflict with the spouse; lack of social support; and the presence of depression in the clinical sense. | T0(baseline)-T1(6 months) |
| 26968834 | Result | Collisson BA, Graham SA, Preston JL, Rose MS, McDonald S, Tough S. Risk and Protective Factors for Late Talking: An Epidemiologic Investigation. J Pediatr. 2016 May;172:168-174.e1. doi: 10.1016/j.jpeds.2016.02.020. Epub 2016 Mar 8. |
| 22716950 | Result | Rowe ML. A longitudinal investigation of the role of quantity and quality of child-directed speech in vocabulary development. Child Dev. 2012 Sep-Oct;83(5):1762-74. doi: 10.1111/j.1467-8624.2012.01805.x. Epub 2012 Jun 20. |
| 18266869 | Result | Buschmann A, Jooss B, Rupp A, Dockter S, Blaschtikowitz H, Heggen I, Pietz J. Children with developmental language delay at 24 months of age: results of a diagnostic work-up. Dev Med Child Neurol. 2008 Mar;50(3):223-9. doi: 10.1111/j.1469-8749.2008.02034.x. Epub 2008 Feb 11. |
| 27717615 | Result | Britto PR, Lye SJ, Proulx K, Yousafzai AK, Matthews SG, Vaivada T, Perez-Escamilla R, Rao N, Ip P, Fernald LCH, MacMillan H, Hanson M, Wachs TD, Yao H, Yoshikawa H, Cerezo A, Leckman JF, Bhutta ZA; Early Childhood Development Interventions Review Group, for the Lancet Early Childhood Development Series Steering Committee. Nurturing care: promoting early childhood development. Lancet. 2017 Jan 7;389(10064):91-102. doi: 10.1016/S0140-6736(16)31390-3. Epub 2016 Oct 4. |
| ID | Term |
|---|---|
| D007805 | Language Development Disorders |
| ID | Term |
|---|---|
| D007806 | Language Disorders |
| D003147 | Communication Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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