Purpose

The purpose of this study was to explore the literature on predictors of outcomes among late talkers using systematic review and meta-analysis methods. We sought to answer the question: What factors predict preschool-age expressive-language outcomes among late-talking toddlers?

Method

We entered carefully selected search terms into the following electronic databases: Communication & Mass Media Complete, ERIC, Medline, PsycEXTRA, Psychological and Behavioral Sciences, and PsycINFO. We conducted a separate, random-effects model meta-analysis for each individual predictor that was used in a minimum of 5 studies. We also tested potential moderators of the relationship between predictors and outcomes using metaregression and subgroup analysis. Last, we conducted publication-bias and sensitivity analyses.

Results

We identified 20 samples, comprising 2,134 children, in a systematic review. According to the results of the meta-analyses, significant predictors of expressive-language outcomes included toddlerhood expressive-vocabulary size, receptive language, and socioeconomic status. Nonsignificant predictors included phrase speech, gender, and family history.

Conclusions

To our knowledge this is the first synthesis of the literature on predictors of outcomes among late talkers using meta-analysis. Our findings clarify the contributions of several constructs to outcomes and highlight the importance of early receptive language to expressive-language development.

Supplemental Materials

https://doi.org/10.23641/asha.5313454

References marked with an asterisk indicate studies included in the meta-analyses.

References

  • Aram, D. M., & Hall, N. E. (1989). Longitudinal follow-up of children with preschool communication disorders: Treatment implications.School Psychology Review, 18, 487–501.
  • * Armstrong, E. S. (2007). School-age cognitive and achievement outcomes for late talkers and late bloomers: Do late bloomers really bloom?Retrieved from ProQuest Information and Learning database. (Accession number 2007-99008-286)
  • Bavin, E. L., & Bretherton, L. (2013). The Early Language in Victoria Study: Late talkers, predictors, and outcomes.In L. A. Rescorla & P. S. Dale (Eds.), Late talkers: Language development, interventions, and outcomes (pp. 3–21). Baltimore, MD: Brookes.
  • Bishop, D. V. M., & Edmundson, A. (1987). Specific language impairment as a maturational lag: Evidence from longitudinal data on language and motor development.Developmental Medicine & Child Neurology, 29, 442–459.
  • * Bishop, D. V. M., Holt, G., Line, E., McDonald, D., McDonald, S., & Watt, H. (2012). Parental phonological memory contributes to prediction of outcome of late talkers from 20 months to 4 years: A longitudinal study of precursors of specific language impairment.Journal of Neurodevelopmental Disorders, 4, 3. https://doi.org/10.1186/1866-1955-4-3
  • Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2009). Introduction to meta-analysis. Chichester, United Kingdom: Wiley.
  • * Carson, C. P., Klee, T., Carson, D. K., & Hime, L. K. (2003). Phonological profiles of 2-year-olds with delayed language development: Predicting clinical outcomes at age 3.American Journal of Speech-Language Pathology, 12, 28–39.
  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.
  • * Dale, P. S., Price, T. S., Bishop, D. V. M., & Plomin, R. (2003). Outcomes of early language delay: I. Predicting persistent and transient language difficulties at 3 and 4 years.Journal of Speech, Language, and Hearing Research, 46, 544–560.
  • Desmarais, C., Sylvestre, A., Meyer, F., Bairati, I., & Rouleau, N. (2008). Systematic review of the literature on characteristics of late-talking toddlers.International Journal of Language & Communication Disorders, 43, 361–389.
  • Dollaghan, C. (2013). Late talker as a clinical category: A critical evaluation.In L. A. Rescorla & P. S. Dale (Eds.), Late talkers: Language development, interventions, and outcomes (pp. 91–112). Baltimore, MD: Brookes.
  • The EQUATOR Network. (n.d.). Enhancing the quality and transparency of health research. Retrieved from http://www.equator-network.org/
  • * Feldman, H. M., Dale, P. S., Campbell, T. F., Colborn, D. K., Kurs-Lasky, M., Rockette, H. E., & Paradise, J. L. (2005). Concurrent and predictive validity of parent reports of child language at ages 2 and 3 years.Child Development, 76, 856–868. https://doi.org/10.1111/j.1467-8624.2005.00882.x
  • Fenson, L., Dale, P. S., Reznick, J. S., Bates, E., Thal, D. J., Pethick, S. J., … Stiles, J. (1994). Variability in early communicative development [Monograph].Monographs of the Society for Research in Child Development, 59(5, Serial No. 242), 1–185.
  • Fenson, L., Marchman, V. A., Thal, D. J., Dale, P. S., Reznick, J. S., & Bates, E. (2007). MacArthur–Bates Communicative Development Inventories, Second Edition. Baltimore, MD: Brookes.
  • * Fernald, A., & Marchman, V. A. (2012). Individual differences in lexical processing at 18 months predict vocabulary growth in typically developing and late-talking toddlers.Child Development, 83, 203–222. https://doi.org/10.1111/j.1467-8624.2011.01692.x
  • * Fischel, J. E., Whitehurst, G. J., Caulfield, M. B., & DeBaryshe, B. (1989). Language growth in children with expressive language delay.Pediatrics, 83, 218–227.
  • * Hadley, P. A., & Holt, J. K. (2006). Individual differences in the onset of tense marking: A growth-curve analysis.Journal of Speech, Language, and Hearing Research, 49, 984–1000. https://doi.org/10.1044/1092-4388(2006/071)
  • * Hadley, P. A., & Short, H. (2005). The onset of tense marking in children at risk for specific language impairment.Journal of Speech, Language, and Hearing Research, 48, 1344–1362. https://doi.org/10.1044/1092-4388(2005/094)
  • Hart, B., & Risley, T. R. (2003). The early catastrophe: The 30 million word gap by age 3.American Educator, 27(1), 4–9.
  • * Henrichs, J., Rescorla, L., Schenk, J. J., Schmidt, H. G., Jaddoe, V. W. V., Hofman, A., … Tiemeier, H. (2011). Examining continuity of early expressive vocabulary development: The Generation R Study.Journal of Speech, Language, and Hearing Research, 54, 854–869. https://doi.org/10.1044/1092-4388(2010/09-0255)
  • J. P. T. Higgins, & S. Green (Eds.). (2008). Cochrane handbook for systematic reviews of interventions. Chichester, United Kingdom: Wiley.
  • Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta-analyses.BMJ: British Medical Journal, 327(7414), 557–560.
  • Kelly, D. J. (1998). A clinical synthesis of the “late talker” literature: Implications for service delivery.Language, Speech, and Hearing Services in Schools, 29, 76–84.
  • Kerlinger, F. N., & Lee, H. B. (1999). Foundations of behavioral research (4th ed.). Fort Worth, TX: Wadsworth.
  • * Lee, J. (2011). Size matters: Early vocabulary as a predictor of language and literacy competence.Applied Psycholinguistics, 32, 69–92. https://doi.org/10.1017/S0142716410000299
  • Leonard, L. B. (2013). Alternative routes to language impairment.In L. A. Rescorla & P. S. Dale (Eds.), Late talkers: Language development, interventions, and outcomes (pp. 363–376). Baltimore, MD: Brookes.
  • Leonard, L. B. (2014). Children with specific language impairment (2nd ed.). Cambridge, MA: MIT Press.
  • * Levickis, P., Reilly, S., Girolametto, L., Ukoumunne, O. C., & Wake, M. (2014). Maternal behaviors promoting language acquisition in slow-to-talk toddlers: Prospective community-based study.Journal of Developmental & Behavioral Pediatrics, 35, 274–281. https://doi.org/10.1097/DBP.0000000000000056
  • Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., … Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration.The BMJ, 339, b2700. https://doi.org/10.1136/bmj.b2700
  • Long, T. (2013). Early intervention.In M. L. Batshaw, N. J. Roizen, & G. R. Lotrecchiano (Eds.), Children with disabilities (7th ed., pp. 547–557). Baltimore, MD: Brookes.
  • * Lyytinen, P., Eklund, K., & Lyytinen, H. (2005). Language development and literacy skills in late-talking toddlers with and without familial risk for dyslexia.Annals of Dyslexia, 55, 166–192.
  • Moyle, J., Stokes, S. F., & Klee, T. (2011). Early language delay and specific language impairment.Developmental Disabilities Research Reviews, 17, 160–169. https://doi.org/10.1002/ddrr.1110
  • * Moyle, M. J., Weismer, S. E., Evans, J. L., & Lindstrom, M. J. (2007). Longitudinal relationships between lexical and grammatical development in typical and late-talking children.Journal of Speech, Language, and Hearing Research, 50, 508–528.
  • Nippold, M. A., & Schwarz, I. E. (1996). Children with slow expressive language development: What is the forecast for school achievement?.American Journal of Speech-Language Pathology, 5(2), 22–25. https://doi.org/10.1044/1058-0360.0502.22
  • * Paul, R. (1993). Patterns of development in late talkers: Preschool years.Communication Disorders Quarterly, 15(1), 7–14. https://doi.org/10.1177/152574019301500103
  • Paul, R. (2000). Predicting outcomes of early expressive language delay: Ethical implications.In D. V. M. Bishop & L. B. Leonard (Eds.), Speech and language impairments in children: Causes, characteristics, intervention and outcome (pp. 195–209). New York, NY: Psychology Press.
  • Paul, R., & Fountain, R. (1999). Predicting outcomes of early expressive language delay.Infant-Toddler Intervention: The Transdisciplinary Journal, 9(2), 123–135.
  • * Paul, R., Looney, S. S., & Dahm, P. S. (1991). Communication and socialization skills at ages 2 and 3 in “late-talking” young children.Journal of Speech and Hearing Research, 34, 858–865.
  • * Petinou, K., & Spanoudis, G. (2014). Early language delay phenotypes and correlation with later linguistic abilities.Folia Phoniatrica et Logopaedica, 66, 67–76. https://doi.org/10.1159/000365848
  • * Peyre, H., Bernard, J. Y., Forhan, A., Charles, M.-A., De Agostini, M., Heude, B., & Ramus, F. (2014). Predicting changes in language skills between 2 and 3 years in the EDEN mother–child cohort.PeerJ, 2, e335. https://doi.org/10.7717/peerj.335
  • Reilly, S., Wake, M., Bavin, E., Eadie, P., Bretherton, L., & Prior, M. R. (2008). Letter regarding “A systematic review of the literature on characteristics of late-talking toddlers,” by Desmarais et al.International Journal of Language & Communication Disorders, 43, 473–475. https://doi.org/10.1080/13682820802242825
  • * Reilly, S., Wake, M., Ukoumunne, O. C., Bavin, E., Prior, M., Cini, E., … Bretherton, L. (2010). Predicting language outcomes at 4 years of age: Findings from Early Language in Victoria Study.Pediatrics, 126, e1530–e1537. https://doi.org/10.1542/peds.2010-0254
  • Rescorla, L. A. (2002). Language and reading outcomes to age 9 in late-talking toddlers.Journal of Speech, Language, and Hearing Research, 45(2), 360–371. https://doi.org/10.1044/1092-4388(2002/028)
  • Rescorla, L. A. (2011). Late talkers: Do good predictors of outcome exist?.Developmental Disabilities Research Reviews, 17, 141–150. https://doi.org/10.1002/ddrr.1108
  • Rescorla, L. A. (2013). Late-talking toddlers: A 15-year follow-up.In L. A. Rescorla & P. S. Dale (Eds.), Late talkers: Language development, interventions, and outcomes (pp. 219–239). Baltimore, MD: Brookes.
  • Rescorla, L. A., & Dale, P. S. (2013). Where do we stand now? Conclusions and future directions.In L. A. Rescorla & P. S. Dale (Eds.), Late talkers: Language development, interventions, and outcomes (pp. 377–387). Baltimore, MD: Brookes.
  • * Rescorla, L. A., & Schwartz, E. (1990). Outcome of toddlers with specific expressive language delay.Applied Psycholinguistics, 11, 393–407. https://doi.org/10.1017/S0142716400009644
  • Roy, P., & Chiat, S. (2013). Teasing apart disadvantage from disorder: The case of poor language.In C. R. Marshall (Ed.), Current issues in developmental disorders (pp. 125–150). New York, NY: Psychology Press.
  • Thal, D. J., & Katich, J. (1996). Predicaments in early identification of specific language impairment: Does the early bird always catch the worm?.K. N. Cole, P. S. Dale, & D. J. Thal (Eds.), Assessment of communication and language (pp. 1–28). Baltimore, MD: Brookes.
  • Thal, D. J., Marchman, V. A., & Tomblin, J. B. (2013). Late-talking toddlers: Characterization and prediction of continued delay.In L. A. Rescorla & P. S. Dale (Eds.), Late talkers: Language development, interventions, and outcomes (pp. 169–201). Baltimore, MD: Brookes.
  • * Thal, D., Tobias, S., & Morrison, D. (1991). Language and gesture in late talkers: A 1-year follow-up.Journal of Speech and Hearing Research, 34, 604–612.
  • Thompson, B., Diamond, K. E., McWilliam, R., Snyder, P., & Snyder, S. W. (2005). Evaluating the quality of evidence from correlational research for evidence-based practice.Exceptional Children, 71, 181–194.
  • Tomblin, J. B., Records, N. L., Buckwalter, P., Zhang, X., Smith, E., & O'Brien, M. (1997). Prevalence of specific language impairment in kindergarten children.Journal of Speech, Language, and Hearing Research, 40, 1245–1260.
  • * Vuksanovic, J. R. (2015). Relationship between social interaction bids and language in late talking children.International Journal of Speech-Language Pathology, 17, 527–536.
  • Washbrook, E., & Waldfogel, J. (2010). Cognitive gaps in the early years: A summary of findings from the report “Low Income and Early Cognitive Development in the UK.”: London, United Kingdom: Sutton Trust.
  • Westerlund, M., Berglund, E., & Eriksson, M. (2006). Can severely language delayed 3-year-olds be identified at 18 months? Evaluation of a screening version of the MacArthur-Bates Communicative Development Inventories.Journal of Speech, Language, and Hearing Research, 49(2), 237–247.
  • Whitehurst, G. J., & Fischel, J. E. (1994). Early developmental language delay: What, if anything, should the clinician do about it?.Journal of Child Psychology and Psychiatry, and Allied Disciplines, 35, 613–648.
  • Whitehurst, G. J., Fischel, J. E., Arnold, D. S., & Lonigan, C. J. (1992). Evaluating outcomes with children with expressive language delay.In S. F. Warren & J. Reichle (Eds.), Causes and effects in communication and language intervention (pp. 277–313). Baltimore, MD: Brookes.
  • * Whitehurst, G. J., Smith, M., Fischel, J. E., Arnold, D. S., & Lonigan, C. J. (1991). The continuity of babble and speech in children with specific expressive language delay.Journal of Speech and Hearing Research, 34, 1121–1129.
  • * Williams, A. L., & Elbert, M. (2003). A prospective longitudinal study of phonological development in late talkers.Language, Speech, and Hearing Services in Schools, 34, 138–153.

Additional Resources