# Late Talkers

## Language Development, Interventions, and Outcomes

**Edited by:**  
Leslie A. Rescorla, Ph.D.  
Bryn Mawr College, Pennsylvania  
Baltimore·London·Sydney

and

Philip S. Dale, Ph.D.  
The University of New Mexico

### Contents
- I Identification and Classification of Late Talkers  
  1. The Early Language in Victoria Study: Late Talkers, Predictors, and Outcomes 3  
  2. Population and Public Health Perspectives on Late Language Emergence at 24 Months as a Risk Indicator for Language Impairment at 7 Years 23  
  3. Danish Late Talkers: A First Portrait 41  
  4. Distinguishing the Bilingual as a Late Talker from the Late Talker Who Is Bilingual 67

- II Characteristics and Causes  
  5. Late Talker as a Clinical Category: A Critical Evaluation 91  
  6. Phonology and the Lexicon in Late Talkers

- III Interventions  
  10. Late Talking in Context: The Clinical Implications of Delayed Language Development 203  
  11. Late-Talking Toddlers: A 15-Year Follow-Up 219  
  12. Outcomes for Late Talkers: A Twin Study 241  
  13. From Words to Early Sentences: Parent-Implemented Intervention for Late-Talking Toddlers 261  
  14. Evidence-Based Language Intervention Approaches for Young Late Talkers 283  
  15. Which Late Talkers Require Intervention? Matching Child Characteristics and Risk Factors to Treatment 303  
  16. Environmental Modification, Intervention, and the Late-Talking Child from a Public Health Perspective 325

- V Conclusion  
  17. Alternative Routes to Language Impairment 363  
  18. Where Do We Stand Now? Conclusions and Future Directions 377

### About the Editors
**Leslie A. Rescorla, Ph.D.**  
Professor of Psychology, Bryn Mawr College, 101 North Merion Avenue, Bryn Mawr, PA 19010

**Philip S. Dale, Ph.D.**  
Professor, Department of Speech and Hearing Sciences, The University of New Mexico, 1700 Lomas Blvd NE, Suite 1300, Albuquerque, NM 87131

## Evidence-Based Language Intervention Approaches for Young Late Talkers

Speech-language pathologists working with 2-year-olds identified as late talkers (LTs) have several options when planning and implementing speech-language services. There is a broad range of language intervention approaches developed for young children from other clinical populations—such as children with autism, Down syndrome, specific language impairment (SLI), and specific speech sound disorders—that clinicians may consider using with LTs.

### Language Intervention Options
When working with a child considered to be an LT, a clinician may choose not to deliver intervention services but instead to monitor the child’s progress. Alternative approaches include general language stimulation, focused stimulation, milieu teaching, or the use of augmentative and alternative communication.

#### General Language Stimulation
General language stimulation approaches involve modifications of the physical and linguistic environments to increase opportunities for children to hear frequent adult models of developmentally appropriate language. These approaches focus on creating a rich language environment tailored to the child’s interests and abilities. Typical procedures include:
1. Following the child’s lead.  
2. Talking about the object to which the child is attending (parallel talk).  
3. Responding to the child’s verbalizations with semantically and grammatically contingent responses.

#### Focused Language Stimulation
Focused stimulation involves identifying specific language targets on which the clinician's teaching efforts will focus. Activities provide many opportunities for adult models of target words and encourage child attempts at these forms.

#### Milieu Teaching
Milieu teaching takes place during meaningful, naturalistic activities and involves the identification of specific goals. The intervention agent is responsive to the child's communication efforts and uses recasts to model correct language forms.

### Conclusion
Evidence suggests that various intervention approaches can benefit late talkers. Each strategy's efficacy may depend on the individual child's needs and characteristics.