Late Talkers

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 - Edith L. Bavin and Lesley Bretherton
  2. Population and Public Health Perspectives on Late Language Emergence at 24 Months as a Risk Indicator for Language Impairment at 7 Years - Catherine L. Taylor, Stephen R. Zubrick, and Mabel L. Rice
  3. Danish Late Talkers: A First Portrait - Dorthe Bleses and Werner Vach
  4. Distinguishing the Bilingual as a Late Talker from the Late Talker Who Is Bilingual - Barbara Zurer Pearson

• II Characteristics and Causes

  5. Late Talker as a Clinical Category: A Critical Evaluation - Christine Dollaghan
  6. Phonology and the Lexicon in Late Talkers

• III Interventions

  10. Late Talking in Context: The Clinical Implications of Delayed Language Development - Rhea Paul and Susan Ellis Weismer
  11. Late-Talking Toddlers: A 15-Year Follow-Up - Leslie A. Rescorla
  12. Outcomes for Late Talkers: A Twin Study - Philip S. Dale and Marianna E. Hayiou-Thomas
  13. From Words to Early Sentences: Parent-Implemented Intervention for Late-Talking Toddlers - Luigi Girolametto, Elaine Weitzman, and Cindy Earle
  14. Evidence-Based Language Intervention Approaches for Young Late Talkers - Lizbeth H. Finestack and Marc E. Fey
  15. Which Late Talkers Require Intervention? Matching Child Characteristics and Risk Factors to Treatment - Stephen Camarata
  16. Environmental Modification, Intervention, and the Late-Talking Child from a Public Health Perspective - James Law

• IV Conclusion

  17. Alternative Routes to Language Impairment - Laurence B. Leonard
  18. Where Do We Stand Now? Conclusions and Future Directions - Leslie A. Rescorla and Philip S. Dale

About the Editors

Leslie A. Rescorla, Ph.D.

Professor of Psychology, Bryn Mawr College, 101 North Merion Avenue, Bryn Mawr, PA 19010
Leslie A. Rescorla is Professor of Psychology and Director of the Child Study Institute and the Thorne Early Childhood Programs at Bryn Mawr College. Educated at Radcliffe College in Massachusetts, the London School of Economics, and Yale University in New Haven, Connecticut, she obtained clinical training at the Yale Child Study Center, the Philadelphia Child Guidance Center, and the Children's Hospital of Philadelphia. Dr. Rescorla's research interests include language delays in young children, longitudinal patterns of school achievement, and empirically based assessment of emotional and behavioral problems.

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
Philip S. Dale received his doctorate in communication sciences from the University of Michigan. He is a Fellow of the American Speech-Language-Hearing Association and the Association for Psychological Science, and he has served as President of the International Association for the Study of Child Language. Dr. Dale's research has focused on the causes and consequences of individual differences in language development, the relationship between oral language and early literacy development.

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. For example, there is a broad range of language intervention approaches that have been developed and evaluated for young children from other clinical populations—such as children with autism, Down syndrome, specific language impairment (SLI), and specific speech sound disorder—that clinicians may consider using with LTs. In addition, there are a few studies that have evaluated language intervention efficacy specifically with LTs as participants and even a very few comparative intervention studies that have examined the benefits of one intervention approach over another.

However, based on the external evidence of published research, there is no single intervention approach that is equally supported, the service plan the clinician adopts must hinge on these internal factors. We begin this chapter by discussing approaches to language intervention that are suitable for children who are considered LTs, highlighting investigations that have focused on late-talking children.

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 aggressively. Alternative approaches, all of which entail the delivery of direct intervention services, include general language stimulation, focused stimulation, milieu teaching, or the use of augmentative and alternative communication.

A Nonintervention Option: Watch and See

The only intervention approach designed specifically to accommodate LTs is the "watch and see" approach (Paul, 1996). Based on her longitudinal study of 2-year-old children who had an expressive vocabulary of fewer than 50 words or were not yet combining words, Paul found that 23 of the 31 children in her study had grown out of their initial language delay by the time they reached first grade. It is important to note that although the majority of children appeared to catch up on several measures, on more complex language tasks, including classroom discourse, grammatical perspective-taking, narrative ability, and reading, clinically significant language delays persisted or reappeared throughout the elementary years.

General Language Stimulation

At their core, all general language stimulation approaches involve modifications of the physical and linguistic environments that aim to increase opportunities for children to hear frequent adult models of developmentally appropriate language and to use language at the edge of their abilities. General stimulation activities may include reading a book, playing house, baking a cake, or making lemonade, depending on how well each activity provides opportunities for the child to talk.

Focused Language Stimulation

Focused stimulation is very similar to general stimulation but differs in one fundamental respect. Unlike general stimulation, focused stimulation involves the identification of one or several specific language targets on which the clinician’s teaching efforts and the child’s language learning resources are to be focused.

Milieu Teaching

Milieu teaching takes place during meaningful, naturalistic activities. As in focused language stimulation, the clinician identifies one or more specific goals on which the intervention is to focus. The intervention agent must be highly responsive to the communication efforts of the child, making special efforts to recast child attempts at the targets into appropriate lexical and grammatical forms.