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Working on Rapid Language Development in Toddlers (WORLD)

This study has been completed.
ClinicalTrials.gov Identifier:
First Posted: November 5, 2013
Last Update Posted: May 2, 2016
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by (Responsible Party):
Ann Kaiser, Vanderbilt University
The goal of the study is to examine the effects of teaching parents to use language support strategies on language skills in toddlers with language delays. We hypothesize that children whose parents who learn to use language support strategies at home will have greater language skills than those children whose parents do not learn the strategies.

Condition Intervention
Language Developmental Disorders Behavioral: Enhanced Milieu Teaching

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: An Efficacy Trial of Milieu Teaching Language Intervention in Children With Language Disorders

Further study details as provided by Ann Kaiser, Vanderbilt University:

Primary Outcome Measures:
  • Change from Baseline in Language Skills at 4 months. [ Time Frame: 4 months ]
    Preschool Language Scale-4th Edition (a norm-referenced measure of receptive and expressive language).

Secondary Outcome Measures:
  • Change from baseline in expressive vocabulary at 4 months. [ Time Frame: 4 months ]
    Number of words the child says and average sentence length during a 20-minute language sample.

Enrollment: 185
Study Start Date: September 2009
Study Completion Date: December 2015
Primary Completion Date: December 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Enhanced Milieu Teaching

Parents receive 28 intervention sessions in which they learn to use language support strategies with their children.

Children are assessed at baseline, 4 months after baseline, 10 months after baseline, and 16 months after baseline.

Behavioral: Enhanced Milieu Teaching
Enhanced Milieu Teaching (EMT) is a conversation-based model of early language intervention that uses child interest and initiations as opportunities to model and prompt language use in everyday contexts.
Other Name: KidTalk
No Intervention: Community Services
Children receive speech-language services in the community. Children are assessed at baseline, 4 months after baseline, 10 months after baseline, and 16 months after baseline.

Detailed Description:
The goal of the proposed project is to conduct an efficacy trial to determine whether Enhanced Milieu Teaching (EMT) significantly improves language deficits in young children at high risk for persistent language delays. The target population is children ages 24 -36 months who exhibit significant co-occurring delays in productive and receptive language skills, who have cognitive skills within the range of normal development, and who do not have other identified disabilities. An empirically based and manualized language intervention, Enhanced Milieu Teaching (EMT), implemented by therapists and parents will be compared to community based "business as usual" services in a randomized experiment enrolling 120 children and their parents. Children assigned to the EMT group will receive 24, 1-hour sessions of direct intervention at home that will include teaching their parents to implement EMT procedures across activities. Children will be assessed at 4 time points (before and after intervention, at 6 months and 12 months post-intervention) allowing the description and comparison of individual language growth trajectories over a period of 18 months. In addition, we will examine the relation between language growth and emergent problems in behavior and social skill development to determine whether early language intervention can prevent these difficulties frequently associated with early language delays. Results from this study will determine the efficacy of parent-plus-therapist implemented EMT with a new population of children, provide evidence about the potential for preventing persistent language delays and secondary social effects of early language delays, and expand developmental theory linking persistent language delays to specific risk factors and behavioral outcomes. The results of this study will have specific policy implications related to early identification and the inclusion of young children with language delays as a target population for early intervention.

Information from the National Library of Medicine

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Ages Eligible for Study:   24 Months to 42 Months   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Language delay

Exclusion Criteria:

  • Hearing loss
  • Language other than English as the home language
  • Additional disabilities (e.g., autism, Down syndrome)
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01975922

United States, Tennessee
Vanderbilt University
Nashville, Tennessee, United States, 37232
Sponsors and Collaborators
Vanderbilt University
Principal Investigator: Ann P Kaiser, PhD Vanderbilt University
  More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Ann Kaiser, Professor, Vanderbilt University
ClinicalTrials.gov Identifier: NCT01975922     History of Changes
Other Study ID Numbers: 090904
R324A090181 ( Other Grant/Funding Number: IES )
First Submitted: October 23, 2013
First Posted: November 5, 2013
Last Update Posted: May 2, 2016
Last Verified: April 2016

Keywords provided by Ann Kaiser, Vanderbilt University:
language impairment
language disorder
language delay
late talkers
late talking

Additional relevant MeSH terms:
Developmental Disabilities
Language Disorders
Neurodevelopmental Disorders
Mental Disorders
Communication Disorders
Neurobehavioral Manifestations
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms