{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:48:41Z","timestamp":1785538121690,"version":"3.56.0"},"reference-count":46,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,5,29]],"date-time":"2023-05-29T00:00:00Z","timestamp":1685318400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp;amp; Comm Disor"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Indirect speech and language therapy, such as parent\u2010implemented intervention, has been shown to be an effective approach for young children with speech and language disorders. However, relatively few studies have compared outcomes of parent\u2010directed therapy with child\u2010directed intervention, that is, individual therapy of a child delivered by a speech and language therapist (SLT). Although speech and language therapists (SLTs) regard parental engagement as imperative for successful intervention, currently they predominantly use child\u2010directed intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate the effect of parent\u2010 versus child\u2010directed speech\u2013language therapy embedded in usual care intervention for young children with developmental language disorder (DLD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods &amp; Procedures<\/jats:title><jats:p>In a randomized trial, forty\u2010six 3\u2010year\u2010old monolingual children with DLD were assigned to parent\u2010directed intervention or child\u2010directed intervention groups. In addition, all children received usual care in special\u2010language daycare centres. Outcomes included children's language development and functional communication, parents\u2019 language output, parents\u2019 perceptions and their self\u2010efficacy. These were assessed at three time intervals, that is, at baseline, immediately after 6 months of treatment, and 1 year after baseline. The parent\u2010directed intervention consisted of twelve 50\u2010min sessions every 2 weeks with parent and child, consisting of parental training with immediate feedback by (SLTs. Children in the child\u2010directed intervention group received individual speech\u2013language therapy in weekly 30\u2010min sessions for 6 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes &amp; Results<\/jats:title><jats:p>Intervention in both groups was equally effective. All children improved significantly in receptive and expressive language measures as well as in functional communication at all intervals. All parents used significantly more language support strategies and were less concerned about their child's participation in communication. Parents in the parent\u2010directed intervention group reported increased self\u2010efficacy in stimulating their child's language development. In contrast, parents in the child\u2010directed intervention group reported a decrease in self\u2010efficacy. Though modest, these group differences were significant in both the short and long terms. Both parents and SLTs were positive about the parent\u2010directed intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Implications<\/jats:title><jats:p>The effects of parent\u2010 and child\u2010directed intervention for young children with DLD are similar. The parent\u2010directed intervention adds to treatment options for parents as well as for SLTs and creates choices for shared decision\u2010making.<\/jats:p><\/jats:sec><jats:sec><jats:title>WHAT THIS PAPER ADDS<\/jats:title><jats:sec><jats:title>What is already known on the subject<\/jats:title><jats:p>Language therapy for young children with DLD comprises various delivery models. Two of these are child\u2010 and parent\u2010directed therapy by SLTs. Compared with no treatment, both delivery models are effective, but it is unclear if one of these results in better language outcomes than the other. SLTs value child\u2010directed intervention more highly than indirect approaches where treatment is delivered by others. This study aims to compare the relative effectiveness of parent\u2010directed intervention with child\u2010directed intervention, both parts of multi\u2010component usual care intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds to existing knowledge<\/jats:title><jats:p>This randomized trial indicates that a parent\u2010directed intervention model is as effective as child\u2010directed intervention by SLTs for children's language development and functional communication. Parents\u2019 use of language support strategies was also similar in both intervention models, in the short and long terms. Like in child\u2010directed therapy, parent\u2010directed intervention reduces parents\u2019 concerns. Contrary to child\u2010directed treatment, parent\u2010directed intervention increases parents\u2019 self\u2010efficacy, that is, supporting their child's language development.<\/jats:p><\/jats:sec><jats:sec><jats:title>What are the potential or actual clinical implications of this work?<\/jats:title><jats:p>Though SLTs predominantly choose a child\u2010directed intervention model, the study results show that they can consider parent\u2010directed approaches too. There are no significant differences in children's language outcomes as a function of parent\u2010 or child\u2010directed intervention. Furthermore, parents and SLTs were positive about the parent\u2010directed intervention program and the SLTs evaluated it as valuable and feasible.<\/jats:p><\/jats:sec><\/jats:sec>","DOI":"10.1111\/1460-6984.12901","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T05:35:30Z","timestamp":1685424930000},"page":"1768-1782","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["A randomized study of parent\u2010 versus child\u2010directed intervention for Dutch toddlers with DLD"],"prefix":"10.1111","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8526-3525","authenticated-orcid":false,"given":"Margo A.","family":"Zwitserlood\u2010Nijenhuis","sequence":"first","affiliation":[{"name":"Pento Centre for Audiology Amersfoort, Department of Hearing, Speech and Language Disorders in Children Amersfoort the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8951-6702","authenticated-orcid":false,"given":"Carin H.","family":"Wiefferink","sequence":"additional","affiliation":[{"name":"Dutch Foundation for the Deaf and Hard of Hearing Child Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4403-0792","authenticated-orcid":false,"given":"Ellen","family":"Gerrits","sequence":"additional","affiliation":[{"name":"HU University of Applied Sciences Utrecht Utrecht University Utrecht the Netherlands"},{"name":"Institute for Language Sciences Utrecht University Utrecht Utrecht Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/105381518801200401"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/1368282031000121651"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0158753"},{"issue":"7","key":"e_1_2_10_5_1","first-page":"1","article-title":"CATALISE: a multinational and multidisciplinary Delphi consensus study identifying language impairments in children","volume":"11","author":"Bishop D.V.M.","year":"2017","journal-title":"PLoS ONE"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1044\/2020_LSHSS-19-00069"},{"key":"e_1_2_10_7_1","volume-title":"Working with LARSP","author":"Crystal D.","year":"1979"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/1460-6984.12165"},{"key":"e_1_2_10_9_1","unstructured":"Davies K.(2014)Parents\u2019 and speech and language therapists\u2019 roles in intervention for pre\u2010school children with speech and language needs. 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