{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T11:15:12Z","timestamp":1790162112256,"version":"4.1.0"},"reference-count":144,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp;amp; Comm Disor"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Caregiver\u2010mediated interventions are commonly used by Speech and Language Therapists to support early language development. Developmental Language Disorder (DLD) is associated with reduced quality of life throughout the lifespan. Understanding factors that predict intervention success is essential for developing appropriate, cost\u2010effective therapy provision for the approximately 12% of preschool children who present with early markers for Developmental Language Disorder (DLD). This systematic review and meta\u2010analysis examined the effectiveness of caregiver\u2010mediated spoken language interventions for under\u2010fives at risk of DLD, and factors influencing intervention effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review following PRISMA guidelines was conducted. Five electronic databases were searched to identify experimental studies comparing caregiver\u2010mediated spoken language interventions to control conditions in under\u2010fives presenting with risk factors for DLD. Risk factors included prematurity, socioeconomic factors, caregiver language development concerns, and formal or informal language screening or assessment scores. Twenty\u2010six experimental studies with 1407 child participants were included in qualitative synthesis. Meta\u2010analysis was performed on nine Randomised Controlled Trials involving 947 children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Effectiveness was examined for outcomes including child language gains, child wellbeing, inclusion and attainment. Meta\u2010analysis indicated a significant effect of caregiver\u2010mediated spoken language interventions on language outcomes compared to treatment\u2010as\u2010usual, non\u2010language intervention or waitlist control conditions. Non\u2010language outcomes were evaluated via qualitative synthesis. Interventions significantly improved language development trajectories for under\u2010fives presenting with risk factors or early markers for DLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion and Implications<\/jats:title>\n                    <jats:p>This review contributes to the growing evidence base demonstrating that caregiver\u2010mediated interventions can positively impact language development and wellbeing outcomes for children under five at risk of DLD. These findings support the implementation of caregiver\u2010mediated environmental language interventions in clinical practice to maximise accessibility and cost\u2010effectiveness while delivering optimal outcomes for vulnerable populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>WHAT THIS PAPER ADDS<\/jats:title>\n                    <jats:p>\n                      <jats:italic>What is already known on this subject<\/jats:italic>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Previous research on caregiver\u2010mediated spoken language interventions has highlighted gaps in the evidence regarding the impact of risk factors, demographic characteristics, dosage and intervention components on child language outcomes. Developmental Language Disorder has relatively high population prevalence, estimated at 7%. Prevalence is associated with risk factors including low household socioeconomic status (SES), prematurity and late language emergence. In contrast to its prevalence, there is low public and professional awareness of DLD and a low diagnostic rate. Therefore, a strengthened evidence base and additional insights into the factors affecting success of family\u2010based interventions is important in order to increase the effectiveness of service provision and care planning for this underserved population. Timely and effective intervention with young children presenting with early markers for DLD has the potential to offer lifelong improvement to their wellbeing, inclusion and attainment outcomes.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Recent systematic reviews of the effectiveness of caregiver\u2010mediated language interventions had differences in population age range and diagnostic inclusion criteria.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                      <jats:italic>What this paper adds to existing knowledge<\/jats:italic>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Our review examines the effectiveness of caregiver\u2010mediated early spoken language interventions on child language, attainment and wellbeing, and on caregiver self\u2010efficacy and adherence to language support strategies. Our population was children under five presenting with risk factors for Developmental Language Disorder, in the absence of other neurodevelopmental or genetic conditions such as intellectual disability or autism. This review adds depth and detail to the evidence base supporting the effectiveness of caregiver\u2010mediated spoken language interventions in improving outcomes for this population of young children, and factors that influence their success.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                      <jats:italic>What are the potential or actual clinical implications of this work?<\/jats:italic>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>The high prevalence of Developmental Language Disorder, estimated at around 7% of the population, and the strong association with risk factors including low SES, prematurity and late language emergence, coupled with the low awareness of DLD and low diagnostic rate, mean that a strengthened evidence base and additional insights into the factors affecting success of family\u2010based interventions can increase the effectiveness of service provision and care planning for this population. Timely and effective intervention in this group of young children has the potential to improve wellbeing and attainment outcomes across the lifespan. This review contributes to our understanding of how to implement cost\u2010effective, socially valid and maximally engaging partnership working with families of young children at risk for DLD.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1460-6984.70304","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T14:22:49Z","timestamp":1787322169000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of Caregiver\u2010Mediated Spoken Language Interventions for Children Under Five at Risk of Developmental Language Disorder: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0162-1226","authenticated-orcid":false,"given":"Victoria","family":"Johnstone\u2010Cooke","sequence":"first","affiliation":[{"name":"Clinical Audiology Speech and Language Research Centre Queen Margaret University  Edinburgh Scotland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2283-6736","authenticated-orcid":false,"given":"Marion","family":"Rutherford","sequence":"additional","affiliation":[{"name":"Clinical Audiology Speech and Language Research Centre Queen Margaret University  Edinburgh Scotland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ainuska","family":"Sheripkanova","sequence":"additional","affiliation":[{"name":"Institute for Global Health and Development Queen Margaret University  Edinburgh Scotland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6812-295X","authenticated-orcid":false,"given":"Rachel","family":"Hutcheson","sequence":"additional","affiliation":[{"name":"NHS Lothian  Edinburgh Scotland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0570-9206","authenticated-orcid":false,"given":"Ann","family":"Hodson","sequence":"additional","affiliation":[{"name":"Clinical Audiology Speech and Language Research Centre Queen Margaret University  Edinburgh Scotland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecresq.2018.11.005"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/10538151211032211"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/00380261221104378"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/09650792.2022.2130386"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2015.11.001"},{"key":"e_1_2_9_8_1","volume-title":"Bayley Scales of Infant and Toddler Development","author":"Bayley N.","year":"2006"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-7138(10)60013-1"},{"key":"e_1_2_9_10_1","volume-title":"Get Ready to Read!: Assessing the Efficacy of an Emergent Literacy Screening Tool","author":"Benmeleh E.","year":"2011"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0265659012459467"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0158753"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.12721"},{"key":"e_1_2_9_14_1","volume-title":"Expressive One\u2010word Picture Vocabulary Test: EOWPVT","author":"Brownell R.","year":"2000"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.12819"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2008.141572"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1053815115609384"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.16149"},{"key":"e_1_2_9_19_1","first-page":"8","article-title":"Il primo vocabolario del bambino: Gesti, Parole e Frasi","volume":"8","author":"Caselli M. 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