Professor Charles Hulme

Background: Oral language skills provide the foundation for formal education, yet many children enter school with language weaknesses. This study evaluated the efficacy of a new language enrichment programme, the Nuffield Early Language Intervention—Preschool (NELI Preschool), delivered to children in the year before they enter formal education.

Methods: We conducted a preregistered cluster randomised controlled trial in 65 nursery schools in England (https://doi.org/10.1186/ISRCTN29838552). NELI Preschool consists of a 20-week whole-class language enrichment programme delivered by a teacher each day for 20 min. In addition, children with the weakest language skills in each class are allocated to receive additional targeted support delivered by classroom assistants (whole-class + targeted). The language skills of all children (n = 1,586) in participating classrooms were assessed using the LanguageScreen automated app (https://oxedandassessment.com/languagescreen/). Settings were then randomly allocated to an intervention or control group. The children with the weakest language in each class (whole-class +
targeted children n = 438), along with four randomly selected children in each class allocated to the whole-class only programme (n = 288) were individually tested on a range of language measures.

Results: Children receiving NELI Preschool made larger gains than children in the control group on an oral language latent variable (whole-class children d = .26; whole-class + targeted children d = .16).

Conclusions: This study provides good evidence that whole-class intervention delivered in preschool can produce educationally significant improvements in children’s language skills. The intervention is scaleable and relatively low cost. These findings have important implications for educational and social policy.

Keywords: Language; RCT; education; preschool; intervention.

Handedness has been studied for association with language-related disorders because of its
link with language hemispheric dominance. No clear pattern has emerged, possibly because
of small samples, publication bias, and heterogeneous criteria across studies.

We assessed the frequency of non-right handedness (NRH) in N = 2,503 cases with reading
and/or language impairment and N = 4,316 sex-matched controls identified from 10 distinct
cohorts (age range 6-19 years old) using a priori set criteria. A meta-analysis (N cases = 1,994)
showed elevated NRH % in individuals with language/reading impairment compared to
controls (OR = 1.21, CI = 1.06 - 1.39, p = 0.01).

The association between reading/language impairments and NRH could result from shared
pathways underlying brain lateralization, handedness, and cognitive functions.

Objective: To report how improvements on a Brazilian language intervention for early childhood education settings (PROLIN) were made and evaluated.

Study Design: In the first phase, the programme layout and materials were improved. This involved redesigning the guidelines for the programme, adding videos (using a learning management system) and creating an observation checklist to monitor the fidelity of implementation. The second phase was a two-week pilot study (a 7-session intervention) involving two teachers and 22 students. Checklists and video footage were analysed to investigate implementation.

Results: Quality of implementation was generally good, but we identified additional areas for improvement. Teachers had some difficulties with aspects related to session dynamics, implementation of activities and use of techniques that reinforce learning.

Conclusions:  The pilot study was instrumental in identifying obstacles for a scaled-up, high-quality implementation. The design of these materials took into consideration ways of guiding and supporting teachers:(1) to offer students adequate participation time; (2) to help include children who are shy or have behaviour problems; (3) to use teaching strategies properly; (4) to bring sessions to a close; and (5) to reach the objectives of each session. Further modification is still needed, especially in the manual, videos and supplementary materials.

The use of spoken and written language is a fundamental human capacity. Individual differences in reading- and language-related skills are influenced by genetic variation, with twin-based heritability estimates of 30-80%, depending on the trait. The genetic architecture is complex, heterogeneous, and multifactorial, but investigations of contributions of single-nucleotide polymorphisms (SNPs) were thus far underpowered. We present a multicohort genome-wide association study (GWAS) of five traits assessed individually using psychometric measures: word reading, nonword reading, spelling, phoneme awareness, and nonword repetition, in samples of 13,633 to 33,959 participants aged 5-26 years. We identified genome-wide significant association with word reading (rs11208009, p=1.098 x 10-8) at a locus that has not been associated with intelligence or educational attainment. All five reading-/language-related traits showed robust SNP-heritability, accounting for 13-26% of trait variability. Genomic structural equation modelling revealed a shared genetic factor explaining most variation in word/nonword reading, spelling, and phoneme awareness, which only partially overlapped with genetic variation contributing to nonword repetition, intelligence and educational attainment. A multivariate GWAS of word/nonword reading, spelling, and phoneme awareness maximized power for follow-up investigation. Genetic correlation analysis of multivariate GWAS results with neuroimaging traits identified association with the surface area of the banks of the left superior temporal sulcus, a brain region linked to processing of spoken and written language. Heritability was enriched for genomic elements regulating gene expression in the fetal brain, and in chromosomal regions that are depleted of Neanderthal variants. Together, these results provide new avenues for deciphering the biological underpinnings of uniquely human traits.

Research in the UK suggests that multi-componential interventions focusing on language and pre-literacy skills can improve children’s reading and language skills. However, simple translations of such programs may not produce equivalent effects in diverse communities. The reasons for this are multi-faceted and include factors beyond the rationale and content of the intervention programs themselves. Understanding these factors is critical for creating programs that will generalise across settings. In this review, we reflect upon challenges encountered in two reading and language intervention programs in South America to identify community and cultural contextual factors that can influence the implementation and scalability of educational programs. We use our findings to develop an education-specific framework to guide the development and implementation of high-quality evidence-based approaches to language and literacy intervention. Our model guides implementation practices in diverse contexts and stresses the importance of the evidence-base and communication.

Background

There is now substantial evidence that language interventions delivered to small groups can be effective for improving language skills and hence strengthening the foundation for formal schooling. However, there are remaining challenges when delivering such interventions in naturalistic environments at scale.

Method

We reflect on three randomised trials designed to evaluate the impact of an early years language programme, prior to the implementation of a large effectiveness trial, delivered in partnership with speech and language professionals. We consider findings within a framework from implementation science.

Results

We found that, in contrast to policy-led interventions for reading and mathematics, language interventions are not prioritised in mainstream settings. Aside from this, other obstacles to delivery were the time taken to prepare and to timetable sessions, lack of communication about the requirements of delivery and the need for language screening. Crucial to success was the support from the class teacher of teaching assistants delivering the intervention. However, feedback was largely positive from most stakeholders, and the intervention was found to have a positive impact on children's language with preliminary evidence for effects on behaviour and on reading comprehension.

Conclusions

While many educators recognise the importance of language for communication, the benefits of oral language interventions are only recently becoming prioritised by policy-makers. We propose that challenges to successful delivery and adoption of evidence-based language interventions in mainstream settings can be remedied through better communication with stakeholders and collaboration between researchers and professional colleagues including senior leaders, teachers, teaching assistants, speech and language therapists and psychologists. It is imperative to take account of issues of implementation when designing an intervention and to do this successfully is a multidisciplinary enterprise.