A systematic review and meta-analysis of predictors of expressive-language outcomes among late talkers
Abstract
Purpose: The purpose of this study was to explore the literature on predictors of outcomes among late talkers using systematic review and meta-analysis methods. We sought to answer the question: What factors predict preschool-age expressive-language outcomes among late-talking toddlers? Method: We entered carefully selected search terms into the following electronic databases: Communication & Mass Media Complete, ERIC, Medline, PsycEXTRA, Psychological and Behavioral Sciences, and PsycINFO. We conducted a separate, random-effects model meta-analysis for each individual predictor that was used in a minimum of 5 studies. We also tested potential moderators of the relationship between predictors and outcomes using metaregression and subgroup analysis. Last, we conducted publication-bias and sensitivity analyses. Results: We identified 20 samples, comprising 2,134 children, in a systematic review. According to the results of the meta-analyses, significant predictors of expressive-language outcomes included toddlerhood expressive-vocabulary size, receptive language, and socioeconomic status. Nonsignificant predictors included phrase speech, gender, and family history. Conclusions: To our knowledge this is the first synthesis of the literature on predictors of outcomes among late talkers using meta-analysis. Our findings clarify the contributions of several constructs to outcomes and highlight the importance of early receptive language to expressive-language development. Supplemental Materials: https://doi.org/10.23641/asha.5313454
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Fisher's meta-analysis showed a small significant effect of socioeconomic status on expressive language outcome (r = 0.111, p < 0.01).
“A small significant effect was observed for socioeconomic status (r = 0.111, p < 0.01).”
From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [72]
Fisher's meta-analysis showed a medium correlation between expressive-vocabulary size and expressive language outcome (r = 0.249, p < 0.01).
“Results of meta-analysis showed a medium correlation between expressive-vocabulary size and expressive language outcome (r = 0.249, p < 0.01)”
From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [72]
Fisher's meta-analysis showed a medium correlation between receptive language and expressive language outcome (r = 0.340, p < 0.01).
“and between receptive language and outcome (r = 0.340, p < 0.01)”
From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [72]
Family history lacked predictive power for later expressive language outcomes in late talkers, possibly due to heterogeneity of the type of family history assessed.
“family history also lacked predictive power, possibly due to the heterogeneity of the type of family history assessed in the various studies.”
From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [72]
MLU and male gender showed no significant effects on later expressive language outcomes in late talkers.
“MLU and male gender showed no significant effects”
From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [72]
According to Fisher, a timely diagnosis can be performed when the child is between 4 and 5 years old, while children under age 3 can only be described as late talkers and therefore only at risk for DLD but not yet diagnosed with DLD, without detail on what happens between 3 and 4 years.
“Therefore, according to Fisher [72], a timely diagnosis can be performed when the child is between 4 and 5 years old, while children under the age of 3 can only be described as late talkers and, therefore, only at risk for DLD but not yet diagnosed with DLD, without any detail on what happens between 3 and 4 years.”
From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [72]
The relationship between the age at which a child is identified as a late talker and the actual outcome has not been adequately examined yet.
“Moreover, Fisher [72] highlighted that the relationship between the age at which a child is identified as a late talker and the actual outcome has not been adequately examined yet.”
From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [72]
Some investigations on predictors of persistent language delay were general population studies, while others referred to late talkers or children at risk of language delay.
“Additionally, some of the investigations on the predictors of persistent language delay were general population studies (e.g., [75]), while others referred to late talkers (e.g., [72,86,88]) or children at risk of language delay (e.g., [79,80,81]).”
From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [72]
Cites
Statistical Power Analysis for the Behavioral Sciences
Muller, K. E., & Cohen, J. (1989) · Technometrics · doi:10.2307/1270020 · Cited by 99,600 · see citing works
Statistical power analysis for the behavioral sciences
Cohen, J. (1990) · Computers Environment and Urban Systems · doi:10.1016/0198-9715(90)90050-4 · Cited by 65,415 · see citing works
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139 · see citing works
Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series
(2008) · doi:10.1002/9780470712184 · Cited by 25,048 · see citing works
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · BMJ · doi:10.1136/bmj.b2700 · Cited by 17,648 · see citing works
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2009) · doi:10.1002/9780470743386 · Cited by 14,225 · see citing works
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2021) · doi:10.1002/9781119558378 · Cited by 9,799 · see citing works
Stockton, R. A., & Kerlinger, F. N. (1974) · American Educational Research Journal · doi:10.2307/1162206 · Cited by 7,359 · see citing works
Variability in Early Communicative Development
Fenson, L., Dale, P. S., Reznick, J. S., Bates, E., Thal, D. J., Pethick, S. J., Tomasello, M., Mervis, C. B., & Stiles, J. (1994) · Monographs of the Society for Research in Child Development · doi:10.2307/1166093 · Cited by 2,790 · see citing works
Children with Specific Language Impairment
Leonard, L. B. (2014) · doi:10.7551/mitpress/9152.001.0001 · Cited by 2,619 · see citing works
Prevalence of Specific Language Impairment in Kindergarten Children
Tomblin, J. B., Records, N. L., Buckwalter, P., Zhang, X., Smith, E., & O’Brien, M. (1997) · Journal of Speech, Language, and Hearing Research · doi:10.1044/jslhr.4006.1245 · Cited by 2,288 · cited 1× · see citing works
“With regard to gender, our finding that expressivelanguage outcomes did not differ between boys and girls is consistent with the finding of no difference in the prevalence of SLI among kindergarten boys and girls in the largest epidemiological study of SLI to date (Tomblin et al., 1997).”
ResultFoundations of Behavioral Research
Medley, D. M., & Kerlinger, F. N. (1965) · American Educational Research Journal · doi:10.2307/1161926 · Cited by 1,152 · see citing works
The Early Catastrophe. The 30 Million Word Gap.
Hart, B. M., & Risley, T. R. (2003) · The American Educator · Cited by 505 · see citing works
Speech and Language Impairments in Children: Causes, Characteristics, Intervention, and Outcome
Needlman, R. D. (2001) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/00004703-200112000-00015 · Cited by 469 · see citing works
Predicting Language Outcomes at 4 Years of Age: Findings From Early Language in Victoria Study
Reilly, S., Wake, M. A., Ukoumunne, O. C., Bavin, E. L., Prior, M. R., Cini, E., Conway, L. J., Eadie, P. A., & Bretherton, L. (2010) · PEDIATRICS · doi:10.1542/peds.2010-0254 · Cited by 379 · see citing works
Fernald, A. E., & Marchman, V. A. (2011) · Child Development · doi:10.1111/j.1467-8624.2011.01692.x · Cited by 368 · see citing works
MacArthur-Bates Communicative Development Inventories, Second Edition
Fenson, L., Marchman, V. A., Thal, D. J., et al. (2006) · PsycTESTS Dataset · doi:10.1037/t11538-000 · Cited by 354 · see citing works
Concurrent and Predictive Validity of Parent Reports of Child Language at Ages 2 and 3 Years
Feldman, H. M., Dale, P. S., Campbell, T. F., Colborn, D. K., Kurs‐Lasky, M., Rockette, H. E., & Paradise, J. L. (2005) · Child Development · doi:10.1111/j.1467-8624.2005.00882.x · Cited by 339 · see citing works
Causes and Effects in Communication and Language Intervention
Warren, S. F., Reichle, J. E., & Schiefelbusch, R. L. (1991) · Cited by 332 · see citing works
Language and Gesture in Late Talkers
Thal, D. J., Tobias, S., & Morrison, D. (1991) · Journal of Speech Language and Hearing Research · doi:10.1044/jshr.3403.604 · Cited by 313 · see citing works
Language and Reading Outcomes to Age 9 in Late-Talking Toddlers
Rescorla, L. A. (2002) · Journal of Speech Language and Hearing Research · doi:10.1044/1092-4388(2002/028 · Cited by 308 · see citing works
Size matters: Early vocabulary as a predictor of language and literacy competence
Lee, J. (2010) · Applied Psycholinguistics · doi:10.1017/s0142716410000299 · Cited by 298 · see citing works
Evaluating the Quality of Evidence from Correlational Research for Evidence-Based Practice
Thompson, B., Diamond, K. E., McWilliam, R. A., Snyder, P., & Snyder, S. W. (2005) · Exceptional Children · doi:10.1177/001440290507100204 · Cited by 273 · see citing works
Late Talkers: Do Good Predictors of Outcome Exist?
Rescorla, L. A. (2011) · Developmental Disabilities Research Reviews · doi:10.1002/ddrr.1108 · Cited by 268 · see citing works
Systematic review of the literature on characteristics of late‐talking toddlers
Desmarais, C., Sylvestre, A., Meyer, F., Bairati, I., & Rouleau, N. (2008) · International Journal of Language & Communication Disorders · doi:10.1080/13682820701546854 · Cited by 224 · see citing works
Bishop, D., & Edmundson, A. (1987) · Developmental Medicine & Child Neurology · doi:10.1111/j.1469-8749.1987.tb02504.x · Cited by 223 · see citing works
Outcome of toddlers with specific expressive language delay
Rescorla, L. A., & Schwartz, E. R. (1990) · Applied Psycholinguistics · doi:10.1017/s0142716400009644 · Cited by 215 · see citing works
Whitehurst, G. J., & Fischel, J. E. (1994) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1994.tb01210.x · Cited by 206 · see citing works
Moyle, M. J., Weismer, S. E., Evans, J. L., & Lindstrom, M. J. (2007) · Journal of Speech Language and Hearing Research · doi:10.1044/1092-4388(2007/035 · Cited by 155 · see citing works
Communication and Socialization Skills at Ages 2 and 3 in “Late-Talking” Young Children
Paul, R., Looney, S. S., & Dahm, P. S. (1991) · Journal of Speech Language and Hearing Research · doi:10.1044/jshr.3404.858 · Cited by 147 · see citing works
Lyytinen, P., Eklund, K., & Lyytinen, H. (2005) · Annals of Dyslexia · doi:10.1007/s11881-005-0010-y · Cited by 146 · see citing works
Examining Continuity of Early Expressive Vocabulary Development: The Generation R Study
Henrichs, J., Rescorla, L. A., Schenk, J. J., Schmidt, H. G., Jaddoe, V. W. V., Albert Hofman, D., Raat, H., Verhulst, F. C., & Tiemeier, H. W. (2010) · Journal of Speech Language and Hearing Research · doi:10.1044/1092-4388(2010/09-0255 · Cited by 139 · see citing works
Longitudinal Follow-Up of Children with Preschool Communication Disorders: Treatment Implications
Aram, D., & Hall, N. E. (1989) · School Psychology Review · doi:10.1080/02796015.1989.12085444 · Cited by 136 · see citing works
Language Growth in Children With Expressive Language Delay
Fischel, J. E., Whitehurst, G. J. “., Lonigan, C. J., & JORDON, R. S. (1990) · PEDIATRICS · doi:10.1542/peds.85.6.1130 · Cited by 105 · see citing works
Bishop, D., Holt, G., Line, E., McDonald, D. J., McDonald, S., & Watt, H. (2012) · Journal of Neurodevelopmental Disorders · doi:10.1186/1866-1955-4-3 · Cited by 103 · see citing works
The Continuity of Babble and Speech in Children With Specific Expressive Language Delay
Whitehurst, G. J. “., Smith, M., Fischel, J. E., Arnold, D. S., & Lonigan, C. J. (1991) · Journal of Speech Language and Hearing Research · doi:10.1044/jshr.3405.1121 · Cited by 100 · see citing works
Patterns Of Development in Late Talkers: Preschool Years
Paul, R. (1993) · Communication Disorders Quarterly · doi:10.1177/152574019301500103 · Cited by 99 · see citing works
Language Growth in Children With Expressive Language Delay
Fischel, J. E., Whitehurst, G. J. “., Caulfield, M. B., & DeBaryshe, B. D. (1989) · PEDIATRICS · doi:10.1542/peds.83.2.218 · Cited by 93 · see citing works
Klingberg, G. (2014) · doi:10.1002/9781118852446.ch7 · Cited by 83 · see citing works
Maternal Behaviors Promoting Language Acquisition in Slow-to-Talk Toddlers
Levickis, P. A., Reilly, S., Girolametto, L. E., Ukoumunne, O. C., & Wake, M. A. (2014) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000000056 · Cited by 83 · see citing works
The Onset of Tense Marking in Children at Risk for Specific Language Impairment
Hadley, P. A., & Short, H. (2005) · Journal of Speech Language and Hearing Research · doi:10.1044/1092-4388(2005/094 · Cited by 82 · see citing works
Current Issues in Developmental Disorders
(2012) · Psychology Press eBooks · doi:10.4324/9780203100288 · Cited by 79 · see citing works
Westerlund, M., Berglund, E., & Eriksson, M. (2006) · Journal of Speech Language and Hearing Research · doi:10.1044/1092-4388(2006/020 · Cited by 77 · see citing works
Individual Differences in the Onset of Tense Marking: A Growth-Curve Analysis
Hadley, P. A., & Holt, J. K. (2006) · Journal of Speech Language and Hearing Research · doi:10.1044/1092-4388(2006/071 · Cited by 70 · see citing works
Thal, D. J., & Katich, J. (1996) · Cited by 64 · see citing works
A Prospective Longitudinal Study of Phonological Development in Late Talkers
Williams, A. L., & Elbert, M. F. (2003) · Language Speech and Hearing Services in Schools · doi:10.1044/0161-1461(2003/012 · Cited by 63 · see citing works
Phonological Profiles of 2-Year-Olds With Delayed Language Development
Carson, C. P., Klee, T. M., Carson, D. K., & Hime, L. K. (2003) · American Journal of Speech-Language Pathology · doi:10.1044/1058-0360(2003/050 · Cited by 52 · see citing works
Predicting changes in language skills between 2 and 3 years in the EDEN mother–child cohort
Peyre, H., Bernard, J. Y., Forhan, A., Charles, M.-A. A., Agostini, M. D., Heude, B., & Ramus, F. (2014) · PeerJ · doi:10.7717/peerj.335 · Cited by 45 · see citing works
Early Language Delay and Specific Language Impairment
Moyle, J., Stokes, S. F., & Klee, T. M. (2011) · Developmental Disabilities Research Reviews · doi:10.1002/ddrr.1110 · Cited by 39 · see citing works
A Clinical Synthesis of the "Late Talker" Literature
Kelly, D. J. (1998) · Language Speech and Hearing Services in Schools · doi:10.1044/0161-1461.2902.76 · Cited by 35 · see citing works
Children With Slow Expressive Language Development
Nippold, M. A., & Schwarz, I. E. (1996) · American Journal of Speech-Language Pathology · doi:10.1044/1058-0360.0502.22 · Cited by 30 · see citing works
Dale (2003) · Oxford University Research Archive (ORA) (University of Oxford) · doi:10.1044/1092-4388(2003/044 · Cited by 21 · see citing works
Predicting Outcomes of Early Expressive Language Delay.
Paul, R., & Fountain, R. L. (1999) · Infant-toddler intervention · Cited by 18 · see citing works
Early Language Delay Phenotypes and Correlation with Later Linguistic Abilities
Petinou, K. C., & Spanoudis, G. C. (2014) · Folia Phoniatrica et Logopaedica · doi:10.1159/000365848 · Cited by 18 · see citing works
Relationship between social interaction bids and language in late talking children
Vuksanović, J. (2015) · International Journal of Speech-Language Pathology · doi:10.3109/17549507.2015.1010579 · Cited by 10 · see citing works
Reilley, S., Wake, M. A., Bavin, E. L., et al. (2008) · International Journal of Language & Communication Disorders · doi:10.1080/13682820802242825 · Cited by 4 · see citing works
Guralnick (1998) · doi:10.1352/0895-8017(1998)102
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SMARTer Approach to Personalizing Intervention for Children With Autism Spectrum Disorder
Kasari, C., Sturm, A., & Shih, W. (2018) · Journal of Speech, Language, and Hearing Research · doi:10.1044/2018_jslhr-l-rsaut-18-0029 · Cited by 46 · see citing works
Suttora, C., Guarini, A., Zuccarini, M., Aceti, A., Corvaglia, L., & Sansavini, A. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17207684 · Cited by 36 · see citing works
Morgan, L., Delehanty, A., Cleary Dillon, J., Schatschneider, C., & Wetherby, A. M. (2020) · Early Childhood Research Quarterly · doi:10.1016/j.ecresq.2019.12.005 · Cited by 29 · see citing works
- Authors
- Fisher, E. L.
- Affiliations
- Georgia State University (US)
- Corresponding author
- Fisher, Evelyn L.
- Venue
- Journal of Speech, Language, and Hearing Research
- Published
- 2017-10-17
- Volume
- 60
- Issue
- 10
- Pages
- 2935-2948
- ISSN
- 1092-4388 (ISSN-L)
- 1558-9102
- OpenAlex
- W2756451836
- Cited by
- 138
- References
- 57
- Citations by year
- 2026: 13 · 2025: 27 · 2024: 18 · 2023: 17 · 2022: 13 · 2021: 20 · 2020: 15 · 2019: 7 · 2018: 6 · 2017: 1
- FWCI
- 1.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Speech Language and Hearing Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Georgia State University
- Topics
- Social Sciences › Psychology › Developmental and Educational Psychology › Language Development and Disorders
- Social Sciences › Psychology › Developmental and Educational Psychology › Child and Animal Learning Development
- Social Sciences › Psychology › Developmental and Educational Psychology › Hearing Impairment and Communication
- Keywords
- late talkers, preschool children, expressive vocabulary, receptive language, socioeconomic status, toddlers, language development
- MeSH terms
- Child, Preschool, Humans, Language Development Disorders, Prognosis
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