This new Cochrane Intervention Review assessed the effects of parent-mediated interventions for improving communication and language development in young children with Down syndrome. Other outcomes were parental behaviour and responsivity, parental stress and satisfaction and children's non-verbal means of communicating, socialisation and behaviour.
The review included three studies with 45 children aged between 29 months and six years with Down syndrome. Two studies compared parent-mediated interventions versus treatment as usual; the third compared a parent-mediated plus clinician-mediated intervention versus a clinician-mediated intervention alone. Treatment duration varied from 12 weeks to six months. One study provided nine group sessions and four individualised home-based sessions over a 13-week period. Another study provided weekly, individual clinic‐based or home‐based sessions lasting 1.5 to 2 hours, over a six‐month period. The third study provided one 2‐ to 3‐hour group session followed by bi‐weekly, individual clinic‐based sessions plus once‐weekly home‐based sessions for 12 weeks.
The findings were inconsistent. Two studies found no differences in expressive or receptive language abilities between the groups. However, they did find that children in the intervention group could use more targeted vocabularly items or utterances with language targets in certain contexts postintervention, compared to the control group. This was not maintained 12 months later. The third study found gains for the intervention group on total-language measures immediately postintervention. One study did not find any differences in parental stress scores between the groups at any time point up to 12 months postintervention. All three studies noted differences in most measures of how the parents talked to and interacted with their children postintervention, and in one study most strategies were maintained in the intervention group at 12 months postintervention. No study reported evidence of language attrition following the intervention in either group, while one study found positive outcomes on children's socialisation skills in the intervention group. One study looked at adherence to the treatment through attendance data, finding that mothers in the intervention group attended seven out of nine group sessions and were present for four home visits. No study measured parental use of the strategies outside of the intervention sessions.
The review authors rated the quality of the evidence as very low, given that only three studies fulfilled the criteria for inclusion and all had small sizes and serious methodological limitations. They concluded that there is currently insufficient evidence to determine the effects of parent-mediated interventions for improving the language and communication of children with Down syndrome.
Read the full review here.