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With a prevalence of about 15% language delay is one of the most frequent developmental problems in 2-year-old children. 1 2 Since language delay can be an indicator for several neurodevelopmental problems, it should be taken seriously and further diagnostic investigation is recommended. 3
There is general agreement regarding the need for intervention for children with persistent deficits in expressive language in the late preschool period and children with deficits in receptive language. 4 5 But in anticipation that young children with specific expressive language delay (SELD) have a good prognosis and will normalise spontaneously, the "wait and see" strategy is widely recommended, 4 - 6 and speech and language therapy is usually not initiated before the age of 4 years. 7 The main reason for this approach is that language development is still quite variable in typically developing young children, and it has been shown that many children with SELD normalise, that is, their language skills at the age of 3-5 years are similar to those of their peers. 6
What is already known on this topic
Although a substantial group of children with expressive language delay will not resolve their problem spontaneously, the "wait and see" approach is widely used.
Parent based language intervention and child directed intervention are effective, but the established programmes are costly and very time consuming.
Evaluated parent based intervention programmes are not available in German speaking countries.
What this study adds
This randomised controlled trial shows that a highly structured and very short parent based language intervention group programme is effective.
The Heidelberg Parent-based Language Intervention is less expensive and time consuming than other published parent based language interventions.
However, the picture is not entirely clear as other studies have found that at least 50% of children with SELD do not resolve their problem spontaneously. 8 - 12 Studies that started with preschool children with follow-up into school age and adolescence, have found that a substantial proportion of children, in particular those with receptive language impairments, will not outgrow their language difficulties and are therefore at risk for cognitive, literacy, behavioural and psychiatric problems. 13 - 15
This unfavourable long term prognosis, combined with parental concerns, child frustration and disturbed parent-child interactions, 16 has led to the development...