***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Mothers whose infants varied in early biological characteristics ( born at term , n = 120 ; born at very low birth weight [ VLBW ] , n = 144 ) were r and omized to a target group ( n = 133 ) or developmental feedback comparison group ( n = 131 ) to determine whether learning responsive behaviors would facilitate infant development . The target condition included videotaped examples , problem-solving activities , and mothers ' critique of their own behaviors through video procedures across 10 home visits . All target versus comparison mothers showed greater increases across multiple responsiveness behaviors observed in 4 assessment s conducted across 6 - 13 months of age ; changes in emotionally supportive behaviors were strongest for target mothers of infants born at VLBW . Increased maternal responsiveness facilitated greater growth in target infants ' social , emotional , communication , and cognitive competence , supporting a causal role for responsiveness on infant development . Although benefits were generally comparable across risk groups , aspects of social and emotional skills showed greater change for those born at VLBW . Evidence for responsiveness as a multidimensional construct was provided as well as the importance of different aspects of responsiveness mediating the effect of the intervention on different infant skill domains Abstract This study examined the impact of  teacher professional development aim ed at improving the capacity of primary teachers in disadvantaged schools to strengthen children 's expressive and receptive oral language skills and early literacy success in the first 2 years of school . Fourteen low-SES schools in Victoria , Australia were r and omly allocated to a research ( n = 8) or control arm ( n = 6 ) , result ing in an initial sample of 1254 students , ( n = 602 in research arm and n = 652 in control arm ) . The intervention comprised 6 days of teacher and principal professional development ( delivered by language and literacy experts ) , school-based continuing contact with the research team and completion by one staff member of each research school of a postgraduate unit on early language and literacy . Schools in the control arm received st and ard teaching according to state auspiced curriculum guidelines . Full data were available on 979 students at follow-up ( time 2 ) . Students in the research arm performed significantly better on Test of Language Development : Primary ( Fourth Edition ) sub-tests ( p ≤ .002 ) and the Reading Progress Test ( F = 10.4(1 ) ; p = .001 ) than students in the control arm at time 2 . Narrative scores were not significantly different at time 2 , although students in research schools showed greater gains . Findings provide “ proof of concept ” for this approach , and are discussed with respect to implication s for teacher professional development and pre-service education concerning the psycholinguistic competencies that underpin the transition to literacy PURPOSE This study evaluated the efficacy of a collaborative intervention where a speech- language pathologist ( SLP ) trained  mainstream secondary school teachers to make modifications to their oral and written instructional language . The trained teachers ' uptake of techniques in their whole-class teaching practice s and the impact this had on the language abilities of students with language impairment ( LI ) were evaluated . METHOD Two secondary schools were r and omly assigned to either a trained or a control condition . A cohort of 13 teachers ( 7 trained and 6 control ) and 43 Year 8 students with LI ( 21 trained and 22 control ) were tested at pre , post , and follow-up times-teachers by structured interview and students by st and ardized spoken and written language assessment s. RESULTS Significantly increased use of the language modification techniques by the trained teachers was observed when compared to the control group of untrained teachers , with this increased use maintained over time . Results from the trained group of students showed a significant improvement in written expression and listening comprehension relative to the control group of students . CONCLUSION This r and omized controlled trial is one of the first investigations to evaluate a collaborative intervention that links changes in mainstream secondary teachers ' instructional language practice s with improvements in the language abilities of adolescents with LI In 2002 , the National Institutes of Health sponsored a meeting concerning method ological challenges of research in psychosocial interventions in Autism Spectrum Disorders . This paper provides a summary of the presentations and the discussion s that occurred during this meeting . Recommendations to federal and private agencies included the need for r and omized clinical trials of comprehensive interventions for autism as the highest , but not the sole priority . Ongoing working groups were proposed to address psychosocial interventions with a focus on relevant statistics , st and ardized documentation and methods of diagnosis , development of outcome measures , establishment of st and ards in research ; and the need for innovative treatment design s , including application of design s from other research areas to the study of interventions in ASD BACKGROUND A manualized language therapy developed via a r and omized controlled trial had proved efficacious in the short-term in developing expressive language for mainstream primary school children with persistent language impairment . This therapy had been delivered to a predetermined schedule by speech and language therapists or speech and language therapy assistants to children individually or in groups . However , this model of service delivery is no longer the most common model in UK schools , where indirect consultancy approaches with intervention delivered by school staff are often used . AIMS A cohort study was undertaken to investigate whether the therapy was equally efficacious when delivered to comparable children by school staff , rather than speech and language therapists or speech and language therapy assistants . METHODS & PROCEDURES Children in the cohort study were selected using the same criteria as in the r and omized controlled trial , and the same manualized therapy was used , but delivered by mainstream school staff using a consultancy model common in the UK . Outcomes were compared with those of r and omized controlled trial participants . OUTCOMES & RESULTS The gains in expressive language measured in the r and omized controlled trial were not replicated in the cohort study . Less language -learning activity was recorded than had been planned , and less than was delivered in the r and omized controlled trial . Implication s for ' consultancy ' speech and language therapist service delivery models in mainstream schools are outlined . CONCLUSIONS & IMPLICATION S At present , the more efficacious therapy is that delivered by speech and language therapists or speech and language therapy assistants to children individually or in groups . This may be related to more faithful adherence to the interventions schedule , and to a probably greater amount of language -learning activity undertaken . Intervention delivered via school-based ' consultancy ' approaches in schools will require to be carefully monitored by schools and SLT services Summary Background Results of small trials suggest that early interventions for social communication are effective for the treatment of autism in children . We therefore investigated the efficacy of such an intervention in a larger trial . Methods Children with core autism ( aged 2 years to 4 years and 11 months ) were r and omly assigned in a one-to-one ratio to a parent-mediated communication-focused ( Preschool Autism Communication Trial [ PACT ] ) intervention or treatment as usual at three specialist centres in the UK . Those assigned to PACT were also given treatment as usual . R and omisation was by use of minimisation of probability in the marginal distribution of treatment centre , age ( ≤42 months or > 42 months ) , and autism severity ( Autism Diagnostic Observation Schedule-Generic [ ADOS-G ] algorithm score 12–17 or 18–24 ) . Primary outcome was severity of autism symptoms ( a total score of social communication algorithm items from ADOS-G , higher score indicating greater severity ) at 13 months . Complementary secondary outcomes were measures of parent-child interaction , child language , and adaptive functioning in school . Analysis was by intention to treat . This study is registered as an International St and ard R and omised Controlled Trial , number IS RCT N58133827 . Results 152 children were recruited . 77 were assigned to PACT ( London [ n=26 ] , Manchester [ n=26 ] , and Newcastle [ n=25 ] ) ; and 75 to treatment as usual ( London [ n=26 ] , Manchester [ n=26 ] , and Newcastle [ n=23 ] ) . At the 13-month endpoint , the severity of symptoms was reduced by 3·9 points ( SD 4·7 ) on the ADOS-G algorithm in the group assigned to PACT , and 2·9 ( 3·9 ) in the group assigned to treatment as usual , representing a between-group effect size of −0·24 ( 95 % CI −0·59 to 0·11 ) , after adjustment for centre , sex , socioeconomic status , age , and verbal and non-verbal abilities . Treatment effect was positive for parental synchronous response to child ( 1·22 , 0·85 to 1·59 ) , child initiations with parent ( 0·41 , 0·08 to 0·74 ) , and for parent-child shared attention ( 0·33 , −0·02 to 0·68 ) . Effects on directly assessed language and adaptive functioning in school were small . Interpretation On the basis of our findings , we can not recommend the addition of the PACT intervention to treatment as usual for the reduction of autism symptoms ; however , a clear benefit was noted for parent-child dyadic social communication . Funding UK Medical Research Council , and UK Department for Children , Schools and Families Background Oral language skills in the preschool and early school years are critical to educational success and provide the foundations for the later development of reading comprehension . Methods In a r and omized controlled trial , 180 children from 15 UK nursery schools ( n = 12 from each setting ; Mage = 4;0 ) were r and omly allocated to receive a 30-week oral language intervention or to a waiting control group . Children in the intervention group received 30 weeks of oral language intervention , beginning in nursery ( preschool ) , in three group sessions per week , continuing with daily sessions on transition to Reception class ( pre-Year 1 ) . The intervention was delivered by nursery staff and teaching assistants trained and supported by the research team . Following screening , children were assessed preintervention , following completion of the intervention and after a 6-month delay . Results Children in the intervention group showed significantly better performance on measures of oral language and spoken narrative skills than children in the waiting control group immediately after the 30 week intervention and after a 6 month delay . Gains in word-level literacy skills were weaker , though clear improvements were observed on measures of phonological awareness . Importantly , improvements in oral language skills generalized to a st and ardized measure of reading comprehension at maintenance test . Conclusions Early intervention for children with oral language difficulties is effective and can successfully support the skills , which underpin reading comprehension BACKGROUND This study compares the efficacy of two school-based intervention programmes ( Phonology with Reading ( P + R ) and Oral Language ( OL ) ) for children with poor oral language at school entry . METHODS Following screening of 960 children , 152 children ( mean age 4;09 ) were selected from 19 schools on the basis of poor vocabulary and verbal reasoning skills and r and omly allocated to either the P + R programme or the OL programme . Both groups of children received 20 weeks of daily intervention alternating between small group and individual sessions , delivered by trained teaching assistants . Children in the P + R group received training in letter-sound knowledge , phonological awareness and book level reading skills . Children in the OL group received instruction in vocabulary , comprehension , inference generation and narrative skills . The children 's progress was monitored at four time points : pre- , mid- and post-intervention , and after a 5-month delay , using measures of literacy , language and phonological awareness . RESULTS The data are clustered ( children within schools ) and robust confidence intervals are reported . At the end of the 20-week intervention programme , children in the P + R group showed an advantage over the OL group on literacy and phonological measures , while children in the OL group showed an advantage over the P + R group on measures of vocabulary and grammatical skills . These gains were maintained over a 5-month period . CONCLUSIONS Intervention programmes design ed to develop oral language skills can be delivered successfully by trained teaching assistants to children at school entry . Training using P + R fostered decoding ability whereas the OL programme improved vocabulary and grammatical skills that are foundations for reading comprehension . However , at the end of the intervention , more than 50 % of at-risk children remain in need of literacy support PURPOSE A r and omized controlled trial was conducted to compare the language and auditory processing outcomes of children assigned to receive the Fast ForWord Language intervention ( FFW-L )  with the outcomes of children assigned to nonspecific or specific language intervention comparison treatments that did not contain modified speech . METHOD Two hundred sixteen children between the ages of 6 and 9 years with language impairments were r and omly assigned to 1 of 4 conditions : ( a ) Fast ForWord Language ( FFW-L ) , ( b ) academic enrichment ( AE ) , ( c ) computer-assisted language intervention ( CALI ) , or ( d ) individualized language intervention ( ILI ) provided by a speech- language pathologist . All children received 1 hr and 40 min of treatment , 5 days per week , for 6 weeks . Language and auditory processing measures were administered to the children by blinded examiners before treatment , immediately after treatment , 3 months after treatment , and 6 months after treatment . RESULTS The children in all 4 conditions improved significantly on a global language test and a test of backward masking . Children with poor backward masking scores who were r and omized to the FFW-L condition did not present greater improvement on the language measures than children with poor backward masking scores who were r and omized to the other 3 conditions . Effect sizes , analyses of st and ard error of measurement , and normalization percentages supported the clinical significance of the improvements on the Comprehensive Assessment of Spoken Language ( E. Carrow-Woolfolk , 1999 ) . There was a treatment effect for the Blending Words subtest of the Comprehensive Test of Phonological Processing ( R. K. Wagner , J. K. Torgesen , & C. A. Rashotte , 1999 ) . Participants in the FFW-L and CALI conditions earned higher phonological awareness scores than children in 
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We report evidence for intervention effectiveness , which children might best be served by each tier , the role SLTs could take within each tier and the effectiveness of these roles .
Regarding universal interventions provided to all children ( Tier 1 ) and those targeted at children with language weaknesses or vulnerabilities ( Tier 2 ) , there is growing evidence that approaches led by education services can be effective when staff are highly trained and well supported .
There is currently limited evidence regarding additional benefit of SLT-specific roles at Tiers 1 and 2 .
With regard to individualized intervention ( Tier 3 ) , children with complex or pervasive language disorders can progress following direct individualized intervention ( Tier 3B ) , whereas children with milder or less pervasive difficulties can make progress when intervention is managed by an SLT , but delivered indirectly by others ( Tier 3A ) , provided they are well trained and supported , and closely monitored .