Assessing the Effects of a Parent-Implemented Language Intervention for Children with Language Impairments Using Empirical Benchmarks: A Pilot Study
Roberts, Megan Y.; Kaiser, Ann P. (2012). Journal of Speech, Language, and Hearing Research, v55 n6 p1655-1670 Dec 2012. Retrieved from: https://eric.ed.gov/?id=EJ994875
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examining34Students, gradePK
Single Study Review
Review Details
Reviewed: March 2026
- Single Study Review (findings for Enhanced Milieu Teaching (EMT))
- Randomized Controlled Trial
- Meets WWC standards without reservations because it is a randomized controlled trial with low attrition.
This review may not reflect the full body of research evidence for this intervention.
Evidence Tier rating based solely on this study. This intervention may achieve a higher tier when combined with the full body of evidence.
Findings
|
Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
Evidence tier |
|
|---|---|---|---|---|---|---|---|---|---|
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Total number of words |
Enhanced Milieu Teaching (EMT) vs. Business as usual |
0 Days |
Full sample;
|
124.19 |
73.75 |
No |
-- | ||
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Number of different root words |
Enhanced Milieu Teaching (EMT) vs. Business as usual |
0 Days |
Full sample;
|
49.85 |
33.99 |
No |
-- | ||
|
Mean length of utterance |
Enhanced Milieu Teaching (EMT) vs. Business as usual |
0 Days |
Full sample;
|
1.74 |
1.49 |
No |
-- | ||
| Show Supplemental Findings | |||||||||
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Preschool Language Scale (PLS-4): Expressive Language Subscale |
Enhanced Milieu Teaching (EMT) vs. Business as usual |
0 Days |
Full sample;
|
82.71 |
75.30 |
Yes |
|
||
|
Mean length of utterance |
Enhanced Milieu Teaching (EMT) vs. Business as usual |
-1 Months |
Full sample;
|
1.52 |
1.33 |
No |
-- | ||
|
Number of different root words |
Enhanced Milieu Teaching (EMT) vs. Business as usual |
-1 Months |
Full sample;
|
36.09 |
27.08 |
No |
-- | ||
|
Total number of words |
Enhanced Milieu Teaching (EMT) vs. Business as usual |
-1 Months |
Full sample;
|
83.89 |
61.06 |
No |
-- | ||
|
Mean length of utterance |
Enhanced Milieu Teaching (EMT) vs. Business as usual |
-2 Months |
Full sample;
|
1.36 |
1.31 |
No |
-- | ||
|
Total number of words |
Enhanced Milieu Teaching (EMT) vs. Business as usual |
-2 Months |
Full sample;
|
52.68 |
43.49 |
No |
-- | ||
|
Number of different root words |
Enhanced Milieu Teaching (EMT) vs. Business as usual |
-2 Months |
Full sample;
|
24.23 |
21.20 |
No |
-- | ||
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Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
Evidence tier |
|---|---|---|---|---|---|---|---|---|
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Preschool Language Scale (PLS-4): Total Score |
Enhanced Milieu Teaching (EMT) vs. Business as usual |
0 Days |
Full sample;
|
80.02 |
71.00 |
Yes |
|
|
Evidence Tier rating based solely on this study. This intervention may achieve a higher tier when combined with the full body of evidence.
Sample Characteristics
Characteristics of study sample as reported by study author.
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Female: 21%
Male: 79% -
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Tennessee
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Race Black 21% Other or unknown 3% White 76% -
Ethnicity Other or unknown 100% -
Eligible for Free and Reduced Price Lunch Other or unknown 100%
Study Details
Setting
This study was conducted with preschool children and their families in an out-of-school setting in Tennessee. The intervention and data collection occurred both in a clinical setting and in participants’ homes.
Study sample
Preschool-aged children and their caregivers were recruited through the Tennessee Early Intervention System, local pediatrician offices, and advertisements in a local publication for parents. The study included a randomized controlled trial of children with, or at risk of, a language impairment. Toddlers were eligible if they were between 24 and 42 months old and their scores on several language assessments indicated expressive and receptive language impairments. Children with intellectual disabilities, hearing loss, major medical conditions, or a diagnosis of autism spectrum disorder were excluded. Children who spoke a language other than English at home were also excluded. Their average age was 31 months old. Most caregivers involved in the study were mothers (82%), and their average age was 33 years old. Although not the primary focus of this review, the study also included a quasi-experimental design that compared toddlers with language impairment to toddlers with typically developing language skills.
Intervention Group
Parents delivered the Enhanced Milieu Training (EMT) intervention to their toddlers. The intervention seeks to embed language building opportunities for children during routine, everyday activities. The intervention included four phases for parents to follow: (1) setting the foundation for communication; (2) modeling and expanding the child's communication; (3) time delay strategies; and (4) prompting strategies when communication with the child. For each phase, the parent learned and used specific strategies, like taking turns, modeling specific target words, waiting with a cue for the child to respond, and asking open questions to the child. The sessions mostly took place at the child's home, during play time, reading a book, eating a snack, and doing a common household task or routine. Children and parents also completed 15-minute sessions with a therapist at the clinic at the start of each phase. There were 24 home sessions and 4 clinic sessions.
Comparison Group
The comparison condition was care-as-usual. Parents in the comparison condition did not use Enhanced Milieu Training (EMT) with their toddlers. Although not the focus of the review, the study also includes a comparison group of toddlers with typically developing language skills; this group also received care-as-usual.
Support for implementation
The parents of the participants who were assigned to the intervention received parent training from either a master's-level special educator or a speech language pathologist. The training entailed four 1-hour workshops followed by twice a week sessions where parents practiced the skills taught in the workshops with their children. Sessions were guided by specific language targets chosen for each child based on baseline assessments. The special educator and speech language pathologist received 6 months of supervision and coaching by the study researchers.
An indicator of the effect of the intervention, the improvement index can be interpreted as the expected change in percentile rank for an average comparison group student if that student had received the intervention.
For more, please see the WWC Glossary entry for improvement index.
An outcome is the knowledge, skills, and attitudes that are attained as a result of an activity. An outcome measures is an instrument, device, or method that provides data on the outcome.
A finding that is included in the effectiveness rating. Excluded findings may include subgroups and subscales.
The sample on which the analysis was conducted.
The group to which the intervention group is compared, which may include a different intervention, business as usual, or no services.
The timing of the post-intervention outcome measure.
The number of students included in the analysis.
The mean score of students in the intervention group.
The mean score of students in the comparison group.
The WWC considers a finding to be statistically significant if the likelihood that the finding is due to chance alone, rather than a real difference, is less than five percent.
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A related publication that was reviewed alongside the main study of interest.
Study findings for this report.
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Tier 2 Moderate indicates moderate evidence of effectiveness, and
Tier 3 Promising indicates promising evidence of effectiveness,
as defined in the
non-regulatory guidance for ESSA
and the regulations for ED discretionary grants (EDGAR Part 77).