Early childhood speech and language difficulties affect approximately 1 in 5 Australian children, with potential long-term impacts on academic achievement, social development, and emotional well-being. While traditional approaches to assessment and intervention have often focused primarily on the child’s abilities, emerging research highlights the critical importance of considering a broader range of factors. The study by Harrison and McLeod (2010) provides valuable insights into the complex interplay of child, parent, family, and community factors that influence speech and language development in Australian children.
Harrison and McLeod’s research examined data from a nationally representative sample of 4,983 Australian children aged 4-5 years. Through rigorous multivariate analysis, they identified several consistent risk factors across multiple outcome measures. Being male emerged as a significant risk factor, supporting previous research indicating that boys are more vulnerable to speech and language difficulties than girls. This finding aligns with clinical observations where we typically see higher referral rates for males in paediatric speech pathology services.
Ongoing hearing problems were also identified as a substantial risk factor. This reinforces the critical importance of early and regular hearing screenings, particularly for children already showing signs of speech or language delays. As clinicians, we must ensure that hearing assessments are prioritised as part of comprehensive speech and language evaluations, particularly in remote regions where access to audiological services may be limited.
The research also highlighted that children with more reactive temperaments—those who respond more intensely to environmental stimuli and may have difficulty with self-regulation—were at increased risk for speech and language impairment. This finding adds an important dimension to our understanding of development, suggesting that temperamental characteristics may influence a child’s ability to engage with communication learning opportunities.
One of the most fascinating aspects of Harrison and McLeod’s research is the identification of temperament as both a risk and protective factor. While a reactive temperament increased risk, children with persistent temperaments—those who can maintain attention and persevere with tasks despite challenges—demonstrated better speech and language outcomes. Similarly, sociable temperaments were associated with stronger language development, likely because these children may seek out and benefit from more social interactions that foster language learning.
From a clinical perspective, this finding suggests that temperament should be considered when designing intervention approaches. For children with less persistent temperaments, therapy activities may need to be shorter, more engaging, and varied to maintain attention. For children with less sociable temperaments, creating comfortable, low-pressure communication environments may be crucial before gradually expanding social communication opportunities.
These findings also suggest that parent coaching around supporting children with different temperamental characteristics could be a valuable component of early intervention. Helping parents understand how to work with their child’s temperament rather than against it may enhance the effectiveness of home-based language stimulation activities.
Harrison and McLeod found that higher levels of maternal well-being served as a significant protective factor across multiple outcome measures. This aligns with a growing body of research highlighting the importance of caregiver mental health in child development. When mothers experience better psychological well-being, they may be more emotionally available, responsive, and consistent in their interactions with their children—all factors that foster language development.
This finding has profound implications for speech pathology practice. It suggests that supporting maternal well-being should be considered an integral component of early intervention programs. As speech pathologists, we might consider:
- Screening for maternal stress, anxiety, or depression during initial assessments
- Incorporating stress management and self-care strategies into parent coaching
- Developing stronger referral pathways to mental health services
- Designing intervention approaches that do not inadvertently increase parental stress or guilt
The research reinforces that child development does not occur in isolation but is deeply embedded within the parent-child relationship and family context. By supporting parents, we ultimately support children’s communication development.
Interestingly, Harrison and McLeod found mixed results for several family factors depending on the specific outcome measure. Having an older sibling showed variable effects—potentially protective for some aspects of language development but a risk factor for others. This nuanced finding reflects the complex nature of sibling relationships, where older siblings might provide language models but also compete for parental attention.
Parents speaking a language other than English also showed mixed effects. While multilingual environments can enrich a child’s linguistic experience, they may also create challenges in specific language domains or affect parent ratings of concern. This highlights the importance of culturally sensitive assessment practices that distinguish between language difference and language disorder.
Parental support for learning at home showed varying relationships with different outcomes, suggesting that the quality and type of home learning activities may be more important than their mere presence. This encourages speech pathologists to focus on coaching parents in specific, high-quality interaction techniques rather than simply recommending increased quantity of activities.
The multifaceted nature of risk and protective factors identified by Harrison and McLeod suggests several implications for clinical practice:
- Holistic assessment approaches: Assessment protocols should extend beyond standardised testing to include consideration of temperament, family dynamics, parental well-being, and home environment.
- Preventative programs: Early identification of children with multiple risk factors could guide the development of preventative intervention programs before language delays become entrenched.
- Tailored intervention: Understanding a child’s unique constellation of risk and protective factors enables more personalised intervention planning. For example, a child with a reactive temperament may benefit from different therapy approaches than one with a more persistent temperament.
- Interprofessional collaboration: The findings reinforce the importance of collaboration between speech pathologists, audiologists, psychologists, and other health professionals to address the multiple factors influencing language development.
- Policy implications: At a systems level, these findings support investment in programs that address maternal well-being and provide additional supports for families with identified risk factors.
As speech pathologists, we can leverage these insights to move beyond a narrow focus on the child’s speech and language skills to consider how broader contextual factors might be harnessed to support development.
The identification of both risk and protective factors provides a more optimistic and empowering framework for intervention. While some risk factors like gender cannot be modified, protective factors often present opportunities for enhancement through targeted support. By bolstering maternal well-being, helping parents adapt to their child’s temperament, and creating supportive home learning environments, speech pathologists can help strengthen the protective factors that support positive communication outcomes.
Harrison and McLeod’s research offers a valuable contribution to our understanding of speech and language development in Australian children. By adopting a more ecological perspective that considers the child within their broader context, we can develop more effective assessment and intervention approaches that address not only the presenting communication difficulties but also the constellation of factors that influence developmental trajectories.
If you or your child need support or have questions, please contact us at Speech Clinic.
How can parents support children who have multiple risk factors for speech and language impairment?
Parents can focus on enhancing protective factors by creating a responsive communication environment, seeking support for their own well-being, adapting interaction styles to match their child’s temperament, and establishing regular hearing checks. For children with reactive temperaments, providing calm, predictable routines and gradually introducing new activities can help. Remember that protective factors like maternal well-being and supportive home interactions can significantly mitigate the impact of biological risk factors.
When should parents seek professional help for speech and language concerns?
Parents should consider consulting a speech pathologist if they notice their child is not meeting communication milestones, particularly if multiple risk factors are present (male gender, ongoing hearing problems, reactive temperament). Early assessment is especially important when concerns persist for more than 3-6 months or impact the child’s social interactions or frustration levels. Remember that early intervention can be more effective than a “wait and see” approach, particularly for children with multiple risk factors.
How might a child’s temperament affect speech therapy approaches?
A child’s temperament significantly influences how they engage with therapy activities. Children with persistent temperaments may benefit from more challenging tasks over longer sessions, while those with reactive temperaments might need shorter activities with more breaks and environmental modifications to reduce overstimulation. Children with sociable temperaments often thrive in group therapy settings, whereas less sociable children might initially need one-on-one intervention before gradually transitioning to social communication activities. Speech pathologists can tailor their approach based on temperamental characteristics to maximise engagement and progress.
What role does maternal mental health play in children’s communication development?
Maternal mental health influences communication development through several pathways. Mothers experiencing better psychological well-being typically engage in more responsive interactions, provide more consistent language stimulation, and create more predictable home environments—all factors that support language acquisition. Additionally, maternal well-being affects the quality of attachment relationships, which form the foundation for communication development. Supporting maternal mental health through referrals to appropriate services, stress management strategies, and creating intervention approaches that empower rather than overwhelm parents can indirectly but significantly benefit children’s communication outcomes.
How are speech pathologists incorporating these research findings into clinical practice?
Progressive speech pathologists are expanding assessment protocols to include screening for key risk and protective factors, developing collaborative relationships with psychologists and other health professionals to address factors like maternal well-being, and designing more family-centred intervention approaches. Some clinics are implementing preventive programs for children with multiple risk factors, even before language delays are apparent. Additionally, speech pathologists are increasingly focusing on parent coaching that considers the parent-child relationship, family dynamics, and parental well-being as integral components of effective intervention, moving beyond a singular focus on the child’s communication skills in isolation.
