A randomised controlled feasibility trial of an early years language development intervention: results of the ‘outcomes of Talking Together evaluation and results’ (oTTer) project

Background
Early language difficulties are associated with poor school readiness and can impact lifelong attainment.
The quality of the early home language environment is linked to language outcomes. However, few homebased
language interventions have sufficient evidence of effectiveness in improving preschool children’s language
abilities. This study reports the first stage in the evaluation of a theory-based programme, Talking Together (developed
and delivered by BHT Early Education and Training) given over 6 weeks to families in the home setting. We aimed to
test the feasibility and acceptability of delivering Talking Together in the Better Start Bradford community prior to a
definitive trial, using a two-armed randomised controlled feasibility study.
Methods
Families from a single site within the Better Start Bradford reach area were randomly allocated (1:1) to the
Talking Together intervention or a wait list control group. Child language and parent-level outcome measures were
administered before randomisation (baseline), pre-intervention (pre-test), 2 months post-intervention start (post-test),
and 6 months post-intervention start (follow-up). Routine monitoring data from families and practitioners were also
collected for eligibility, consent, protocol adherence, and attrition rates. Descriptive statistics on the feasibility and
reliability of potential outcome measures were analysed alongside qualitative feedback on trial design acceptability.
Pre-defined progression-to-trial criteria using a traffic light system were assessed using routine monitoring data.
Results
Two-hundred and twenty-two families were assessed for eligibility; of these, 164 were eligible. A total of 102
families consented and were randomised (intervention: 52, waitlist control: 50); 68% of families completed outcome
measures at 6-month follow-up. Recruitment (eligibility and consent) reached ‘green’ progression criteria; however,
adherence reached ‘amber’ and attrition reached ‘red’ criteria. Child- and parent-level data were successfully measured,
and the Oxford-CDI was identified as a suitable primary outcome measure for a definitive trial. Qualitative data not
only indicated that the procedures were largely acceptable to practitioners and families but also identified areas for
improvement in adherence and attrition rates.
Conclusions
Referral rates indicate that Talking Together is a much-needed service and was positively received by
the community. A full trial is feasible with adaptations to improve adherence and reduce attrition.