Late Talkers & Parent Talk

Published in the February 2025 issue of the ISHA Voice.

By Suzanne Meldrum, Ph.D.

Dr. Suzanne Meldrum was invited to submit this article for the membership by the Evidence-based Practice Committee. 

As a clinician working with families of late talking children, I have been most struck when I meet a family who have parents who are extremely motivated to encourage their child’s language.

Yet their child does not speak and continues not to.

I would carefully watch their interactions, note how they encourage all communicative attempts, following the child’s lead, adding, and extending any language attempts. I’d walk away thinking “great job parents, no notes”. So, what on earth was I to tell the parents who have come for my advice? Watch and wait? Most often they would be referred for ‘parent training’ about language stimulation anyway, even though I didn’t think this was the underlying problem.

One of my favorite bloggers is the stalwart Professor Dorothy Bishop. One of her best posts (in my opinion) is now 10 years old, but still holds true today. It discusses child language and parent talk. BishopBlog: Parent talk and child language.

In this blog, she discusses the oft-cited view that children who have poor language skills are the fault of parents who do not speak enough to their children. As Professor Bishop notes, such stories sell papers – inducing moral superiority in the audience. ‘Ah well my Johnny has great language skills – all that speaking I did to him certainly did the trick”.  It aligns with the Mozart effect, whereby parents ‘doing something’ can create or mitigate the development of certain traits. But is it true?

At its heart, this discussion is a ‘nature vs nurture’ argument.  How much of an influence do parents have over their child’s language acquisition? We SLPs often have a vested interest. We can’t alter anything genetic, but we can suggest environmental adaptations and modifications. One of our main treatment approaches for young children who are delayed in language acquisition is to train parents in increasing their amount and ‘responsiveness’ to child talk (Rescorla et al. (2013). We work in the ‘nurture’.

And research does support us to some extent. Parent talk is extremely variable, driven by parents own genetics, environmental circumstances, and communication skills (Conti-Ramsden and Friel-Patti, 2021). There is research demonstrating correlations between parent talk and child language outcomes, linked to socio-economic status (Hirsh-Pasek et al. 2015; Madigan et al. 2019; Rowe 2012). Factors such as limited time, different priorities and cultural differences are oft cited as reasons for the relationship. There are also the cases of minimal human interaction (Curtiss et al. 2014), parental post-natal (Clifford et al. 2024) and chronic neglect (Sylvestre et al. 2016), which can all significantly negatively impact language development. Treatment efficacy data relating to parent-training programs supports this side of the argument too. When we train parents in talking to their children, it seems to have a positive impact, at least for some children (Fisher 2017).

So certainly ‘none’ or ‘very little’ language stimulation has a negative influence. But is there a cut-point which we can find that beyond that children will be ok? Does more parent-talk result in a steadily positive correlation – whereby the more they hear, they better they are? In a word, no. It’s just not that simple.

Firstly, communication is a two-way street. A child who has language issues is unlikely to communicate frequently or with a high degree of skill. This means that their parents have less opportunity to communicate back and may not do so enough – subsequently limiting their language input. Yep, this makes sense. But this would not explain the client who I discussed at the start of this piece.

Secondly and probably more importantly, parents share a lot of genetic risk with their children, and we know from twin studies that genetics plays a role in language development (Bishop, 2006). This is the ‘nature’ argument. If a parent has weak language skills themselves, this might be an inherited trait. But consider, this is probably also driving the ‘parent talk- child language’ correlation. To a certain extent our ‘nurture’-supporting data may be ‘nature’ influences in disguise.

Studies such as those of parents of deaf or hard of hearing children support the nature claim. When Deaf of hard of hearing parents raise hearing children, such children receive enough language stimulation from other sources (e.g. school, friends, television) that they develop language normally (Schiff-Meyers, 1988). Language development has always appeared remarkably sturdy, harking back to Noam Chomsky and the ‘poverty of the stimulus’ (Berwick and Chomsky, 2008).

So, how does this help me with my tricky client? With what I know now, I would not send parents any information or to any courses which I don’t think they need. Nor would I suggest that any clinic send the parents of all language delayed children to such services as a matter of course. At the minimum, clinical observation needs to work out if any environmental or interactional factors can be improved upon. If watch and wait seems too risky, then alternate emerging treatments such as cross-situational statistical learning published by the laboratory of Professor Mary Alt in Arizona may be worth investigating (Alt et al. 2014).

My final consideration would be that we need to use delicacy and compassion when working with these families. When we target something like increasing parent talk, there is always an implied meaning that ‘too little’ must have been the cause. We need to address this assumption head on and without waiting for parents to articulate this thought. An effective response may be to point to other children in the family who have no such issues and were raised in the same household. Or discuss how the child’s limited communication may limit their reciprocity. Like all things, kindness is key here.