In early 2023, the National Institutes of Health (NIH) launched the Tackling Acquisition of Language in Kids (TALK) initiative in response to congressional interest in research to support late talking children. It has since grown into an initiative with engagement across five institutes co-led by the National Institute on Deafness and Other Communication Disorders (NIDCD) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and with participation from the National Institute of Neurological Disorders and Stroke (NINDS), the National Institute of Mental Health (NIMH), and the National Center for Advancing Translational Sciences (NCATS).
Children vary in their development of speech and language skills, but there is an average progression or timetable for mastering the skills of language. Late talking, also known as late language emergence, is diagnosed when a child, usually over the age of 18 months, is not meeting expressive language milestones. Approximately 10 to 20% of children receive this diagnosis. The purpose of the TALK initiative is to advance understanding of why children with various conditions or risk factors are late to talk; define developmental trajectories that lead to better outcomes; and evaluate the effectiveness of clinical approaches to improve language outcomes. The ultimate goal of the initiative is to provide parents, caregivers, educators, and health care professionals with the information they need to help late talking children grow and thrive in school and life.
The TALK initiative has three complementary themes for action to provide multiple pathways toward achieving the overarching purpose.
- Create longitudinal data sets: Spark researchers to create the infrastructure to bring together existing longitudinal data on different populations of late talking children. Then, analyze these integrated data sets in novel ways to address broader questions about developmental trajectories in late talking children. The goal is to create the foundation for future, targeted longitudinal research.
- Develop novel approaches: Challenge the research community to create, adapt, or apply new methods to study late talking children. The goal is to improve the design of clinical research studies so that they can lead to more effective interventions.
- Translate research into practice: Galvanize researchers to better understand the needs of individuals who support late talking children and to determine whether those needs are being met. This theme will serve to develop and disseminate evidence-based practices to effectively guide parents, caregivers, educators, and health care professionals in supporting late talking children.
The participating institutes intend to publish two new Notices of Funding Opportunities: Leveraging Extant Data to Understand Developmental Trajectories of Late Talking Children and Information and Practice Needs Relevant to Late Talking Children. The funding opportunities will solicit applications that aim to fill knowledge gaps and work toward the overarching goals of this initiative, including gathering, storing, and evaluating data to understand longitudinal development in late talking children, and providing caregivers and clinicians with state-of-the-science information on supporting late talkers.
Through the TALK initiative, NIH is funding several research project grants and has provided supplemental funding in 2023 to relevant ongoing awards. These research projects focus on late talking across diverse groups of children, including children who were born preterm or with genetic disorders; those with Down syndrome or at risk for autism or language disorders; children from low-income environments; those with behavioral problems; children who are deaf or hard of hearing; and those being raised in bilingual or bimodal language environments. The studies offer an exciting range of focus and need regarding language trajectories in these diverse populations. Future research opportunities may include determining why some children present as late talkers for no known reason.
Long-term outcomes for late talking children vary, and the unique early indicators and developmental consequences are not fully understood There is a critical need to build a more robust knowledge base about this population to better inform parents, other caregivers, educators, and health care professionals regarding the nature, extent, and developmental course of late talking children and to develop new and more effective ways of supporting communication success for this broad and diverse array of children. NIH will continue to engage with researchers and the broader community to advance the priorities of the TALK initiative.