Where do we go from here? Examining pediatric and population-level interventions to improve child outcomes

This paper summarizes and comments on emerging, but important, developments in practice, policy, and research focused on population-level interventions to address disparities in language development among young American children. This examination draws parallels between the need for broad scale Word Gap interventions and existing public health approaches to prevention and early intervention across many dimensions of child well-being. The authors conducted a review of the literature showing both the limited evidence base and promising aspects that predict efficacious implementation in pediatric and public health systems. Based on the results of a literature search, as well as the authors’ experiences in reviewing and developing interventions designed for implementation at scale, we describe some of the important considerations and challenges associated with designing and implementing a population-level effort. After a summarizing the results of the formal literature review, we present case studies of 2 community-based interventions with an evidence base for addressing the word gap as well as 4 promising programs that suggest innovative and scalable ideas for broader implementation, dissemination and research exploration. Further, we highlight the ways in which these interventions, individually and collectively, are showing promise and evidence for implementation in pediatric and public health settings. Interventions include components of universal contact with populations of interest, early and continuous contact with individuals within these populations, coordinated and aligned messaging and intervention across multiple service sectors, and use of both stakeholder engagement in intervention design and trusted messengers in intervention delivery. We close by providing suggestions for population-level interventions aimed at the word gap, including: universal contact with populations of interest, early and continuous contact.