Early Literacy Research Library (ELRL) - Article

Where Do We Go from Here? Examining Pediatric and Population-Level Interventions to Improve Child Outcomes

Darcy-Mahoney, A., McConnell, S.R., Larson, A.L., Becklenberg, A., Stapel-Wax, J.L. (2020) Where Do We Go from Here? Examining Pediatric and Population-Level Interventions to Improve Child Outcomes. Early Childhood Research Quarterly, 50, 205–220.,

Access: FREE/Open Access

Publication year


study description

Review of literature for peer-reviewed single-case or group design interventions (quasi-experimental and randomized control studies).

core topic(s)

Early Literacy , Pediatric Primary Care

Exposures, Outcomes, Other

Clinic-Based Programs and Interventions , Community , Disparity/Adversity , Language and Literacy Development , Programs and Interventions (other)


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.


Disparities in language development.

outcomes evaluated

Early language development and interventions to improve child outcomes.


Topics Discussed: Status of an Emerging Scientific Literature on Population-Level Efforts to Promote Language Development; Results from Literature Review [Participant Description; Participant Risk Factors; Intervention Description and Effects; Primary Care-Based Studies; Hospital-Based Studies; Home Visiting or Home-Based Interventions; Implication of Literature Review]; Rational for Case Study Approach; Evidence Based Practices [Video Interaction Project; Reach Out and Read]; Promising Programs [Thirty Million Words (TMW); Providence Talks; Talk With Me Baby; Too Small to Fail]; Discussion [Intervention Across Programs and Sectors; Multilevel Interventions; Empirical Evaluation].

sample size

n=14 (articles reviewed); n=2 (case studies reviewed)




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.


Not discussed.