Effects of dose frequency of early communication intervention in young children with and without Down syndrome.

Paul and team asked: does more therapy each week give toddlers with intellectual disability more words?

They split the kids into two groups. All got Milieu Communication Teaching. One group had one session a week. The other had five.

Kids were two to four years old. Some had Down syndrome. Sessions happened at home with parents coached by a therapist.

After six months the five-day group knew about 90 new words. The one-day group knew about 40.

Children with Down syndrome made the biggest leap when IQ was held steady.

More practice each week doubled vocabulary growth for the whole sample.

Wolchik et al. (1982) already showed that rewarding parents with a lottery ticket lifts child language. Paul adds: more sessions per week help too.

McGarty et al. (2018) paid caregivers 50 cents a visit and saw better print knowledge. Paul’s study swaps literacy for spoken words but keeps the parent-coach setup, giving a near-perfect match.

Conine et al. (2025) warns caregiver gains fade without ongoing support. Paul did not track long-term loss, so plan follow-up booster sessions.

If you run parent-mediated MCT, push for at least four to five visits each week. Kids with Down syndrome especially need that density. Ask funders for short, frequent sessions instead of one long visit. Track words weekly; you should see a faster climb by week four.