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Meta-Analysis
. 2025 Jul-Aug;96(4):1519-1545.
doi: 10.1111/cdev.14252. Epub 2025 May 3.

Combined Language and Code Emergent Literacy Intervention for At-Risk Preschool Children: A Systematic Meta-Analytic Review

Jennie Cusiter  1   2   3 , Kate Short  1   2   4 , Annabel Webb  1   5   6 , Natalie Munro  1   7
Affiliations
Meta-Analysis

Combined Language and Code Emergent Literacy Intervention for At-Risk Preschool Children: A Systematic Meta-Analytic Review

Jennie Cusiter et al. Child Dev. 2025 Jul-Aug.

Abstract

This meta-analytic review explored the characteristics and effectiveness of combined language (e.g., vocabulary) and code (e.g., phonological awareness) interventions, including synergistic intervention effects for at-risk preschoolers. Data from 29 randomized controlled trials, published before March 2023, reporting on 43 interventions, including 9333 children (4-6 years; 55% male, 45% African American, 30% Hispanic) were included in the meta-analyses. Composite intervention effects were small: language (g = 0.11) and code (g = 0.23). Language and code outcomes were significantly related (p = 0.032). Interventions equally targeting code and language subskills produced equivalent or greater code and language outcomes than those with an unequal emphasis. Implications for future combined intervention studies are discussed.

Keywords: at‐risk; early literacy; emergent literacy development; intervention; language disorder; preschool.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flow chart (Page et al. 2021).
FIGURE 2
FIGURE 2
Forest plot for composite language effects.
FIGURE 3
FIGURE 3
Forest plot for composite code intervention effects.
FIGURE 4
FIGURE 4
Forest plot for studies reporting distal vocabulary effects.
FIGURE 5
FIGURE 5
Forest plot for studies reporting proximal vocabulary effects.
FIGURE 6
FIGURE 6
Forest plot for studies reporting alphabet knowledge effects.
FIGURE 7
FIGURE 7
Forest plot for studies reporting print awareness effects.
FIGURE 8
FIGURE 8
Forest plot for studies reporting phonological awareness effects.
FIGURE 9
FIGURE 9
Meta‐regression comparing language composite and code composite effect sizes (SMD, standardized mean difference).
See this image and copyright information in PMC

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