Illusory recovery: are recovered children with early language delay at continuing elevated risk?

To examine the later development of language and literacy of children who had delayed language at age 2 but were in the normal range at age 4.

Longitudinal data were analyzed from 3,598 pairs of twins participating in the Twins Early Development Study (TEDS). Six hundred thirty-three twins (8.8%) were delayed at age 2 based on parent-reported expressive vocabulary, and of these, 373 (59.0%) were classified as recovered based on 4-year measures. Each recovered 4-year-old was matched on vocabulary, gender, and zygosity to another 4-year-old without a history of early delay.

Although the recovered group was below the mean for the total TEDS sample on measures of language at ages 7 and 12, there were no significant differences between the recovered and matched groups. Within the recovered group, it was not possible to predict outcome at better than a chance level.

Children who appear to have recovered by age 4 from early delay are at modest risk for continuing difficulties, but this appears to be no higher than the risk for other 4-year-olds with equivalent scores, reflecting the continuing variability in longitudinal outcome after age 4. All children in the low normal range at age 4 merit continuing monitoring.