Development of a Language Screening Instrument for Swedish 4-Year-Olds

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Autor/inn/en	Lavesson, Ann; Lövdén, Martin; Hansson, Kristina
Titel	Development of a Language Screening Instrument for Swedish 4-Year-Olds
Quelle	In: International Journal of Language & Communication Disorders, 53 (2018) 3, S.605-614 (10 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	1368-2822
DOI	10.1111/1460-6984.12374
Schlagwörter	Preschool Children; Language Impairments; Semantics; Allied Health Personnel; Speech Language Pathology; Language Tests; Questionnaires; Parent Surveys; Followup Studies; Interrater Reliability; Phonology; Foreign Countries; Pilot Projects; Screening Tests; Sweden + Suchen Sie Ihr Suchwort? Pre-school age; Preschool age; Child; Children; Pre-school education; Preschool education; Vorschulalter; Kind; Kinder; Vorschulkind; Vorschulkinder; Vorschulerziehung; Vorschule; Speech disorder; Speech disorders; Speech disabilities; Speech disability; Speech handicap; Speech handicaps; Speech impairment; Speech impairments; Language handicaps; Sprachbehinderung; Semantik; Language test; Sprachtest; Fragebogen; Follow-up studies; Kontaktstudium; Interrater-Reliabilität; Fonologie; Ausland; Pilot project; Modellversuch; Pilotprojekt; Screening-Verfahren; Schweden
Abstract	Background: The Swedish Program for health surveillance of preschool children includes screening of language and communication abilities. One important language screening is carried out at age 4 years as part of a general screening conducted by health nurses at child health centres. The instruments presently in use for this screening mainly focus on expressive phonology. This may result in both over-referral of children with phonological difficulties and under-referral of children with language disorders (LDs), involving difficulties with vocabulary, grammar and/or language comprehension. Previous research has proposed non-word repetition as a clinical marker for LD. It has also been found that higher predictive power is achieved when non-word repetition is combined with the assessment of lexical/semantic skills. Taking these findings into account, the construction of a language screening instrument may yield more adequate referrals to speech-language therapists (SLTs). Aims: To construct a new standardized language screening instrument for 4-year-olds and to test its properties. Methods & Procedures: An instrument was developed and revised after piloting. A population of 352 children was screened at the regular 4-year check-up by 11 health nurses. The final sample consisted of 328 children aged 46-53 months (23% multilingual). Children performing below a preliminary cut-off were referred to an SLT (n = 52). Five SLTs carried out an assessment on average within 5 weeks using a gold standard language test battery. Children who screened negatively were followed up with a parent questionnaire at age 5;6. Outcomes & Results: Thirty-one true-positives and 11 false-positives were identified after SLT assessment. A further six children were identified as false-negatives (two through referral to an SLT and four through parent questionnaire at age 5;6). A receiver-operating characteristics curve with a C statistic of 0.94 was calculated. Based on optimal cut-off, the sensitivity of the screening instrument was found to be 0.84, and specificity was 0.96. Multilingual children performed similar to monolingual children; boys performed significantly lower than girls; and children with a family history of language-related problems performed lower than those without. Interrater reliability was high, as was Cronbach's alpha. Conclusions & Implications: The screening instrument seems sufficiently valid for its purpose to identify children who need further assessment by an SLT. A follow-up study including SLT assessment for all children to check for false-negatives would be interesting in future, as would studies comparing results from the 4-year screening with those from earlier screens. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2020/1/01