Insufficient evidence for the validity of the Language Development Survey and the MacArthur-Bates Communicative Development Inventories as screening tools: A critical review.

Abstract

The Language Development Survey (LDS) and the MacArthur-Bates Communicative Development Inventories (MB-CDI) are two parental report forms that have been productive in providing data on early child language during the past 30 years. The instruments have been used both in studies relating to typical developing children and in screening for language difficulties. To review the evidence for the LDS and the MB-CDI utility as screening instruments. A literature search in PubMed and PsychInfo identified 16 articles based on LDS or MB-CDI that reported statistics pertinent to early screening for language difficulties. It was found that most reviewed studies were explorative in nature and tried out different versions of the screening test, including different cut-off values, multiple reference tests, small sample sizes and rarely reported confidence intervals. Spectrum, verification and review biases were common. Moreover, no study could convincingly show that the actual diagnostic accuracy was sufficient for clinical use. There is insufficient evidence that the LDS or any version of the MB-CDI is a valid tool for screening for language difficulties. Of course, this is not to say that sufficient evidence will not be achieved in future studies, or that the instruments do not work well for purposes other than screening. What is already known on this subject The LDS and the MB-CDI are two often-used instruments assessing various aspects of early child language by parental reports. Both instruments have also been used in screening for early language difficulties. What this study adds This study reveals that most published studies in which the classification accuracy of LDS and the MB-CDI has been investigated contain serious methodological shortcomings limiting conclusions about their validity. Currently, there is no good evidence about the usefulness of the LDS and the MB-CDI as general screening tools for language difficulties. What are the potential or actual clinical implications of this work? The LDS and MB-CDI should not be used as screening tools for language difficulties until better evidence of their effectiveness has been demonstrated.