Language Screening Research Articles

Examining the language skills of children with ADHD following a play-based intervention

Communication and play skills are important aspects of development yet are largely uncharted in children with attention deficit hyperactivity disorder (ADHD). This exploratory study examined whether changes in pragmatic skills and problem-solving skills were observed in children with ADHD pre- and post-participation in a play-based intervention conducted by occupational therapists and speech-language pathologists. The study also investigated whether the presence of language difficulties affected the children’s play outcomes. Fourteen children with ADHD (5;0–10;7 years) participated in a 7-week, pilot intervention to address play and social skill deficits. Pre- and post-intervention testing included: (a) the assessment of play and problem-solving skills via standardized testing, and (b) pragmatic skills via parent report. The children’s language skills were also screened and compared with their play scores. Play skills significantly improved post-intervention. No significant differences were observed for pragmatic skills while prediction skills, an aspect of problem-solving, significantly improved pre- and post-play-based intervention. Fifty percent of children failed the language screener, yet separate paired t-tests identified significant play improvements irrespective of the presence or absence of language difficulty. Two independent t-tests revealed significant differences in play scores between these groups at pre- but not post-intervention. While play and predicting skills significantly improved post-play-based intervention, other aspects of problem-solving and pragmatics did not. Reasons for the lack of change in these areas are discussed. The presence of language difficulties did not appear to affect the play outcomes of children with ADHD following a play-based intervention. A larger scale experimental trial investigating the play and language skills of children with ADHD is warranted, as is future collaborative research between occupational therapists and speech-language pathologists in the assessment and management of children with ADHD.

Sprachentwicklung von der U7 bis zur U7a bei Kindern mit und ohne Sprachentwicklungsverzögerungen

At the beginning the course of language acquisition has a high degree of variability and it is unclear so far, at what age language delay is of clinical relevance. The present study addresses the question whether language skills at the age of 2 years allow prognostic statements and whether children with language delay at this age, are to be considered as children of risk.Starting from birth announcements children of average (n=42), borderline (n=28) and below-average stage of language development (n=50) were recruited. The language skills were assessed at the age of 2 (25+0.6 months) and 3 years (37+0.6 months) using standardized language tests.The correlation between the global stage of language development at the age of 2 and 3 years was strong (rsp=0.78, p<0.001). At 3 years of age one third of the former late talkers reached language abilities within the normal range (late bloomers), one third showed language difficulties and the last third met the criteria of specific language impairment. The risk for language difficulties was increased in these children to the 13-fold. Even the late bloomers scored significantly lower in the language test compared to the control children.From the third year of live language development is relatively stable, and language skills at the age of 2 allow a prediction of the stage of language development one year later. Late talkers are at high risk for persistent language difficulties. A general language screening at the age of 2 years would enable an early identification of children at risk and an early parent-based intervention.

Psychometric testing of the English Language Acculturation Scale in first‐year nursing students

This article is a report of the psychometric testing of the five-item English Language Acculturation Scale, an indicator of English language usage as reported by first-year undergraduate nursing students. Nursing students who have English as an additional language can struggle clinically and academically due to low levels of English language proficiency. A self-report screening tool may provide early identification of nursing students at risk of underperformance. Prospective correlational survey design. The study used a prospective, correlational survey design. In 2010 and 2011, 1400 commencing nursing students were surveyed about their English language usage using the English Language Acculturation Scale. In addition to descriptive statistics, exploratory and confirmatory factor analyses and Cronbach's alpha reliabilities, the relationship between English Language Acculturation Scale score and Grade Point Average at the end of first year was computed. Results show good reliability and construct validity of the English Language Acculturation Scale. Principal component analysis yielded only one component in which all five items loaded highly. This was further supported by confirmatory factor analysis, with standardized factor loadings ranging from 0·79 to 0·90. The results also showed strong association between English language use and academic performance; students in the high English Language Acculturation Scale score group were most likely to be in the high Grade Point Average group at the end of first year. Language screening tools can be an important strategy to identify nursing students at risk of underperforming in their studies. The English Language Acculturation Scale has the potential to be a useful brief self-report measure for commencing nursing students.

A universal 30-month child health assessment focussed on social and emotional development

Background : The Glasgow Parenting Support Framework was published in 2009 with a view to improving universal and targeted parenting support for families in the city of Glasgow. In order to provide structured support to families at all levels of need (i.e., either the whole population (universal) or those families with identified problems (targeted)), it was important to have a robust means of assessing the needs of families. To this end, two routine family visits by Health Visitors (community child nurses) were piloted in order to assess their utility in assessing need for parenting support. Both visits involved home assessments, one when the child reached 13 months of age and the other at 30 months. The utility of the 13 month visit is reported elsewhere [6] . We describe findings from the 30 month contact in this paper. Aims : The present study aimed to assess the utility of a home visit at 30 months of age in assessing families’ need for parenting support. It describes (a) the level of need established and (b) the extent to which the home assessment influenced health visitors’ choice of subsequent action. Methods : Health visitors were asked to arrange to see the principal carer (usually the mother) of the child at home with the child within a month of the child reaching 30 months of age. They collected data on: existing problems and service provision to families, including whether there were known developmental problems for the child or parental issues such as substance misuse or medical problems; parenting stress reported by the child’s principal carer using the Parenting Daily Hassles Scale; parent’s perception of their child’s language development using a two-item brief language screen and parent’s perception of the child’s behaviour using the Behaviour Screening Questionnaire. Using unique Community Health Index identification numbers, linked data from the Child Health Surveillance System, which allowed us to allocate a social deprivation score (using Scottish Index of Multiple Deprivation (SIMD)) to families, were incorporated into statistical models of service use. Results : From a whole population of 819, data were obtained for 437 families of which 330 had a completed visit. The remaining families were not visited usually due to difficulties in securing an appointment or families not being home at the time of the planned appointment. Parenting stress was generally low and behaviour problems commonly reported. Scores on both parenting stress and behaviour measures were higher in families already identified to have higher levels of need and those living in more deprived areas. Health visitors were more likely to intend to revisit or refer as parenting stress and behaviour scores increased, and where there was previously identified need and socio-economic deprivation. Conclusions: Current service provision matches need to some extent but routine visits focused on children’s social and emotional development at 30 months may help to identify families needing support who would not otherwise have received it.

Language Delay Is Not Predictable from Available Risk Factors

Aims. To investigate factors associated with language delay in a cohort of 30-month-old children and determine if identification of language delay requires active contact with families. Methods. Data were collected at a pilot universal 30-month health contact. Health visitors used a simple two-item language screen. Data were obtained for 315 children; language delay was found in 33. The predictive capacity of 13 variables which could realistically be known before the 30-month contact was analysed. Results. Seven variables were significantly associated with language delay in univariate analysis, but in logistic regression only five of these variables remained significant. Conclusion. The presence of one or more risk factors had a sensitivity of 89% and specificity of 45%, but a positive predictive value of only 15%. The presence of one or more of these risk factors thus can not reliably be used to identify language delayed children, nor is it possible to define an “at risk” population because male gender was the only significant demographic factor and it had an unacceptably low specificity (52.5%). It is not possible to predict which children will have language delay at 30 months. Identification of this important ESSENCE disorder requires direct clinical contact with all families.

FCET2EC (From controlled experimental trial to = 2 everyday communication): How effective is intensive integrative therapy for stroke-induced chronic aphasia under routine clinical conditions? A study protocol for a randomized controlled trial

BackgroundTherapy guidelines recommend speech and language therapy (SLT) as the “gold standard” for aphasia treatment. Treatment intensity (i.e., ≥5 hours of SLT per week) is a key predictor of SLT outcome. The scientific evidence to support the efficacy of SLT is unsatisfactory to date given the lack of randomized controlled trials (RCT), particularly with respect to chronic aphasia (lasting for >6 months after initial stroke). This randomized waiting list-controlled multi-centre trial examines whether intensive integrative language therapy provided in routine in- and outpatient clinical settings is effective in improving everyday communication in chronic post-stroke aphasia.Methods/DesignParticipants are men and women aged 18 to 70 years, at least 6 months post an ischemic or haemorrhagic stroke resulting in persisting language impairment (i.e., chronic aphasia); 220 patients will be screened for participation, with the goal of including at least 126 patients during the 26-month recruitment period. Basic language production and comprehension abilities need to be preserved (as assessed by the Aachen Aphasia Test).Therapy consists of language-systematic and communicative-pragmatic exercises for at least 2 hours/day and at least 10 hours/week, plus at least 1 hour self-administered training per day, for at least three weeks. Contents of therapy are adapted to patients’ individual impairment profiles.Prior to and immediately following the therapy/waiting period, patients’ individual language abilities are assessed via primary and secondary outcome measures. The primary (blinded) outcome measure is the A-scale (informational content, or 'understandability’, of the message) of the Amsterdam-Nijmegen Everyday Language Test (ANELT), a standardized measure of functional communication ability. Secondary (unblinded) outcome measures are language-systematic and communicative-pragmatic language screenings and questionnaires assessing life quality as viewed by the patient as well as a relative.The primary analysis tests for differences between the therapy group and an untreated (waiting list) control group with respect to pre- versus post 3-week-therapy (or waiting period, respectively) scores on the ANELT A-scale. Statistical between-group comparisons of primary and secondary outcome measures will be conducted in intention-to-treat analyses.Long-term stability of treatment effects will be assessed six months post intensive SLT (primary and secondary endpoints).Trial registrationRegistered in ClinicalTrials.gov with the Identifier NCT01540383

The relation between language experience and receptive-expressive semantic gaps in bilingual children

The purpose of the current study was to explore the influence of language experience on the presence of the receptive-expressive gap. Each of 778 Spanish-English bilingual children screened pre-kindergarten in Utah and Texas were assigned to one of five language experience groups, ranging from functionally monolingual to balanced bilingual. Children's scores from the language screener semantics subtest administered in both Spanish and English were standardized, and receptive and expressive semantic scores were compared. Children presented with a meaningful gap between receptive and expressive semantic knowledge in English but not Spanish. This gap increased as target-language exposure decreased. Results indicate that current language experience plays a dominant role in influencing the appearance and magnitude of the receptive-expressive gap.

The Narrative Language Measures: Tools for Language Screening, Progress Monitoring, and Intervention Planning

This authors of this article present a new language assessment, the Narrative Language Measures (NLM), designed for screening, progress monitoring, and intervention planning purposes. The authors examine NLM for its ability to satisfy the requirements of the assessment of language in a Response to Intervention (RTI) framework. Specifically, they describe the extent to which the NLM reflects socially important outcomes, involves standardized administration and scoring procedures, is time efficient and economical, has adequate psychometric properties, and is sensitive to language growth over time.

The ready to learn evaluation: characterising neurodevelopmental problems identified at a universal nurse contact with 30 month old children

Aims ▶To assess the prevalence of language delay and social/emotional difficulties in a population of children at 30 months old ▶To assess the overlap between language delay and social/emotional difficulties ▶To assess the acceptability and feasibility of the new routine 30 month contact for health visitors. Methods Families of 30 month old children were offered a visit from their health visitor. Structured data were collected relating to language, social and emotional development using three instruments; The Strengths and Difficulties Questionnaire (SDQ), the abbreviated Sure Start Language Measure and a two-item language screen. Based on the results of these measures, children were then allocated into one of three groups: 1) difficulties on SDQ only; 2) language difficulties only; and 3) both SDQ and language difficulties. Results There was an 83% return rate of contact forms from the health visitors. We have partial data on 474 / 570 (83%) children and full data on 415/570 (73%) of the sample of eligible children. Data on language delay are presented in table 1: Data on SDQ abnormalities are presented in table 2: There were highly significant correlations between language delay and social and emotional difficulties, with similar results observed with each of the language measures. Furthermore, problem scores on each of the SDQ subscales were highly correlated with the SSLM 50-word list. Conclusion Language delay and social and emotional problems are highly correlated with adverse physical, mental health and forensic outcomes in adulthood; there is the potential for their early detection in childhood. A significant proportion of children were identified as having both language and social and emotional difficulties through this pilot 30m contact. The potential for early identification and intervention resulting from this contact is substantial and, if it were rolled out to the wider population, could improve the health and social outcomes of a generation.

Werden mit dem SETK 3–5 klinisch diagnostizierte Sprachentwicklungsstörungen erfasst?

The German language development test for 3- to 5-year-olds (SETK 3-5) as well as its short form, the language screening for pre-school children (SSV), are widely used tests for language impairment in German mother-tongue children. However, data published on validation are sparse. We investigated to what extent those children who demonstrated language impairment in clinical assessment were also detected by the SETK 3-5 and SSV tests. A group of 201 children aged 4-5 years was tested using the SETK 3-5, in addition to which assessments in phonology, active vocabulary, grammar, receptive language abilities, and the recall of nonsense syllables and sentences were conducted. Correlation analyses were performed and the clinical assessment based on the aforementioned tests was compared to the results of the SETK 3-5 and the SSV. Raw values of the test results were significantly correlated on different levels of correlation. Those of comparable subtests were high. The SETK 3-5 had good specificity but sensitivity of only 71.9%. Children with language impairment are not always detected using the SETK 3-5 test. Standardization with a sufficient number of children should be carried out.

Tools and Early Management of Language and Swallowing Disorders in Acute Stroke Patients

The role of the stroke units in improving morbidity, mortality, and recovery from stroke is clearly demonstrated. However, acute management of language disorders in these specialized units remains controversial, and management of swallowing disorders is usually nonstandardized. The recent validation of a scale for rapid screening of language disorders (LAST [Language Screening Test]) in acute stroke patients should allow optimization of their detection and early management. Swallowing disorders should be screened and managed using a standardized protocol. Following early initial evaluation repeated on a daily basis, they justify tailored rehabilitation sessions, adaptation of food textures, team formation, and families' information. The use of these protocols implies the cooperation and coordination of the medical and paramedical teams and the daily presence of speech therapists. These aspects are crucial for patients in the stroke units to achieve full benefits from the management proposed in this paper, leading to diminution of complications and better long-term functional prognosis.

Late Talkers: Do Good Predictors of Outcome Exist?

Both small-scale and epidemiological longitudinal studies of early language delay indicate that most late talkers attain language scores in the average range by age 5, 6, or 7. However, late talker groups typically obtain significantly lower scores than groups with typical language histories on most language measures into adolescence. These findings support a dimensional account of language delay, whereby late talkers and typically developing peers differ quantitatively on a hypothetical language ability spectrum. Variation in language ability is presumed to derive from variation in skills subserving language, such as auditory perception/processing, word retrieval, verbal working memory, motor planning, phonological discrimination, and grammatical rule learning. Expressive language screening at 18-35 months can serve an important public health function by identifying children whose expressive delay is secondary to autism spectrum disorder, intellectual disability, hearing impairment, receptive language delay, or demographic risk. Finally, the review suggests that demographic risk associated with low SES may become more important as a causal factor in language delay as children get older.

Risk for poor performance on a language screening measure for bilingual preschoolers and kindergarteners.

This study documents the risk for language impairment in Latino children who had different levels of exposure to English and Spanish. A total of 1,029 preschool- and kindergarten-age children were screened in the domains of semantics and morphosyntax in both Spanish and English. Parent report was used to document current exposure to and use of Spanish and English, as well as year of first exposure to English. Risk for language impairment was compared for language group, year of first English exposure, age, and mother's education. While bilingual children's scores on each subtest were significantly lower compared to their functional monolingual peers, they were no more likely to fall in the at-risk range based on a combination of all 4 subtests. Maternal education and year of first English exposure were weakly associated with risk for language impairment but not with language group (via 5 levels of first and second language exposure). Prevalence of risk for language impairment when both languages are tested is not related to language group.

How to Fit Response to Intervention Into a Heavy Workload

How to Fit Response to Intervention Into a Heavy Workload

Habilidades em consciência fonológica: diferenças no desempenho de meninos e meninas

OBJETIVO: verificar se existem diferenças entre meninas e meninos pré-escolares e em processo de alfabetização, quanto ao desempenho em tarefas de consciência fonológica (CF). MÉTODO: a amostra foi constituída de 75 crianças do sexo masculino e 88 do sexo feminino, com idades entre 5:6 e 8:0, avaliadas por meio de questionário enviado aos pais, triagem fonoaudiológica completa, avaliação do nível intelectual, do nível de escrita e das habilidades em CF. A análise estatística foi realizada pelos testes: ANOVA de Duas Vias complementado pelo teste Tukey, e Teste t de Student. RESULTADOS: o sexo feminino apresentou significância positiva nas tarefas: segmentação silábica com palavras quadrissílabas (p=0,03); detecção silábica posição inicial (p=0,05), posição final (p=0,01) e posição medial (p=0,04). Na análise percentual da média de acertos por tarefa, o desempenho dos meninos foi superior apenas nas tarefas de segmentação de frases em palavras com duas (média=7,52), três (média=5,79), quatro (média=4,56), cinco (média=3,93) e seis palavras (média=3,56), e no realismo nominal (média=8,93). CONCLUSÕES: encontrou-se desempenho significantemente superior das meninas em tarefas de segmentação silábica com quadrissílabos e de detecção silábica. Em análise qualitativa, as meninas obtiveram médias mais elevadas em todas as tarefas de consciência e rimas, de sílabas e de fonemas.

Improving the access of young urban children to speech, language and hearing screening via telehealth

We studied the feasibility of low-cost videoconferencing (using Skype) in urban community health clinics for speech, language and hearing screening of children up to six years of age. During a two-year study, screening services were provided via videoconferencing at two community clinics in an inner city area of Cleveland, Ohio. In total, 411 screenings were completed. Of these, 358 children (87%) received hearing screenings, 377 (92%) received tympanometry screening and 263 (64%) received speech and language screening only. A total of 151 children were aged three years or under (37%). The reliability of pure tone hearing screening (n = 7), DPOAE screening (n = 51) and speech-language screening (n = 10) was 100%. Typanometry screenings (n = 55) were 84% reliable. Families reported a high level of satisfaction with both the technology and with the videoconferencing. The results indicate that low-cost videoconferencing for screening of speech, language and hearing development in very young children in urban community health clinics is feasible, reliable and strongly supported by the community.

Validation of a New Language Screening Tool for Patients With Acute Stroke

Standard aphasia scales such as the Boston Diagnosis Aphasia Evaluation are inappropriate for use in acute stroke. Likewise, global stroke scales do not reliably detect aphasia, and existing brief aphasia screening scales suitable for patients with stroke have several limitations. The objective of this study was to generate and validate a bedside language screening tool, the Language Screening Test, suitable for use in the emergency setting. The Language Screening Test comprises 5 subtests and a total of 15 items. To avoid retest bias, we created 2 parallel versions of the scale. We report the equivalence of the 2 versions, their internal and external validity, and their interrater reliability. We validated the scale by administering it to 300 consecutive patients within 24 hours after admission to our stroke unit and to 104 stabilized patients with and without aphasia using the Boston Diagnosis Aphasia Evaluation as a reference. The 2 versions of the Language Screening Test were equivalent with an intraclass correlation coefficient of 0.96. Internal validity was good; none of the items showed a floor or ceiling effect with no redundancy and good internal consistency (Cronbach α 0.88). External validation against the Boston Diagnosis Aphasia Evaluation showed a sensitivity of 0.98 and a specificity of 1. Interrater agreement was near perfect (intraclass correlation coefficient, 0.998). The median time to complete the Language Screening Test was approximately 2 minutes. Importantly, the Language Screening Test does not need to be administered by a speech and language therapist. This comprehensively validated language rating scale is simple and rapid, making it a useful tool for bedside evaluation of patients with acute stroke in routine clinical practice.

Tradução do Questionário de Berlim para língua Portuguesa e sua aplicação na identificação da SAOS numa consulta de patologia respiratória do sono

Background Berlin Questionnaire (BQ), an English language screening tool for obstructive sleep apnea (OSA) in primary care, has been applied in tertiary settings, with variable results. Aims Development of BQ Portuguese version and evaluation of its utility in a sleep disordered breathing clinic (SDBC). Material and methods BQ was translated using back translation methodology and prospectively applied, previously to cardiorespiratory sleep study, to 95 consecutive subjects, referred to a SDBC, with OSA suspicion. OSA risk assessment was based on responses in 10 items, organized in 3 categories: snoring and witnessed apneas (category 1), daytime sleepiness (category 2), high blood pressure (HBP)/obesity (category 3). Results In the studied sample, 67.4% were males, with a mean age of 51 ± 13 years. Categories 1, 2 and 3 were positive in 91.6, 24.2 and 66.3%, respectively. BQ identified 68.4% of the patients as being in the high risk group for OSA and the remaining 31.6% in the low risk. BQ sensitivity and specificity were 72.1 and 50%, respectively, for an apnea-hipopnea index (AHI) > 5, 82.6 and 44.8% for AHI > 15, 88.4 and 39.1% for AHI > 30. Being in the high risk group for OSA did not influence significantly the probability of having the disease (positive likelihood ratio [LR] between 1.44–1.49). Only the items related to snoring loudness, witnessed apneas and HBP/obesity presented a statistically positive association with AHI, with the model constituted by their association presenting a greater discrimination capability, especially for an AHI > 5 (sensitivity 65.2%, specificity 80%, positive LR 3.26). Conclusions The BQ is not an appropriate screening tool for OSA in a SDBC, although snoring loudness, witnessed apneas, HBP/obesity have demonstrated being significant questionnaire elements in this population.

Translation of Berlin Questionnaire to Portuguese language and its application in OSA identification in a sleep disordered breathing clinic

BackgroundBerlin Questionnaire (BQ), an English language screening tool for obstructive sleep apnea (OSA) in primary care, has been applied in tertiary settings, with variable results. AimsDevelopment of BQ Portuguese version and evaluation of its utility in a sleep disordered breathing clinic (SDBC). Material and methodsBQ was translated using back translation methodology and prospectively applied, previously to cardiorespiratory sleep study, to 95 consecutive subjects, referred to a SDBC, with OSA suspicion. OSA risk assessment was based on responses in 10 items, organized in 3 categories: snoring and witnessed apneas (category 1), daytime sleepiness (category 2), high blood pressure (HBP)/obesity (category 3). ResultsIn the studied sample, 67.4% were males, with a mean age of 51 ± 13 years. Categories 1, 2 and 3 were positive in 91.6, 24.2 and 66.3%, respectively. BQ identified 68.4% of the patients as being in the high risk group for OSA and the remaining 31.6% in the low risk. BQ sensitivity and specificity were 72.1 and 50%, respectively, for an apnea-hipopnea index (AHI) > 5, 82.6 and 44.8% for AHI > 15, 88.4 and 39.1% for AHI > 30. Being in the high risk group for OSA did not infl uence significantly the probability of having the disease (positive likelihood ratio [LR] between 1.44-1.49). Only the items related to snoring loudness, witnessed apneas and HBP/obesity presented a statistically positive association with AHI, with the model constituted by their association presenting a greater discrimination capability, especially for an AHI > 5 (sensitivity 65.2%, specificity 80%, positive LR 3.26). ConclusionsThe BQ is not an appropriate screening tool for OSA in a SDBC, although snoring loudness, witnessed apneas, HBP/obesity have demonstrated being significant questionnaire elements in this population.

Kartlegging av barns språk: Godt for hvem – godt for hva?

Title: Screening of children’s language: Who is it good for? What is it good for? Abstract: In this article I discuss the importance of teacher’s knowledge regarding children’s language learning as a qualification for screening of language in preschools. Teachers have to be able to use the screening results in ways that support children’s further language learning and development. Screening, whether standardized or not, will not give teachers any information about how they can assist the children who are struggling with language learning. Tests and screening may reveal when and at which age a child masters something or not. They do not display how a child learns language and can be assisted in her or his learning process. A study of 46 early childhood teacherstudents in language interactions with children showed that many of them offered children little language support. They rarely invited children to talk and their vocabulary did not contatin many known or unknown words. Screening of children’s language skills gives little effect if the teachers lack knowledge of the importance of a rich language environment and how to support children’s language learning.