Language Screening Tool Research Articles

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.

Expressive language skills in Chinese Singaporean preschoolers with nonsyndromic cleft lip and/or palate

Objective The main objective of the present study was to examine THE EXPRESSIVE LANGUAGE SKILLS and obtain a prevalence estimate of expressive language IMPAIRMENT (not skills) in Chinese Singaporean preschoolers with nonsyndromic cleft lip and/or palate (CLP). Methods A group of 43 Chinese Singaporean preschoolers aged 3 to 6 years with a diagnosis of nonsyndromic CLP was assessed using the Singapore English Action Picture Test (SEAPT). The SEAPT is an English Language screening tool standardised on typically developing English–Mandarin Chinese Singaporean preschoolers that assesses expressive vocabulary and grammatical usage. A grammar and/or information score below the 20 th percentile on the SEAPT is indicative of an expressive language impairment. In addition, the medical records of this cohort were examined retrospectively for documentation of surgical timings, audiological history, articulation and resonance. Results Based on the results of the SEAPT, 33% of the preschoolers with CLP were identified as having a—possible expressive language impairment. Hence, the likelihood that a child with CLP with normal cognitive functioning will have an expressive language impairment is between 3.9 to 12.7 times more likely than in the general population. There was no statistical significance when comparisons were made between dominant language groups or CLP groups on SEAPT measures of information and grammar content. Significantly more males than females were identified with language difficulties, relative to the sex ratio in the sample. No significance was found for the other participant variables. Conclusions The findings of this study suggest that Chinese Singaporean preschoolers with CLP have more difficulty in the expressive use of grammar and vocabulary than their peers of typical development, with significantly more males affected than females. As language performance was not related to hearing, articulation or resonance; these early results suggest that a comprehensive investigation of cognition, literacy and family aggregation of communication disorders is urgently warranted to study other possible aetiologies for language impairment in children with CLP in Singapore.

An independent assessment of the internal reliability of the ‘Bilston and Ettingshall Sure Start (BESS) Speech and Language Therapy Two Year Developmental Check’

Speech and language difficulties in British pre‐school children from disadvantaged backgrounds have become increasingly prevalent over the last decade. Consequently, there has been a growing demand for a British standardised speech and language screening tool that is reliable and valid. In 2000, to fulfil the need of an appropriate tool that could meet all of their requirements, Bilston and Ettingshall Sure Start (BESS) developed a BESS Speech and Language Therapy Two Year Developmental Check. The focus of the current article is to examine the internal reliability of this tool using Cronbach’s alpha, Kuder‐Richardson and item‐whole correlations. The BESS tool maintained an acceptable level of internal consistency on its quantitative and qualitative items and on all three sub‐scales of Understanding, Expression and Speech. Item‐whole correlations found no weak quantitative items (p < 0.01). Thus, an internally consistent British standardised speech and language screening tool for two‐year‐old children has been developed.

Effect of Repetition of Exposure and Proficiency Level in L2 Listening Tests

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Exploring the Utility of a Web-Based English Language Screening Tool

This article describes the process of developing and implementing a quick Web‐based screening test designed for the purpose of identifying, within a large, culturally diverse population of undergraduates enrolled at an English-medium university, those students unlikely to require English language support during their 1st year of academic study. Linguistically competent students (including native speakers) scoring above a certain threshold on the screening test are exempt from sitting a more time-consuming diagnostic English language needs assessment. Before implementing the procedure, which had been pretested on a population of 100 students, 353 test-takers took both the screening and accompanying diagnostic instrument so that an optimum cut-score could be set at a point which minimized unnecessary testing of linguistically able students and which captured the maximum number of “at-risk” students. Five years after the test was launched, the overall utility of the screening tool was reviewed. Findings of the original validation efforts show that the screening tool (if appropriately used) provides a valid, practical, and ethical (nondiscriminatory) means whereby students with limited academic language skills can be targeted for further diagnosis and intervention. The article argues that the assessment program has been successful in raising consciousness among the university community of the language needs of the student population and in stimulating action to address these needs.

The Efficiency of the Revised Denver Developmental Screening Test as a Language Screening Tool

The purpose of this study was to determine the number of false positives and false negatives derived from the language domain of the Revised Denver Developmental Screening Test (RDDST) in a community preschool screening. Six months after the initial screening, 199 RDDST protocols were reviewed and the status of each child was documented. The study identified nine false positives and three false negatives, which resulted in a positive hit rate of 93.5 %. The results of the study indicate that the RDDST is an effective tool in predicting the need for formal assessment.