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BMC Pediatrics
Published in: BMC Pediatrics 1/2023

Open Access 01-12-2023 | Public Health | Research

The development and productivity of a measure for identifying low language abilities in children aged 24–36 months

Authors: James Law, Jenna Charlton, Philip Wilson, Robert Rush, Vicky Gilroy, Cristina McKean

Published in: BMC Pediatrics | Issue 1/2023

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Abstract

Background

Accurate early identification of children with low language ability is important but existing measures generally have low sensitivity. This remains an area of concern for preventive and public health services. This study aimed to create and evaluate a measure of child language, communication and related risks which can be used by community health nurses to accurately identify children with low language aged 24–30 months.

Methods

The Early Language Identification Measure (ELIM) was developed and comprised five measurement sections, each measuring different aspects of development combined into a single measure. This was tested blind against a reference standard language measure, the Preschool Language Scale-5 (PLS-5), at the universal 24–30-month health visitor review in England. The threshold for likely low language was the tenth centile or below on the PLS-5. The aim was to ascertain the performance of the five individual sections in the scale, and consider the optimum combination of sections, for predicting low language ability. Specificity, sensitivity, and positive and negative predictive values were reported for each of the five sections of the ELIM alone and in conjunction with each other. The performance for children from monolingual English-speaking families and those who spoke languages other than English were also considered separately.

Results

Three hundred and seventy-six children were assessed on both the ELIM identification measure and the PLS-5 with 362 providing complete data. While each section of the ELIM predicted low language ability, the optimal combination for predicting language outcome was the parent reported vocabulary checklist coupled with the practitioner observation of the child’s communication and related behaviours. This gave a sensitivity of 0·98 with a specificity of 0·63.

Conclusions

A novel measure has been developed which accurately identifies children at risk of low language, allowing clinicians to target resources efficiently and intervene early.
Appendix
Available only for authorised users
Literature
1.
Sim F, O’Dowd J, Thompson L, Law J, Macmillan S, Affleck M, et al. Language and social/emotional problems identified at a universal developmental assessment at 30 months. BMC Pediatr. 2013;13(1):206.CrossRefPubMedPubMedCentral
2.
Sim F, Haig C, O’Dowd J, Thompson L, Law J, McConnachie A, et al. Development of a triage tool for neurodevelopmental risk in children aged 30 months. Res Dev Disabil. 2015;45–46:69–82.CrossRefPubMed
3.
Ripley K, Yuill N. Patterns of language impairment and behaviour in boys excluded from school. Br J Educ Psychol. 2005;75(Pt 1):37–50.CrossRefPubMed
4.
Johnson CJ, Beitchman JH, Brownlie EB. Twenty-year follow-up of children with and without speech-language impairments: family, educational, occupational, and quality of life outcomes. Am J Speech-Language Pathol. 2010;9:51–65.CrossRef
5.
Law J, Rush R, Schoon I, Parsons S. Modeling developmental language difficulties from school entry into adulthood: literacy, mental health, and employment outcomes. J Speech Lang Hear Res. 2009;52(6):1401–16.CrossRefPubMed
6.
Norbury CF, Gooch D, Wray C, Baird G, Charman T, Simonoff E, et al. The impact of nonverbal ability on prevalence and clinical presentation of language disorder: evidence from a population study. J Child Psychol Psychiatry. 2016;57(11):1247–57.CrossRefPubMedPubMedCentral
7.
Information Services Division (ISD). Child Health 27–30 month review statistics. Edinburgh; 2014.
8.
Golinkoff RM, Hoff E, Rowe ML, Tamis-LeMonda CS, Hirsh-Pasek K. Language matters: denying the existence of the 30-Million-word gap has serious Consequences. Child Dev. 2019;90(3):985–92.CrossRefPubMed
9.
Pearce A, Dundas R, Whitehead M, Taylor-Robinson D. Pathways to inequalities in child health. Arch Dis Child. 2019;104(10):998–1003.CrossRefPubMed
10.
Taylor-Robinson DC, Lai ET, Whitehead M, Barr B. Child health unravelling in UK. BMJ. 2019;364:l963.CrossRefPubMed
11.
Fernald A, Marchman VA, Weisleder A. SES differences in language processing skill and vocabulary are evident at 18 months. Dev Sci. 2013;16(2):234–48.CrossRefPubMed
12.
Law J, Reilly S, Snow PC. Child speech, language and communication needs re-examined in a public health context: a new direction for the speech and language therapy profession. Int J Lang Communication Disorders. 2013;48(5):486–96.CrossRef
13.
Wilson JMG, Junger G. Principles and practice of screening for disease. editor. Geneva: WHO;: WHO; 1968.
14.
Greenwood CR, Schnitz AG, Carta JJ, Wallisch A, Irvin DW. A systematic review of language intervention research with low-income families: a word gap prevention perspective. Early Child Res Q. 2019;50:1–16.
15.
Wallace IF, Berkman ND, Watson LR, Coyne-Beasley T, Wood CT, Cullen K, et al. Screening for speech and language delay in children 5 years old and younger: a systematic review. Pediatrics. 2015;136(2):e448–e62.CrossRefPubMed
16.
Voigt RG, Accardo PJ. Formal Speech-Language Screening not shown to help children. Pediatrics. 2015;136(2):e494–5.CrossRefPubMed
17.
Wilson P, Wood R, Lykke K, Hauskov Graungaard A, Ertmann RK, Andersen MK, et al. International variation in programmes for assessment of children’s neurodevelopment in the community: understanding disparate approaches to evaluation of motor, social, emotional, behavioural and cognitive function. Scand J Public Health. 2018;46(8):805–16.CrossRefPubMed
18.
Wilson P, Rush R, Charlton J, Gilroy V, McKean C, Law J. Universal language development screening: comparative performance of two questionnaires. BMJ Paediatrics Open. 2022;6(1):e001324.CrossRefPubMedPubMedCentral
19.
20.
DfE. Unlocking talent, fulfilling potential: a plan for improving social mobility through education. London; 2017.
21.
Law J, Charlton J, McKean C, Watson R, Roulstone S, Holme C, et al. Identifying and supporting Children’s Early Language needs. Newcastle upon Tyne: Newcastle University; 2020.
22.
McKean C, Watson R, Charlton J, Roulstone S, Holme C, Gilroy V, et al. Making the most of together time’: development of a Health Visitor-led intervention to support children’s early language and communication development at the 2–2(1/2)-year-old review. Pilot Feasibility Stud. 2022;8(1):35.CrossRefPubMedPubMedCentral
23.
24.
Zimmerman B, Pond RE, Steiner VG. Preschool Language Scale - Fifth Edition (PLS-5 UK). London: Pearson Assessment; 2014.
25.
Walker D, Gugenheim S, Downs MP, Northern JL. Early Language Milestone Scale and language screening of young children. Pediatrics. 1989;83(2):284–8.CrossRefPubMed
26.
Roy P, Kersley H, Law J. The Sure Start Language Measure Standardisation Study: Report to the Sure Start Unit London Available from Newcastle University c/o School of Education, Communication and Language Sciences, University of Newcastle, Newcastle-upon-Tyne NE1 7RU e: cristina.mckean@ncl.ac.uk; 2004.
27.
Taylor CL, Christensen D, Lawrence D, Mitrou F, Zubrick SR. Risk factors for children’s receptive vocabulary development from four to Eeight Years in the longitudinal study of australian children. PLoS ONE. 2013;8(9):e73046.CrossRefPubMedPubMedCentral
28.
Cunningham RD. Jr. Can clinical judgment detect children with speech-language problems? Pediatrics. 1991;88(4):875–6.CrossRefPubMed
29.
Glascoe FP. Parents’ concerns about children’s development: prescreening technique or screening test? Pediatrics. 1997;99(4):522–8.CrossRefPubMed
30.
Fenson L, Dale PS, Reznick JS, Thal DJ, Bates E, Hartung JP, et al. MacArthur Communicative Development inventories: user’s guide and technical manual. San Diego: Singular Publishing Group Inc.; 1997.
31.
Law J, Charlton J, Dockrell J, Gascoigne M, McKean C, Theakston A. Early Language Development: needs, provision, and intervention for preschool children from socio-economically disadvantage backgrounds. London: Institute of Education; 2017.
32.
Reilly S, Wake M, Bavin EL, Prior M, Williams J, Bretherton L, et al. Predicting language at 2 years of age: a prospective community study. Pediatrics. 2007;120(6):e1441–e9.CrossRefPubMed
33.
34.
35.
Orme L, Maggs C. Decision-making in clinical practice: how do expert nurses, midwives and health visitors make decisions? Nurse Educ Today. 1993;13(4):270–6.CrossRefPubMed
36.
PHE. Early language identification measure and intervention: Guidance handbook to support children’s speech, language, and communication development as part of the 2 to 2½ year review in England. Public Health England, Department of Social Health Care, Department for Education; 2020.
Metadata
Title
The development and productivity of a measure for identifying low language abilities in children aged 24–36 months
Authors
James Law
Jenna Charlton
Philip Wilson
Robert Rush
Vicky Gilroy
Cristina McKean
Publication date
01-12-2023
Publisher
BioMed Central
Keyword
Public Health
Published in
BMC Pediatrics / Issue 1/2023
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-023-04079-x

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