Improving the positive predictive value of screening for developmental language disorder

Area of Science:

• Pediatric Language Development
• Developmental Psychology
• Speech-Language Pathology

Background:

• Previous early language screening identified 91% of 2-year-olds with delays but had many false positives.
• Parent-report questionnaires are a common tool for early language screening.

Purpose of the Study:

• To examine a revised screening criterion to reduce false positives in early language delay identification.
• To improve the specificity and positive predictive value of the screening tool.

Main Methods:

• A revised parent-report questionnaire criterion was evaluated.
• Screening results were compared to clinical evaluations.
• Key performance metrics including sensitivity, specificity, and predictive values were analyzed.

Main Results:

• The revised criterion reduced overall positive screens and improved specificity (96% vs. 87%) and positive predictive value (77% vs. 51%).
• High sensitivity (91%) and negative predictive value (98%) were maintained.
• A new screening score was proposed to aid clinical decision-making.

Conclusions:

• The revised screening criterion effectively reduces over-referrals in early language screening.
• The proposed screening score can help optimize the referral process for further evaluation.
• Accurate early identification of language delay is crucial for timely intervention.