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Evaluation of a structured test and a parent led method for screening for speech and language problems: prospective
Gabrielle J Laing1, James Law, Abigail Levin
1Child Health Department, St Leonard's Hospital, City and Hackney Primary Care Trust, London N1 5LZ, UK.
BMJ (Clinical Research Ed.)
|November 16, 2002
Summary
Evaluating screening methods for preschool speech and language problems revealed significant limitations. Both structured screening tests and parent-led methods failed to identify many children needing intervention, suggesting screening
Area of Science:
- Pediatric Speech-Language Pathology
- Early Childhood Development
- Public Health Screening
Background:
- Early identification of speech and language problems in preschool children is crucial for timely intervention.
- Existing screening methods require evaluation for effectiveness and efficiency in identifying at-risk populations.
Purpose of the Study:
- To compare the effectiveness of a structured screening test versus a parent-led method in identifying speech and language problems in 30-36 month old children.
- To assess the sensitivity and specificity of each screening method for detecting severe language problems and the need for therapy.
Main Methods:
- A prospective, population-based study conducted in Inner London.
- 37 health visitors were randomized to use either a structured screening test or a parent-led approach.
- 582 children aged 30-36 months participated; assessments were conducted by blinded speech and language therapists using the Reynell developmental language scales.
Main Results:
- Of 474 screened children, 21% had severe language problems and 29% needed therapy.
- The structured screening test had a sensitivity of 66% for severe problems and 54% for needing therapy.
- The parent-led method showed similar performance, with a sensitivity of 56% for severe problems and 58% for needing therapy; both methods had high specificity but low sensitivity.
Conclusions:
- Both the structured screening test and the parent-led method failed to detect a significant proportion of preschool children with speech and language issues.
- These screening approaches resulted in over-referral for diagnostic assessments, indicating inefficiency.
- Screening may be an ineffective strategy for managing speech and language problems in this preschool population.
