Screening for pragmatic language impairment: the potential of the children's communication checklist

The present study examines the validity of the Dutch Children's Communication Checklist (CCC) for children in kindergarten in a community sample, in order to assess the feasibility of using it as a screening instrument in the general population. Teachers completed the CCC for a representative sample of 1396 children at kindergarten level, taken from 53 primary schools in The Netherlands. The CCC was also completed for a clinical group consisting of children with SLI in special education. Reliability as measured with internal consistency scores was found to be good for the community sample. With regard to the construct validity, a five-factor second-order factor model was found when the pragmatic subscales were analysed, which provided a reasonable fit. Criterion validity as measured using the concordance between the CCC and teacher opinions was moderate. The children identified by the CCC as having Pragmatic Language Impairment (defined as scoring below the cut off of 132) were often characterized by the teachers as having social-emotional problems, language problems or combined problems. Comparison with a clinical SLI sample showed the pragmatically impaired children in the community sample to have a profile similar to that of the clinical group of children with PLI in special education. The main difference was visible in structural language problems, which were less severe for the PLI group in mainstream education. The results of this study suggest that screening for PLI is indeed possible using the CCC.