Extending use of the NRT to preschool-age children with and without specific language impairment

The purpose of this study was to assess the diagnostic accuracy of the Nonword Repetition Test (NRT; Dollaghan & Campbell, 1998) using a sample of 4- and 5-year-olds with and without specific language impairment (SLI) and to evaluate its feasibility for use in universal screening.

The NRT was administered to 29 children with SLI and 47 age-matched children with typical development. Diagnostic accuracy was computed using alternative scoring methods, which treated out-of-inventory phonemes either as errors or as unscorable. To estimate accuracy in a universal screening context, the probability of identifying a child at risk for language impairment was computed using the prevalence of SLI (7%) as the base rate.

Diagnostic accuracy was acceptable using both scoring methods. The resulting likelihood ratios (LR+ = 22.66, 19.43; LR- = .05, .05) were similar to those reported for older children. The probability of accurate detection of children with SLI in the general population increased from 7% to 61%. However, this value suggests that many false positives could be expected.

The NRT yielded results similar to those reported for older children. However, despite its strengths, the NRT is not sufficient for screening the general population of 4- and 5-year-olds.