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Updated: Oct 10, 2025
Universal Screening for Prevention of Reading, Writing, and Math Disabilities in Spanish
Published on: July 18, 2020
Language Screening in 3-Year-Olds: Development and Validation of a Feasible and Effective Instrument for Pediatric
Daniel Holzinger1,2,3, Christoph Weber2,4, William Barbaresi2,5
1Institute of Neurology of Senses and Language, Hospital of St. John of God, Linz, Austria.
Insights
The SPES-3 (Sprachentwicklungsscreening) language screener, using parent reports, shows high accuracy and feasibility for identifying language disorders in 3-year-olds during routine pediatric check-ups.
Area of Science:
- Pediatric Medicine
- Developmental Psychology
- Speech-Language Pathology
Background:
- Early identification of language disorders in young children is crucial for timely intervention.
- Routine pediatric check-ups offer a valuable opportunity for developmental screening.
Purpose of the Study:
- To evaluate the validity and feasibility of the SPES-3 (Sprachentwicklungsscreening) language screening tool for 3-year-old children.
- To assess the accuracy of parent-reported and pediatrician-administered components of the SPES-3.
Main Methods:
- A four-component screening measure, including parental reports (MacArthur Communicative Development Inventory) and pediatrician assessments, was administered to 2,044 children.
- Validation involved a gold standard assessment for 144 children; accuracy was analyzed using ROC curves.
- Feasibility was assessed via pediatrician questionnaires.
Main Results:
- Parental report subscales demonstrated excellent accuracy (AUCs of 0.910 and 0.908).
- A composite score from parental scales achieved the highest accuracy (AUC = 0.946).
- The screening demonstrated good sensitivity (0.878) and specificity (0.876) with high ratings for practicability and acceptability.
Conclusions:
- Parent-reported subscales of the SPES-3 are a valid and feasible tool for language screening in primary pediatric care.
- The SPES-3 can effectively identify 3-year-olds at risk for language disorders.
- The tool supports early intervention by facilitating timely diagnosis in routine healthcare settings.
Abstract:
Objective: The study was aimed at evaluating the validity and feasibility of SPES-3 (Sprachentwicklungsscreening), a language screening in 3-year-old children within the constraints of regular preventive medical check-ups. Methods: A four-component screening measure including parental reports on the child's expressive vocabulary and grammar based on the MacArthur Communicative Development Inventory and pediatrician-administered standardized assessments of noun plurals and sentence comprehension was used in a sample of 2,044 consecutively seen children in 30 pediatric offices. One-hundred forty-four children (70 who failed and 74 who passed the screener) comprised the validation sample and also underwent follow-up gold standard assessment. To avoid verification and spectrum bias multiple imputation of missing diagnosis for children who did not undergo gold standard assessment was used. Independent diagnoses by two experts blinded to the screening results were considered gold standard for diagnosing language disorder. Screening accuracy of each of the four subscales was analyzed using receiver operator characteristic (ROC) curves. Feasibility was assessed by use of a questionnaire completed by the pediatricians. Results: The two parental screening subscales demonstrated excellent accuracy with area under the curve (AUC) scores of 0.910 and 0.908 whereas AUC scores were significantly lower for the subscales directly administered by the pediatricians (0.816 and 0.705). A composite score based on both parental screening scales (AUC = 0.946) outperformed single subscales. A cut off of 41.69 on a T-scale resulted in about 20% positive screens and showed good sensitivity (0.878) and specificity (0.876). Practicability, acceptability and sustainability of the screening measure were mostly rated as high. Conclusion: The parent-reported subscales of the SPES-3 language screener are a promising screening tool for use in primary pediatric care settings.
