Assessment fidelity of a language screening instrument for 4-year-olds

Johanna Dahlén1, Eva Drevenhorn1, Nelli Kalnak2

  • 1Public Health Nurse, Department of Health Sciences, Lund University, Lund, Sweden.

Insights

Assessment fidelity of Språkfyran, a language screening for four-year-olds, was evaluated. Findings reveal significant deviations from protocol, particularly with bilingual children, highlighting a need for improved training and test development within Swedish Child Health Services.

Area of Science:

  • Child language development
  • Speech-language pathology
  • Pediatric healthcare assessment

Background:

  • Språkfyran is a mandatory language screening for four-year-olds in Swedish Child Health Services (CHS).
  • The screening is offered to all four-year-olds in the Scania region, Sweden.
  • Assessment fidelity is crucial for accurate language screening outcomes.

Purpose of the Study:

  • To evaluate the assessment fidelity of the Språkfyran language screening instrument.
  • To identify deviations from the Språkfyran protocol among CHS nurses.
  • To explore factors influencing adherence to the screening protocol.

Main Methods:

  • Structured observations of 24 specialist CHS nurses administering Språkfyran.
  • Systematic recording of deviations from the established test protocol.
  • Comparison of adherence rates between monolingual and bilingual children.

Main Results:

  • All observed nurses deviated from the Språkfyran protocol.
  • Significant variation in deviations noted, with specific items showing higher non-adherence.
  • Bilingual children exhibited significantly more protocol deviations than monolingual children.
  • Half of the nurses did not utilize the test protocol as intended.

Conclusions:

  • There is a critical need to enhance the assessment fidelity of Språkfyran.
  • Improvements in nurse training and the Språkfyran test itself are essential for quality CHS work.
  • Increased access to speech-language pathology expertise within CHS is recommended for supporting child language development.
Abstract