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.
Aim:
The aim of the study was to explore the assessment fidelity of Språkfyran, a language screening instrument for four-year-old children. Språkfyran is a mandatory part of the healthcare program within the Swedish Child Health Service (CHS) and is offered to all four-year-olds in the region Scania in Sweden.
Methods:
The study was based on structured observations of twenty-four specialist CHS nurses' adherence to the Språkfyran protocol during screening.
Results:
All the observed nurses deviated from the test protocol. There was a large variation in the number of deviations from the test protocol per nurse, with the highest number of deviations occurring for three specific testing items. Significantly more deviations were made with four-year-old bilingual children as opposed to four-year-old monolingual children. Half of the nurses did not use the test protocol.
Conclusions:
There is a clear need to improve the assessment fidelity of Språkfyran. Both the training that the nurses are offered, and the development of the test, are essential in securing the aim of high-quality work within the CHS. Support from experts in child speech-language development and disorders is suggested to be available at the CHS in Sweden.
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