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Updated: Aug 30, 2025

Universal Screening for Prevention of Reading, Writing, and Math Disabilities in Spanish
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Universal language development screening: comparative performance of two questionnaires.

Philip Wilson1, Robert Rush2, Jenna Charlton3

  • 1Centre for Rural Health, Institute of Applied Health Sciences, University of Aberdeen, Inverness, UK p.wilson@abdn.ac.uk.

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|September 2, 2022
PubMed
Summary
This summary is machine-generated.

The Sure Start Language Measure (SSLM) is a better tool for screening early language development than the Ages and Stages Questionnaire (ASQ) Communication Scale. The ASQ missed many children with low language skills.

Keywords:
health services research

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Area of Science:

  • Child Development
  • Linguistics
  • Psychopathology

Background:

  • Early childhood language ability predicts later life outcomes, including psychopathology and educational attainment.
  • Despite universal language development assessments, few tools have been rigorously evaluated.
  • Accurate screening is crucial for early intervention and support.

Purpose of the Study:

  • To compare the screening performance of two widely used early language assessment instruments.
  • To evaluate the diagnostic accuracy of the Ages and Stages Questionnaire (ASQ) Communication Scale and the Sure Start Language Measure (SSLM).
  • To inform the selection of effective tools for early language screening.

Main Methods:

  • A pragmatic diagnostic accuracy study was conducted in five English regions.
  • Compared the ASQ Communication Scale and SSLM against the Preschool Language Scale, 5th edition (PLS-5) as a reference standard.
  • Included 357 children aged 23–30 months.

Main Results:

  • The SSLM demonstrated higher sensitivity (0.83) and negative predictive value (0.98) compared to the ASQ Communication Scale (sensitivity 0.55, NPV 0.95).
  • The ASQ Communication Scale exhibited higher specificity (0.95) than the SSLM (0.81).
  • Both tools performed less effectively in multilingual households where English was not exclusively spoken.

Conclusions:

  • The widely used ASQ Communication Scale is not optimal for language screening, missing over a third of children with low language ability.
  • The SSLM demonstrated superior performance as a language screening tool in this cohort.
  • Consideration of the home language environment is important when interpreting screening results.