Accuracy of the ABFW ‒ Screening for speech disorders in early childhood
Marianna Momoe Nanakuma Matsumoto1, Bruna Fernanda Alves da Silva1, Maria Luiza Paulo de Oliveira Costa1
1Fundação Faculdade de Medicina da Universidade de São Paulo (FMUSP), Departamento de Fonoaudiologia, São Paulo, SP, Brazil.
Insights
The ABFW Screening protocol demonstrated 72.1% accuracy in identifying language alterations in Brazilian children. This speech and hearing screening tool shows potential for primary healthcare, particularly for autism spectrum disorder detection.
Area of Science:
- Speech-Language Pathology
- Developmental Pediatrics
- Public Health
Background:
- The Adapted Child Language Test (ABFW) is a key tool for assessing language development in children.
- A specific screening protocol, ABFW Triagem, was developed for the Brazilian population.
- Accurate and accessible screening tools are crucial for early intervention in pediatric speech and hearing disorders.
Purpose of the Study:
- To evaluate the diagnostic accuracy of the ABFW Triagem protocol for the Brazilian population.
- To assess the tool's effectiveness in identifying potential speech and hearing issues in young children.
- To determine the protocol's utility in a primary healthcare setting.
Main Methods:
- A diagnostic accuracy study was conducted at a university speech therapy clinic.
- 188 patient records (ages 0-5 years 11 months) from 2016-2019 were analyzed.
- A follow-up in 2024 assessed the assertiveness of speech therapy hypotheses.
Main Results:
- The ABFW Screening protocol achieved 72.1% overall accuracy and 64.3% balanced accuracy.
- Language alteration suggestive of autism spectrum disorder was the most common hypothesis (88.89%), with high sensitivity (94.12%) and specificity (92.31%).
- Only 43 out of 188 caregivers were reachable for follow-up.
Conclusions:
- The ABFW protocol shows promise as a valuable tool for speech and hearing screening in Brazilian primary healthcare.
- Further validation with a larger number of diagnostic hypotheses is recommended to enhance its methodological rigor and clinical utility.
- The protocol has the potential to significantly impact Brazilian public health policies for early childhood development.
Objective:
To verify the accuracy of a protocol for the Brazilian population of the ABFW ‒ Adapted Child Language Test, named ABFW Triagem.
Methods:
This was a diagnostic accuracy study carried out at the speech therapy outpatient clinic of one of Brazil's leading public universities. Through the database, protocols were selected for patients aged between 0 and 5 years and 11-months who visited the outpatient clinic between 2016 and 2019 with any speech and hearing complaint. A follow up was carried out in 2024 to find out whether the speech therapy hypothesis was assertive or not.
Results:
188 protocols were selected and only 43 caregivers answered the researcher's call. The ABFW Screening protocol showed 72.1% accuracy and 64.3% balanced accuracy. Of all the hypotheses, the main one was language alteration characteristic of autism spectrum disorder (88.89%) with a sensitivity of 94.12% and specificity of 92.31%.
Conclusion:
The ABFW protocol adapted for speech and hearing screening proved to be a tool with the potential to make significant contributions to Brazilian public policies of interest to Primary Health Care. We suggest a greater volume of other speech therapy diagnostic hypotheses so that it can be validated and used by specialists, thus fulfilling the methodological rigor and development essential for its quality.
Level Of Evidence:
Is this diagnostic or monitoring test accurate? (Diagnosis) ‒ Level 2 (Individual cross-sectional studies with consistently applied reference standard and blinding).
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