Diagnostic accuracy of parent reports for speech-language disorders in young children: a meta-analysis

Speech and language disorders are among the most common developmental concerns in early childhood, yet there is limited consensus in pediatrics regarding how accurately parent-report instruments identify affected children. Prior reviews have combined heterogeneous screening formats, making it difficult to evaluate the performance of parent-completed measures widely used in developmental surveillance and primary care.

We conducted a systematic review and meta-analysis of studies evaluating the diagnostic accuracy of parent-report instruments for identifying speech and/or language disorders in children aged 0-6 years. Searches of PubMed/MEDLINE, CINAHL, PsycINFO, Web of Science, Google Scholar, and gray literature (January 2000-September 2024) identified studies comparing a parent-report index test with an independent clinician-administered or expert diagnostic reference standard and providing extractable 2 × 2 accuracy data. Two reviewers independently screened studies, extracted data, and assessed risk of bias (QUADAS-2). Pooled estimates were derived using a bivariate random-effects model, with prespecified subgroup analyses by age, disorder type, bilingualism, administration language, and tool category.

Twenty-six studies (17,820 children) met inclusion criteria. Pooled sensitivity was 0.81 (95% CI, 0.72-0.87) and specificity was 0.83 (95% CI, 0.78-0.86). The diagnostic odds ratio was 20.17; LR⁺ was 4.68 and LR⁻ 0.23. Exploratory subgroup estimates suggested numerical variation by age group, disorder type, bilingualism, administration language, and tool category. Formal moderator analyses indicated that age group was associated with specificity, whereas bilingualism, administration language, and tool category were not significant moderators. Deeks' test indicated no evidence of small-study effects.

Parent-report instruments demonstrate good diagnostic accuracy for early identification of speech and language disorders and offer scalable, family-centered tools suitable for developmental surveillance and primary-care screening. Standardization and cultural validation appear critical to optimizing performance.

Parent-report instruments are widely used in pediatrics, yet their diagnostic accuracy for detecting speech and language disorders has not been systematically established. This meta-analysis synthesizes evidence from 26 studies (17,820 children) to provide the most comprehensive evaluation to date of caregiver-report tools across early childhood. Findings show that several validated parent-report instruments demonstrate good accuracy for identifying children at risk, supporting their use in primary care and developmental follow-up pathways. Results offer clear, evidence-based guidance for pediatricians on when caregiver reports can reliably inform referral and early intervention decisions.