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The Fluharty Preschool Speech and Language Screening Test: a population-based validation study using
R A Sturner1, J H Heller, S G Funk
1Department of Pediatrics, Duke University Medical Center, Durham, NC 27710.
Insights
The Fluharty Preschool Speech and Language Screening Test shows low sensitivity for identifying language disorders in preschoolers. It may be more effective for screening children with articulation impairments.
Area of Science:
- Speech-Language Pathology
- Developmental Psychology
- Pediatric Audiology
Background:
- Accurate screening tools are crucial for early identification of speech and language disorders in preschool children.
- The Fluharty Preschool Speech and Language Screening Test is a widely used tool for this purpose.
- Validation studies are essential to determine the clinical utility of screening instruments.
Purpose of the Study:
- To clinically validate the Fluharty Preschool Speech and Language Screening Test.
- To assess the test's sensitivity, specificity, and predictive value for identifying speech and language impairments in 4- and 5-year-old children.
- To compare the screening performance for language disorders versus articulation impairments.
Main Methods:
- Two cohorts of 700 preschool children (4- and 5-year-olds) were screened using the Fluharty test.
- Stratified samples from each cohort underwent criterion testing for articulation and language.
- Clinical validation indices including sensitivity, specificity, and predictive value were calculated.
Main Results:
- The Fluharty test demonstrated low sensitivity for language outcomes (0.43 and 0.31) but higher sensitivity for articulation impairments.
- Specificity was high (0.82 and 0.93), indicating good ability to correctly identify children without disorders.
- Overreferral rates were 14% and 5%, with underreferral at 14% for both cohorts.
Conclusions:
- The Fluharty Preschool Speech and Language Screening Test is not sensitive enough for reliable screening of language disorders in preschoolers.
- The test shows potential for identifying children with articulation impairments.
- Further research may be needed to refine screening protocols or explore alternative measures for language disorders.
Abstract:
Two cohorts of 4- and 5-year-old children (N = 700) were screened with the Fluharty Preschool Speech and Language Screening Test. Two stratified samples (n = 51 cohort 1; n = 147 cohort 2), based on speech/language screening results, were administered criterion tests for articulation (AAPS-R or Templin-Darley) and language (TOLD or TALC-R). Clinical validation indices for combined speech or language outcome in the two cohorts were as follows: sensitivity, .43 and .31 respectively; specificity, .82 and .93; predictive value, .43 and .54; overreferral, 14% and 5%; underreferral, 14% in both cohorts, and percent agreement, 72% and 80%. The measure of sensitivities for language outcomes was lower than the above, whereas sensitivities for articulation was higher. These results suggest that the Fluharty is too insensitive to be relied on for screening programs aimed at identifying preschool children with language disorders, although it appears to have promise for the identification of children with articulation impairments.
