Identifying language impairment in children: combining language test scores with parental report.

Journal article

BACKGROUND: Children who meet language test criteria for specific language impairment (SLI) are not necessarily the same as those who are referred to a speech and language therapist. AIMS: To consider how far this discrepancy reflects insensitivity of traditional language tests to clinically important features of language impairment. METHODS and PROCEDURES: A total of 245 twin children, 52 of whom had been referred to a speech and language therapist for assessment or intervention, were studied. They were given a battery of language tests and their parents completed the Children's Communication Checklist - 2 (CCC-2). RESULTS: Language tests that stressed verbal short-term memory were best at distinguishing clinically referred from other cases; narrative and vocabulary tasks were less effective. A discriminant function analysis identified a combination of language test and parental report measures as giving the best discrimination between referred and non-referred cases. Nevertheless, of 82 children classified as language impaired by the discriminant function, 44 had never been referred to a speech and language therapist. These did not appear to be false-positives; they scored at least as poorly as referred cases on literacy tests. They had significantly lower socio-economic backgrounds than referred cases. CONCLUSIONS and IMPLICATIONS: Language test scores provide important information about which children are at risk of academic failure, though this varies from test to test. Reliance on language tests alone, however, is insufficient; a parental report provides important complementary information in the diagnostic process. Children of low socio-economic status with language problems are particularly likely to have no contact with speech and language therapist services.

Authors: Bishop, D; McDonald, D

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: John Wiley and Sons
• Journal: International journal of language and communication disorders / Royal College of Speech and Language Therapists
• Volume: 44
• Issue: 5
• Pages: 600-615
• Publication date: 2009-01-01
• DOI: 10.1080/13682820802259662
• EISSN: 1460-6984
• ISSN: 1368-2822
• Language: English
• Keywords: Male; Diseases in Twins; Language Therapy; Sensitivity and Specificity; Parents; Child; Language Tests; Female; Referral and Consultation; Psychometrics; Social Class; Speech Therapy; Humans; Language Development Disorders