McGill University, Montreal, Quebec, Canada.
J Speech Lang Hear Res. 2011 Apr;54(2):580-97. doi: 10.1044/1092-4388(2010/09-0196). Epub 2010 Nov 16.
Research on the diagnostic accuracy of different language measures has focused primarily on English. This study examined the sensitivity and specificity of a range of measures of language knowledge and language processing for the identification of primary language impairment (PLI) in French-speaking children. Because of the lack of well-documented language measures in French, it is difficult to accurately identify affected children, and thus research in this area is impeded.
The performance of 14 monolingual French-speaking children with confirmed, clinically identified PLI (M = 61.4 months of age, SD = 7.2 months) on a range of language and language processing measures was compared with the performance of 78 children with confirmed typical language development (M age = 58.9 months, SD = 5.7). These included evaluations of receptive vocabulary, receptive grammar, spontaneous language, narrative production, nonword repetition, sentence imitation, following directions, rapid automatized naming, and digit span. Sensitivity, specificity, and likelihood ratios were determined at 3 cutoff points: (a) -1 SD, (b) -1.28 SD, and (b) -2 SD below mean values. Receiver operator characteristic curves were used to identify the most accurate cutoff for each measure.
Significant differences between the PLI and typical language development groups were found for the majority of the language measures, with moderate to large effect sizes. The measures differed in their sensitivity and specificity, as well as in which cutoff point provided the most accurate decision. Ideal cutoff points were in most cases between the mean and -1 SD. Sentence imitation and following directions appeared to be the most accurate measures.
This study provides evidence that standardized measures of language and language processing provide accurate identification of PLI in French. The results are strikingly similar to previous results for English, suggesting that in spite of structural differences between the languages, PLI in both languages involves a generalized language delay across linguistic domains, which can be identified in a similar way using existing standardized measures.
不同语言测量方法的诊断准确性研究主要集中在英语上。本研究考察了一系列语言知识和语言处理测量方法在识别法语儿童原发性语言障碍（PLI）方面的敏感性和特异性。由于缺乏有文献记录的法语语言测量方法，因此难以准确识别受影响的儿童，从而阻碍了该领域的研究。
比较了 14 名经临床确诊患有 PLI 的单语法语儿童（M = 61.4 个月，SD = 7.2 个月）和 78 名经临床确诊具有典型语言发育儿童（M 年龄= 58.9 个月，SD = 5.7 个月）在一系列语言和语言处理测量方法上的表现。这些评估包括接受性词汇、接受性语法、自发语言、叙事生成、非词重复、句子模仿、听从指令、快速自动命名和数字跨度。在 3 个截断点（a）-1 SD、（b）-1.28 SD 和（b）-2 SD 低于平均值，确定了敏感性、特异性和似然比。使用接收者操作特征曲线来确定每个测量方法的最准确截断点。
在大多数语言测量中，PLI 组和典型语言发育组之间存在显著差异，具有中等到大的效应大小。这些测量方法在敏感性和特异性方面存在差异，以及在哪个截断点提供最准确的决策方面存在差异。理想的截断点在大多数情况下处于平均值和-1 SD 之间。句子模仿和听从指令似乎是最准确的测量方法。
本研究提供了证据表明，语言和语言处理的标准化测量方法可以准确识别法语中的 PLI。结果与之前的英语结果非常相似，这表明尽管两种语言在结构上存在差异，但两种语言的 PLI 都涉及到语言领域的普遍语言延迟，可以使用现有的标准化测量方法以类似的方式识别。
