Nash Hannah, Leavett Ruth, Childs Helen
Department of Psychology, University of York, UK.
Int J Lang Commun Disord. 2011 Nov-Dec;46(6):675-685. doi: 10.1111/j.1460-6984.2011.00038.x. Epub 2011 May 11.
The early identification of children is one of five themes identified by the Bercow review of 2008. The review also notes that there is a wide range in the methods used to identify children and it goes on to recommend that there needs to be a more systematic approach. One such approach would be to screen children before, or shortly after, school entry. The GAPS test has been designed as a screening tool to identify young children with language impairment and is reported to be of value in identifying children with language difficulties. However, the test has previously only been evaluated by its authors and the sensitivity of the test for identifying children from an unselected sample has not been evaluated.
This study evaluated the ability of the GAPS test to identify language-impaired children in an unselected sample. In addition, the effect of tester status (a trained researcher and a teaching assistant) was investigated.
METHODS & PROCEDURES: A total of 106 children aged 3-6 years completed the GAPS test, the Early Repetition Battery (ERB) and the core language scales from the Clinical Evaluation of Language Fundamentals-Preschool 2 with a trained researcher. Half the children completed the GAPS test a second time with a teaching assistant.
OUTCOMES & RESULTS: There was a significant effect of tester only for the non-word repetition subtest of the GAPS test in the nursery age group; the teaching assistants awarded higher scores than trained researchers. Of the 106 children, ten were language impaired according to the CELF-Preschool 2 core language score. The GAPS test identified two of these children at the 10th percentile cut-off, resulting in a low sensitivity estimate of 20%. However, the GAPS test only identified four of the 96 remaining unimpaired children resulting in a high specificity value of 96%. These values were similar when the 15th percentile cut-off was used and when parental concern or a family history of reading difficulties were used as the criterion measure.
CONCLUSIONS & IMPLICATIONS: These data show that although the GAPS test can be used by a range of people who work with young children, it is not a sensitive screener for language impairment when used by trained researchers.
儿童的早期识别是2008年贝尔考审查确定的五个主题之一。该审查还指出,用于识别儿童的方法多种多样,并进而建议需要采用更系统的方法。一种这样的方法是在儿童入学前或入学后不久对其进行筛查。GAPS测试被设计为一种筛查工具,用于识别有语言障碍的幼儿,据报道在识别有语言困难的儿童方面具有价值。然而,该测试此前仅由其作者进行过评估,其从未经过挑选的样本中识别儿童的敏感性尚未得到评估。
本研究评估了GAPS测试从未经过挑选的样本中识别有语言障碍儿童的能力。此外,还调查了测试人员身份(一名训练有素的研究人员和一名教学助理)的影响。
共有106名3至6岁的儿童在一名训练有素的研究人员的指导下完成了GAPS测试、早期重复测验(ERB)以及《语言基本能力临床评估学前版2》中的核心语言量表。一半的儿童由一名教学助理再次进行GAPS测试。
仅在幼儿年龄组的GAPS测试的非单词重复子测试中,测试人员产生了显著影响;教学助理给出的分数高于训练有素的研究人员。在这106名儿童中,根据《语言基本能力临床评估学前版2》核心语言得分,有10名儿童存在语言障碍。GAPS测试在第10百分位临界值时识别出了其中两名儿童,导致敏感性估计值较低,为20%。然而,GAPS测试仅在其余96名未受损儿童中识别出了4名,特异性值较高,为96%。当使用第15百分位临界值以及将家长关注或阅读困难家族史用作标准测量时,这些值相似。
这些数据表明,尽管GAPS测试可供一系列与幼儿打交道的人员使用,但由训练有素的研究人员使用时,它并非语言障碍的敏感筛查工具。