Institute of Health and Society, School of Education, Communication and Language Sciences, Newcastle University, Newcastle-upon-Tyne NE1 7RU United Kingdom.
Pediatrics. 2012 Jul;130(1):e132-7. doi: 10.1542/peds.2011-1673. Epub 2012 Jun 11.
Early language delays across the preschool period have important implications for children, parents, and services raising the significance of early identification. Screening tests are an appealing solution but have proved problematic. A combined risk model would seem promising but has yet to be tested. The goal of this study was to examine the factors that predict language change in a nationally representative sample of children between 3 and 5 years when most children are identified as being in need of services.
By using data from children (n = 13,016) in the Millennium Cohort Study (a national UK birth cohort), linear regression was used to predict 5-year performance from 3-year test performance data coupled with sociodemographic and within-child factors and indicators of parental concern. Patterns of change were identified and logistic regression was used to predict the difference between children for whom profiles change and those for whom they do not.
The final model (predicting 32% of the variance) included maternal education, pattern construction, behavior, language concerns, and 3-year vocabulary. Four change patterns were identified: one consistently low (n = 201), one consistently high (n = 12,066), a group that is resilient (n = 572), and one with a declining profile (n = 177). The models accurately predicted 71% of the declining group and 99% of the resilient group. Maternal education (odds ratio: 0.49) and behavior (odds ratio: 0.9) were significant predictors for the former and maternal education (odds ratio: 0.6) and pattern construction (odds ratio: 1.03) the latter.
Early identification of delayed language remains problematic but, once identified, there are key indicators that predict which children are likely to be more or less at risk across time. The implications are discussed in terms of policy and practice.
学龄前早期语言迟缓对儿童、家长和服务机构都有重要影响，这提高了早期识别的重要性。筛查测试是一种很有吸引力的解决方案，但已经证明存在问题。综合风险模型似乎很有前景，但尚未经过测试。本研究的目的是在一个具有全国代表性的 3 至 5 岁儿童样本中，检查在大多数儿童被确定需要服务时，预测语言变化的因素。
利用来自英国千禧年队列研究（一项全国性的英国出生队列研究）中儿童（n = 13016）的数据，我们使用线性回归来预测 5 岁时的表现，将 3 岁时的测试表现数据与社会人口统计学和儿童内部因素以及父母关注的指标相结合。确定了变化模式，并使用逻辑回归来预测具有变化模式和没有变化模式的儿童之间的差异。
最终模型（预测了 32%的方差）包括母亲的教育程度、模式构建、行为、语言问题以及 3 岁时的词汇量。确定了四种变化模式：一种始终较低（n = 201），一种始终较高（n = 12066），一种具有弹性的群体（n = 572），一种具有下降模式的群体（n = 177）。模型准确地预测了 71%的下降组和 99%的弹性组。母亲的教育程度（优势比：0.49）和行为（优势比：0.9）是前者的显著预测因素，而母亲的教育程度（优势比：0.6）和模式构建（优势比：1.03）是后者的显著预测因素。
延迟语言的早期识别仍然存在问题，但一旦确定，就有一些关键指标可以预测哪些儿童在时间上更有可能或不太可能面临风险。本文从政策和实践的角度讨论了其意义。
