Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
Int J Lang Commun Disord. 2013 Sep-Oct;48(5):534-53. doi: 10.1111/1460-6984.12028. Epub 2013 Jul 25.
Identifying 3-4-year-olds who are most at risk of persisting language difficulties, and possibly specific language impairment (SLI), is difficult due to the natural variation of language in young children. In older children, markers for SLI have been identified that differentiate between children with and without SLI. It is not known whether these markers can be used at an earlier age to identify children most at risk of persisting language difficulties.
To identify possible risk markers of current status that distinguish children who have specific expressive language delay (SELD) from the variation observed in normally developing children at age 3;0-4;0 and 4;0-5;0. To determine the most suitable measure(s) that would predict which children with SELD at age 3;0-4;0 were likely to have persistent expressive language delay (PELD) at age 4;0-5;0.
METHODS & PROCEDURES: Forty-seven children with SELD and 47 children with typical language development (TLD) were assessed on language, nonverbal IQ and marker tasks at age 3;0-4;0 (baseline). Ninety-one children were reassessed on the measures one year later (follow-up). At both time points, the marker tasks were compared with a reference standard (Expressive Communication subscale (EC) of the Preschool Language Scale-3 (PLS-3) (UK)) to determine the most useful marker for identifying children with SELD. Possible predictors were examined to determine the most suitable measure(s) that would predict which children with SELD at baseline were likely to have PELD at follow-up.
OUTCOME & RESULTS: A modified version of Recalling Sentences, a subtest of the Clinical Evaluation of Language Fundamentals (CELF)-Preschool UK, was the most useful marker for identifying children with SELD at baseline and at follow-up. Thirty-five (76.1%) of the 46 children with SELD at baseline had PELD at follow-up. Performance on the Auditory Comprehension (AC) and EC subscales of the PLS-3 (UK) and on modified Recalling Sentences at age 3;0-4;0 were predictors of PELD at age 4;0-5;0.
CONCLUSIONS & IMPLICATIONS: A modified Recalling Sentences task was a good risk marker for SELD at age 3;0-4;0 and SELD at age 4;0-5;0. PLS-3 AC, PLS-3 EC and modified Recalling Sentences at baseline were the best predictors of PELD. The use of modified Recalling Sentences as a predictive marker requires confirmation.
由于幼儿语言的自然变化，很难确定哪些 3-4 岁儿童最有可能持续存在语言困难，也可能是特定的语言障碍（SLI）。在年龄较大的儿童中，已经确定了 SLI 的标记，可以区分有和没有 SLI 的儿童。目前尚不清楚这些标记是否可以更早地用于识别最有可能持续存在语言困难的儿童。
确定当前状态的可能风险标记，以区分在 3 岁时具有特定表达性语言延迟（SELD）的儿童与正常发育儿童的变化，年龄为 3 岁；0-4 岁；0 和 4 岁；0-5 岁；0。确定最适合的测量方法，以预测哪些在 3 岁时患有 SELD 的儿童在 4 岁时更有可能持续存在表达性语言延迟（PELD）；0-5 岁；0。
在 3 岁时对 47 名患有 SELD 的儿童和 47 名具有典型语言发育的儿童（TLD）进行语言、非语言智商和标记任务评估；0-4；0（基线）。91 名儿童在一年后（随访）重新评估这些措施。在这两个时间点，标记任务都与参考标准（学前语言量表-3（PLS-3）（英国）的表达性沟通子量表（EC））进行比较，以确定最有用的标记，以识别基线时患有 SELD 的儿童。对可能的预测因素进行了检查，以确定最适合的测量方法，以预测哪些在基线时患有 SELD 的儿童最有可能在随访时出现 PELD。
临床评估语言基础知识（CELF）-英国学前版中的句子回忆测试的修改版本是识别基线和随访时患有 SELD 的儿童的最有用标记。在基线时患有 SELD 的 46 名儿童中有 35 名（76.1%）在随访时患有 PELD。PLS-3（英国）的听觉理解（AC）和 EC 子量表以及在 3 岁时进行的修改后的句子回忆任务；0-4；0 是 4 岁时 PELD 的预测因素；0-5；0。
修改后的句子回忆任务是 3 岁时 SELD 和 4 岁时 SELD 和 SELD 的良好风险标记；0-5 岁；0。PLS-3 AC、PLS-3 EC 和基线时的修改后的句子回忆是 PELD 的最佳预测因子。需要进一步证实使用修改后的句子回忆作为预测标记。
