Petersen Douglas B, Chanthongthip Helen, Ukrainetz Teresa A, Spencer Trina D, Steeve Roger W
University of Wyoming, Laramie.
Synertx Rehabilitation, Great Falls, Montana.
J Speech Lang Hear Res. 2017 Apr 14;60(4):983-998. doi: 10.1044/2016_JSLHR-L-15-0426.
This study investigated the classification accuracy of a concentrated English narrative dynamic assessment (DA) for identifying language impairment (LI).
Forty-two Spanish-English bilingual kindergarten to third-grade children (10 LI and 32 with no LI) were administered two 25-min DA test-teach-test sessions. Pre- and posttest narrative retells were scored in real time. Using a structured intervention approach, examiners taught children missing story grammar elements and subordination. A posttest was administered using a parallel story.
Four classification predictors were analyzed: posttest scores, gain scores, modifiability ratings, and teaching duration. Discriminant function analysis indicated that an overall modifiability rating was the best classifier, with 100% sensitivity and 88% specificity after 1 DA session and 100% sensitivity and specificity after 2 sessions. Any 2 combinations of posttest scores, modifiability ratings, and teaching duration for just 1 session resulted in sensitivity and specificity rates over 90%. Receiver operating characteristic analyses were used to identify clinically usable cutoff points. Post hoc exploration indicated that similar results could be obtained after only one 5-10-min teaching cycle, potentially further abbreviating the DA process.
Concentrated English narrative DA results in high classification accuracy for bilingual children with and without LI. This efficient version of DA is amenable to clinical use.
本研究调查了集中式英语叙事动态评估（DA）在识别语言障碍（LI）方面的分类准确性。
对42名西班牙语 - 英语双语幼儿园至三年级儿童（10名有语言障碍，32名无语言障碍）进行了两次各25分钟的DA测试 - 教学 - 测试环节。对测试前和测试后的叙事复述进行实时评分。考官采用结构化干预方法，教授儿童缺失的故事语法元素和从属关系。使用平行故事进行后测。
分析了四个分类预测指标：后测分数、增益分数、可修改性评级和教学时长。判别函数分析表明，总体可修改性评级是最佳分类器，在1次DA环节后敏感性为100%，特异性为88%，在2次环节后敏感性和特异性均为100%。仅1次环节的后测分数、可修改性评级和教学时长的任意2种组合，敏感性和特异性率均超过90%。使用接受者操作特征分析来确定临床可用的临界值。事后探索表明，仅经过一个5 - 10分钟的教学周期就能获得类似结果，这可能会进一步缩短DA过程。
集中式英语叙事DA对有和无语言障碍的双语儿童具有较高的分类准确性。这种高效的DA版本适用于临床应用。
