Assessment fidelity of a language screening instrument for 4-year-olds.

AIM

The aim of the study was to explore the assessment fidelity of a language screening instrument for four-year-old children. is a mandatory part of the healthcare program within the Swedish Child Health Service (CHS) and is offered to all four-year-olds in the region Scania in Sweden.

METHODS

The study was based on structured observations of twenty-four specialist CHS nurses' adherence to the protocol during screening.

RESULTS

All the observed nurses deviated from the test protocol. There was a large variation in the number of deviations from the test protocol per nurse, with the highest number of deviations occurring for three specific testing items. Significantly more deviations were made with four-year-old bilingual children as opposed to four-year-old monolingual children. Half of the nurses did not use the test protocol.

CONCLUSIONS

There is a clear need to improve the assessment fidelity of . Both the training that the nurses are offered, and the development of the test, are essential in securing the aim of high-quality work within the CHS. Support from experts in child speech-language development and disorders is suggested to be available at the CHS in Sweden.