Centre for Rural Health, Institute of Applied Health Sciences, University of Aberdeen, Inverness, UK
Independent statistical consultant, Edinburgh, UK.
BMJ Paediatr Open. 2022 Jan;6(1). doi: 10.1136/bmjpo-2021-001324.
Low language ability in early childhood is a strong predictor of later psychopathology as well as reduced school readiness, lower educational attainment, employment problems and involvement with the criminal justice system. Assessment of early language development is universally offered in many countries, but there has been little evaluation of assessment tools. We planned to compare the screening performance of two commonly used language assessment instruments.
A pragmatic diagnostic accuracy study was carried out in five areas of England comparing the performance of two screening tools (Ages and Stages Questionnaire (ASQ) and Sure Start Language Measure (SSLM)) against a reference test (Preschool Language Scale, 5th edition).
Results were available for 357 children aged 23-30 months. The ASQ Communication Scale using optimal cut-off values had a sensitivity of 0.55, a specificity of 0.95 and positive and negative predictive values of 0.53 and 0.95, respectively. The SSLM had corresponding values of 0.83, 0.81, 0.33 and 0.98, respectively. Both screening tools performed relatively poorly in families not using English exclusively in the home.
The very widely used ASQ Communication Scale performs poorly as a language screening tool, missing over one-third of cases of low language ability. The SSLM performed better as a screening tool.
儿童早期语言能力低是后期精神病理学以及入学准备不足、教育程度较低、就业问题和涉及刑事司法系统的强有力预测因素。许多国家普遍提供早期语言发展评估，但对评估工具的评估很少。我们计划比较两种常用语言评估工具的筛选性能。
在英格兰的五个地区进行了一项实用的诊断准确性研究，比较了两种筛查工具（年龄和阶段问卷（ASQ）和起点语言测量（SSLM））与参考测试（学前语言量表，第 5 版）的性能。
357 名 23-30 个月大的儿童的结果可用。使用最佳截断值的 ASQ 沟通量表的灵敏度为 0.55，特异性为 0.95，阳性和阴性预测值分别为 0.53 和 0.95。SSLM 的相应值分别为 0.83、0.81、0.33 和 0.98。两种筛查工具在家庭中不专门使用英语的家庭中的表现相对较差。
非常广泛使用的 ASQ 沟通量表作为语言筛查工具表现不佳，错过了三分之一以上语言能力低的病例。SSLM 作为一种筛查工具表现更好。
