Pennington Lindsay, Potts Lily, Murray Janice, Geytenbeek Johanna, Laws Kate, Sargent Jenefer, Clarke Michael, Swettenham John, Lachkovic Julie, Martin Catherine, McColl Elaine
Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK.
Int J Lang Commun Disord. 2025 Mar-Apr;60(2):e70025. doi: 10.1111/1460-6984.70025.
Current UK measures of early spoken language comprehension require manipulation of toys and/or verbal responses and are not accessible to children with severe motor impairments. The Computer-Based Instrument for Low motor Language Testing (C-BiLLT) (originally validated in Dutch) is a computerized test of spoken language comprehension that children with motor disorders control using their usual response methods.
To create a UK version of the C-BiLLT, evaluate its validity and reliability, and assess its practicability for children with motor disorders.
METHODS & PROCEDURES: The C-BiLLT was translated into British English and items were adapted to ensure familiarity to UK children. A total of 424 children (233 females, 191 males) aged 1:6-7:5 (years:months) without developmental disabilities were recruited from North East England. Children completed the UK C-BiLLT and Preschool Language Scales 5 (PLS-5) for convergent validity evaluation and either the visual reception subtest of the Mullen Scales of Early Learning (MSEL) (children aged 1:8-5:5) or Ravens Coloured Progressive Matrices (CPM) (ages 5:6-7:5) to assess divergent validity. A total of 33 children completed the UK C-BiLLT within 4 weeks of initial assessment for test-retest reliability assessment (intraclass correlation coefficient-ICC). Internal consistency was assessed using Cronbach's alpha and exploratory factor analysis examined structural validity. A total of 24 children (10 female, 14 male; aged 4-12 years) with non-progressive motor disorders who use augmentative and alternative communication (AAC), rated the UK C-BiLLT's ease of use and completed British Picture Vocabulary Scales (BPVS) and CPM as for convergent and divergent validity testing.
OUTCOMES & RESULTS: Internal consistency was high for children without motor disorders (α = 0.96). Exploratory factor analysis extracted two factors, together explaining 68% of the total variance. Test-retest reliability was excellent (ICC = 0.95; 0.90-0.98 95% confidence interval-CI). UK C-BiLLT scores correlated highly with PLS-5 (r = 0.91) and MSEL (r = 0.81), and moderately with CPM (r = 0.41); and increased across full-year age-bands (F(6, 407) = 341.76, p = < 0.001, η = 0.83). A total of 19 children with motor disorders rated the UK C-BiLLT as easy/ok to use; two judged it hard; three declined to rate the ease of use. Their UK C-BiLLT scores correlated highly with BPVS (r = 0.77) and moderately with CPM (r = 0.57).
CONCLUSIONS & IMPLICATIONS: The UK C-BiLLT is a valid, reliable measure of early spoken language development and is potentially practicable for children with motor disorders. It may facilitate international research on the language development of children with motor disorders and evaluation of intervention at the national level.
What is already known on the subject Young children with motor disorders have difficulties accessing standardized assessments of language comprehension that require children to handle objects or to speak a response. What this paper adds to the existing knowledge This study demonstrates the validity and reliability of a UK translation of the C-BiLLT and suggests that the measure is feasible for children with motor disorders who use AAC and have a reliable method of response via computer access. What are the potential or clinical implications of this work? The UK C-BiLLT is a useful addition to the limited tools currently available to assess early spoken language comprehension of children with motor disorders.
英国目前用于早期口语理解能力的测量方法需要操作玩具和/或口头回应，严重运动障碍儿童无法使用。基于计算机的低运动语言测试工具（C-BiLLT）（最初在荷兰验证）是一种口语理解能力的计算机化测试，运动障碍儿童可以使用他们常用的回应方式进行操作。
创建C-BiLLT的英国版本，评估其有效性和可靠性，并评估其对运动障碍儿童的实用性。
将C-BiLLT翻译成英式英语，并对项目进行调整以确保英国儿童熟悉。从英格兰东北部招募了424名年龄在1:6至7:5（岁:月）之间、无发育障碍的儿童（233名女性，191名男性）。儿童完成英国版C-BiLLT和《学前语言量表第5版》（PLS-5）以进行聚合效度评估，并完成《马伦早期学习量表》（MSEL）的视觉接受子测试（1:8至5:5岁的儿童）或《瑞文彩色渐进矩阵》（CPM）（5:6至7:5岁）以评估区分效度。共有33名儿童在初次评估后的4周内完成英国版C-BiLLT以进行重测信度评估（组内相关系数-ICC）。使用克朗巴哈系数评估内部一致性，并通过探索性因素分析检验结构效度。共有24名使用辅助和替代沟通（AAC）的非进行性运动障碍儿童（10名女性，14名男性；年龄4至12岁）对英国版C-BiLLT的易用性进行评分，并完成《英国图片词汇量表》（BPVS）和CPM以进行聚合效度和区分效度测试。
无运动障碍儿童的内部一致性较高（α = 0.96）。探索性因素分析提取了两个因素，共同解释了总方差的68%。重测信度极佳（ICC = 0.95；95%置信区间-CI为0.90 - 0.98）。英国版C-BiLLT得分与PLS-5（r = 0.91）和MSEL（r = 0.81）高度相关，与CPM中度相关（r = 0.41）；并且在全年年龄组中有所增加（F(6, 407) = 341.76，p = < 0.001，η = 0.83）。共有19名运动障碍儿童将英国版C-BiLLT评为易于使用/尚可；两名认为使用困难；三名拒绝评价易用性。他们的英国版C-BiLLT得分与BPVS高度相关（r = 0.77），与CPM中度相关（r = 0.57）。
英国版C-BiLLT是早期口语发展的有效、可靠测量工具，对运动障碍儿童具有潜在实用性。它可能有助于国际上对运动障碍儿童语言发展的研究以及国家层面的干预评估。
关于该主题已知的信息 患有运动障碍的幼儿难以进行需要儿童操作物体或口头回应的标准化语言理解评估。本文对现有知识的补充 本研究证明了C-BiLLT英国版的有效性和可靠性，并表明该测量方法对使用AAC且通过计算机访问具有可靠回应方式的运动障碍儿童是可行的。这项工作的潜在或临床意义是什么？英国版C-BiLLT是目前可用于评估运动障碍儿童早期口语理解能力的有限工具中的一个有用补充。
