The development and productivity of a measure for identifying low language abilities in children aged 24 – 36 months

James Law; Jenna Charlton; Philip Wilson; Robert Rush; Vicky  Gilroy; Cristina  McKean

doi:10.1186/s12887-023-04079-x

The development and productivity of a measure for identifying low language abilities in children aged 24 – 36 months

James Law
, Jenna Charlton
, Philip Wilson
, Robert Rush
, Vicky Gilroy
, Cristina McKean^* (Corresponding Author)

^*Corresponding author for this work

Applied Health Sciences

Newcastle University
Institute of Health Visiting

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

8 Downloads (Pure)

Abstract

Background
Accurate early identification of children with low language ability is important but existing measures generally have low sensitivity. This remains an area of concern for preventive and public health services. This study aimed to create and evaluate a measure of child language, communication and related risks which can be used by community health nurses to accurately identify children with low language aged 24–30 months.

Methods
The Early Language Identification Measure (ELIM) was developed and comprised five measurement sections, each measuring different aspects of development combined into a single measure. This was tested blind against a reference standard language measure, the Preschool Language Scale-5 (PLS-5), at the universal 24–30-month health visitor review in England. The threshold for likely low language was the tenth centile or below on the PLS-5. The aim was to ascertain the performance of the five individual sections in the scale, and consider the optimum combination of sections, for predicting low language ability. Specificity, sensitivity, and positive and negative predictive values were reported for each of the five sections of the ELIM alone and in conjunction with each other. The performance for children from monolingual English-speaking families and those who spoke languages other than English were also considered separately.

Results
Three hundred and seventy-six children were assessed on both the ELIM identification measure and the PLS-5 with 362 providing complete data. While each section of the ELIM predicted low language ability, the optimal combination for predicting language outcome was the parent reported vocabulary checklist coupled with the practitioner observation of the child’s communication and related behaviours. This gave a sensitivity of 0·98 with a specificity of 0·63.

Conclusions
A novel measure has been developed which accurately identifies children at risk of low language, allowing clinicians to target resources efficiently and intervene early.

Original language	English
Article number	495
Number of pages	10
Journal	BMC Pediatrics
Volume	23
Early online date	29 Sept 2023
DOIs	https://doi.org/10.1186/s12887-023-04079-x
Publication status	Published - 29 Sept 2023

Bibliographical note

Acknowledgements
First, we would like to acknowledge the leadership, mentorship and unparalleled contribution to the field of child language research of Professor James Law, OBE, who led this study. Professor Law passed away in October 2021. We also acknowledge the contribution of Professor Sue Roulstone, Caitlin Holme and Rose Watson in aspects of the wider study which contributed to the successful data collection in this study. We would like to express sincere thanks to all the practitioners and parents who gave their time, expertise, and insights in the workshop and codesign activities. The team also wish to acknowledge the role of Sheena Carr and Renvia Mason and colleagues at Public Health England and The Department for Education for their feedback on the original report.

Funding
The project was funded by the UK’s Department for Education in conjunction with Public Health England.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Child development
Language
language delay
Surveillance
Developmental screening
Early prevention
Public Health

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Cite this

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title = "The development and productivity of a measure for identifying low language abilities in children aged 24 {\textendash} 36 months",

abstract = "Background Accurate early identification of children with low language ability is important but existing measures generally have low sensitivity. This remains an area of concern for preventive and public health services. This study aimed to create and evaluate a measure of child language, communication and related risks which can be used by community health nurses to accurately identify children with low language aged 24{\textendash}30 months. Methods The Early Language Identification Measure (ELIM) was developed and comprised five measurement sections, each measuring different aspects of development combined into a single measure. This was tested blind against a reference standard language measure, the Preschool Language Scale-5 (PLS-5), at the universal 24{\textendash}30-month health visitor review in England. The threshold for likely low language was the tenth centile or below on the PLS-5. The aim was to ascertain the performance of the five individual sections in the scale, and consider the optimum combination of sections, for predicting low language ability. Specificity, sensitivity, and positive and negative predictive values were reported for each of the five sections of the ELIM alone and in conjunction with each other. The performance for children from monolingual English-speaking families and those who spoke languages other than English were also considered separately. Results Three hundred and seventy-six children were assessed on both the ELIM identification measure and the PLS-5 with 362 providing complete data. While each section of the ELIM predicted low language ability, the optimal combination for predicting language outcome was the parent reported vocabulary checklist coupled with the practitioner observation of the child{\textquoteright}s communication and related behaviours. This gave a sensitivity of 0·98 with a specificity of 0·63. Conclusions A novel measure has been developed which accurately identifies children at risk of low language, allowing clinicians to target resources efficiently and intervene early.",

keywords = "Child development, Language, language delay, Surveillance, Developmental screening, Early prevention, Public Health",

author = "James Law and Jenna Charlton and Philip Wilson and Robert Rush and Vicky Gilroy and Cristina McKean",

note = "Acknowledgements First, we would like to acknowledge the leadership, mentorship and unparalleled contribution to the field of child language research of Professor James Law, OBE, who led this study. Professor Law passed away in October 2021. We also acknowledge the contribution of Professor Sue Roulstone, Caitlin Holme and Rose Watson in aspects of the wider study which contributed to the successful data collection in this study. We would like to express sincere thanks to all the practitioners and parents who gave their time, expertise, and insights in the workshop and codesign activities. The team also wish to acknowledge the role of Sheena Carr and Renvia Mason and colleagues at Public Health England and The Department for Education for their feedback on the original report. Funding The project was funded by the UK{\textquoteright}s Department for Education in conjunction with Public Health England.",

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doi = "10.1186/s12887-023-04079-x",

language = "English",

volume = "23",

journal = "BMC Pediatrics",

issn = "1471-2431",

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TY - JOUR

T1 - The development and productivity of a measure for identifying low language abilities in children aged 24 – 36 months

AU - Law, James

AU - Charlton, Jenna

AU - Wilson, Philip

AU - Rush, Robert

AU - Gilroy, Vicky

AU - McKean, Cristina

N1 - Acknowledgements First, we would like to acknowledge the leadership, mentorship and unparalleled contribution to the field of child language research of Professor James Law, OBE, who led this study. Professor Law passed away in October 2021. We also acknowledge the contribution of Professor Sue Roulstone, Caitlin Holme and Rose Watson in aspects of the wider study which contributed to the successful data collection in this study. We would like to express sincere thanks to all the practitioners and parents who gave their time, expertise, and insights in the workshop and codesign activities. The team also wish to acknowledge the role of Sheena Carr and Renvia Mason and colleagues at Public Health England and The Department for Education for their feedback on the original report. Funding The project was funded by the UK’s Department for Education in conjunction with Public Health England.

PY - 2023/9/29

Y1 - 2023/9/29

N2 - Background Accurate early identification of children with low language ability is important but existing measures generally have low sensitivity. This remains an area of concern for preventive and public health services. This study aimed to create and evaluate a measure of child language, communication and related risks which can be used by community health nurses to accurately identify children with low language aged 24–30 months. Methods The Early Language Identification Measure (ELIM) was developed and comprised five measurement sections, each measuring different aspects of development combined into a single measure. This was tested blind against a reference standard language measure, the Preschool Language Scale-5 (PLS-5), at the universal 24–30-month health visitor review in England. The threshold for likely low language was the tenth centile or below on the PLS-5. The aim was to ascertain the performance of the five individual sections in the scale, and consider the optimum combination of sections, for predicting low language ability. Specificity, sensitivity, and positive and negative predictive values were reported for each of the five sections of the ELIM alone and in conjunction with each other. The performance for children from monolingual English-speaking families and those who spoke languages other than English were also considered separately. Results Three hundred and seventy-six children were assessed on both the ELIM identification measure and the PLS-5 with 362 providing complete data. While each section of the ELIM predicted low language ability, the optimal combination for predicting language outcome was the parent reported vocabulary checklist coupled with the practitioner observation of the child’s communication and related behaviours. This gave a sensitivity of 0·98 with a specificity of 0·63. Conclusions A novel measure has been developed which accurately identifies children at risk of low language, allowing clinicians to target resources efficiently and intervene early.

AB - Background Accurate early identification of children with low language ability is important but existing measures generally have low sensitivity. This remains an area of concern for preventive and public health services. This study aimed to create and evaluate a measure of child language, communication and related risks which can be used by community health nurses to accurately identify children with low language aged 24–30 months. Methods The Early Language Identification Measure (ELIM) was developed and comprised five measurement sections, each measuring different aspects of development combined into a single measure. This was tested blind against a reference standard language measure, the Preschool Language Scale-5 (PLS-5), at the universal 24–30-month health visitor review in England. The threshold for likely low language was the tenth centile or below on the PLS-5. The aim was to ascertain the performance of the five individual sections in the scale, and consider the optimum combination of sections, for predicting low language ability. Specificity, sensitivity, and positive and negative predictive values were reported for each of the five sections of the ELIM alone and in conjunction with each other. The performance for children from monolingual English-speaking families and those who spoke languages other than English were also considered separately. Results Three hundred and seventy-six children were assessed on both the ELIM identification measure and the PLS-5 with 362 providing complete data. While each section of the ELIM predicted low language ability, the optimal combination for predicting language outcome was the parent reported vocabulary checklist coupled with the practitioner observation of the child’s communication and related behaviours. This gave a sensitivity of 0·98 with a specificity of 0·63. Conclusions A novel measure has been developed which accurately identifies children at risk of low language, allowing clinicians to target resources efficiently and intervene early.

KW - Child development

KW - Language

KW - language delay

KW - Surveillance

KW - Developmental screening

KW - Early prevention

KW - Public Health

U2 - 10.1186/s12887-023-04079-x

DO - 10.1186/s12887-023-04079-x

M3 - Article

SN - 1471-2431

VL - 23

JO - BMC Pediatrics

JF - BMC Pediatrics

M1 - 495

ER -

The development and productivity of a measure for identifying low language abilities in children aged 24 – 36 months

Abstract

Bibliographical note

UN SDGs

Keywords

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