Universal language development screening: comparative performance of two questionnaires

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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
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Background and objective 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.

Methods 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 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.

Conclusion 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.
Original languageEnglish
Article numbere001324
Number of pages8
JournalBMJ Paediatrics Open
Issue number1
Early online date6 Jan 2022
Publication statusPublished - 6 Jan 2022

Bibliographical note

The authors would like to acknowledge other members of the “Early Identification” team: Professor Sue Roulstone and Caitlin Holme from the Bristol Speech and Language Therapy Research Unit, Rose Watson from Newcastle University, and Sheena Carr and Renvia Mason from Public Health England for their support throughout the project. Finally, we would like to thank the children and their families who attended the clinics and the health visitors and speech and language therapists who were involved in collecting data for the project.

Data Availability Statement

Data are available in a public, open access repository. The data from this project, together with other data from the study, will be available in the Newcastle University data repository. The protocol (initial accepted response to tender), the final report, the deidentified participant data and a data dictionary will be made available with publication from Newcastle University - My data (ncl.ac.uk). The reports are available currently. The data will be available by March 2022. Data access will be subject to a data access agreement but beyond that will be fully accessible. Those wishing to access the data will be given support from the investigator team if required.


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