Improving the Positive Predictive Value of Screening for Developmental Language Disorder
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In a previous study, we reported the results of an early language screening program in which 306 children were screened using a parent-report questionnaire sent through the mail (Klee et al., 1998). A sample of the children screened were given clinical evaluations within a month of screening (n=64) and again 1 year later (n=36). Although the screening program correctly identified 91% of 2-year-olds with language delay, it produced a large number of over-referrals. In the present study we examine a revised screening criterion designed to reduce the number of false positives. The revised criterion generated fewer positive screens overall than the original and resulted in improved specificity (96% vs. 87%) and positive predictive value (77% vs. 51%), while maintaining the high sensitivity (91%) and negative predictive value (98%) of the original criterion. We also propose a screening score based on the new criterion, designed to inform the process of deciding which children to bring in for further evaluation.
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The Language Development Survey (LDS) administered at age 2 years had the best predictive value with regard to language development (sensitivity 67%, specificity 94%, NPV 88%, PPV 80%).
“The screening tool with the best predictive value with regard to language development was the Language Development Survey (LDS [106,107,108,109]) administered at age 2 years (sensitivity 67%, specificity 94%, Negative Predictive Value NPV 88% and PPV 80%).”
From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [108]
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- Authors
- Klee, T., Pearce, K., & Carson, D. K.
- Affiliations
- Newcastle University (GB)
- University of Wyoming (US)
- ORCID
- Klee, Thomas
- Venue
- Journal of Speech, Language, and Hearing Research
- Published
- 2000-08
- Volume
- 43
- Issue
- 4
- Pages
- 821-833
- ISSN
- 1092-4388 (ISSN-L)
- 1558-9102
- OpenAlex
- W2089716454
- Cited by
- 114
- References
- 45
- Citations by year
- 2026: 4 · 2024: 6 · 2023: 3 · 2022: 4 · 2021: 8 · 2020: 4 · 2019: 3 · 2018: 6 · 2017: 3 · 2016: 8 · 2015: 4 · 2013: 4 · 2012: 6
- FWCI
- 4.19
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Journal of Speech Language and Hearing Research (publishedVersion)
- PubMed (publishedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- Nuffield Foundation
- Topics
- Social Sciences › Psychology › Developmental and Educational Psychology › Language Development and Disorders
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hearing Loss and Rehabilitation
- Keywords
- specific language impairment, language screening, positive predictive value, screening criteria, false positives, over-referral, specificity, sensitivity, parent questionnaires, screening score, two-year-old children
- MeSH terms
- Child, Preschool, Double-Blind Method, Female, Humans, Language Development Disorders, Language Tests, Male, Mass Screening, Otitis Media, Parents, Predictive Value of Tests, Surveys and Questionnaires, Severity of Illness Index, Program Evaluation
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