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Cited by 220Language Development and DisordersStuttering Research and TreatmentVoice and Speech Disorders

Screening for Speech and Language Delay in Children 5 Years Old and Younger: A Systematic Review

Wallace, Ina F., Berkman, Nancy D., Watson, Linda R., Coyne-Beasley, Tamera, Wood, Charles T., Cullen, Katherine, Lohr, Kathleen N.·2015·Pediatrics
DOI 10.1542/peds.2014-3889
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Abstract

BACKGROUND AND OBJECTIVES: No recommendation exists for or against routine use of brief, formal screening instruments in primary care to detect speech and language delay in children through 5 years of age. This review aimed to update the evidence on screening and treating children for speech and language since the 2006 US Preventive Services Task Force systematic review. METHODS: Medline, the Cochrane Library, PsycInfo, Cumulative Index to Nursing and Allied Health Literature, ClinicalTrials.gov, and reference lists. We included studies reporting diagnostic accuracy of screening tools and randomized controlled trials reporting benefits and harms of treatment of speech and language. Two independent reviewers extracted data, checked accuracy, and assigned quality ratings using predefined criteria. RESULTS: We found no evidence for the impact of screening on speech and language outcomes. In 23 studies evaluating the accuracy of screening tools, sensitivity ranged between 50% and 94%, and specificity ranged between 45% and 96%. Twelve treatment studies improved various outcomes in language, articulation, and stuttering; little evidence emerged for interventions improving other outcomes or for adverse effects of treatment. Risk factors associated with speech and language delay were male gender, family history, and low parental education. A limitation of this review is the lack of well-designed, well-conducted studies addressing whether screening for speech and language delay or disorders improves outcomes. CONCLUSIONS: Several screening tools can accurately identify children for diagnostic evaluations and interventions, but evidence is inadequate regarding applicability in primary care settings. Some treatments for young children identified with speech and language delays and disorders may be effective.

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  • Wallace et al. confirmed the validity of some screening tools: MB-CDI and CSBS ITC for parents, and SKOLD for professionals.

    “The study by Wallace et al. [66] confirmed the validity of some screening tools, such as, for parents, the MacArthur–Bates Communicative Development Inventory (MB-CDI; [113]), and the Infant Toddler Checklist of the Communication and Symbolic Behavior Scales ([CSBS ITC; [114]), and, for professionals, the Screening Kit of Language Development ([SKOLD, [112]) questionnaires.”

    From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [66]

  • The absence of large differences between tools for parents and for professionals suggests that parent-filled tools can be useful for screening without overloading health services.

    “The fact that the review did not reveal any large differences between tools for parents and for professionals suggests that the use of tools filled out by parents (e.g., MB-CDI, CSBS ITC, and LDS) can be useful for screening without overloading health services.”

    From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [66]

  • The accuracy of some screening tools seems to drop over time, as observed in two studies on a parent report screening tool administered at 2 and 3 years of age, which showed lower sensitivity in one study and lower specificity in the other.

    “The accuracy of some screening tools seems to drop over time, as observed in two studies on a parent report screening tool administered at 2 and at 3 years of age, which showed lower sensitivity in one study and lower specificity in the other.”

    From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [66]

  • The decrease in specificity with time may mean that some children with language delays catch up and display more typical language skills as they grow older.

    “The authors suggested that the decrease in specificity with time may mean that some children with language delays catch up and display more typical language skills as they grow older [66].”

    From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [66]

  • Although some screening tools can accurately identify language delays or disorders, none appear more accurate than others, and no age is shown to be particularly adequate for screening.

    “Wallace et al. [66] confirmed that, although some screening tools can accurately identify language delays or disorders, none of them appear to be more accurate than others, and no age is shown to be particularly adequate for screening.”

    From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [66]

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Authors
Wallace, I. F., Berkman, N. D., Watson, L. R., Coyne-Beasley, T., Wood, C. T., Cullen, K., & Lohr, K. N.
Affiliations
  • RTI International (US)
  • Division of Speech and Hearing Sciences, and
  • University of North Carolina at Chapel Hill (US)
  • Departments of Pediatrics, and
Corresponding author
Wallace, Ina F.
ORCID
Venue
Pediatrics
Publisher
American Academy of Pediatrics (AAP)
Published
2015-08-01
Volume
136
Issue
2
Pages
e448-e462
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.2014-3889
OpenAlex
W2168190201
Cited by
220
References
105
Citations by year
2026: 16 · 2025: 20 · 2024: 19 · 2023: 39 · 2022: 20 · 2021: 23 · 2020: 29 · 2019: 21 · 2018: 17 · 2017: 3 · 2016: 10 · 2015: 2
FWCI
2.27
Type
journal article
Language
en
Open access
closed
Locations
  • PEDIATRICS (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Battelle
  • U.S. Public Health Service (HHSA290201200015ITO2)
Topics
  • Social Sciences › Psychology › Developmental and Educational Psychology › Language Development and Disorders
  • Social Sciences › Psychology › Clinical Psychology › Stuttering Research and Treatment
  • Health Sciences › Medicine › Physiology › Voice and Speech Disorders
Keywords
speech delay, language delay, children under five, speech therapy, stuttering, articulation disorders, primary care, risk factors, parental education, family history (medicine)
MeSH terms
Child, Preschool, Humans, Infant, Language Development Disorders, Mass Screening, Primary Health Care

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