A systematic review on diagnostic procedures for specific language impairment: The sensitivity and specificity issues
Open accessAbstract
Background: Identification of children with specific language impairment (SLI) has been viewed as both necessity and challenge. Investigators and clinicians use different tests and measures for this purpose. Some of these tests/measures have good psychometric properties, but it is not sufficient for diagnostic purposes. A diagnostic procedure can be used for identification a specific population with confidence only when its sensitivity and specificity are acceptable. In this study, we searched for tests/measures with predefined sensitivity and specificity for identification of preschool children with SLI from their typically developing peers. Materials and Methods: A computerized search in bibliographic databases from 2000 to August 2015 was performed with the following keywords: “specific language impairment” or SLI” and “primary language impairment” or ‘PLI’ with at least one of the followings: “diagnosis,” “identification,” “accuracy,” “sensitivity,” and “specificity.” In addition, the related citations and reference lists of the selected articles were considered. Results: The results of reviewing 23 included studies show that the index measures used in studies vary in accuracy with the sensitivity ranging from 16% to 100% and the specificity ranging from 14% to 100%. Conclusion: These varieties in sensitivity and specificity of different tests/measures confirm the necessity of attention to the diagnostic power of tests/measures before their use as diagnostic tool. Further, the results indicate there are some promising tests/measures that the available evidence supports their performances in the diagnosis of SLI in preschool-aged children, yet the place of a reference standard for the diagnosis of SLI is vacant among investigations.
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The combination of several measures provides better results for identifying language delay/disorder.
“the review by Maleki Shahmahmood et al. [71] suggests that the combination of several measures provides better results.”
From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [71]
Three-year-old at-risk children produce fewer communicative gestures.
“Furthermore, this study showed that 3-year-old at-risk children produce fewer communicative gestures.”
From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [71]
Maleki Shahmahmood et al. pointed at the preschool period, starting from 3 years, as the most important in the diagnostic process.
“Maleki Shahmahmood et al. [71] pointed at the preschool period, starting from 3 years, as the most important in the diagnostic process.”
From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [71]
Maleki Shahmahmood et al. [71] analyzed literature published in English-language journals between 2000 and 2015, including 23 studies concerning diagnosis of DLD (SLI) in monolingual preschool children over age 3.
“Another review by Maleki Shahmahmood et al. [71] analyzed the literature published in English-language journals between 2000 and 2015, including 23 studies concerning the diagnosis of DLD (in the paper, SLI) in monolingual children of preschool age over the age of 3 years.”
From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [71]
All studies examined by the review were performed on samples composed of an equal number of TD and DLD subjects (prevalence 50%) and most on unselected populations.
“(b) all the studies were performed on samples composed of an equal number of TD and DLD subjects (prevalence 50%) and most of them on unselected populations;”
From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [71]
Overall, studies included in Maleki Shahmahmood et al. [71] showed sensitivity and specificity values for tests and psycholinguistic measures that varied across studies (sensitivity range 16-100%; specificity range 14-100%).
“Overall, the studies included in Maleki Shahmahmood et al. [71] showed sensitivity and specificity values for tests and psycholinguistic measures that varied across the different studies (sensitivity range: 16–100%; specificity range: 14–100%).”
From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [71]
Children with DLD in the studies examined by the review were recruited from those under treatment.
“(c) children with DLD were recruited from those under treatment;”
From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [71]
The studies included in Maleki Shahmahmood et al. [71] were heterogeneous as to the language examined.
“The included studies were heterogeneous as to the language examined and included: 12 studies with English/American English speaking participants; 3 studies concerning Italian speaking participants; the remaining studies concerned the following languages: Cantonese (n = 3), French (n = 1), Spanish (n = 1), Slovak (n = 1), Hebrew (n = 1), Persian (n = 1).”
From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [71]
Variability and arbitrariness in the choice of the cut-off of the index test significantly influenced the results in terms of accuracy values in the studies examined by the review.
“(d) variability and arbitrariness in the choice of the cut-off of the index test have significantly influenced the results in terms of accuracy values.”
From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [71]
In most studies examined by the review, the gold standard was experts' clinical judgment.
“(a) in most cases, the gold standard was represented by experts’ clinical judgment;”
From Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review (2021) · cites this paper as [71]
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- Authors
- Shahmahmood, T. M., Jalaie, S., Soleymani, Z., Haresabadi, F., & Nemati, P.
- Affiliations
- Mashhad University of Medical Sciences (IR)
- Tehran University of Medical Sciences (IR)
- University of Tübingen (DE)
- Corresponding author
- Jalaie, Shohreh
- Venue
- Journal of Research in Medical Sciences
- Published
- 2016-01
- Volume
- 21
- Issue
- 1
- Pages
- 67-67
- ISSN
- 1735-1995 (ISSN-L)
- 1735-7136
- PMC
- PMC5122002
- OpenAlex
- W2416508091
- Cited by
- 28
- References
- 57
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 3 · 2022: 3 · 2021: 2 · 2020: 5 · 2019: 2 · 2018: 4 · 2017: 2
- FWCI
- 0.49
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Journal of Research in Medical Sciences (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Psychology › Developmental and Educational Psychology › Language Development and Disorders
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Social Sciences › Psychology › Developmental and Educational Psychology › Reading and Literacy Development
- Keywords
- specific language impairment, diagnostic accuracy, sensitivity and specificity, language assessment tests, preschool children, reference materials
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