ABSTRACT
BACKGROUND: The German Kindersprachscreening (KiSS) is a universal speech and language screening test for large-scale identification of Hessian kindergarten children requiring special educational language training or clinical speech/language therapy. PARTICIPANTS AND METHODS: To calculate the procedural screening validity, 257 children (aged 4.0 to 4.5 years) were tested using KiSS and four language tests (Reynell Development Language Scales III, Patholinguistische Diagnostik, PLAKSS, AWST-R). The majority or consensus judgements of three speech-language professionals, based on the language test results, served as a reference criterion. The base (fail) rates of the professionals were either self-determined or preset based on known prevalence rates. RESULTS: Screening validity was higher for preset than for self-determined base rates due to higher inter-judge agreement. The confusion matrices of the overall index classification of the KiSS (speech-language abnormalities with educational or clinical needs) with the fixed base rate expert judgement about language impairment, including fluency or voice disorders, yielded a sensitivity of 88% and a specificity of 78%, for just language impairment 84% and 75%, respectively. Specificities for disorders requiring clinical diagnostics in the KiSS (language impairment alone or combined with fluency/voice disorders) related to the test-based consensus expert judgment was about 93%. Sensitivities were unsatisfactory because the differentiation between educational and clinical needs requires improvement. CONCLUSION: Since the judgement concordances between the speech-language professionals was only moderate, the development of a comprehensive German reference test for speech and language disorders with evidence-based algorithmic decision rules rather than subjective clinical judgement is advocated.
Subject(s)
Language Development Disorders/diagnosis , Language Tests/standards , Mass Screening/methods , Mass Screening/standards , Practice Guidelines as Topic , Child, Preschool , Early Diagnosis , Female , Germany , Humans , Language Development Disorders/classification , Male , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
BACKGROUND: A psychometrically constructed short test as a prerequisite for screening was developed on the basis of a revision of the Marburger Speech Screening to assess speech/language competence among children in Hessen (Germany). PARTICIPANTS AND METHODS: A total of 257 children (age 4.0 to 4.5 years) performed the test battery for speech/language competence; 214 children repeated the test 1 year later. RESULTS: Test scores correlated highly with scores of two competing language screenings (SSV, HASE) and with a combined score from four diagnostic tests of individual speech/language competences (Reynell III, patholinguistic diagnostics in impaired language development, PLAKSS, AWST-R). Validity was demonstrated by three comparisons: (1) Children with German family language had higher scores than children with another language. (2) The 3-month-older children achieved higher scores than younger children. (3) The difference between the children with German family language and those with another language was higher for the 3-month-older than for the younger children. CONCLUSION: The short test assesses the speech/language competence of 4-year-olds quickly, validly, and comprehensively.
Subject(s)
Language Disorders/diagnosis , Language Tests , Mass Screening/methods , Psychometrics/methods , Child, Preschool , Female , Humans , Male , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
BACKGROUND: Since autumn 1998 the multicenter interdisciplinary study group "Test Materials for CI Children" has been compiling a uniform examination tool for evaluation of speech and hearing development after cochlear implantation in childhood. METHODS USED: After studying the relevant literature, suitable materials were checked for practical applicability, modified and provided with criteria for execution and break-off. For data acquisition, observation forms for preparation of a PC-version were developed. RESULTS: The evaluation set contains forms for master data with supplements relating to postoperative processes. The hearing tests check supra-threshold hearing with loudness scaling for children, speech comprehension in silence (Mainz and Göttingen Test for Speech Comprehension in Childhood) and phonemic differentiation (Oldenburg Rhyme Test for Children), the central auditory processes of detection, discrimination, identification and recognition (modification of the "Frankfurt Functional Hearing Test for Children") and audiovisual speech perception (Open Paragraph Tracking, Kiel Speech Track Program). The materials for speech and language development comprise phonetics-phonology, lexicon and semantics (LOGO Pronunciation Test), syntax and morphology (analysis of spontaneous speech), language comprehension (Reynell Scales), communication and pragmatics (observation forms). The MAIS and MUSS modified questionnaires are integrated. CONCLUSIONS: The evaluation set serves quality assurance and permits factor analysis as well as controls for regularity through the multicenter comparison of long-term developmental trends after cochlear implantation.