Improving the Positive Predictive Value of Screening for Developmental Language Disorder 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 ... Research Article
Research Article  |   August 01, 2000
Improving the Positive Predictive Value of Screening for Developmental Language Disorder
 
Author Affiliations & Notes
  • Thomas Klee
    University of Newcastle upon Tyne England
  • Kim Pearce
    University of Newcastle upon Tyne England
  • David K. Carson
    University of Wyoming Laramie, WY
Article Information
Research Issues, Methods & Evidence-Based Practice / Language Disorders / Language / Research Articles
Research Article   |   August 01, 2000
Improving the Positive Predictive Value of Screening for Developmental Language Disorder
Journal of Speech, Language, and Hearing Research, August 2000, Vol. 43, 821-833. doi:10.1044/jslhr.4304.821
History: Received February 8, 1999 , Accepted January 25, 2000
 
Journal of Speech, Language, and Hearing Research, August 2000, Vol. 43, 821-833. doi:10.1044/jslhr.4304.821
History: Received February 8, 1999; Accepted January 25, 2000

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.

Acknowledgments
This project was supported in part by a grant from The Nuffield Foundation, London. We appreciate the helpful comments of William Gavin, James Law, Leslie Rescorla, Stephanie Stokes, Anne Whitworth, Trevor Cox, Dave Walshaw, and Tina Fry on an earlier draft of this paper, as well as Ruth Watkins, Mabel Rice, and three anonymous reviewers.
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