Bilingual Language Assessment: A Meta-Analysis of Diagnostic Accuracy PurposeTo describe quality indicators for appraising studies of diagnostic accuracy and to report a meta-analysis of measures for diagnosing language impairment (LI) in bilingual Spanish–English U.S. children.MethodThe authors searched electronically and by hand to locate peer-reviewed English-language publications meeting inclusion criteria; the authors rated quality features, calculated accuracy metrics and ... Article
Article  |   August 01, 2011
Bilingual Language Assessment: A Meta-Analysis of Diagnostic Accuracy
 
Author Affiliations & Notes
  • Christine A. Dollaghan
    University of Texas at Dallas
    University of Texas at Dallas
  • Elizabeth A. Horner
    University of Texas at Dallas
    University of Texas at Dallas
  • Correspondence to Christine A. Dollaghan: dollaghan@utdallas.edu
  • Editor: Janna Oetting
    Editor: Janna Oetting×
  • Associate Editor: Ron Gillam
    Associate Editor: Ron Gillam×
Article Information
Special Populations / Cultural & Linguistic Diversity / Research Issues, Methods & Evidence-Based Practice / Language Disorders / Language
Article   |   August 01, 2011
Bilingual Language Assessment: A Meta-Analysis of Diagnostic Accuracy
Journal of Speech, Language, and Hearing Research, August 2011, Vol. 54, 1077-1088. doi:10.1044/1092-4388(2010/10-0093)
History: Received April 8, 2010 , Revised September 24, 2010 , Accepted November 10, 2010
 
Journal of Speech, Language, and Hearing Research, August 2011, Vol. 54, 1077-1088. doi:10.1044/1092-4388(2010/10-0093)
History: Received April 8, 2010; Revised September 24, 2010; Accepted November 10, 2010
Web of Science® Times Cited: 37

PurposeTo describe quality indicators for appraising studies of diagnostic accuracy and to report a meta-analysis of measures for diagnosing language impairment (LI) in bilingual Spanish–English U.S. children.

MethodThe authors searched electronically and by hand to locate peer-reviewed English-language publications meeting inclusion criteria; the authors rated quality features, calculated accuracy metrics and confidence intervals, and generated forest plots.

ResultsOf 771 citations (86 unique) located initially, accuracy metrics could be calculated for 17 index measures studied in a total of 100 children with LI and 109 with typical language. Most studies lacked clear descriptions of reference standards, procedures, and controls for subjective bias, making it difficult to rate specific quality features with confidence. Positive likelihood ratios (LR+) for most measures were at least diagnostically suggestive (pooled LR+ = 4.12; 95% CI [2.94, 5.78]). Negative likelihood ratios (LR−) were also generally suggestive, but heterogeneity precluded averaging. For every measure, confidence intervals for LR+ and LR− included diagnostically uninformative values.

ConclusionsThe available evidence does not support strong claims concerning the diagnostic accuracy of these measures, but a number appear promising. Several steps are suggested for strengthening future investigations of diagnostic accuracy.

Acknowledgment
The impetus for this study was an undergraduate honors thesis completed by the second author under the direction of the first in April of 2009. We thank Tom Campbell for his helpful comments.
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