Classification accuracy of the Quick Interactive Language Screener for preschool children with and without developmental language disorder

A new screener predicts Toddlers' language development from age 2-3: The QUILS:TOD

Language interventions may yield greater benefits for younger children than their older counterparts, making it critical to evaluate children's language skills as early as possible. Yet, assessing young children's language presents many challenges, such as limited attention spans, low expressive language, and hesitancy to speak with an unfamiliar examiner. To address these challenges, the Quick Interactive Language Screener for Toddlers (QUILS:TOD; for children 24- to 36-months of age) was developed as a quick, tablet-based language screener capable of assessing children's vocabulary, syntax, and word learning skills. We explored how children's performance on the QUILS:TOD and the MacArthur-Bates Communicative Development Inventory, another language screener, at two years of age relates to their performance one year later on the Quick Interactive Language Screener (QUILS), a validated and normed screener for children between three and six years of age. Results revealed that performance on the QUILS:TOD was predictive of QUILS performance, highlighting the utility of the QUILS:TOD for identifying which children at age two would continue to lag behind their peers at age three. Lastly, although all QUILS:TOD areas (vocabulary, syntax, and word learning) were predictive of QUILS performance, the most robust predictor of children's performance on the same receptive language dimensions at 3 years was their syntax, emphasizing the necessity of evaluating language beyond vocabulary.

Screening for Speech and Language Delay and Disorders in Children 5 Years or Younger: Evidence Report and Systematic Review for the US Preventive Services Task Force

Importance

Children with speech and language difficulties are at risk for learning and behavioral problems.

Objective

To review the evidence on screening for speech and language delay or disorders in children 5 years or younger to inform the US Preventive Services Task Force.

Data Sources

PubMed/MEDLINE, Cochrane Library, PsycInfo, ERIC, Linguistic and Language Behavior Abstracts (ProQuest), and trial registries through January 17, 2023; surveillance through November 24, 2023.

Study Selection

English-language studies of screening test accuracy, trials or cohort studies comparing screening vs no screening; randomized clinical trials (RCTs) of interventions.

Data Extraction and Synthesis

Dual review of abstracts, full-text articles, study quality, and data extraction; results were narratively summarized.

Main Outcomes and Measures

Screening test accuracy, speech and language outcomes, school performance, function, quality of life, and harms.

Results

Thirty-eight studies in 41 articles were included (N = 9006). No study evaluated the direct benefits of screening vs no screening. Twenty-one studies (n = 7489) assessed the accuracy of 23 different screening tools that varied with regard to whether they were designed to be completed by parents vs trained examiners, and to screen for global (any) language problems vs specific skills (eg, expressive language). Three studies assessing parent-reported tools for expressive language skills found consistently high sensitivity (range, 88%-93%) and specificity (range, 88%-85%). The accuracy of other screening tools varied widely. Seventeen RCTs (n = 1517) evaluated interventions for speech and language delay or disorders, although none enrolled children identified by routine screening in primary care. Two RCTs evaluating relatively intensive parental group training interventions (11 sessions) found benefit for different measures of expressive language skills, and 1 evaluating a less intensive intervention (6 sessions) found no difference between groups for any outcome. Two RCTs (n = 76) evaluating the Lidcombe Program of Early Stuttering Intervention delivered by speech-language pathologists featuring parent training found a 2.3% to 3.0% lower proportion of syllables stuttered at 9 months compared with the control group when delivered in clinic and via telehealth, respectively. Evidence on other interventions was limited. No RCTs reported on the harms of interventions.

Conclusions and Relevance

No studies directly assessed the benefits and harms of screening. Some parent-reported screening tools for expressive language skills had reasonable accuracy for detecting expressive language delay. Group parent training programs for speech delay that provided at least 11 parental training sessions improved expressive language skills, and a stuttering intervention delivered by speech-language pathologists reduced stuttering frequency.

Examining the Relation Between Exercise and Word Learning in Preschool-Age Children

PURPOSE

There is evidence suggesting that aerobic exercise immediately after vocabulary training can improve word recall in school-age children. This work examined whether the previously identified word-learning benefits associated with exercise can be extended to preschoolers. Additionally, we evaluated whether the effects of physical activity on vocabulary learning may be influenced by existing language skills that the child possesses.

METHOD

Children ages 3-6 years completed the study (N = 42). Data were collected via a virtual testing session in which participants completed a word-learning task that included two experimental conditions (exercise and resting). In the resting measure, children were taught names of novel objects and then sat down and colored for 3 min before being tested on their ability to identify the trained words. The exercise condition was identical, except that participants engaged in 3 min of guided aerobic exercise before testing. Additionally, at the end of the visit, participants completed the Quick Interactive Language Screener (QUILS), which measured general language skills.

RESULTS

Accuracy of word recognition was significantly higher after the exercise condition compared to the resting condition. Furthermore, this pattern of results was not related to children's existing language skills, as measured by the QUILS.

CONCLUSIONS

This study is one of the first to closely examine the relation between physical activity and word-learning abilities in children as young as 3-6 years of age. Results align with previous findings stating that aerobic exercise can boost vocabulary learning and suggest that this is the case regardless of existing language skills.