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 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.
Klee
T
T
University of Newcastle upon Tyne, England. thomas.klee@newcastle.ac.uk
Pearce
K
K
Carson
D K
DK
D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007805:Language Development Disorders / Q000175:diagnosis* / Q000453:epidemiology; D007807:Language Tests / Q000592:standards*; D008297:Male; D008403:Mass Screening; D010033:Otitis Media / Q000453:epidemiology; D010290:Parents; D011237:Predictive Value of Tests; D015397:Program Evaluation; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires