Relationship between a global rating of speech ability at the age of 3 yrs and a phonological screening 1 yr later: a prospective field study.
OBJECTIVE
This study, which was carried out under routine conditions, evaluates the predictability of a global rating of children's speaking manner made by Child Health Centre nurses. The global rating was added to a formalized screening of 3-yr olds, which intended to identify severely language disabled children. This screening procedure is used in several Swedish counties and the participation rate is nearly 100%. The main questions of the study are: (i) can a global rating of speech ability in children, who have passed the 3-yr screening, predict the outcome of a new population screening 1 yr later? and if so (ii) what is the most efficient cut-off point?


METHODS
The global ratings of the 3-yr olds were made using a 100 mm visual analogue scale (VAS). At the age of 4 yrs, 2065 globally rated children with no objections from the 3-yr screening participated in a second, well-established assessment. The purpose of this second screening was to identify not only severe but also moderate disability.


RESULTS
The mean VAS value of the global ratings was 62 mm. One-third of the ratings fell on the lower half of the scale. With a cut-off level set at < or =50 mm on the VAS two newly-identified, severely disabled children and 74% of the moderately disabled 4-yr olds were identified.


CONCLUSIONS
The results suggest that the global rating in connection to the 3-yr screening would serve as a useful tool for selective screening of 4-yr olds, and thus, reduce the work load.
Westerlund
M
M
Central Unit of Child Health Care, Department of Women's and Children's Health, Uppsala University Children's Hospital, Uppsala, Sweden. monica.westerlund@kbh.uu.se
D000367:Age Factors; D016022:Case-Control Studies; D002675:Child, Preschool; D006801:Humans; D007805:Language Development Disorders / Q000517:prevention & control*; D008403:Mass Screening / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013548:Sweden