No abstract

To identify a simple and effective screening instrument for language delays in 3-year-old children the reliability, validity, and accuracy of five screening instruments were examined. A postal questionnaire sent to parents of 11 423 children included the Dutch version of the General Language Screen (GLS), the Van Wiechen (VW) items, the Language Screening Instrument for 3-to 4-year-olds, consisting of a parent form (LSI-PF) and a child test (LSI-CT), and parents' own judgement of their child's language development on a visual analogue scale (VAS). The response rate was 78% or 8877 children. Reliability (internal consistency) was found to be acceptable (α α=0.67-0.72) for all instruments. Significant correlations between the screening instruments (r=0.29-0.55, p<0.01) indicated good concurrent validity. Accuracy was estimated by the sensitivity, specificity, and receiver operating characteristic (ROC) curves against two reference tests based on parent report and specialists' judgement. If the test would classify approximately 5% of the population as screen-positive, the mean sensitivity was 50%; assigning between 20% and 30% of the population as screen-positive, the mean sensitivity was 77%. The sensitivity was lowest for the LSI-CT (range 43-62%), whereas short instruments like the LSI-PF, VW, and the one-item VAS exhibited high levels of sensitivity (range 50-86%). The area under the ROC curves, ranged from 0.75 to 0.87. Apparently, short and simple parent report instruments like the LSI-PF and the one-item VAS perform remarkably well in detecting language delays in preschool children.

Summary Members of the Late Effects Taskforce of the Dutch Childhood Oncology Group (DCOG) and of the Haematology-Oncology Section of the Dutch Paediatric Association are involved in the development of guidelines for the follow-up of childhood cancer survivors. The recommendations of these guidelines are based on the best available clinical evidence, current guidelines and clinical experience of late effects specialists. The guidelines will lead to a uniform and standardised post-treatment care and long-term follow-up of childhood cancer survivors in the Netherlands. The information in the guidelines will be of importance for care providers in paediatrics, general medicine, internal medicine, gynaecology/obstetrics as well as for other specialists and particularly for childhood cancer survivors themselves. The information will lead to an increased awareness for all Dutch care providers who are responsible for the health problems of childhood cancer survivors. The development of guidelines for childhood cancer survivors is an important part of a new Dutch project: Late Effects Registry (LATER). Within this new national project patient and treatment data as well as follow-up data on childhood cancer survivors in the Netherlands will be registered. The project LATER aims at: to coordinate and to evaluate care of the survivors, and to stimulate new research in the field of late effects of childhood cancer.

False-positive UNHS test results do not cause long-term general parental anxiety. However, 6 months after screening, a considerable proportion of parents continued to experience hearing-specific worries regarding their child.

We investigated health-related quality of life (HRQOL) of children with language problems and controls. Data on language development (Language Screening Instrument 3-years-olds, Van Wiechen items) and HRQOL by means of the TNO-AZL Pre-school children Quality of Life-questionnaire (TAPQOL) were collected at age 3 in a population-based cohort by parental questionnaire (n = 8877, response 78%; mean age 39.1 months (SD 2.0), 4347 were girls). Cronbach's alpha (internal consistency) ranged between 0.63 and 0.85. Dependent on the definition of language problem, 131 to 316 children appeared to be language impaired. Receiver Operating Characteristic analyses (ROC-curves) to assess the discriminative ability of six TAPQOL scales revealed that the Communication scale and Social Functioning scale discriminated best between children with language problems and children without these problems. Language-impaired children had significantly lower scores on the Communication scale and Social Functioning scale as compared to children without language problems (p < 0.01). The findings indicate that language problems at age three can have an impact on children's social life. These results provide additional evidence for the importance of monitoring the language development and its consequences during childhood.