A System for the Diagnosis of Specific Language Impairment in Kindergarten Children

Abstract

A valid and reliable diagnostic standard for language impairment is required for the conduct of epidemiologic research on specific language disorder. A rationale is provided for such a diagnostic system labeled the EpiSLI system. This system employed five composite scores representing norm-referenced performance in three domains of language (vocabulary, grammar, and narration) and two modalities (comprehension and production). Children who have two or more composite scores below –1.25 standard deviations were considered as children with language disorder. The performance of the EpiSLI diagnostic system was examined on a sample of 1,502 kindergarten children and it was shown that this diagnostic system yielded results that were consistent with clinician rating and previous research results.

Identification of Specific Language Impairment in Bilingual Children: I. Assessment in English

“…Receiver operating curve (ROC) analyses were used to identify the optimal prediction model for SLI. (Tomblin, Records, & Zhang, 1996) yielded a sensitivity of .95 and a specificity of .45 (LR+ = 1.73, LR− = 0.11, and AUC = .79) for our bilinguals. Revised cutoff scores yielded a sensitivity of .86 and a specificity of .68 (LR+ = 2.67, LR− = 0.21, and AUC = .77).…”

“…Perhaps the most influential study of the diagnosis of SLI was a large-scale epidemiological study by Tomblin, Records, and Zhang (1996). Their diagnostic criteria, known as the EpiSLI model, was based on an the analysis of five composite scores (expressive, receptive, vocabulary, grammar, and narration) that were derived from performance on the Test of Language Development-Primary (Newcomer & Hammill, 1997) and a narrative comprehension and production screening task (Culatta, Page, & Ellis, 1983).…”

“…Like Tomblin et al (1996), we created a reference standard by asking examiners to complete a severity rating scale at the time of testing (see also Records & Tomblin, 1994). Three bilingual SLPs, each with more than 10 years of experience diagnosing and treating SLI in bilingual children, reviewed English and Spanish language samples and the raw scores of testing administered in English and Spanish.…”

“…In addition, no single TOLD-P:3 or TNL subtest yielded minimally acceptable sensitivity or specificity values of .80 or above. Changing to the cut scores associated with the EpiSLI model for identifying SLI in monolingual, English-speaking children (Tomblin et al, 1996;Tomblin et al, 1997) did not result in acceptable levels of diagnostic accuracy for identifying SLI in Spanish-English bilingual children. …”

“…Their diagnostic criteria, known as the EpiSLI model, was based on an the analysis of five composite scores (expressive, receptive, vocabulary, grammar, and narration) that were derived from performance on the Test of Language Development-Primary (Newcomer & Hammill, 1997) and a narrative comprehension and production screening task (Culatta, Page, & Ellis, 1983). For a sample of 1,502 children, the criterion of −1.25 standard deviations below the mean on two or more composites resulted in a sensitivity of .77 and a specificity of .91 (Tomblin et al, 1996), demonstrating the validity and reliability of this model for identifying SLI in monolingual children.Much less is known about the identification of SLI in bilingual children. Bilingual children with SLI often present difficulties in their first and second languages (L1 and L2, respectively; Peña, Iglesias, & Lidz, 2001;Restrepo & Kruth, 2000).…”