Telehealth Measures Screening for Developmental Language Disorders in Spanish-Speaking Toddlers

Abstract

Background: This is the second of two studies that described the use of telehealth language screening measures for use with young Spanish-speaking children. Introduction: The purpose of this study was to describe the classification accuracy of individual telehealth language screening measures as well as the accuracy of combinations of measures used with Spanishspeaking toddler-age children from rural and underserved areas of the country. Materials and Methods: This study applied an asynchronous hybrid telehealth approach that implemented parent-structured play activities with a standard set of stimuli, and interaction with a My First Words e-book. These interactions were recorded with a mini camcorder. In addition, a traditional pen and paper parent questionnaire measure was collected. Sixty-two mostly Spanish-speaking preschool-age children and their parents participated. Twentytwo children had developmental language disorders (DLDs) and 40 had typical language development. Results: Although several of the individual measures were significantly and strongly associated with standardized language scores, only reported vocabulary had classification accuracy values that were desirable for screening for DLDs. An improvement was observed when reported vocabulary was combined with a number of different words children produced during interactions with parents. Conclusions: This research provides additional evidence showing the effectiveness of a hybrid telehealth model in screening the language development of Spanish-speaking children. More specifically, reported vocabulary combined with number of different words produced by a child can provide informative and accurate diagnostic information when screening Spanish-speaking toddler-age children for DLDs. These findings replicate the first study in showing that hybrid telehealth approaches that combine the use of video technology and traditional pen and paper surveys yield strong results, and may be a viable screening alternative when face-to-face access to a bilingual provider is not possible.

Speech and language screening for children with medical complexity: A comparison of telepractice and in-person methods

“…The most common statistical method used to calculate concordance was percentage agreement, with criteria for acceptable agreement ranging between 70-95% (34,(36)(37)(38) Pearson product-moment correlation coefficients (40,41), partial correlation (39), diagnostic accuracy (sensitivity and specificity, likelihood ratios) (39,40), and Bland-Altman analyses (41).…”

“…Guiberson (39) used logistic regression to calculate the diagnostic accuracy of combined telepractice screening measures.…”

“…Test-retest bias was eliminated by simultaneous scoring by two SLPs (a telepractice and an in-person SLP); or by using two different assessment tools for the telepractice and in-person conditions. Most papers did not randomly allocate participants to assessment conditions, which introduced possible bias (33,(36)(37)(38)(39)(40)(41). Two studies eliminated assessment condition bias by randomly allocating the participants to different conditions, and these studies also reduced clinician bias by randomly allocating SLP roles (34,35).…”

“…All of the formal speech and language screeners and assessments used in the studies are validated tools (185)(186)(187)(188)(189)(190)(191)(192)(193)(194). Four papers examined language screening/assessment (35,(39)(40)(41), three papers examined speech screening/assessment (33,34,36), and two papers considered both speech and language screening/assessment (37, 38).…”

“…There is a growing body of research that supports telepractice for speech pathology service delivery (32), however, only one study to date has investigated the use of telepractice for screening or assessment with CMC (33). There is also limited evidence to support telepractice speech and language screening among the broader paediatric population (34)(35)(36)(37)(38)(39)(40)(41). Thus, the overall aim of my thesis is to investigate the role of telepractice for remote speech and language screening of CMC.…”