Universal Screening of Young Children for Developmental Disorders: Unpacking the Controversies

Wallace, Ina

doi:10.3768/rtipress.2018.op.0048.1802

Cited by 7 publications

(10 citation statements)

References 29 publications

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“…Universal screening refers to a process using developmental screening tools with all children and families within a setting, regardless of risk status (e.g., a screening tool is used to assess all toddlers in a childcare center at 16 months) (Wallace, 2018). Universal screening identifies children with delayed development as early as possible in a systematic prevention approach to mitigating developmental deficits.…”

Section: Universal Screening For Language and Social-emotional Develo...mentioning

confidence: 99%

A Case for Early Language and Behavior Screening: Implications for Policy and Child Development

Kaiser

Chow

Cunningham

2022

Policy Insights from the Behavioral and Brain Sciences

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Early language skills and prosocial behavior contribute to positive outcomes across the lifespan. Screening has improved the identification and early intervention (EI) for children with hearing loss, autism spectrum disorders, and genetically based disabilities. However, many children with significant functional impairments in language and behavior are not identified before school entry. These children have missed a critical window for EI that might have prevented or mitigated persistent developmental language impairment and challenging behaviors. The critical need for early identification of children with delays in both language and social-emotional development by proposing a preventive, universal screening approach. This approach to early screening aims to reduce the number of children on a trajectory of academic failure and social difficulties as a result of these early developmental delays.

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Section: Universal Screening For Language and Social-emotional Develo...mentioning

confidence: 99%

A Case for Early Language and Behavior Screening: Implications for Policy and Child Development

Kaiser

Chow

Cunningham

2022

Policy Insights from the Behavioral and Brain Sciences

View full text Add to dashboard Cite

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“…Developmental screening involves the use of brief questionnaires and/or standardized tools, used at a designated point in time, to assist in the identification of children who are vulnerable to developmental difficulty. The purpose of developmental screening is to identify children at increased risk of a disorder and who need referral for further in-depth diagnostic assessment (7,8). Universal screening is recommended when there is a tool sufficiently accurate to ensure confidence in identifying children truly at risk from all children in a certain age group of the population regardless of symptomatology (8), for example, with infant hearing screening.…”

Section: Developmental Surveillance and Screeningmentioning

confidence: 99%

“…The purpose of developmental screening is to identify children at increased risk of a disorder and who need referral for further in-depth diagnostic assessment (7,8). Universal screening is recommended when there is a tool sufficiently accurate to ensure confidence in identifying children truly at risk from all children in a certain age group of the population regardless of symptomatology (8), for example, with infant hearing screening. Neither universal nor targeted speech and language screening are currently recommended; two systematic reviews conducted for the US Preventative Services Task Force (4,9), concluded there was inadequate evidence on the accuracy of screening instruments for speech and language delay.…”

Section: Developmental Surveillance and Screeningmentioning

confidence: 99%

“…Developmental surveillance, therefore, provides a continuous, collaborative and cumulative process to document developmental history and identify children who may be at risk for developmental problems due to highly individualized and contextual factors. It is the ongoing monitoring of a child's developmental progress which sets surveillance apart from screening (8). While developmental surveillance holds the best opportunity to identify children with vulnerable language skills, there remain significant challenges in what we know, and gaps in how to translate knowledge to primary health and clinical settings.…”

Section: Developmental Surveillance and Screeningmentioning

confidence: 99%

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Developing Preschool Language Surveillance Models - Cumulative and Clustering Patterns of Early Life Factors in the Early Language in Victoria Study Cohort

et al. 2022

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BackgroundScreening and surveillance of development are integral to ensuring effective early identification and intervention strategies for children with vulnerabilities. However, not all developmental skills have reliable screening processes, such as early language ability.MethodWe describe how a set of early life factors used in a large, prospective community cohort from Australia are associated with language abilities across the preschool years, and determine if either an accumulation of risk factors or a clustering of risk factors provide a feasible approach to surveillance of language development in preschool children.ResultsThere were 1,208 children with a 7-year language outcome. The accumulation of early life factors increased the likelihood of children having low language skills at 7-years. Over a third of children with typical language skills (36.6%) had ≤ two risks and half of the children with low language (50%) had six or more risks. As the number of factors increases the risk of having low language at 7-years increases, for example, children with six or more risks had 17 times greater risk, compared to those with ≤ two risks. Data collected from 1,910 children at 8- to 12-months were used in the latent class modeling. Four profile classes (or groups) were identified. The largest group was developmentally enabled with a supportive home learning environment (56.2%, n = 1,073). The second group was vulnerable, both developmentally and in their home learning environment (31.2%, n = 596); the third group was socially disadvantaged with a vulnerable home learning environment (7.4%, n = 142); the final group featured maternal mental health problems and vulnerable child socio-emotional adjustment (5.2%, n = 99). Compared to developmentally enabled children, the risk of low language at 7-years was greater for children in the three other groups.ConclusionThe cumulative and cluster risk analyses demonstrate the potential to use developmental surveillance to identify children within the first years of life who are at risk of language difficulties. Importantly, parent-child interaction and the home learning environment emerged as a consistent cluster. We recommend they be adopted as the common focus for early intervention and universal language promotion programs.

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“…The Task Force therefore did not support routine screening in asymptomatic children ( 11 ). This has raised concerns in the professional community who believe in the benefits of routine screening ( 12 ). However, it is undeniable that another contributing factor for the recommendation of the Task Force was that screening tools for language disorder vary greatly in design and construct resulting in the variability in identification accuracy.…”

Section: Introductionmentioning

confidence: 99%

Systematic Review and Meta-Analysis of Screening Tools for Language Disorder

2022

Front. Pediatr.

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Language disorder is one of the most prevalent developmental disorders and is associated with long-term sequelae. However, routine screening is still controversial and is not universally part of early childhood health surveillance. Evidence concerning the detection accuracy, benefits, and harms of screening for language disorders remains inadequate, as shown in a previous review. In October 2020, a systematic review was conducted to investigate the accuracy of available screening tools and the potential sources of variability. A literature search was conducted using CINAHL Plus, ComDisCome, PsycInfo, PsycArticles, ERIC, PubMed, Web of Science, and Scopus. Studies describing, developing, or validating screening tools for language disorder under the age of 6 were included. QUADAS-2 was used to evaluate risk of bias in individual studies. Meta-analyses were performed on the reported accuracy of the screening tools examined. The performance of the screening tools was explored by plotting hierarchical summary receiver operating characteristic (HSROC) curves. The effects of the proxy used in defining language disorders, the test administrators, the screening-diagnosis interval and age of screening on screening accuracy were investigated by meta-regression. Of the 2,366 articles located, 47 studies involving 67 screening tools were included. About one-third of the tests (35.4%) achieved at least fair accuracy, while only a small proportion (13.8%) achieved good accuracy. HSROC curves revealed a remarkable variation in sensitivity and specificity for the three major types of screening, which used the child's actual language ability, clinical markers, and both as the proxy, respectively. None of these three types of screening tools achieved good accuracy. Meta-regression showed that tools using the child's actual language as the proxy demonstrated better sensitivity than that of clinical markers. Tools using long screening-diagnosis intervals had a lower sensitivity than those using short screening-diagnosis intervals. Parent report showed a level of accuracy comparable to that of those administered by trained examiners. Screening tools used under and above 4yo appeared to have similar sensitivity and specificity. In conclusion, there are still gaps between the available screening tools for language disorders and the adoption of these tools in population screening. Future tool development can focus on maximizing accuracy and identifying metrics that are sensitive to the dynamic nature of language development.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=210505, PROSPERO: CRD42020210505.

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Universal Screening of Young Children for Developmental Disorders: Unpacking the Controversies

Cited by 7 publications

References 29 publications

A Case for Early Language and Behavior Screening: Implications for Policy and Child Development

A Case for Early Language and Behavior Screening: Implications for Policy and Child Development

Developing Preschool Language Surveillance Models - Cumulative and Clustering Patterns of Early Life Factors in the Early Language in Victoria Study Cohort

Systematic Review and Meta-Analysis of Screening Tools for Language Disorder

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