Can Clinical Judgment Detect Children With Speech-Language Problems?

PEDIATRICS ◽  
1991 ◽  
Vol 87 (3) ◽  
pp. 317-322 ◽  
Author(s):  
Frances P. Glascoe
Keyword(s):  
Language Development ◽  
Clinical Judgment ◽  
Screening Tests ◽  
Pediatric Care ◽  
Parental Concern ◽  
Detection Rates ◽  
Developmental Problems ◽  
Parental Concerns ◽  
Language Screening ◽  
Standardized Screening

Pediatricians often rely on clinical judgment derived from observation or parental concern to identify children with developmental problems. The less popular but recommended alternative is to repeatedly administer standardized screening tests. Such tests are time consuming but, unlike clinical judgment, have known detection rates. Preliminary research concerning clinical judgment showed that clusters of parental concerns related to their childrens' performances on screening tests. In the present study, previous research was refined by assessment of the meaning of parents' concerns about their childrens' speech-language development. In this study of 157 families seeking pediatric care, 72% of children whose speech-language screening yielded positive results had parents who were concerned about their speech-language development. Of children with negative screening results, 83% had parents with no concerns about their speech-language development. Although standardized screening tests should be used occasionally in the developmental surveillance process, the findings show that the problems of most children with developmental problems were detected through clinical judgment based on parental concern.

Do Parental Concerns Predict Developmental and Behavioral Diagnoses in a Developmental Clinic?

2016 ◽  
Vol 56 (3) ◽  
pp. 263-267 ◽  
Author(s):  
Doris P. Yimgang ◽  
Rebecca A. Albury ◽  
Mary L. Leppert
Keyword(s):  
Language Development ◽  
Behavioral Problems ◽  
Autism Spectrum ◽  
Pediatric Care ◽  
Care Providers ◽  
Communication Disorder ◽  
Specific Diagnosis ◽  
Parental Concerns ◽  
Clinical Diagnoses ◽  
And Behavior

Parental concerns are useful tools to help pediatric care providers identify the presence of developmental and behavioral problems. This study sought to learn whether specific parental concerns helped predict diagnoses in a tertiary developmental clinic. Parents of preschoolers who attended a preschool developmental clinic (n = 101) were surveyed about behavioral and developmental concerns and their concerns about possible diagnoses. Clinical diagnoses were subsequently obtained on all children and compared with parents’ primary concerns. In our sample, approximately 50% of concerns were about language development and 21% about behavior. The most common diagnoses were communication disorder (41%) and developmental delay (42%). Only 30% of children whose parents had concerns about an autism spectrum diagnosis had actually received that diagnosis. Neither parental concerns about development and behavior nor their concerns about specific diagnosis predict clinical diagnosis in our tertiary developmental setting.

Sensitivity of the Denver Developmental Screening Test in Speech and Language Screening

PEDIATRICS ◽  
1986 ◽  
Vol 78 (6) ◽  
pp. 1075-1078
Author(s):  
Kathleen C. Borowitz ◽  
Frances P. Glascoe
Keyword(s):  
Language Development ◽  
Screening Test ◽  
Expressive Language ◽  
Receptive Language ◽  
Developmental Screening ◽  
Speech And Language ◽  
Developmental Problems ◽  
Significant Difference ◽  
Language Screening ◽  
Speech And Language Development

A retrospective study was undertaken to determine whether the Denver Developmental Screening Test (DDST) language sector is a sensitive screen of speech and language development. Seventy-one children between 18 and 66 months of age with suspected developmental problems were referred to screening clinics conducted by a child evaluation team. Each child was screened using the DDST (revised) and another screening measure of speech and language development. Statistically significant differences were found between the DDST language sector and the speech-language screening in identification of expressive language and articulation problems. No significant difference was found with receptive language. The DDST failed to identify more than one half of the children with expressive language and/or articulation problems. These results demonstrate that the DDST may fail to identify children with speech and language impairment. Professionals involved in developmental screening need to be advised of alternative speech and language screening measures.

Accuracy of the Denver-II in Developmental Screening

PEDIATRICS ◽  
1992 ◽  
Vol 89 (6) ◽  
pp. 1221-1225
Author(s):  
Frances Page Glascoe ◽  
Karen E. Byrne ◽  
Linda G. Ashford ◽  
Katherine L. Johnson ◽  
Bernard Chang ◽  
...  
Keyword(s):  
Learning Disabilities ◽  
Normal Development ◽  
Language Impairments ◽  
Developmental Screening ◽  
Screening Tests ◽  
Mild Mental Retardation ◽  
Scoring Method ◽  
Day Care Centers ◽  
Developmental Problems ◽  
Further Development

One of the oldest and best known developmental screening tests was recently restandardized and revised as the Denver-II. Because it was published without evidence of its accuracy, the present study was undertaken with 104 children between 3 and 72 months of age attending one of five day-care centers. To determine the presence of developmental problems, children were administered individual measures of intelligence, speech-language, achievement, and adaptive behavior. A second psychological examiner, blind to the outcome of the diagnostic battery, administered the Denver-II. Developmental problems including language impairments, learning disabilities, mild mental retardation, and/or functional developmental delay were found in 17% of the children. The Denver-II identified correctly 83% and thus had high rates of sensitivity. However, more than half the children with normal development also received abnormal, questionable, or untestable Denver-II scores. Thus the test had limited specificity (43%) and a high overreferral rate. The alternative scoring method, categorizing questionable/untestable scores as normal, caused sensitivity to drop to 56% although specificity rose to 80%. Since neither scoring method produced acceptable levels of accuracy, an effort was made to locate the sources of accuracy and inaccuracy within the test. Only items in the language domain were modestly helpful in discriminating children with and without difficulties. The findings suggest that the authors of the Denver-II need to engage in further development of the instrument including revising scoring criteria and item placement in relation to children's ages. In the interim, test users should employ screening tests which are more accurate such as the Minnesota Inventories or the Battelle Developmental Inventory Screening Test.

scholarly journals Risk factors for infant developmental problems

2007 ◽  
Vol 15 (spe) ◽  
pp. 837-842 ◽  
Author(s):  
Margaret Rose Santa Maria-Mengel ◽  
Maria Beatriz Martins Linhares
Keyword(s):  
Family Environment ◽  
Preventive Intervention ◽  
Expressive Language ◽  
Clinical Sample ◽  
Family Health ◽  
Screening Tests ◽  
Developmental Problems ◽  
Family Health Program ◽  
The Family ◽  
Familiar Environment

This descriptive-correlational study aimed to detect risks for child developmental problems in the first four years of age, to identify the protective resources in the familiar environment, and to verify the best predictive variables of the development at risk. The non-clinical sample was composed by 120 children registered in a Family Health Program. The assessment instruments for global development, expressive language and familiar environment were used. The logistic regression analysis indicated that the lower the father's educational level, the higher the risk for developmental problems. Both the history of low nutritional state at six months of age and the psychosocial risk in the family environment increased the chances of having expressive language problems. It is concluded that screening tests of risk for developmental problems and the analysis of the psychosocial factors in the familiar context should be considered as preventive intervention procedure in the Family Health Programs.

scholarly journals Trisomy 21 in both fetuses in a DCDA twin pregnancy

2019 ◽  
Vol 12 (4) ◽  
pp. e227608
Author(s):  
Jiawen Ong ◽  
Arundhati Gosavi ◽  
Arijit Biswas ◽  
Mahesh Choolani
Keyword(s):  
Down Syndrome ◽  
Trisomy 21 ◽  
Twin Pregnancy ◽  
Prenatal Screening ◽  
Chorionic Villus ◽  
Screening Tests ◽  
In Vitro Fertilisation ◽  
Chorionic Villus Sampling ◽  
Detection Rates

A woman’s chances of having a child with Down syndrome increases with age. By age 40, the risk of conceiving a child with Down syndrome is about 1 in 100. We report a rare case of dizygotic dichorionic diamniotic twin pregnancy conceived via in vitro fertilisation, with both twins having trisomy 21. Both fetuses were independently detected to be at high risk of autosomal trisomy, initially via first-trimester screening and subsequently via invasive definitive diagnostic tests (ie, chorionic villus sampling and amniocentesis).Diagnosis of trisomy 21 has to be made via initial non-invasive prenatal screening, followed by further rigorous and accurate invasive pregnancy testing for confirmation. The gravity of the results necessitates high detection rates and high specificity of prenatal screening tests. Management of the patient must be multidisciplinary and supportive in nature, involving extensive and non-directive pregnancy counselling and management, genetic counselling and management of psychological distress.

scholarly journals Developing a preclinical model to evaluate the results of ridge preservation techniques

2015 ◽  
Vol 61 (1) ◽  
pp. 84-90
Author(s):  
C. Cioban ◽  
◽  
R.S. Câmpian ◽  
Ş.A. Petruţiu ◽  
A. Roman ◽  
...  
Keyword(s):  
Healing Process ◽  
Canine Model ◽  
Screening Tests ◽  
Preclinical Model ◽  
Ridge Preservation ◽  
Preclinical Research ◽  
Repeated Use ◽  
Almost All ◽  
Standardized Screening ◽  
Early Healing

Preclinical tests required for the qualification of a biomaterial, designed for tissue-engineering approaches and regenerative medicine, for human trials are generally directed toward the evaluation of the device in animal models that approach the specific clinical application which the device is to be used. Depending on the knowledge in the field and previous data on product one can choose the appropriate model to screen the potential of the biomaterial. The protocols that are now accepted as standardized screening tests are those specific protocols which have been „validated“ through repeated use by different groups and for which consistent results were generated. Our team planned an ample preclinical research to evaluate the post-extraction healing when ridge preservation was performed using different biomaterials. Because these materials have been already tested and used in clinical practice and many data sustain their biocompatibility, we chose to perfect a canine model because: almost all preclinical studies on ridge preservation have been performed on the dog; the alveolar ridge has a similar shape to that of humans; the healing process of the extraction socket is obviously the same as humans and has already been extensively described; the roots of the experimental teeth can be easily removed. Our team studied the early healing qualitative phenomena and the late-healing qualitative and quantitative (dimensional) modifications of the ridges when different ridge preservation approaches were applied. The presented animal model that we perfected was validated by the publication of the results of our research in prestigious journals.

scholarly journals Validity and Reliability of the Persian Version of Language Screening Test (LAST) for Patients in the Acute Phase of Stroke

2020 ◽  
Vol 3 (1) ◽  
pp. 91-100
Author(s):  
Seyyede Zohreh Mousavi ◽  
◽  
Reyhaneh Jafari ◽  
Saman Maroufizadeh3 ◽  
Mohammad Moez Shahramnia ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Acute Phase ◽  
Screening Test ◽  
Intraclass Correlation ◽  
Chronic Phase ◽  
Weighted Kappa ◽  
Screening Tests ◽  
Rater Reliability ◽  
Persian Version ◽  
Language Screening

Background & Objectives: Aphasia is one of the most common consequences of a stroke; thus, screening tests for early diagnosis of the problem are necessary when dealing with aphasia patients. One of these screening tests is the Language Screening Test (LAST). The purpose of this study was to translate, validate, and utilize this test in the Persian language for patients after stroke. Methods: The original version of LAST was translated into Persian, and then administrated on 100 patients in the acute phase by two examiners at the patient’s bedside in order to check the inter-rater reliability. To assess the agreement between the two forms (a and b) of the LAST, Concordance Correlation Coefficient (CCC), weighted Kappa, and Intraclass Correlation Coefficient (ICC) were used. Also, the Persian version of LAST and the Western Aphasia Battery (WAB) were performed at the chronic phase with two independent examiners with blind scoring. Results: Inter-rater reliability between Rater 1 and Rater 2 on LAST-a and LAST-b score were very good for both phases. The CCC for LAST-a and LAST-b, respectively, were 0.874 and 0.865 for the acute phase and 0.923 and 0.927 for the chronic phase. The weighted Kappa for LAST-a and LAST-b, respectively, were 0.750 and 0.740 for the acute phase, and 0.822 and 0.846 for the chronic phase. Conclusion: The obtained results showed that LAST is a very simple, fast, and valid test and can be used as a reliable tool in stroke patients. Lack of cultural and language dependency are the advantages of using this test.

scholarly journals Concerns of Parents Requesting Screening Tests for Their Children: a cross-sectional study

2020 ◽  
Author(s):  
Emrah Ersoy ◽  
Cuneyt Ardic
Keyword(s):  
Family Physician ◽  
Cross Sectional Study ◽  
Screening Tests ◽  
The Black Sea ◽  
Medical Conditions ◽  
Cross Sectional ◽  
Parental Concerns ◽  
Phone Calls ◽  
The Mean ◽  
Parent Concerns

Abstract Background and objectiveWhile previous researchers provide insights into parental concerns about emotional, developmental, or behavioural problems in children, it is not known how children's complaints and possible medical conditions related to these complaints impact parent concerns. The aim of this study is to investigate concerns of parents visiting a family physician to request screening tests for their own child.MethodsOur sample was 407 children aged 2-16 years visiting a family physician for screening in Rize, a city in the Black Sea (Northern part) Region of Turkey, from January 2019 to January 2020. After January 2020, the researchers contacted 407 parents of the children by telephone and they completed the questionnaire via phone calls. The questionnaire includes sociodemographic data, parents’ opinion about screening tests, parent concern scores, children's complaints and probable medical conditions related with those complaints during the visit. The data was analyzed using the SPSS (SPSS v26) statistical analysis program.ResultsThe mean age of the children was 7.9 ± 4.2 years and the mean age of the parents was 31.7 ± 8.3 years. Of the parents, 65.8% (n=268) were female and of the children, 54.1% (n=220) were male. Of the parents, 60.0% (n=244) had concerns when they requested screening tests for their own child. Of the children, 40.0% (n=163) had no complaints. Of the parents, 56.8% (n=231) were not in favor of requesting a screening test for their child if he/she had no complaints. There was a significant relationship between parents’ opinion about screening tests and parent concerns/children’s complaints (p<0.001). Children’s complaints and probable medical conditions related with the complaints had significant impact on the mean score of parent concerns (p<0.001).ConclusionsThis study has shown that most of the children who underwent screening were not asymptomatic and most of the parents who requested screening tests for their own child had concerns related with their child's complaint/s. The concerns of parents were the main motivation for requesting screening.

Developmental Testing

1995 ◽  
Vol 16 (9) ◽  
pp. 338-345
Author(s):  
Kathleen E. Gilbride
Keyword(s):  
At Risk ◽  
Historical Review ◽  
Screening Tools ◽  
Screening Tests ◽  
Children At Risk ◽  
Behavioral Disturbances ◽  
Developmental Surveillance ◽  
Early Intervention Services ◽  
Parental Concerns ◽  
Sensitivity Specificity

Many screening tools are available to the pediatrician; the ones described here are just a sample of some that are used commonly. Understanding the purpose and limitations of each screening measure, in terms of reliability, validity, sensitivity, specificity, and the population for which it was designed, will help the pediatrician use these tools effectively to identify children at risk for developmental delay. Most importantly, the pediatrician should view screening tests as one source of information to be used in an overall strategy of developmental surveillance that includes careful historical review, systematic clinical observations, and solicitation of parental concerns and attitudes. Pediatricians play a central role in monitoring the development of infants and children during the course of providing well child care. Parents turn to pediatricians for help in determining whether their child has a temporary lag in development, a serious delay or disorder, or a significant behavior problem that should be addressed. With the passage of PL 99-457, pediatricians also play a key role in referring children at risk to early intervention services. By employing a strategy of developmental surveillance, with periodic developmental screening, the pediatrician can determine when a child should be referred for more extensive developmental or psychological testing, which will aid in the process of diagnosis and treatment of developmental disabilities and behavioral disturbances. Knowledge of the screening and testing measures used commonly, as well as their limitations, will result in more accurate interpretation of the data derived from such measures. Once delays are diagnosed and treatment is initiated, repeated assessments over time will serve to identify areas in need of continuing intervention while indicating gains made in specific areas of developmental functioning. Throughout this process, the pediatrician's role as advocate for the child and family serves as a bridge to other professionals and services, with the ultimate goal of facilitating the optimal development of the child.

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