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- Nayeb, Laleh
(author)
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Lika men ändå olika : Språkscreening av enspråkiga och flerspråkiga barn vid 2,5-3 år på BVC
- 2022
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Doctoral thesis (other academic/artistic)abstract
- Children who do not develop their language as expected are at risk of difficulties in school and with peer relations. The Swedish Child Health Services (CHS) offer preventive health surveillance, including language screening, at 2.5-3 years. However, the screening has only been validated for monolingual children. The aims of the thesis were to explore CHS nurses’ experiences of language screening of bilingual children, to evaluate the 3-year screening for language disorder for use at 2.5 years, and to assess the stability of the children’s diagnoses and the classification accuracy of the screening after 6 months. In Study I, 863 nurses answered a web-based survey. Half of the nurses simplified the screening processes for bilingual children, and 74% postponed referrals to speech and language services. About 80% believed that language development was slower in bilingual children which was the strongest predictor of simplified screening practices. In Studies II and III, 105 monolingual and 111 bilingual children were screened and clinically assessed at age 2.5. The screening classification accuracy for monolinguals vs bilinguals screened in both their languages was: sensitivity 91% vs 88%, specificity 91% vs 82%, PPV 56% vs 67%, and NPV 99% vs 94%, respectively. Study IV reassessed 141 children (48 mono- and 93 bilinguals) at age 3, i.e. all children with a positive outcome at age 2.5 from studies II and III, and matched children from the same studies with negative outcomes. The number of new cases with language disorder (n=4) was about the same as the number who had recovered (n=5) at age 3. These few changes were statistically significant, but not considered to be of clinical relevance since the classification accuracy of the screening was still within 95 CI after 6 months. The screening classification accuracy for monolinguals vs bilinguals was: sensitivity 71% vs 81%, specificity 93% vs 82%, PPV 39% vs 67%, and NPV 98% vs 90%. In conclusion, the modified language screening can be recommended for use at age 2.5. Bilingual children who don’t pass the screening in Swedish, should be screened in their mother tongue using a standard procedure. The wait-and-see strategy reported by the nurses in Study I was not supported as screening results remained stable between 2.5 and 3 years. There is a need to implement new evidence-based routines in child health services to equitably screen both monolingual and bilingual children for language disorder.
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| 2. |
- Nayeb, Laleh, et al.
(author)
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Answer to the letter concerning our published paper about identifying language disorder in bilingual children
- 2021
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In: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 110:1, s. 362-363
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Journal article (other academic/artistic)abstract
- Reply by the current authors to the comments made by Daisy I. Perry & Gurdas V. Singh (see record 2020-99156-061) on the original article (see record 2020-99156-046). We read the commentary by Perry and Singhs with great interest and would like to take the opportunity to respond to their concerns, namely exclusion criteria; quality of parental information; control for SES; limited languages; varying expertise of professionals; and low sample size. The purpose of the screening was to identify new cases. Premature (<37 weeks) children and those with known disabilities were excluded as they are already in receipt of CHC services. Although we agree with Perry and Singhs that SES is associated with the prevalence of DLD, we cannot see that SES would affect the choice between the four screening models tested, negating the need for a control group. The issue of different professionals, with unclear or inadequate training, being involved is discussed. To this, we want to clarify that the screening method was already established and has been used for around two decades in the CHCs, albeit conducted solely in Swedish with 36-month-old children, rather than in multiple languages with 30-month-olds. Finally, we are in agreement with Perry and Singhs that the sample size was relatively small and the inclusion of more children would strengthen reliability.
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| 3. |
- Nayeb, Laleh, et al.
(author)
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Identifying language disorder in bilingual children aged 2.5 years requires screening in both languages
- 2021
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In: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 110:1, s. 265-272
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Journal article (peer-reviewed)abstract
- AIM: Bilingual children are at risk of being overlooked for early identification of language difficulties. We investigated the accuracy of four screening models for children aged 2.5. The first model screened the child using their mother tongue, the second screened in Swedish, and the third screened in both languages used by the child. The fourth model consisted of direct screening in Swedish and using parental information about the child's language development in their mother tongue.METHODS: Overall, 111 bilingual children (51% girls), 29-33 months, were recruited from three child health centres in Gävle, Sweden, from November 2015 to June 2017. All children were consecutively assessed by a speech and language pathologist, blinded to the screening outcomes.RESULTS: Developmental language disorder was confirmed in 32 children (29%). Only the third model, based on direct assessment using the two languages used by the child, attained adequate accuracy; 88% sensitivity, 82% specificity, 67% positive and 94% negative predictive values.CONCLUSION: Bilingual children should be screened directly in both their languages in order to achieve adequate accuracy. Such screening procedure is particularly important for children from families with low socio-economic status living in complex linguistic environments.
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| 4. |
- Sandgren, Olof, et al.
(author)
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Using a word association task to investigate semantic depth in swedish-speaking children with developmental language disorder
- 2021
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In: Logopedics Phoniatrics Vocology. - : Informa UK Limited. - 1401-5439 .- 1651-2022. ; 46:3, s. 134-140
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Journal article (peer-reviewed)abstract
- We examined word associations in Swedish children with Developmental Language Disorder (DLD) compared to their typically developing (TD) peers. Furthermore, the study aimed to explore the dimensions of vocabulary knowledge (breadth, depth, and fluency) in these children. Fifty children (15 DLD and 35 TD) participated in the study, aged six to nine years. This age span is commonly associated with substantial lexical reorganisation, by some referred to as the syntagmatic-paradigmatic shift. Fifty items from the Kent-Rosanoff list were used to elicit word associations (say the first word that comes to mind). Word associations were coded as paradigmatic (lion-tiger), syntagmatic (chair-sit), phonological (moon-poon), and other/no answer (foot-hello/bed- -). A semantic depth score (paradigmatic and syntagmatic associations) was calculated and analysed. The children with DLD showed significantly lower semantic depth scores than their TD peers, in line with previous research in English-speaking children. However, the vocabulary dimensions were uniformly affected for the DLD group, contradicting previous findings of semantic depth as a particular area of weakness in this group.
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