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Predicting Meaningful Differences in School-Entry Language Skills from Child and Family Factors Measured at 12 months of Age

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Abstract

Early childhood services which seek to promote early language development are hampered by the absence of reliable methods to identify children who may develop persistent language difficulties. This is because of variability in preschool children’s language development and that existing measures have limited diagnostic accuracy. In this study, we examined two approaches to identifying children at 12 months of age who are at risk of poor language skills at 4 years of age: (1) measurement of socio-cognitive and communicative foundations of language using the “Sure Steps to Talking” (SSTT) Questionnaire; (2) a “combined risk model” utilising child, family, and parenting characteristics. The study had three phases, and they are as follows: (1) evaluation of the predictive validity of SSTT through longitudinal follow-up of children in a matched cohort in the UK; (2) modelling application of SSTT as a population screener and assessing its validity in a longitudinal community cohort in Australia (Early Language in Victoria Study ELVS); and (3) evaluation of a list of risk factors through secondary data analysis of the ELVS cohort. Prediction using the SSTT measure was modest. A “risk model” that included seven factors (child communicative behaviours, family, and parenting characteristics) measured at 12 months reached “fair” levels of predictive validity and approached a similar level of prediction for language difficulties at age 4 years as found by measures of vocabulary at 24 months. This latter assessment approach potentially provides an additional 12-month window within which preventative interventions could be implemented.

Résumé

Les services aux jeunes enfants qui cherchent à promouvoir le développement du langage sont gênés par l’absence de méthodes fiables permettant d’identifier les enfants qui pourraient développer des difficultés persistantes du langage. Ceci est dû à la variabilité du développement du langage chez les enfants d’âge préscolaire et au fait que les mesures existantes ont une précision de diagnostic limitée. Dans cette étude, nous avons examiné deux approches pour identifier les enfants de 12 mois qui risquent d’avoir de faibles habiletés langagières à l’âge de 4 ans: (1) la mesure des fondements sociocognitifs et communicatifs du langage à l’aide du questionnaire «Sure Steps To Talking» (SSTT, Des étapes sûres vers la parole); (2) un «modèle de risques combinés» faisant appel aux caractéristiques de l’enfant, de la famille et du rôle parental. L’étude s’est déroulée en trois phases: (1) évaluation de la validité prédictive du SSTT au moyen du suivi longitudinal des enfants d’une cohorte comparable au Royaume-Uni; (2) modélisation de l’application du SSTT pour trier une population et évaluation de sa validité auprès de la cohorte longitudinale d’une collectivité australienne (Early Language in Victoria Study, ELVS, Étude du langage des jeunes enfants du Victoria); (3) évaluation d’une liste de facteurs de risques par une analyse de données secondaires de la cohorte de l’ELVS. La prédiction par la mesure SSTT s’est avérée modeste. Un «modèle de risque» comprenant sept facteurs (comportements communicatifs de l’enfant, caractéristiques de la famille et du rôle parental) mesurés à 12 mois a permis d’atteindre de «bons» niveaux de validité prédictive et a avoisiné un niveau semblable de prédiction de difficultés de langage à l’âge de 4 ans comme l’ont révélé des mesures de vocabulaire à 24 mois. Cette dernière approche d’évaluation apporte un créneau potentiel de 12 mois supplémentaires au cours desquels des interventions préventives pourraient être mises en œuvre.

Resumen

Los servicios de niñez temprana que buscan promover el desarrollo lingüístico temprano enfrentan obstáculos debido a la ausencia de métodos confiables para identificar a aquellos que puedan desarrollar dificultades persistentes en la adquisición de lenguaje. Esto se debe a la diversidad en el desarrollo lingüístico de niños y niñas en edad pre-escolar y al hecho de que la exactitud diagnóstica de las medidas existentes es limitada. Este estudio examina dos métodos para identificar a niños/as de 12 meses de edad en riesgo de presentar escasas habilidades lingüísticas a los cuatro años de edad: (1) medición de bases lingüísticas socio-cognitivas y comunicativas utilizando el Cuestionario “Pasos Seguros para el Habla” [Sure Steps to Talking (SSTT, por su abreviatura en inglés)]; (2) un ‘modelo de riesgo combinado’ que utiliza las características del niño/a, la familia y el estilo de crianza. El estudio tiene tres fases: (1) evaluación de la validez predictiva del cuestionario SSTT por medio de un seguimiento longitudinal de niños/as en una población base equiparada en el Reino Unido; (2) aplicación modelo de SSTT como un filtro de población y evaluación de su validez en una comunidad longitudinal base en Australia (Estudio de Lenguaje Temprano en Victoria [ELVS, por su abreviatura en inglés]; (3) evaluación de una lista de factores de riesgo mediante el análisis de información secundaria de la población base ELVS. La predicción lograda utilizando la medida SSTT fue modesta. Un “modelo riesgo” que incluyo siete factores (comportamiento comunicativo de los niños, características de las familias y de la crianza) medidos a los 12 meses de edad, alcanzaron niveles “equitativos” de validez predictiva y lograron alcanzar un nivel similar de predicción de dificultades lingüísticas a los 4 años de edad, según lo descubierto con las mediciones del vocabulario a los 24 meses de edad. Este último método de evaluación brinda un período de oportunidad de 12 meses durante el cual se pueden llevar a cabo intervenciones de prevención.

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Acknowledgments

The Early Language Victoria Study was funded by the Australian National Health and Medical Research Council (NHMRC #237106, #9436958 and #1041947). The authors thank the members of the Early Language Victoria Study team and all participating families and acknowledge the support of the NHMRC-funded Centre of Research Excellence in Child Language (#1023493). (C. McKean, Centre of Research Excellence, #1023493, F. Mensah, Early Career Fellowship #1037449, Career Development Fellowship #1111160, S. Reilly, Practitioner Fellowship #1041892, J. Law, Centre of Research Excellence, #1023493). Research at the Murdoch Children’s Research Institute is supported by the Victorian Government’s Operational Infrastructure Support Program. The Northumberland Early Identification of Communication Delay (NEICD) Project was funded from the Flexibility and Sustainability Fund provided by the National Institute for Health Research. The authors thank the parents of the children in the study; Speech and Language Therapists Lynne Ross and Amy Pegram for their contribution to data collection; Neil McCarthy, NHS information analyst; Mark Pearson, Newcastle University; the health visiting and speech and language therapy staff for making this study possible and to Sue Welsh for her continuing support for SLT research.

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Authors and Affiliations

  1. Newcastle University, King George VI Building, Queen Victoria Rd, Newcastle upon Tyne, NE1 7RU, UK

    Cristina McKean & James Law

  2. Murdoch Children’s Research Institute, Royal Children’s Hospital, Flemington Road, Parkville, Melbourne, VIC, 3052, Australia

    Cristina McKean, Fiona Mensah, Eileen Cini & Sheena Reilly

  3. University of Melbourne, Melbourne, VIC, 3010, Australia

    Fiona Mensah, Patricia Eadie & Sheena Reilly

  4. Royal Children’s Hospital, Flemington Road, Parkville, Melbourne, VIC, 3052, Australia

    Fiona Mensah

  5. Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Rake Lane, North Shields, NE29 8NH, UK

    Kath Frazer

  6. Menzies Health Institute Queensland, Griffith University, Parklands Drive, Southport, QLD, 4222, Australia

    Sheena Reilly

Authors
  1. Cristina McKean
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  2. James Law
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  3. Fiona Mensah
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  4. Eileen Cini
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  5. Patricia Eadie
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  6. Kath Frazer
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  7. Sheena Reilly
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Corresponding author

Correspondence to Cristina McKean.

Appendix

Appendix

See Table 3.

Table 3 SSTT and ELVS-SSTT questions
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McKean, C., Law, J., Mensah, F. et al. Predicting Meaningful Differences in School-Entry Language Skills from Child and Family Factors Measured at 12 months of Age. IJEC 48, 329–351 (2016). https://doi.org/10.1007/s13158-016-0174-0

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