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Screening for language delay after life-saving therapies in term-born infants

Published online by Cambridge University Press:  28 December 2015

Brenda G. Clark ,
Bryan V. Acton ,
Gwen Y. Alton ,
Ari R. Joffe ,
Irina A. Dinu  and
Charlene M. T. Robertson
Brenda G. Clark
Affiliation:
Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada Pediatric Rehabilitation, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
Bryan V. Acton
Affiliation:
Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
Gwen Y. Alton
Affiliation:
Pediatric Rehabilitation, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
Ari R. Joffe
Affiliation:
Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
Irina A. Dinu
Affiliation:
School of Public Health (Biostatistics), University of Alberta, Edmonton, Alberta, Canada
Charlene M. T. Robertson*
Affiliation:
Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada Pediatric Rehabilitation, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
*
Correspondence to: Dr C. M. T. Robertson, Room 242A, GlenEast, Glenrose Rehabilitation Hospital, 10230 111 Avenue, Edmonton, Alberta, Canada T5G 0B7. Tel: +780 735 6110; Fax: +780 735 7907; E-mail: Charlene.robertson@albertahealthservices.ca
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Abstract

Background

Strong recommendations have been made for the periodic developmental surveillance, screening, and evaluation of children with CHD. This supports similar calls for all at-risk children in order to provide timely, structured early developmental intervention that may improve outcomes. The aim of this study was to determine the accuracy of screening for language delay after life-saving therapies using the parent-completed vocabulary screen of the language Development Survey, by comparing screening with the individually administered language scores of the Bayley Scales of Infant and Toddler Development, Third edition.

Method

In total, 310 (92.5%) of 335 eligible term-born children, born between 2004 and 2011, receiving complex cardiac surgery, heart or liver transplantation, or extracorporeal membrane oxygenation in infancy, were assessed at 21.5 (2.8) months of age (lost, 25 (7.5%)), through developmental/rehabilitation centres at six sites as part of the Western Canadian Complex Pediatric Therapies Follow-up Group.

Results

Vocabulary screening delay was defined as scores ⩽15th percentile. Language delay defined as scores >1 SD below the mean was calculated for language composite score, receptive and expressive communication scores of the Bayley-III. Delayed scores for the 310 children were as follows: vocabulary, 144 (46.5%); language composite, 125 (40.3%); receptive communication, 98 (31.6%); and expressive communication, 124 (40%). Sensitivity, specificity, positive predictive values, and negative predictive values of screened vocabulary delay for tested language composite delay were 79.2, 75.7, 68.8, and 84.3%, respectively.

Conclusion

High rates of language delay after life-saving therapies are concerning. Although the screening test appears to over-identify language delay relative to the tested Bayley-III, it may be a useful screening tool for early language development leading to earlier referral for intervention.

Keywords

Life-saving therapiesinfancyscreeninglanguage delay
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 7 , October 2016 , pp. 1343 - 1351
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Copyright
© Cambridge University Press 2015 

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References

1. US Preventive Services Task Force. Screening for speech and language delay in preschool children: recommendation statement. Pediatrics 2006; 117: 497–501.Google Scholar
2. Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health, World Health Organization, Geneva. 2008. Retrieved September 6, 2013, from www.who.int/social_determinants/thecommission/finalreport/en/ index.html.Google Scholar
3. American Academy of Pediatrics, Council on Children with Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee and Medical Home Initiatives for Children with Special Needs Project Advisory Committee. Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening. Pediatrics 2006; 118: 405–422.Google Scholar
4. The American Academy of Pediatrics. Follow-up care of high-risk infants. Pediatrics 2004; 114: 1377–1397.Google Scholar
5. Barre, N, Morgan, A, Doyle, LW, et al. Language abilities in children who were preterm and/or very low birth weight: a meta-analysis. J Pediatr 2011; 158: 766–774.Google Scholar
6. Mossabeb, R, Wade, KC, Finnegan, K, et al. Language development survey provides a useful screening tool for language delay in preterm infants. Clin Pediatr 2012; 51: 638–644.Google Scholar
7. Marino, BS, Lipkin, PH, Newburger, JW, et al. Neurodevelopmental outcomes in children with congenital heart disease: evaluation and management. A scientific statement from the American Heart Association. Circulation 2012; 126: 1143–1172.Google Scholar
8. Brosig, C, Butcher, J, Ilasdi, DL, et al. Supporting development in children with congenital heart disease. Circulation 2014; 130: e175–e176.Google Scholar
9. Fricke, S, Bowyer-Crane, C, Haley, AJ, et al. Efficacy of language intervention in the early years. J Child Psychol Psychiatry 2013; 54: 280–290.Google Scholar
10. Moharir, M, Barett, N, Taras, J, et al. Speech and language support: how physicians can identify and treat speech and language delays in the office setting. Paediatr Child Health 2014; 19: 13–18.Google Scholar
11. Bellinger, DC, Wypij, D, Rivkin, MJ, et al. Adolescents with d-transposition of the great arteries corrected with the arterial switch procedure. Circulation 2011; 124: 1361–1369.Google Scholar
12. Neufeld, RE, Clark, BG, Robertson, CMT, et al. Five-year neurocognitive and health outcome after the neonatal arterial switch operation. J Thorac Cardiovasc Surg 2008; 136: 1413–1421.Google Scholar
13. Acton, BV, Biggs, WSC, Creighton, DE, et al. Overestimating neurodevelopment using the Bayley-III after early complex cardiac surgery. Pediatrics 2011; 128: e794–e800.Google Scholar
14. Rescorla, L. The Language Development Survey: a screening tool for delayed language in toddlers. J Speech Hear Disord 2001; 54: 587–599.Google Scholar
15. Nelson, HD, Nygren, P, Walker, M, Panoscha, R. Screening for speech and language delay in preschool children: systematic evidence review. Pediatrics 2006; 117: 2336–2347.Google Scholar
16. Feldman, HM, Campbell, TF, Kurs-Lasky, M, et al. Concurrent and predictive validity of parent reports of child language at ages 2 and 3 years. Child Dev 2005; 76: 856–868.Google Scholar
17. Achenbach, TM, Rescorla, LA. Manual for the ASEBA Preschool Forms and Profiles. University of Vermont, Research for Children, Youth and Families, Burlington, VT, 2000.Google Scholar
18. Bayley, N. Bayley Scales of Infant and Toddler Development, 3rd edn, Technical Manual. The Psychological Corporation, Harcourt Assessment, San Antonio, TX, 2006.Google Scholar
19. Aylward, GP. Developmental screening and assessment: what are we thinking? J Dev Behav Pediatr 2009; 30: 169–173.Google Scholar
20. Robertson, CM, Sauve, RS, Joffe, AR, et al. The registry and follow-up of complex pediatric therapies program of western Canada: a mechanism for service, audit, and research after life-saving therapies for young children. Cardiol Res Pract 2011; 1–11.Google Scholar
21. Blishen, BR, Carroll, WK, Moore, C. The 1981 socioeconomic index for occupations in Canada. Can Rev Sociol Anthropol 1987; 24: 465–488.Google Scholar
22. Rescorla, L, Alley, A. Validation of the Language Development Survey (LDS): a parent report tool for identifying language delay in toddlers. J Speech Hear Disord 2001; 44: 434–445.Google Scholar
23. Rescorla, L, Ratner, NB, Jusczyk, P, Jusczyk, AM. Concurrent validity of the language development survey: associations with the MacArthur-Bates communicative development inventories: words and sentences. Am J Speech Lang Pathol 2005; 14: 156–163.Google Scholar
24. Newburger, JW, Wypi, D, Bellinger, DC, et al. Length of stay after infant heart surgery is related to cognitive outcome at age 8 years. J Pediatr 2003; 14: 67–73.Google Scholar