Aug 2026· Language, Speech & Hearing Services in Schools· pp.
1-18
· 0 citations· 29 references
Medicine
Abstract
Purpose
Developmental language disorder (DLD) is linked to long-term academic and social difficulties. Despite these lasting impacts, state-level prevalence estimates are limited. This study estimated prevalence among early-elementary students in West Virginia who may be at risk for DLD and examined variation by grade, locale, and assessment instrument.
Method
A cross-sectional screening battery was administered to 252 students in Grades 1-2 across six Title I schools. Children with Kaufman Brief Intelligence Test-Second Edition Matrices standard scores ≤ 70 were excluded prior to analysis. A dual-criterion definition of DLD risk was used: ≤ 80 on the Clinical Evaluation of Language Fundamentals-Fifth Edition (CELF-5) core composite and ≤ 92 on the Test of Narrative Language-Second Edition (TNL-2). Descriptive statistics and mixed-effects logistic regression (random intercept for school) tested effects of grade, gender, and locale.
Results
Using the dual-criterion definition, 72 of 252 students (28.6%) met criteria for being at risk for DLD. Adjusted models showed higher odds of DLD risk in town versus urban schools (odds ratio = 3.06, 95% confidence interval [1.31, 7.15], p = .010), whereas grade and gender were not significant predictors after accounting for school-level clustering. Instrument-specific classification rates diverged substantially, with the TNL-2 identifying a higher proportion of students relative to the CELF-5.
Conclusions
Although based on a relatively small yet representative sample of West Virginia students, prevalence estimates substantially exceed commonly cited large-scale population estimates. Results underscore the influence of instrument choice on suspected prevalence and the need for locally calibrated screening protocols and targeted service planning.
ABSTRACT Background Developmental Language Disorder (DLD) is a prevalent neurodevelopmental condition associated with long‐term cognitive, academic, and psychosocial consequences. Early identification is critical for timely intervention, yet predictive frameworks within German‐speaking contexts remain limited. Parent‐report questionnaires such as the FRAKIS‐K and SBE‐2‐KT are widely used in the German paediatric U7 check‐up for two‐year‐olds, but their predictive validity for DLD has not been systematically evaluated. Aims This study assessed the predictive validity of the FRAKIS‐K and SBE‐2‐KT administered at age two for identifying risk for DLD at age four. A secondary objective was to test whether adjusting the screening cut‐off values could enhance predictive accuracy. Methods and Procedures A community sample of 500 families in Hanover, Germany, was contacted through the city register; 186 children (mean age = 2;0) participated at the first assessment. At age four (N = 145), expressive vocabulary and grammar were measured using the Potsdam‐Illinois Test of Psycholinguistic Abilities (P‐ITPA). Children scoring ≤ –1.5 SD on P‐ITPA subtests were classified as having language impairment consistent with risk for DLD. Predictive validity indices—sensitivity, specificity, positive and negative predictive values, relative improvement over chance (RIOC), and area under the curve (AUC)—were calculated for both parent‐report tools. ROC analysis was applied to explore optimal cut‐off adjustments. Outcomes and Results Prevalence of language impairment at age four was 5.5%. The SBE‐2‐KT showed moderate predictive power (AUC = 0.85; RIOC = 0.51), with sensitivity of 57% and specificity of 89%. The FRAKIS‐K vocabulary alone performed similarly (AUC = 0.83; RIOC = 0.58), achieving sensitivity of 63% and specificity of 91%, while including grammar criteria reduced predictive validity. ROC analysis indicated improved sensitivity (up to 71%) with minimal specificity loss when adjusting cut‐offs. Conclusion and Implications Both FRAKIS‐K vocabulary and SBE‐2‐KT demonstrate adequate predictive validity for identifying risk of DLD at age two within the German U7 screening context. They function effectively as first‐tier tools to rule out children not at risk, though positive screens should be followed by comprehensive assessments. The study's longitudinal design and evaluation of clinically relevant screening instruments using multiple predictive validity indices strengthen the findings. While refining vocabulary‐based cut‐offs may improve early detection, the small number of children with language impairment in the sample limits the generalizability of optimization suggestions, highlighting the need for further research in larger clinical populations. WHAT THIS PAPER ADDS What is already known on this subject Parent‐report questionnaires are commonly used for early language screening, but their predictive validity for DLD is often limited. In German‐speaking contexts, evidence on the predictive accuracy of brief tools such as FRAKIS‐K and SBE‐2‐KT is scarce. What this study adds to the existing knowledge This longitudinal study shows that both FRAKIS‐K (vocabulary component) and SBE‐2‐KT at age two moderately predict outcomes of language impairment at age four. Adjusting the screening cut‐offs increased sensitivity while maintaining acceptable specificity, indicating that predictive validity may be improved through threshold refinement. However, as the sample included few children with risk for DLD, recommendations for optimizing these tools should be interpreted with caution. What are the potential or actual clinical implications for this work? FRAKIS‐K vocabulary and SBE‐2‐KT can be used as first‐tier screening instruments during the U7 paediatric check‐up in Germany. Using adjusted cut‐offs may enhance early identification of children at risk for DLD, supporting earlier referral and intervention, though further validation in larger samples is required.
Eveline Pinstock, Satyam Antonio Schramm· International journal of lan...· 0 citations
Background and Aims Although developmental language disorder (DLD) is a lifelong, neurodevelopmental condition, its presentation in adulthood has received scant research and clinical attention. Several longitudinal studies have demonstrated that poor language ability may be negatively associated with wider life factors in adulthood. Moreover, although a growing body of qualitative evidence illustrates the lived experience of adults with DLD, more quantitative research on this subject is needed, which may guide evidence-informed assessment and support practices for adults. In this short report, we aim to explore the presentation of DLD in adulthood. We share the demographic characteristics, language difficulties, and mental health profile of a sample of adults with DLD based on self-report data. Methods We collected data from 92 adult participants recruited via Engage with Developmental Language Disorder (E-DLD), an international database set up to facilitate DLD research. Participants completed a DLD screening questionnaire, a set of demographic questions, and measures of emotional health including anxiety, depression, and self-esteem. We used the resulting data to construct an overview of the characteristics and profiles of two subgroups in the database: (a) adults who self-reported a clinical diagnosis of DLD (n = 30); and (b) adults who scored highly on the screening questionnaire (“possible DLD,” n = 62) but who did not have a formal diagnosis. For some measures, we also include a comparative sample of typical adults with no confirmed or suspected DLD (n = 91). Results More women than men completed the survey, with the average age of the DLD participants being just under 37 years of age, whereas the controls were on average 43 years of age. About 70% of the DLD participants were UK residents, while 30% were from countries across the world. Participants with DLD tended to be lower earners than controls but were represented in all income bands. In total, 43% (39) were parents and 43% (39) were living with a partner. Word finding and expressive language were the most reported areas of language difficulty, and the clinically diagnosed sample reported significantly more pragmatic language challenges than the “possible DLD” group. Respondents across both DLD groups had higher levels of emotional challenges including anxiety, depression, alexithymia, and low self-efficacy compared to the comparison sample. Conclusions Adults with DLD are a diverse group, with potentially more women than men seeking diagnosis or recognition in adulthood. It is possible that the high rates of emotional difficulties may indicate notable levels of need in those with DLD in adulthood. Implications Our findings show that there are many adults with likely DLD without a formal diagnosis. As such, they are unlikely to qualify for support. We recommend that services providing for adults with DLD should make every effort to be accessible to those on lower incomes, given our income findings, and services could usefully collaborate with mental health services to understand the complexities of co-occurring needs. Speech and language services should also consider how to work alongside other advocates to increase recognition of DLD in adulthood, given the lifelong impact of DLD, whether diagnosed or not.
J. Gibson, Nicola Botting, Ellie Barker et al.· Autism & Developmental Langu...· 0 citations
Participation in education refers to children’s attendance and involvement in educational activities and is central to their development. Educational activities are highly language-dependent, making children with developmental language disorder (DLD) potentially vulnerable to participation barriers. However, DLD is heterogeneous, and many children show co-occurring nonlinguistic difficulties. Little is known about how educational participation varies within this population in relation to these difficulties. Parents of 72 children with DLD aged 5–10 years, recruited from a specialized inpatient rehabilitation clinic in Germany between March and September 2023, completed the Participation and Environment Measure for Children and Youth. Children were grouped according to whether they had no, one, or at least two co-occurring nonlinguistic difficulties, as assessed by standardized measures in visual-perceptual, motor, and behavioral domains. Group differences were tested with Kruskal–Wallis tests, and associations with Spearman correlations. Participation frequency and involvement in individual educational activities were largely similar across groups. However, mean participation frequency across activities decreased with increasing numbers of co-occurring difficulties and was significantly lower in children with two or more difficulties than in the other groups. Higher motor coordination was associated with higher mean participation frequency, whereas visual-perceptual and behavioral abilities were not. Involvement was high across groups, with no significant group differences or associations. Within the context of this clinical sample, findings suggest that co-occurring difficulties in DLD, particularly more complex developmental profiles and lower motor coordination, may contribute to reduced participation frequency in educational activities. Supporting educational participation in children with DLD requires a holistic, context-sensitive approach that considers co-occurring difficulties.
Katharina Kuhlmann· Frontiers in Education· 0 citations
Abstract Purpose Although early identification and intervention for children with autism spectrum disorder (ASD) have advanced considerably, their transition to school and subsequent educational success remain uncertain. This exploratory study aimed to identify the challenges faced by parents in the schooling of children with autism spectrum disorder aged 6–10 years for promoting positive educational outcomes. Method The study was conducted in three phases. During Phases 1 and 2, a 13-item questionnaire was developed and content-validated by speech-language pathologists and special educators. In Phase 3, the validated questionnaire was administered through semi-structured interviews to 40 parents of children with ASD aged 6–10 years. Quantitative responses recorded on a 5-point rating scale were analyzed using descriptive statistics, while one open-ended question was included for qualitative analysis. Results Despite high awareness across other parent-centered factors, participants demonstrated limited knowledge regarding the Individualized Education Plan (IEP) and specialized teaching strategies for children with ASD. Conclusion Though having adequate recognition toward key parent-related factors, such as family support, education of the parents, timely intervention, and educational training at home, supports their child’s schooling, their understanding toward critical areas, such as knowledge regarding IEPs and school-based services, was inadequate. Thus, these findings underscore the need for autism rehabilitation to move beyond its traditional emphasis on early identification and intensive intervention toward strengthening supportive school environments, educational practices, and policy frameworks that facilitate inclusive education.
Varsha R, Lakshmi S Mohan· International Journal of Dev...· 0 citations
Background Early childhood neuropsychological development exhibits substantial heterogeneity, yet the identification of distinct developmental profiles and their associated risk factors remains limited. This study aimed to delineate latent profiles of neuropsychological development in children aged 0–6 years and to identify factors influencing membership in these profiles. Methods A total of 2,297 children (1,193 boys and 1,104 girls) were assessed using the Chinese Developmental Scale for Children – Second Edition (CDSC-II). Latent profile analysis (LPA) was conducted based on age-standardized percentile scores across five developmental domains: gross motor, fine motor, language, adaptive behavior, and social behavior. A one-step regression mixture model, adjusting for child age and sex, was employed to examine associations between profile membership and perinatal and demographic factors. Results The LPA identified two distinct profiles: an Ordinary Development Group (28.6%, n = 656) and an Excellent Development Group (71.4%, n = 1,641), with good class separation (entropy = 0.818). In the regression mixture model, low birth weight (OR = 2.09, 95% CI: 1.19–3.67), preterm birth (OR = 5.23, 95% CI: 3.14–8.71), maternal pregnancy complications (OR = 1.43, 95% CI: 1.15–1.78), and older child age (OR = 1.02, 95% CI: 1.007–1.027) were significantly associated with increased odds of belonging to the Ordinary Development Group. Conversely, female sex (vs. male) was associated with lower odds of membership in the Ordinary Development Group (OR = 0.67, 95% CI: 0.54–0.83). Parenting style (parental vs. non-parental care) and the timing of complementary food introduction were not independently associated with profile membership after adjustment (both p > 0.05). Conclusion These findings indicate that specific maternal environmental exposures during pregnancy and the postnatal period, alongside child demographic characteristics, are significantly associated with neurodevelopmental outcomes in early childhood. The results underscore the importance of early developmental screening and targeted intervention for high-risk children to optimize long-term neurodevelopmental trajectories.
Ruili Li, Rui Zhang, Xiaoguo Zheng et al.· Frontiers in Psychology· 0 citations
Background: Attention-deficit/hyperactivity disorder (ADHD) was a common neurodevelopmental disorder among school-going children, with Indian prevalence estimates ranging widely (5–25%) depending on setting and screening tools. Socioeconomic status (SES) had been proposed as a key determinant of ADHD risk, acting through chronic stress, reduced healthcare access and inconsistent parenting. To determine the prevalence of ADHD among school-going children aged 7–12 years and to examine its association with socioeconomic status.
Methods: A cross-sectional study was conducted from April 2024 to October 2025 among 400 children aged 7–12 years, recruited from Government/Government-aided schools around Chidambaram (community-based) and a tertiary hospital paediatric OPD (hospital-based confirmation) using multistage cluster sampling. ADHD was screened using the Vanderbilt Assessment Scale (teacher-completed), with positive screens confirmed via CBCL evaluation and psychiatric assessment. SES was classified using a standard composite scale. Associations were assessed using chi-square testing and multivariate logistic regression (p<0.05 considered significant).
Results: Overall ADHD prevalence was 11.0% (44/400), with a significant association found between ADHD and SES (p=0.041); prevalence rose as SES declined, from 6.3% in the upper class to 12.5% in the lower-middle and upper-lower classes. Adjusted odds remained elevated for lower-middle (AOR 1.72), upper-lower (AOR 1.65) and lower-class (AOR 1.58) children relative to the upper class but did not retain significance after adjustment for gender, family type and parental education.
Conclusions: Approximately one in ten children had ADHD, with a consistent gradient of higher prevalence among lower and lower-middle socioeconomic strata. SES appeared to act alongside other familial and psychosocial factors rather than independently, supporting broader, multi-factorial intervention strategies.
Ummu Gulthoom M., Saravanan S., Ilangumaran L. et al.· International Journal of Con...· 0 citations