A System for the Diagnosis of Specific Language Impairment in Kindergarten Children

Abstract

A valid and reliable diagnostic standard for language impairment is required for the conduct of epidemiologic research on specific language disorder. A rationale is provided for such a diagnostic system labeled the EpiSLI system. This system employed five composite scores representing norm-referenced performance in three domains of language (vocabulary, grammar, and narration) and two modalities (comprehension and production). Children who have two or more composite scores below –1.25 standard deviations were considered as children with language disorder. The performance of the EpiSLI diagnostic system was examined on a sample of 1,502 kindergarten children and it was shown that this diagnostic system yielded results that were consistent with clinician rating and previous research results.

Full text

Journal
of
Speech
and Hearing
Research, Volume
39,
1284-1294,
December
1996
A
System
for
the
Diagnosis
of
Specific
Language
Impairment
in
Kindergarten
Children
J.
Bruce Tomblin
Nancy
L.
Records*
Xuyang Zhang
The
University
of
Iowa
Iowa
City
A
valid
and
reliable
diagnostic
standard
for
language
impairment
is
required
for
the
conduct
of
epidemiologic
research
on
specific
language disorder.
A
rationale
is
provided
for
such
a
diagnostic
system
labeled
the
EpiSLI
system.
This
system
employed five
composite
scores
representing norm-referenced performance
in
three
domains
of
language
(vocabulary,
gram-
mar,
and
narration)
and
two
modalities
(comprehension and
production).
Children
who
have
two
or more
composite
scores
below
-1.25
standard
deviations
were
considered
as
children
with
language
disorder.
The
performance
of
the
EpiSLI
diagnostic
system
was
examined
on
a
sample
of
1,502
kindergarten
children
and
it
was shown
that
this
diagnostic
system yielded
results
that
were
consistent with clinician
rating
and
previous
research results.
KEY WORDS:
specific
language
impairment
(SLI),
diagnosis,
epidemiology, children
This
paper
describes the
development
of
a
system
for
the
diagnosis of
specific
language
impairment
(SLI)
that
has
been
developed
for
use
in a
large
scale
epidemiologic study
of
SLI.
This
diagnostic
system,
which
we
will
refer
to
as
the
EpiSLI
system, was
to
(a)
incorporate
current views
regarding language
impairment
and
SLI,
(b)
provide
for
reliable and
replicable
decisions,
and
(c)
be
grounded,
where
possible,
in
external
evidence
of
language
disability.
Background
Diagnosis
of
SLI
In
recent
years
there
has been
an
increased interest
in
issues
having
to
do
with
the
diagnosis
of
SLI.
Recently,
Aram,
Morris, and
Hall
(1992)
summarized
the criteria
often
used
for
SLI.
One
set
of
criteria
were
those concerned with
exclusionary
conditions
such
as hearing
impairment,
mental
retardation,
and
significant
emotional
disturbance.
These
exclusionary
conditions
separate
forms
of
developmental
lan-
guage impairment
associated
with sensory
and
developmental
disorders
from
SLI
that
occurs without
these associated
conditions.
These
exclusionary
conditions
have
their
origin
in
definitions
of
childhood
aphasia
from
which
the
construct
of
SLI
arose
(Benton, 1964;
Eisenson,
1972)
and,
as
noted by
Aram,
Morris, and
Hall
(1992),
these
conditions
have
received
general
acceptance
in
definitions
of
SLI.
The
second
type of diagnostic
criteria
used
for
SLI
diagnosis
is
concerned
with
the
evaluation
of
a
discrepancy
between
the
child's
achieved language
status
and
some
standard of
expectation
for
the
child's
language
status.
Unlike
the
general
agree-
*Currently
affiliated
with
Pennsylvania State
University,
University
Park
©
1996,
American
Speech-Language-Hearing
Association
0022-4685/96/3906-1284
1284