Karin Wiefferink’s research while affiliated with Nederlandse Stichting voor het Dove en Slechthorende Kind and other places

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Publications (11)


Number of referrals to the speech and hearing centers across ages.
Speech-language difficulty profiles across age groups. SC = speech comprehension/perception; SP = speech production; LC = language comprehension; LP = language production.
Characteristics of Children and Youth Referred for Language Assessment at Different Ages
  • Article
  • Publisher preview available

July 2024

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17 Reads

Elise de Bree

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Karin Wiefferink

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Purpose Early detection of language delays is essential, as language is key for academic outcomes, well-being, and societal participation. Previous studies have focused on undetected delays in young children. Much less is known about referrals at older ages. In this study, we aimed to (a) establish how many children are referred at toddler age (2–3 years) and how many at lower elementary (4–7 years), upper elementary (8–12 years), and high school (13–16 years) age; (b) evaluate characteristics of the referred children and adolescents across age groups; and (c) assess whether the ensuing classification (no language disorder [LD], developmental LD, LD + additional problems) differed across age groups. Method We used the 2010–2014 database of the Dutch federation of speech and hearing centers, containing 18,894 cases with target ages. We established the number of referrals in each age group (Q1) and assessed the composition of the age groups in terms of speech, language, behavioral, and cognitive outcomes (Q2), as well as in terms of classification (Q3). To answer Q2 and Q3, we conducted chi-squared analyses with the toddler group as reference group. Results Late-identified LDs exist: There were new referrals in all age groups. Compared to older age groups, the toddler group contained fewer girls and multilingual children. The toddler group also contained fewer children without an LD and more children with LD + additional problems. Conclusions Reassuringly, children with multiple language problems are referred earliest. However, late-identified LDs exist, even at high school age. Girls and multilingual children tend to be missed at younger ages. More work on awareness and identification of language delays is needed, requiring awareness, knowledge, and tools for educational professionals.

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Figure 1. Consolidated Standards of Reporting Trials diagram. TG = tablet game condition; RO = real objects condition.
Figure 2. Play kitchen and screenshot of tablet game My PlayHome's kitchen scene.
Means and standard deviations (sd) of correct target words and control words on the receptive vocabulary picture selection task in TG (tablet game) and RO (real objects) conditions at the three time points.
To Game or Not to Game? Efficacy of Using Tablet Games in Vocabulary Intervention for Children with DLD

February 2022

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207 Reads

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3 Citations

Applied Sciences

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Marjan ter Harmsel

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Johanna Schulting

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[...]

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The adoption of tablets by young children has raised enthusiasm and concern among speech and language pathologists. This study investigated whether tablet games can be used as effectively as real play objects in vocabulary intervention for children with developmental language disorder (DLD). A randomized, controlled non-inferiority trial was conducted with 70 3-year-old children with DLD. The novel intervention group (n = 35) received 12 10-min scripted intervention sessions with symbolic play using a tablet game spread out over 8–9 weeks. The standard intervention group (n = 35) received the same amount of intervention with real objects using the same vocabulary scripts. In each session, children were exposed to 22 target words. The primary outcome was the number of new target words learned. This was measured using a picture selection task including 22 target words and 22 control words at 3 time intervals: before the intervention, immediately post-intervention, and 5 weeks later. In both intervention groups, the children learned significantly more target words than control words. No significant differences in gains between the two intervention conditions were found. This study provides evidence that vocabulary intervention for toddlers with DLD using a tablet game is equally as effective as an intervention using real objects.


Figure 1. Number of children with (a suspicion of ) language disorder at age of referral (years).
Figure 6. Behavioural problems in children with language disorder (LD) and additional problems.
Figure 7. Cognitive problems in children with language disorder (LD) and additional problems.
Children with language delay referred to Dutch speech and hearing centres: caseload characteristics

May 2020

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248 Reads

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34 Citations

International Journal of Language & Communication Disorders

Background Early detection and remediation of language disorders are important in helping children to establish appropriate communicative and social behaviour and acquire additional information about the world through the use of language. In the Netherlands, children with (a suspicion of) language disorders are referred to speech and hearing centres for multidisciplinary assessment. Reliable data are needed on the nature of language disorders, as well as the age and source of referral, and the effects of cultural and socioeconomic profiles of the population served in order to plan speech and language therapy service provision. Aims To provide a detailed description of caseload characteristics of children referred with a possible language disorder by generating more understanding of factors that might influence early identification. Methods & Procedures A database of 11,450 children was analysed consisting of data on children, aged 2–7 years (70% boys, 30% girls), visiting Dutch speech and hearing centres. The factors analysed were age of referral, ratio of boys to girls, mono‐ and bilingualism, nature of the language delay, and language profile of the children. Outcomes & Results Results revealed an age bias in the referral of children with language disorders. On average, boys were referred 5 months earlier than girls, and monolingual children were referred 3 months earlier than bilingual children. In addition, bilingual children seemed to have more complex problems at referral than monolingual children. They more often had both a disorder in both receptive and expressive language, and a language disorder with additional (developmental) problems. Conclusions & Implications This study revealed a bias in age of referral of young children with language disorders. The results implicate the need for objective language screening instruments and the need to increase the awareness of staff in primary child healthcare of red flags in language development of girls and multilingual children aiming at earlier identification of language disorders in these children. What this paper adds What is already known on the subject • Identifying language disorders before children enter school can foster the initiation of early interventions before these problems interfere with formal education and behavioural adjustment. Information on caseload characteristics is important to plan speech and language therapy service provision. There are only a few studies on the caseload characteristics of children at first referral for language assessment. What this paper adds to existing knowledge • This study provides a detailed description of the caseload characteristics of children referred to Dutch speech and hearing centres. The results reveal an age bias in referral: boys were referred earlier than girls, and monolingual children were revealed earlier than bilingual children. On top of that, bilingual children seemed to have more complex problems at referral. What are the potential or actual clinical implications of this work? • This study indicates that it is important to be aware of bias in the age of referral of subgroups of children with language disorders. Solutions might be to implement a language screening instrument designed for use by non‐speech–language therapists, and training in early recognition of girls and multilingual children with (less complex) language disorders for health professionals in key positions in child healthcare. In addition, it might be worthwhile to assign speech and language therapists with diverse ethnic and language backgrounds and/or with experience with bilingual/cultural children in a regional mentoring function to support referral agents and parents.


Accuracy of a Screening Tool for Early Identification of Language Impairment

January 2018

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117 Reads

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11 Citations

Purpose A screening tool called the VTO Language Screening Instrument (VTO-LSI) was developed to enable more uniform and earlier detection of language impairment. This report, consisting of 2 retrospective studies, focuses on the effects of using the VTO-LSI compared to regular detection procedures. Method Study 1 retrospectively compared VTO-LSI with regular detection procedures. Outcome measure was the detection rate of language impairment among 24-month-old children. Data were retrieved from medical records of children attending a youth health care center. Study 2 retrospectively compared the effects of VTO-LSI and regular detection procedures on the age at referral for diagnostic investigations and the influence of sex. Data were retrieved from medical records from the speech and hearing center and analyzed with multivariate analysis of variance. Results With the VTO-LSI, significantly more cases with language impairment were identified compared with the regular detection procedure (2.4% vs. 0.4%). In regions where the VTO-LSI was used, girls were almost 2 years younger, and boys were 1 year younger when referred to diagnostic investigations than in regions with regular detection procedures. Conclusion The VTO-LSI was more effective than regular detection procedures.


Effectiviteit van Target Word bij ‘late talkers’: Een onderzoek naar het effect van het Hanen-ouderprogramma Target Word op de taalontwikkeling van ‘late talkers’

November 2016

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64 Reads

JGZ Tijdschrift voor jeugdgezondheidszorg

Het Hanen-ouderprogramma Target Word is gericht op de bevordering van de taalontwikkeling bij kinderen met een achterstand in de taalproductie (‘late talkers’). We onderzochten het effect van dit programma in een gerandomiseerd onderzoek bij 60 peuters tussen de 24 en 30 maanden die op een van de consultatiebureaus van JGZ Kennemerland op het VTO-taalsignaleringsinstrument in het risicogebied scoorden. De ouders van dertig kinderen kregen de Target Word-cursus aangeboden. Dertig andere kinderen deden mee in een controlegroep waarvoor alleen de gebruikelijke zorg beschikbaar was. De uitkomst van het onderzoek is dat kinderen in de Target Word-groep meer vooruitgegaan waren in hun actieve woordenschat dan kinderen in de controlegroep. We concluderen dat Target Word bij late talkers effectief ingezet kan worden bij het helpen voorkomen of verminderen van taalproblemen.







Citations (4)


... Focus groups and questionnaires showed clearly that therapists wish to have access to more and better-designed tools, including TUI and IoT; however, these tools should allow for the personalization, localization, and translation of activities and should not disrupt the social fabric of the home environment. A randomized, controlled non-inferiority trial conducted by Zwitserlood and colleagues [9] among children with developmental language disorders (DLDs) showed that a vocabulary intervention using the "My PlayHome" tablet game had a similar efficacy to that achieved via an intervention using real objects. Cancer et al. [10] investigated the contribution of the visual component (i.e., the presence of a visual cue supporting rhythmic synchronization) to the training transfer effects of Rhythmic Reading Training (RRT), a music-and rhythm-based computerized intervention program for developmental dyslexia. ...

Reference:

New Digital Technologies for Diagnosis and Rehabilitation of Neurodevelopmental Disorders
To Game or Not to Game? Efficacy of Using Tablet Games in Vocabulary Intervention for Children with DLD

Applied Sciences

... Intellectual disability, n(%) 0 (0) group was 2 to 3-year-old in the primary (59.3%) and secondary (37%) groups, similar to previous studies in Jakarta and the Netherlands. 3,18 The largest maternal age group was 19-35 years, with 79.6% in the primary group and 70.4% in the secondary group. Data on maternal and paternal age in previous studies of speech-language disorders are limited. ...

Children with language delay referred to Dutch speech and hearing centres: caseload characteristics

International Journal of Language & Communication Disorders

... Furthermore, the language delays of boys tend to be identified earlier than those of girls (e.g., Bishop & McDonald, 2009;Morgan et al., 2017;Uilenburg et al., 2018;Zhang & Tomblin, 2000). Next to sex, other cognitive or behavioral problems or a minority background influences identification and time of referral. ...

Accuracy of a Screening Tool for Early Identification of Language Impairment

... These latter findings address a relation between age of implantation and communicative mode. However, Giezen (2011) andGiezen et al. (2014)pointed out that most studies on deaf education, aside from case studies (De Raeve et al., 2009), have compared achievements of children exposed to OC with achievements of children exposed to TC or bilingual educational settings. To improve reliability,Giezen et al. (2014)advocated a comparison of these two educational settings by planning a within-subject design that tested whether the same deaf children benefitted more from a TC or OC setting. ...

Invloed van het taalaanbod op de ontwikkeling van jonge dove kinderen met een cochleair implantaat