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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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