BACKGROUND: Atypical speech and language development is one of the most common developmental difficulties in young children. However, which clinical signs characterize atypical speech-language development at what age is not clear.AIM: To achieve a national and valid consensus on clinical signs and red flags (i.e. most urgent clinical signs) for atypical speech-language development in children from 1 to 6 years of age.METHODS & PROCEDURES: A two-round Delphi study in the Netherlands with a national expert panel (n = 24) of speech and language therapists was conducted. The panel members responded to web-based questionnaires addressing clinical signs. Consensus was defined as ≥ 70% of the experts agreeing on an issue.OUTCOMES & RESULTS: The first round resulted in a list of 161 characteristics of atypical speech and language development. The second round led to agreement on 124 clinical signs and 34 red flags.CONCLUSIONS & IMPLICATIONS: Dutch national consensus concerns 17-23 clinical signs per age year for the description of an atypical speech-language development in young children and three to 10 characteristics per age year being red flags for atypical speech-language development. This consensus contributes to early identification and diagnosis of children with atypical speech-language development, awareness and research.
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Atypical language is one of the most common developmental problems in early childhood. The estimated prevalence of children with atypical language development varies from 2% to 19%. Early identification of children with atypical language development is important in order to prevent the significant impact on social emotional development, aca- demic school success, and quality of life in the preschool years. The article by Guarini et al.(2016) is of great interest as it can contribute to the identification of children born pre- term at risk for language impairments. It also contributes to the discussion about the concept of atypical language and the relation between language development, and cog- nitive and memory skills. This commentary aims to describe three controversial issues concerning the identifi- cation of atypical language development in young children.
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Background Atypical speech and language development is one of the most common developmental difficulties in young children. However, which clinical signs characterize atypical speech–language development at what age is not clear. Aim To achieve a national and valid consensus on clinical signs and red flags (i.e. most urgent clinical signs) for atypical speech–language development in children from 1 to 6 years of age. Methods & Procedures A two‐round Delphi study in the Netherlands with a national expert panel (n = 24) of speech and language therapists was conducted. The panel members responded to web‐based questionnaires addressing clinical signs. Consensus was defined as ≥ 70% of the experts agreeing on an issue. Outcomes & Results The first round resulted in a list of 161 characteristics of atypical speech and language development. The second round led to agreement on 124 clinical signs and 34 red flags. Conclusions & Implications Dutch national consensus concerns 17–23 clinical signs per age year for the description of an atypical speech–language development in young children and three to 10 characteristics per age year being red flags for atypical speech–language development. This consensus contributes to early identification and diagnosis of children with atypical speech–language development, awareness and research.
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Only a small number of children with atypical language development who can benefit from early intervention are actually identified before reaching school age. Our aim was to explore perceptions of caregivers of monolingual and multilingual children with and without atypical language development in order to provide relevant themes for improving language screening and referral in Well Child Care (WCC). We interviewed 38 Dutch caregivers of monolingual and multilingual children with and without atypical language development. They were recruited via kindergarten, nurseries, and speech and language pathologists. First, we analyzed the interviews of caregivers of monolingual children with atypical language development and caregivers of multilingual children. Second, we adopted data source triangulation with the interviews of caregivers of monolingual children without atypical language development for further exploration of the results of the first round. Third, we categorized emerging codes across identified subthemes and themes. We identified six subthemes: (1) Perception WCC; (2) Perception consult at the WCC; (3) Opinion of the consult at the WCC; (4) Desires regarding WCC; (5) Parent factors, and (6) Child factors (first and second round). Target themes, relating to the themes and subthemes, that can be used to enhance structural language screening in WCC are: a more family oriented consult, better interprofessional collaboration, and more specific knowledge about language development and different referral routes for children with atypical language development.
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In a class or group of twenty children, - statistically - one child has a developmental language disorder (DLD). For children with DLD it is very difficult to keep up at school. The problems in the language also easily lead to miscommunication, which can cause behavioral problems. The timely recognition of a DLD is of great importance for early treatment. This way you can prevent or reduce problems at school, at home and in the children's leisure time. At the moment, children with DLD are not always identified early.Problems in language development can be identified early, for example at the age of two by child health workers. Parents, kindergarten teachers and elementary school teachers can also identify problems in children's language development. This requires a language screening instrument that can easily determine whether a child's language is 'at risk' or 'not at risk'. Early identification of language problems is important, but until today children are still missed. In this dissertation I present a new instrument for the identification of problems in the language development of children from one to six years old, the Early Language Scale (ELS). I also describe the development of the milestones in the language development of children, how good the current screening at the age of two at the health care office is and what parents think of this language screening. The ELS appears to detect DLD in young children well and can therefore make an important contribution to the detection of these problems at the primary health care.
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Bespreking proefschrift 'Uniform screening for atypical language development in Dutch child health care'
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The expressive vocabulary of children with Down Syndrome (DS) is generally measured with parental reports, such as the Communicative Development Inventory (CDI), given that standardized tests for assessing vocabulary levels may be too difficult for most young children with DS. The CDI provides important insight into the parents’ perception of their child’s vocabulary development. The CDI has proven to be a valid measurement of expressive vocabulary, spoken and gestural, in typical and atypical populations. The validity in children with DS is not well established and signed vocabulary is often not included. This longitudinal study examined the concurrent and predictive validity of the Dutch version of the CDI (N-CDI) in children with DS between 2;0 and 7;6 years old to assess spoken and signed vocabulary. N-CDI scores were assessed on strength of association with mental age,an expressive vocabulary test and spontaneous language analyses in a play setting with parents at T1 and T2 (1.5 years later), and a therapy setting with speech language pathologists at T1. The results of the present study show that the N-CDI is a valuable and valid measurement of expressive vocabulary in children with DS. Strengths and weaknesses of several assessment methods for expressive vocabulary are discussed.
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Purpose: This case study is presented to inform the reader of potential speech, language, cognitive, and emotional characteristics in preadolescent cluttering. Method: This case study describes a 10-year-old boy who started to clutter during preadolescence. The case illustrates that, in some adolescents, cluttering can co-occur with temporary stuttering-like behavior. In this case, signs of disturbances in speech-language production associated with behavioral impulsiveness as a young child were noted. Speech, language, cognitive, and emotional results of the case are reported in detail. Results: The changes in fluency development are reported and discussed within the context of changes in the adolescent brain as well as adolescent cognitive and emotional development. While being unaware of their speech condition before adolescence, during preadolescence, the changes in brain organization lead to an increase in rate and a decrease in speech control. Given that the client had limited understanding of what was occurring, they were at risk of developing negative communication attitudes. Speech-language therapists are strongly advised to monitor children with cluttering signals in the early years of their adolescence.
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This thesis focuses on topics such as preterm birth, variation in gross motor development, factors that influence (premature) infant gross motor development, and parental beliefs and practices. By gaining insight into these topics, this thesis aims to contribute to clinical decision-making of paediatric physiotherapists together with parents, and with that shape early intervention.
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