Bilingual Language Assessment: A Meta-Analysis of Diagnostic Accuracy

Christine A. Dollaghan · Elizabeth A. Horner

135 citations0/0 files storedJournal of Speech Language and Hearing Research

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Language Development and Disorders Hearing Loss and Rehabilitation Neurobiology of Language and Bilingualism

Abstract

PURPOSE: To describe quality indicators for appraising studies of diagnostic accuracy and to report a meta-analysis of measures for diagnosing language impairment (LI) in bilingual Spanish-English U.S. children. METHOD: The authors searched electronically and by hand to locate peer-reviewed English-language publications meeting inclusion criteria; the authors rated quality features, calculated accuracy metrics and confidence intervals, and generated forest plots. RESULTS: Of 771 citations (86 unique) located initially, accuracy metrics could be calculated for 17 index measures studied in a total of 100 children with LI and 109 with typical language. Most studies lacked clear descriptions of reference standards, procedures, and controls for subjective bias, making it difficult to rate specific quality features with confidence. Positive likelihood ratios (LR+) for most measures were at least diagnostically suggestive (pooled LR+ = 4.12; 95% CI [2.94, 5.78]). Negative likelihood ratios (LR-) were also generally suggestive, but heterogeneity precluded averaging. For every measure, confidence intervals for LR+ and LR- included diagnostically uninformative values. CONCLUSIONS: The available evidence does not support strong claims concerning the diagnostic accuracy of these measures, but a number appear promising. Several steps are suggested for strengthening future investigations of diagnostic accuracy.

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2002Quantifying heterogeneity in a meta‐analysis 2003Towards Complete and Accurate Reporting of Studies of Diagnostic Accuracy: The STARD Initiative 2006Meta-DiSc: a software for meta-analysis of test accuracy data 1998Nonword Repetition and Child Language Impairment 1995Bootstraps taxometrics: Solving the classification problem in psychopathology.2008Diagnostic test accuracy may vary with prevalence: implications for evidence-based diagnosis 2002A Research Agenda for DSM-V 1998Identifiers of Predominantly Spanish-Speaking Children With Language Impairment

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2014Specific Language Impairment and Early Second Language Acquisition: The Risk of Over- and Underdiagnosis 2016Early Language Milestones and Specific Language Impairment 2016Bilingual Language Assessment: Contemporary Versus Recommended Practice in American Schools 2013Identification of Specific Language Impairment in Bilingual Children: I. Assessment in English 2017Psychometric Properties of Language Assessments for Children Aged 4–12 Years: A Systematic Review

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