Clinical Screening Tools to Identify Adolescents at Risk for Developmental Language Disorder: A Systematic Review.

Purpose: Adolescents with developmental language disorder (DLD) are an underserved population. Having DLD affects adolescents' academic and eventual economic success, supporting the need for accurate, clinically feasible DLD screening tools for adolescents. The objective of this review is to identify clinically feasible screening tools for adolescents and to appraise the quality of the methods used in studies that report the classification accuracy of the identified screeners.

Method: Records were included that described empirical studies of brief tasks to identify risk for DLD in 12- to 21-year-old participants with DLD or typical language. A systematic search of PubMed, PsycINFO, and Web of Science was conducted together with reviews of language disorder textbooks and four prior systematic reviews. In all, 15 records describing potential DLD screening tasks met the inclusion criteria and were summarized. Included records described studies with participant ages that overlapped the target age range, but none included only participants in the 12-21 year range. The quality of all included studies was appraised using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) protocol.

Results: Six of 15 potential screening tasks reported diagnostic accuracy metrics, three of which demonstrated clinically useful levels of classification accuracy to screen adolescents at risk for DLD. None of the studies that evaluated the included screening tools fully met QUADAS-2 standards for avoiding risks of bias that may have affected diagnostic accuracy findings.

Conclusions: Two commercially available screening tasks are available in English to screen adolescents for DLD. One task evaluated in the research literature is available in Danish. Other potentially useful screening tasks have not been fully evaluated for their diagnostic accuracy. The QUADAS-2 review identified opportunities for screener developers to employ more rigorous methods to determine the classification accuracy of screeners; this will allow clinicians to have more confidence in the reported findings.

Supplemental material: https://doi.org/10.23641/asha.30057850.