Assessment fidelity of a language screening instrument for 4-year-olds

Abstract

Aim

The aim of the study was to explore the assessment fidelity of Språkfyran, a language screening instrument for four-year-old children. Språkfyran is a mandatory part of the healthcare program within the Swedish Child Health Service (CHS) and is offered to all four-year-olds in the region Scania in Sweden.

Methods

The study was based on structured observations of twenty-four specialist CHS nurses’ adherence to the Språkfyran protocol during screening.

Results

All the observed nurses deviated from the test protocol. There was a large variation in the number of deviations from the test protocol per nurse, with the highest number of deviations occurring for three specific testing items. Significantly more deviations were made with four-year-old bilingual children as opposed to four-year-old monolingual children. Half of the nurses did not use the test protocol.

Conclusions

There is a clear need to improve the assessment fidelity of Språkfyran. Both the training that the nurses are offered, and the development of the test, are essential in securing the aim of high-quality work within the CHS. Support from experts in child speech-language development and disorders is suggested to be available at the CHS in Sweden.

Keywords:

• Language screening
• assessment fidelity
• child health services
• nurses
• developmental language disorder
• bilingual

Acknowledgement

We are grateful to the study participants, and the families for their cooperation. Thank you to speech-language pathologist Allyson Plumberg, M.S., CCC-SLP, for her help with language revision of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Johanna Dahlén

Johanna Dahlén, MSc, Public Health Nurse, Samarithemmets Child Health Care Center, Region Uppsala, Sweden.

Eva Drevenhorn

Eva Drevenhorn, PhD, Public Health Nurse, Associate Professor at the Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.

Nelli Kalnak

Nelli Kalnak, PhD, Speech-Language Pathologist, Clinical Specialist in Neurodevelopmental Disorders. Researcher at the Department of Women's and Children's Health, Karolinska Institutet, and Helsingborg Hospital. Research focus on developmental language and reading disorders.