Screening for language delay after life-saving therapies in term-born infants.
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.
['Clark|Brenda G|BG|', 'Acton|Bryan V|BV|', 'Alton|Gwen Y|GY|', 'Joffe|Ari R|AR|', 'Dinu|Irina A|IA|', 'Robertson|Charlene M T|CM|']
D002170:Canada D002675:Child, Preschool D003071:Cognition D005260:Female D005500:Follow-Up Studies D006801:Humans D007223:Infant D007231:Infant, Newborn D007804:Language Development D007805:Language Development Disorders D008020:Life Support Care D016015:Logistic Models D008297:Male D008403:Mass Screening D015999:Multivariate Analysis D009483:Neuropsychological Tests D010290:Parents D011446:Prospective Studies D011795:Surveys and Questionnaires D047929:Term Birth
screening language delay Life-saving therapies infancy