Validity of the language development survey in infants born preterm

• The Language Development Survey accurately identifies preterm born infants with language delay at 18 months corrected age.
• Accuracy is improved by using a cut-off on the screening tool of 10 words or less in both boys and girls born preterm.
• A cut-off of 10 words has a sensitivity and a specificity of 77% to detect language delay in preterm born infants.

BackgroundPreterm infants are at greater risk of language delay. Early identification of language delay is essential to improve functional outcome in these children.AimTo examine the concurrent validity of Rescorla's Language Development Survey and the Bayley Scales of Infant and Toddler Development (Bayley-III) at 18 months corrected age in preterm infants.Study designTest accuracy study.Participants189 preterm infants born < 29 weeks were assessed at 18 months.Outcome measuresThe Language Development Survey, a parent-reported screening instrument, was administered in French concurrently with the Language Scales of the Bayley-III. Receiver-Operating-Characteristics curves were used to determine optimal cut-off score on the Language Development Survey to identify Bayley-III score < 85. Sensitivity, specificity, positive and negative predictive values, and κ coefficient were calculated.ResultsUsing Rescorla's original cut-off scores of ≤ 10 words for boys and ≤ 24 for girls, sensitivity was 76% and 88% for boys and girls, respectively, and specificity was 73% and 52% for boys and girls, respectively, in identifying language delay as per the Bayley-III. The optimal threshold was ≤ 10 words for both boys and girls. In girls, lowering the cut-off score decreased sensitivity (79%), but improved specificity (82%), thus lowering the number of false-positives.ConclusionOur findings support using the Language Development Survey as an expressive language screener in preterm infants.