Identification of Communication Impairments in Preschoolers: A Comparison of Parent and Teacher Success

Abstract

The use of a parent questionnaire to identify speech and language impairments in 5-year-old children in Western Australia was measured against a speech and language screening assessment performed by a speech-language pathologist. In addition, an identification and referral package containing information on speech and language behaviour and a Teacher Check-list was devised for preschool teachers and piloted with the same population. The comparative clinical usefulness of the parent and teacher tools in identifying those children who had a moderate-severe impairment rather than a mild problem was examined. The value of using teachers as a second order screen, thereby assisting in prioritising children identified through the parent tool, was also investigated. Results showed that, while the parent tool identified a high percentage of children with moderate-severe impairments, clinical utility was undermined by the high over-referral rate resulting in long waiting lists and non-differentiation between mild and moderate-severe impairments. Despite a lower return rate, the teacher tool, when analysed independently of parent data, identified a similar number of children with moderate-severe impairments and had a lower over-referral rate. When the teacher Check-list was used as a second order screen and teacher data analysed only in the event of positive parent identification, the overall effectiveness of the screening process was reduced. Clinical implications are discussed and recommendations made to maximise early identification of communication impairments in preschoolers.