JCPSLP - March 2018

Developmental Language Disorder

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Statement 2: The term “language disorder” is proposed for children who are likely to have language problems enduring into middle childhood and beyond, with a significant impact on everyday social interactions or educational progress. The authors note that prognosis is a key factor, in that language disorder involves significant functional impairments which are unlikely to resolve without specialist support. Additionally, the term “disorder” was selected due to its connotations of seriousness and importance, consistency with other neurodevelopmental disorders (e.g., autism spectrum disorder), and compatibility with diagnostic systems (such as the Diagnostic and Statistical Manual of Mental Disorders ). Statement 3: Research evidence indicates that predictors of poor prognosis vary with a child’s age, but in general language problems that affect a range of skills are likely to persist. The indicators of prognosis vary by age, and prediction of outcome for children under 3 years is particularly difficult. Prediction of outcome improves from 4 years of age, with problems still evident at 5 years being more likely to persist over time. Statement 4: Some children may have language needs because their first or home language differs from the local language, and they have had insufficient exposure to the language used by the school or community to be fully fluent in it. This should not be regarded as language disorder, unless there is evidence that the child does not have age appropriate skills in any language. This statement is particularly relevant in Australia, and reminds clinicians to consider culture and language; particularly in the interpretation of assessment results (i.e., a low score does not necessarily indicate that the child has a disorder). Statement 5: Rather than using exclusionary criteria in the definition of language disorder, we draw a threefold distinction between differentiating conditions, risk factors and co-occurring conditions. The use of exclusionary criteria, particularly as criteria for excluding children from services, has previously been a significant issue in relation to terminology for language disorder. Statement 6: Differentiating conditions are biomedical conditions in which language disorder occurs as part of a more complex pattern of impairments. This may indicate a specific intervention pathway. We recommend referring to “Language disorder associated with X”, where X is the differentiating condition, as specified above. Differentiating conditions in which there is common co-morbidity with language disorder include autism spectrum disorder, intellectual disability, genetic conditions

Bishop, D. V. M., Snowling, M. J., Thompson, P. A., Greenhalgh, T., & CATALISE-2 Consortium. (2017). Phase 2 of CATALISE: A multinational and multidisciplinary Delphi consensus study of problems with language development: Terminology. Journal of Child Psychology and Psychiatry , 58 (10), 1068–1080. doi:10.1111/jcpp.12721 Emily Dawes This article reports on the second phase of a consensus study investigating criteria and terminology for language difficulties. This second phase aimed to provide consensus for terminology used refer to unexplained language difficulties. A panel of 57 English-speaking members (the CATALISE Consortium) participated in the study. The majority of the panel were speech pathologists, with the remainder of the panel psychologists, pediatricians, charity representatives, specialist teachers, a psychiatrist, and an audiologist. Nine of the panel members had a close relative with language difficulties. The authors acted as moderators during the process and organised the study methodology. A process called the Delphi method was used, in which sets of statements are rated in an iterative process. The study aimed for the statements to reach at least 75% agreement. First, a set of statements about terminology were rated by the panel using a 5-point scale (1 strongly disagree to 5 strongly agree ). Second, the panel members viewed other panel members’ ratings of the statements anonymously. During this stage, the panel members could modify their initial ratings or provide further rationale for their view/s. A meeting was held with panel members and additional stakeholders (who represented similar backgrounds to the panel) in which the ratings and statements were discussed. The study moderators subsequently revised and reworded some of the statements. Then the statements were again rated and commented on by the panel. At this stage, 19 of the 21 statements had agreement of 78% or more. Two items, which involved terms for subtypes of language disorder, had lower agreement (46% and 68%), which indicated that they needed to be revised or removed. Finally, the statements were revised by the moderators based on the panel comments. These were provided to the panel for final comments and approval, and again revised to provide 12 finalised statements agreed by the panel. The main body of the article presents the final consensus statements with additional comments, discussion, and references. Statement 1: It is important that those working in the field of children’s language problems use consistent terminology. The lack of consistent terminology for children’s language difficulties is the reason for the CATALISE studies, and has been recognised as a major issue in research and clinical practice.

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JCPSLP Volume 20, Number 1 2018

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