Outcomes at school age of preschool children with developmental language impairment

Shevell, Michael I.; Majnemer, Annette; Webster, Richard I.; Platt, Robert W.; Birnbaum, Rena

doi:10.1016/j.pediatrneurol.2004.12.008

« Previous Next »Pediatric Neurology
Volume 32, Issue 4 , Pages 264-269, April 2005

Outcomes at school age of preschool children with developmental language impairment

Michael I. Shevell, MD
- Department of Neurology/Neurosurgery, McGill University, Montreal Children’s Hospital-McGill University Health Centre, Montreal, Quebec, Canada
- Department of Pediatrics, McGill University, Montreal Children’s Hospital-McGill University Health Centre, Montreal, Quebec, Canada
- Communications should be addressed to: Dr. Shevell; Room A-514; Montreal Children’s Hospital; 2300 Tupper Street; Montreal, Quebec H3H 1P3; Canada
Annette Majnemer, PhD
- Department of Neurology/Neurosurgery, McGill University, Montreal Children’s Hospital-McGill University Health Centre, Montreal, Quebec, Canada
- Department of Pediatrics, McGill University, Montreal Children’s Hospital-McGill University Health Centre, Montreal, Quebec, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal Children’s Hospital-McGill University Health Centre, Montreal, Quebec, Canada
Richard I. Webster, MB BS, MSc
- Department of Neurology/Neurosurgery, McGill University, Montreal Children’s Hospital-McGill University Health Centre, Montreal, Quebec, Canada
Robert W. Platt, PhD
- Department of Pediatrics, McGill University, Montreal Children’s Hospital-McGill University Health Centre, Montreal, Quebec, Canada
- Department of Biostatistics/Epidemiology, McGill University, Montreal Children’s Hospital-McGill University Health Centre, Montreal, Quebec, Canada
Rena Birnbaum, MSc
- School of Physical and Occupational Therapy, McGill University, Montreal Children’s Hospital-McGill University Health Centre, Montreal, Quebec, Canada

Received 13 September 2004; accepted 20 December 2004.

In a prospective study, preschool children diagnosed with developmental language impairment were systematically reassessed during the early school years with standardized developmental (Battelle Developmental Inventory) and functional measures (Vineland Adaptive Behavior Scale). Of an original cohort of 70 children assessed and diagnosed at a mean age of 3.6 ± 0.7 years, 43 were reassessed at a mean age of 7.4 ± 0.7 years. Group performance on the Battelle overall was 71.9 ± 8.2 with the lowest sub-domain score in communication at 69.5 ± 8.9. On the Battelle, 67% of children fell below the 1.5 standard deviation (S.D.) cutoff signifying significant developmental concerns. Between 36% (gross motor) and 83% (communication) of the cohort performed at least 1.5 S.D. below the normative mean on the individual domains of the Battelle. Seventy-four percent were impaired in two or more domains of the Battelle. The group mean on the Vineland overall was 81.1 ± 16.9 with between 19% (socialization) to 48% (communication) of the cohort scoring more than 1.5 S.D. below the mean on each of the sub-domains. Almost half of the cohort (20/42, 48%) manifested functional impairment in at least two domains of the Vineland. Univariate and multivariate analysis of potential predictor variables identified only female sex as being predictive of significantly poorer performance on the Vineland communication sub-domain and the Vineland total score.

Children with early developmental language impairment demonstrate persistent impairments in developmental and functional skills at school entry not limited to language. Deficits remain especially evident in the communication sub-domain. These results have implications with respect to later prognostication, family counseling, and devising a programmatic approach to this group of children.