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A Brief Measure of Language Skills at 3 Years of Age and Special Education Use in Middle Childhood

Published:November 28, 2016DOI:https://doi.org/10.1016/j.jpeds.2016.10.035

      Objective

      To test whether a language screener administered during early childhood predicts special education referrals and placement in middle childhood.

      Study design

      A series of logistic regressions was conducted in a longitudinal study of 731 children. Predictor variables included scores on the early language screener (Fluharty Preschool Speech and Language Screening Test-Second Edition [Fluharty-2]) at ages 3 and 4 years, a standardized measure of academic achievement at age 5 years, and parent report of special education services at ages 7.5, 8.5, and 9.5 years.

      Results

      Results showed that higher scores on the Fluharty-2 predicted a reduced likelihood of having an individualized education program (OR 0.48), being referred for special education (OR 0.55), and being held back a grade (OR 0.37). These findings did not vary by sex, race, or ethnicity, and remained significant after controlling for male sex, behavior problems, parental education, and family income. The Fluharty-2 remained predictive of special education outcomes even after controlling for children's academic skills at age 5 years.

      Conclusions

      Results suggest that structured, brief assessments of language in early childhood are robust predictors of children's future engagement in special education services and low academic achievement. Primary care physicians may use a multipronged developmental surveillance and monitoring protocol designed to identify children who may need comprehensive evaluation and intervention. Early intervention may reduce the need for costly special education services in the future and reduce comorbid conditions.

      Keywords

      Abbreviations:

      Fluharty-2 (Fluharty Preschool Speech and Language Screening Test-Second Edition), IEP (Individualized education program), Woodcock-Johnson III (Woodcock Johnson III Tests of Achievement)
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