| Anderson/ 2014/ USA |
Web-Based Telerehabilitation for Assessing Receptive Language in Children |
Methodological validation study |
Assessment |
“Peabody Picture Vocabulary Test, Fourth Edition (PPVT-4) in web format.” |
34 children aged between 4 and 13 years. |
To evaluate the efficacy of a web-based receptive language test compared to the traditional test. |
Remote and in-person administration of PPVT-4. |
“The web test showed results comparable to traditional ones. There was no significant difference between the two administration formats (p > 0.05).” |
Telehealth can be a viable alternative for language assessment in underserved populations. |
| Ciccia et al./ 2011/ USA |
“Improving the access of young urban children to speech, language and hearing screening via telehealth” |
Exploratory feasibility study |
Screening |
“Receptive-Expressive Emergent Language Test – Third Edition (REEL-3): This test was used for children up to three years old or with estimated language skills in that age range and the Screening Kit of Language and Development (SKOLD): for children 2.5 to 4 years old, testing expressive and receptive language. The Preschool Language Scale 4 Articulation Screener (PLS-4) test was applied to children who underwent assessment with the SKOLD, to verify the phonetic inventory.” |
“411 screenings over 24 months of study (263 in language screening). In the first year, 33% of the children were up to three years old (n=60) and in the second year, 40% (n=91).” |
“To analyze the feasibility of using low-cost videoconferencing in urban community health clinics for speech, language, and hearing screening in children up to six years of age, as well as to assess family satisfaction with videoconferencing and the reliability of remote screenings.” |
A comparison was made between the pass and fail rates of screening tests applied in-person and via videoconferencing (Skype). |
“High family satisfaction rate, 72% scheduled complete evaluations after screening failures. 100% reliability for hearing and language screenings.” |
“The use of teleconsultations can improve access to screening services for urban families, overcoming barriers to healthcare access.” |
| Guiberson et al/ 2015/ USA |
Accuracy of Telehealth-Administered Measures to Screen Language in Spanish-Speaking Preschoolers |
Methodological validation study |
Screening |
Questionnaire with parents; and video recording of a story retelling sample for analysis of Nonword Repetition (NWR) and agrammatism index (AI). |
“82 children between 37 and 69 months of age (mean = 53.65 months)” |
To evaluate the accuracy of telehealth-administered language screening measures to Spanish-speaking children. |
“The results of the screening test battery were compared with the SPLS-4 (Spanish Preschool Language Scale, 4th edition)” |
“NWR scores, agrammatism index, and SDLQ measures were significantly correlated with the standard expressive language scores of the SPLS-4 (r = 0.55, p < 0.01; r = −0.38, p < 0.01; vocabulary, r = 0.46, p = 0.01; language questions, r = 0.45, p = 0.01; M3L-W, r = 0.42, p = 0.01). However, only when NWR scores were combined with language sample measures or parent survey, promising classification accuracy values that approached or were greater than 0.8 were obtained.” |
“A hybrid telehealth model may be effective in screening for language development in Spanish-speaking children, especially when processing efficiency measures are combined with parent questionnaires or language samples.” |
| Guiberson/ 2016/ USA |
Telehealth Measures Screening for Developmental Language Disorders in Spanish-Speaking Toddlers |
Methodological validation study |
Screening |
Video-recorded behavior measures and parent reports on vocabulary. |
“62 children between 2 and 2.11 years old and their mothers” |
To evaluate the efficacy of a hybrid model for screening developmental language in Hispanic toddlers. |
“The results of the screening test battery were compared with the SPLS-4 (Spanish Preschool Language Scale, 4th edition).” |
“Gesture and play measures were not significantly correlated with language scores on the Spanish expressive SPLS-4. However, both language sample measures (MLU-W and NDW), as well as parent report measures (reported vocabulary and RM3L) were significantly correlated (p≤0.01) with language scores. The results showed that improved classification precision and accuracy can be achieved when reported vocabulary is combined with NDW.” |
Hybrid screening models for the studied population are promising, offering a viable alternative for language screening. |
| Taylor/ 2017/ Australia |
Speech and Language Screening for Children with Medical Complexity |
“Two studies(1): descriptive-exploratory (Survey), with speech-language pathologists, seeking to understand barriers for children with medical complexity (CMC)* to access speech-language pathology services and the adoption of telehealth in language screening in this population(2); Methodological validation study” |
Screening |
For language screening, the following tests were used: PLS-4 Screening Test (3 to 5 years) or CELF-4 Screener (6 to 12 years). |
(1) Survey applied at two times (n=46) in 2011 and (n=47) in 2015(2), 34 children aged between 3 and 12 years |
To evaluate the efficacy of speech and language screening in children with medical complexity. |
“A comparison was made between screening tests applied in-person and in a remote setting using two methods, the Hardware-based telepractice (HBT) and System Software-based telepractice (SBT) System using consumer-grade equipment.” |
“The correlation was moderate for the PLS-4 screening test with the HBT method (r = 0.39) and for the CELF-4 screener with the SBT method (r = 0.44), while it was high for the PLS-4 screening test with the SBT method (r = 0.65) and for the CELF-4 screener with the HBT method (r = 0.68).” |
Screening is a valuable tool for improving access to speech-language pathology services for children with medical complexity. |
| Campbell et al./ 2024 / USA |
Reliability and Feasibility of Administering a Child Language Assessment via Telehealth |
Methodological validation study |
Assessment |
CELF (Clinical Evaluation of Language Fundamentals). Depending on
the age, the CELF
Preschool–Third
Edition; CELF 5,
5 to 8-year-old
version; CELF-5,
9 to 21-year-old
version |
100 children aged 3 to 12 years |
To evaluate the efficacy of remote administration of child language assessments, CELF (Clinical Evaluation of Language Fundamentals) in in-person and remote format |
CELF (Clinical Evaluation of Language Fundamentals), administered in both in-person and remote formats. |
“Bland-Altman analysis, paired t-tests, there were no significant differences in standard scores between administration conditions.” |
“Remote administration of language assessments is feasible and reliable, with no significant systematic differences.” |
| “Hulme, et al/ 2024/ England” |
“Language Screen: The Development, Validation, and Standardization of an Automated Language Assessment App” |
Methodological validation study |
Screening |
Language Screen |
350,000 children aged 3 years and 6 months up to 8 years and 11 months |
“To develop and standardize the mobile application “Language Screen”, providing teachers and educational professionals with a fast and reliable method to assess children's language ability” |
“A total of 1,156 children, who presented the lowest scores in their classes, were reassessed by speech-language pathologists using standardized measures (such as the Clinical Evaluation of Language Fundamentals (CELF), Expressive Vocabulary and Sentence Recall and the Renfrew Action Picture Test Information and Grammar). Total language assessment scores made by speech-language pathologists correlated strongly with total Language Screen scores (r = 0.74).” For the overall sample, psychometric analysis of the application was performed using the Rasch model and other statistical tools to evaluate its properties and validity. |
“Language Screen presents excellent psychometric properties, including high reliability, good fit to the Rasch model, and minimal difference in item functioning across major student groups.” |
“The Language Screen provides an easy-to-use and reliable method for identifying children with language difficulties. Its use in schools can help increase teacher awareness of variations in language skills and their importance for educational practice.” |
| “Kachergis, et al/ 2022/ USA” |
Online Computerized Adaptive Tests of Children’s Vocabulary Development in English and Mexican Spanish |
Methodological validation study |
Assessment |
CDI-CAT |
251 children aged between 15 and 36 months |
“To create computerized adaptive versions (CAT) of the CDIs, in English and Spanish.” |
“There was a comparison between the results of the traditional versions, the MacArthur–Bates Communicative Development Inventories (CDIs), with the adaptive version (CDI-CAT).” |
“The adaptive test proved effective in retrieving participants' ability with high correlation regarding estimates made with the complete test. The study found a high correlation (r = 0.92) between estimated abilities from the full test and the adaptive test.” |
The adaptive version of the test offers a more efficient yet accurate way to assess the vocabulary of young children. The study provides recommendations for creating adaptive versions in new languages and discusses when this approach is suitable. |
| “Maleka, et al/ 2016/ South Africa” |
Developmental Screening—Evaluation of an m-Health Version of the Parents’ Evaluation Developmental Status Tool |
Methodological validation study |
Screening |
Parents’ Evaluation of Developmental Status (PEDS) and PEDS: Developmental Milestones (PEDS:DM) |
“207 caregivers who were in a child welfare clinic. The caregivers were divided into a stratified sample according to their children's age groups. The age groups were 6 to 18 months (69%, n = 142) and 19 to 36 months (31%, n = 65).” |
To evaluate developmental screening in terms of 1-correspondence between the conventional paper-based test performed by the speech-language pathologist and the test using a smartphone application performed by the community health worker, and 2- the inter-rater reliability between the speech-language pathologist and the community health worker. |
Correspondence between test methods (paper and application) and Inter-rater reliability (speech-language pathologists and CHWs). |
“A high positive (100%) and negative (96%) correspondence was found between the paper PEDS tools and the smartphone application, as well as between the SLP and the CHW. Near-perfect inter-rater agreement (Cohen’s Kappa) was demonstrated between conditions (κ=0.873 to κ=0.961). “ |
“The smartphone application results, operated by a Community Health Worker (CHW), closely matched the standards of the PEDS tools operated by a health professional. Trained CHWs can perform accurate developmental screenings using the smartphone version of the PEDS tools.” |
| “Ruiz, et al/ 2014/ Spain” |
Evaluating a Web-Based Clinical Decision Support System for Language Disorders Screening in a Nursery School |
Methodological validation study |
Screening |
Web-based Clinical Decision Support System (CDSS) - online platform |
“146 children, 94 from 0 to 3 years and 52” in the 4- to 6-year-old phase |
“The study evaluates a system called CDSS, which is a digital tool designed to aid in the screening of language disorders in young children, especially in settings like nursery schools.” |
A comparison of the results provided by the system and the evaluation of a speech-language pathologist was performed, however, there was no detail on this evaluation. |
“The validation process showed an overall success rate of 83.6% (122/146) in language assessment and a rate of 7% (7/94) of unaccepted system decisions within the 0- to 3-year-old age range. The system helped speech-language pathologists identify new children with possible disorders who needed further evaluation.” |
“This research demonstrated the benefit of the web-based CDSS for monitoring child neurodevelopment through the early detection of language delays in a nursery school. The system helped identify children with possible language disorders who needed additional assessment. However, the system needs adjustments, as therapists suggested changes to the knowledge base, including new questions about speech production and pragmatic skills.” |
| “Talbott, et al./ 2020/ USA” |
Brief Report: Preliminary Feasibility of the TEDI: A Novel Parent - Administered Telehealth Assessment for Autism Spectrum Disorder Symptoms in the First Year of Life |
Exploratory feasibility study |
Screening |
“Telehealth Evaluation of Development for Infants (TEDI) - during teleconsultations, parents perform play activities with their babies following the instructions on the interaction cards and the materials provided in the TEDI kit. These sessions are video recorded for later analysis. Tests used: CSBS-DP Infant-Toddler Checklist (ITC); Ages and Stages Questionnaires: 3rd Edition (ASQ-3); Ages and Stages Questionnaire: Social Emotional, Second Edition (ASQ:SE-2); Autism Observation Scale for Infants (AOSI)” |
Children between 6 and 12 months and their parents |
“To investigate the feasibility of a novel Level 2 telehealth assessment of infants' early social communication and ASD symptoms, the Telehealth Evaluation of Development for Infants (TEDI).” |
Comparisons were made between the results of different evaluators and between test and retest. |
“Infants averaged 10.23 months at the time of the TEDI 1a visit (with a range of 6.30 to 14.00 months). TEDI 1a and 1b sessions occurred, on average, 22 days apart (ranging from 7 to 41 days). As expected, there were significant associations between infants’ age (in months) at TEDI 1a and all three behavioral measures (AOSI total score: rs=−0.64,p=0.034; AOSI markers: rs=−0.82,p=0.002; ECI: rs=0.73, p=0.02)” |
“The study highlights the feasibility of the adapted telehealth protocol for behavioral screening of infants with ASD symptoms, being the first to systematically test this approach. The results indicate that the protocol is acceptable to parents and may lead to earlier referrals and better outcomes for infants with persistent symptoms. However, the lack of diagnostic data and the limited sample size are significant limitations, and more research with larger samples is needed to validate the results and evaluate the clinical usefulness of the telehealth screening protocol.” |
| “Varadharajan, et al/ 2024/ India” |
Efficacy of a Mobile Health Screening Tool for Developmental and Speech Language Disorders |
Methodological validation study |
Screening |
“SRESHT screener, a tool developed by the group for developmental and language screening.” |
“9 Community Health Workers (CHWs), 1 speech-language pathologist who validated the screening applied by the CHWs in 109 children aged 0 to 6 years.” |
To evaluate the efficacy of the SRESHT screener in screening children for speech and language disorders. |
No comparison was made with in-person measures. Only inter-rater reliability analysis was performed. |
“Analysis of the RBSK developmental screening results indicated a “"substantial agreement”” (κ=0.62), according to Cohen's kappa coefficient. Furthermore, a “"near-perfect agreement”” (0.81) was observed in the comparison between the screening results performed by the SLP and the GRW.” |
The use of technology can improve the screening of speech and language disorders in rural communities. |
| “Waite, et al./ 2010/ Australia” |
Internet-Based Telehealth Assessment of Language Using the CELF–4 |
Methodological validation study |
Assessment |
CELF–4 (Clinical Evaluation of Language Fundamentals). |
“25 children (4 aged 5 years, 8 aged 6 years, 3 aged 7 years, and 10 aged 8 years) and 3 speech-language pathologists.” |
To examine the validity and reliability of the videoconferencing system for assessing the core components of a standardized assessment tool. |
Comparison of intra- and inter-rater administration of the CELF-4 in-person and remotely. |
“High intra- and inter-rater reliability was observed, with Intraclass Correlation Coefficient ranging from 0.84 to 1.00 for different measures, with 92% total agreement among participating speech-language pathologists.” |
The CELF-4 test is valid and reliable for remote administration by a speech-language pathologist. |
| “Schmitt, et al/ 2022/ USA” |
Feasibility of Assessing Expressive and Receptive Vocabulary via Telepractice for Early Elementary-Age Children With Language Impairment. |
Methodological validation study |
Assessment |
Diagnostic Evaluation of Language Variation–Norm Referenced (DELV-NR); Comprehensive-Receptive and Expressive Vocabulary Test–Third Edition (CREVT-3); Test of Language Development (Primary)–Fifth Edition (TOLDP:5). |
20 children with a mean age of 5 years and 11 months |
To investigate the procedures necessary to perform receptive and expressive vocabulary assessments via telepractice in children with intellectual disability and to evaluate the reliability of scores from these virtually administered assessments. |
No comparison was made with in-person measures. Only inter-rater reliability analysis was performed. |
“All ICCs were strong for each of the three norm-referenced measures across all subtests, ranging from 0.937 to 0.998. The results suggest that these adaptations result in strong inter-rater reliability for scoring participants' responses in an online format.” |
The study results suggest that conducting telepractice assessments can be a useful and reliable tool for school speech-language pathologists. |
| “Fuchs, et al/ 2023/ South Africa” |
“Combined screening of early childhood development, hearing and vision by community health workers using mHealth tools in a low-income-community” |
Descriptive-analytical observational study |
Screening |
“The mHealth developmental screening consisted of the Parents' Evaluation of Developmental Status (PEDS) and PEDS Developmental Milestones (PEDS: DM) tools; hearing screening - hear Screen; vision screening - Vula Vision application” |
“63 children between 4 years and 1 month and 6 years and 11 months, with a mean age of 61.78 months (SD 6.131).” |
To describe a combined screening program (developmental and sensory – hearing and vision) supported by mHealth conducted by community health workers with children aged four to six years (n = 63) in early childhood development centers in a low-income community |
No comparison was made with in-person measures. Only the description of referral rates was performed. |
“The overall referral rate for developmental screening was 30% (n = 19), for hearing screening was 6% (n = 4), and for vision screening was 5% (n = 3). The majority of children (64%; n = 40) passed all three screening tests. No child was referred in both sensory screenings. One child (2%; n = 1) was referred in both the developmental and vision screenings, and two children (3%; n = 2) were referred in both the developmental and hearing screenings. Some children (25%; n = 16) were referred only in the developmental screening, two children (3%; n = 2) were referred only in the vision screening, and two children (3%; n = 2) were referred only in the hearing screening. The referral rate for developmental screening was significantly higher (30%) compared to the referral rate for vision (5%; z=4.183, p<0.001) and hearing (6%; z=3.908,p<0.001), respectively.” |
“The integrated screening program, supported by mHealth and conducted by community health workers along with child development professionals, proved to be feasible, contributing to the early detection of developmental delays and sensory losses in children from low-income communities.” |
| “Makransky, et al/ 2016/ USA” |
“An Item Response Theory–Based, Computerized Adaptive Testing Version of the MacArthur–Bates Communicative Development Inventory: Words & Sentences (CDI:WS)” |
Methodological validation study |
Assessment |
CDI-CAT |
1,461 children aged between 16 and 30 months |
“To investigate the feasibility and potential validity of a computerized adaptive testing (CAT) version, aiming to reduce the length while maintaining measurement precision.” |
A comparison was made between the results of the complete CDI with the adaptive version (CDI-CAT). |
“Simulations of real CDI-CAT data with at least 50 items presented correlations above 0.95 compared to the full CDI results. Furthermore, these CDI-CATs showed similar correlations with age and socioeconomic status compared to the full CDI:WS.” |
The results indicated strong evidence that a CAT version of the CDI:WS has the potential to reduce length without compromising the accuracy and precision of the complete instrument. |
| “deMayo, et al. / 2021/ USA” |
Web-CDI: A system for online administration of the MacArthur Bates Communicative Development Inventories |
Descriptive-analytical observational study |
Assessment |
Web-CDI |
“*CDI Words & Gestures (WG) - 1620 forms, *CDI Words & Sentences (WS) - 1900 forms” |
“To present Web-CDI, a web-based tool that allows researchers to collect CDI data online.” |
No comparison was made with in-person measures. Only a general comparison was made between the demographic characteristics obtained in previous works using the paper-and-pencil CDI form with those obtained by Web-CDI |
“More than 3,500 valid administrations of the WG and WS forms were collected on Web-CDI by more than a dozen researchers in the United States, after applying strict exclusion criteria derived from previous normative studies. The demographic trends observed in previous works using the paper-and-pencil CDI form were replicated in the data obtained by Web-CDI.” |
Web-CDI is a valid alternative to the paper form and captures similar results |
| “du Toit, et al/ 2021/ South Africa” |
mHealth developmental screening for preschool children in low-income communities |
Methodological validation study |
Screening |
mHealth Parents’ Evaluation of Developmental Status (PEDS) and PEDS: Developmental Milestones (PEDS: DM) |
276 participants with children between three years and six years and 11 months |
To validate an mHealth-based developmental screening tool for children aged 36 to 83 months compared to a standardized developmental assessment instrument. It also sought to determine whether a significant association exists between referral criteria. |
“A comparison was made between the screening results with the mHealth PEDS tool and the results obtained with the Vineland Adaptive Behavior Scales, Third Edition (Vineland-3).” |
“The mHealth PEDS tools identified 237 children (85.9%) at risk for developmental delay, while the Vineland-3 identified 221 children (80.1%) with delay. The sensitivity of the PEDS tools was high (92.6%), but the specificity was low (22.5%) when using standardized US criteria. According to the PEDS: DM (89.3%; n = 142) and the Vineland-3 (87.1%; n = 134), literacy skills were the most delayed.” |
“Despite the mHealth PEDS tools presenting high sensitivity and lower specificity, they may be useful for monitoring child development in preschool children in low-income settings.” |
| “Eriks ‐ Brophy, et al. /2008/ Canada” |
Part of the problem or part of the solution? Communication assessments of Aboriginal children residing in remote communities using videoconferencing |
Exploratory and reliability study |
Assessment |
“Peabody Picture Vocabulary Test-3rd edition (PPVT-III); Preschool Language Scale-4th edition (PLS-4); subtests of the Clinical Evaluation of Language Fundamentals-4th edition (CELF-4); Expressive One Word Picture Vocabulary Test (EOWPVT), Goldman Fristoe Test of Articulation-2nd edition (GFTA-2)” |
7 children aged 4;3–12;9. These children were referred for assessment by caregivers or teachers due to concerns regarding their speech and/or language development. |
“To examine how the issue of test bias may affect the use of videoconferencing in speech-language pathology assessment for northern and Aboriginal communities in Ontario, complemented by the collection of community perceptions on the usefulness of these technologies.” |
A percentage agreement analysis was performed between the two speech-language pathologists responsible for filling out the tests, one present on-site and the other working remotely. |
“Percentage agreement ranged from 96% to 100% for language tests and from 66% to 100% for the articulation measure. The children generally adjusted well to the system, responding easily to the remote speech-language pathologist and following test instructions. However, all required an adjustment period to understand the test dynamics and how to interact with the technology.” |
The results suggest that videoconferencing can be an effective complement to service delivery when procedures are organized to minimize bias in test administration and interpretation of test performance. |
| “Haaf, et al/ 1999/ Canada” |
Computer-Based Language Assessment Software: The Effects of Presentation and Response Format |
Experimental study |
Assessment |
“Peabody Picture Vocabulary Test, Revised (PPVT-R)” |
72 children with normal development between the ages of 4:0 (years:months) and 8:11 |
“To investigate the effects of computerized presentation of the PPVT, Form M, using two computer-based response formats.” |
A comparison was made between the results of the three testing conditions (standard, computer with trackball, and with automated scanning). |
“The main effects for testing condition (F = 0.217, p = 0.81) and age (F = 0.46, p > 0.50) were not significant, and there was no significant interaction between these factors (F = 0.491, p > 0.61). These results indicated that there was no significant difference in subject performance across the three testing conditions, and that test performance in each condition did not vary significantly as a function of age.” |
The adapted response formats of the computerized version constitute statistically equivalent forms of the PPVT-R and can be used with the published norms for this test. |
Instruments for screening and assessing oral language in preschool children via digital health: a scoping review
Thumbnail
