Printer Friendly

Usefulness of the Bayley scales of infant and toddler development, third edition, in the early diagnosis of language disorder.

Language disorder (LD) is a neurodevelopmental disorder (Diagnostic and Statistical Manual of Mental Disorders [DSM]-5th edition, American Psychiatric Association [APA], 2013) and the conceptualization, classification and criteria for identifying it have been evolving through clinical practice and scientific literature. The American Speech-Language Hearing Association (ASHA, 1980), defined language disorder as "the abnormal acquisition, comprehension or expression of spoken or written language". The ASHA specified, moreover, that the problem "may involve all, one, or some of the phonological and morphological, semantic, syntactic, or pragmatic components of the linguistic system". Currently there is a consensus in the consideration of LD as a highly heterogeneous diagnostic entity, and there are several classification proposals depending on whether a clinical or empirical approach is used. The most frequently reported clinical approaches are those of Rapin and Allen (1989) and those of the DSM-III (APA, 1980) and its later editions. The DSM-5 (APA, 2013) includes LDs in the diagnostic category of communication disorders, along with speech sound disorder, childhood-onset fluency disorder, social communication disorder, and other specified communication disorders.

Currently the identification of LD is based on the following criteria: (a) inclusion/exclusion, differentiating it from other developmental disorders; (b) specificity: the disorder especially affects linguistic capabilities; (c) discrepancy, demonstrating that linguistic capabilities are significantly worse than other cognitive capabilities; and (d) evolution, assessing durability and resistance to treatment, according to the revision by Fresneda and Mendoza (2005). To this diagnostic complexity must be added, as suggested by Bishop (1992), Hill (2001), Leonard (2002) and the APA (2013) that the majority of individuals with LD also present non-linguistic difficulties.

In the clinical context of early intervention, delayed language acquisition entails the most common reason for consultation related to developmental disorders between 2- and 4-year-olds. The differential diagnosis of LD below 4-years of age is particularly complex because of the close relationship between language development and other cross-sectional skills related to cognition and communication, and also, individual differences, as single indicators, are not highly predictive of later outcomes (DSM-5; APA, 2013). Furthermore, in the neuropsychological development process, other diagnostic entities such as intellectual disability (Puyuelo, Lorente, & Brun, 2001), autism spectrum disorder (Levy et al., 2010; Bishop, 2010; Carlsson, Norrelgen, Kjellmer, Westerlund, & Fernell Gillberg, 2013), attention deficit disorder / hyperactivity disorder (Hagberg, Miniscalco, & Gillberg, 2010), etc., will also share symptoms related to the communication and language functions and, in some cases, can coexist with LD.

The importance of the detection and early diagnosis of LD is justified by the importance of initiating specific therapeutic intervention given the advantage of greater brain plasticity in children at early ages (Van den Bergh, 2011). A diagnosis of LD is made based on the synthesis of the individual's history, direct clinical observation in different contexts, and scores from standardized tests of language ability that can be used to guide estimates of severity (DSM-5; APA, 2013). Clinical practice requires a rigorous diagnostic process at a functional, differential and etiologic level by an interdisciplinary team expert in neurodevelopment, and needs validated assessment instruments that allow the greatest accuracy in the diagnostic criteria.

The Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) were created by Nancy Bayley (2006) and assess the development of infants and toddlers between 1 and 42 months of age. The Bayley-III provides a clear advantage in the differential diagnosis of the initial suspicions of developmental disorders by allowing obtaining independent standard scores in the different scales and subtests (Cognitive, Language, Receptive Communication, Expressive Communication, Fine Motor, Gross Motor, Social-Emotional and Adaptive Behavior). Predecessors Bayley-II (BSID-II; Bayley, 1993) only allowed obtaining a Mental Development Index as a result of the set of scores of the Cognitive and Language scales, which underestimated the cognitive ability of children with different specific developmental disorders, as described in the study by Hack et al. (2005).

The purpose of this study is to assess the validity, reliability, and usefulness of the Cognitive and Language scales of the BayleyIII in the early diagnosis of communication disorders detected before 3.5 years of age, through a longitudinal study using the diagnostic criteria of the DSM-5 (APA, 2013) in the classification of symptoms, as they affect processes of expressive, receptive language or speech sound.

In the context of the above, the following objectives were proposed: 1

1. To confirm whether, in children with a clinical diagnosis of LD at 4.5 years, the Bayley-III had already detected

discrepancies between cognitive and language level before the age of 3.5 years.

2. To determine whether, in children with receptive-expressive language disorder at 4.5 years, the Bayley-III had already detected verbal comprehension deficits before the age of 3.5 years.

3. To study the cognitive profile of children with a suggestive communication disorder (LD and speech sound disorder) at the age of 4.5 years.

4. To assess the possible discrepancies between the sequential processing level (based on the seriation or temporal order of presentation of stimuli in problem solving) and simultaneous processing (which requires a graphic representation, frequently spatial, as well as the effective integration of stimuli in the solution to the problem) in children with a suggestive communication disorder (LD and speech sound disorder) at age 4.5 years.

Method

Participants

The clinical sample consisted of a total of 187 children (126 boys, 61 girls) with communication disorder diagnostic hypothesis as the primary diagnosis at 4.5 years (children diagnosed with intellectual disability, autism spectrum disorder, motor impairment, childhood-onset fluency disorder, social [pragmatic] communication disorder and sensory disorder were excluded). A classification in three subtypes of communication disorder as the diagnostic criteria of DSM-5 (APA, 2013) was established: The subtype 1: speech sound component (n = 35, 54% males), the subtype 2: expressive language component (n = 85, 62% males) and the subtype 3: receptive and expressive language component (n = 67, 80% males). All participants were born between August 2005 and December 2008 and had received attention at the Centre for Child Development and Early Intervention (CDIAP) Parc Tauli Sabadell-Hospital Universitari before 3.5 years for consultation reasons related to their development. Established as inclusion criteria were: a minimum of 12 month of follow-up, and accordance in the clinical LD or speech sound disorder impression between the neurologist and the clinical psychologist.

The control group sample consisted of 66 children (33 boys, 33 girls) between 3 and 3.5 years born between May 2009 and April 2010. The sample was obtained from different public and private schools in the area of Valles Occidental (Barcelona). Parents interested in participating in the study answered a questionnaire about their educational level and their children's personal medical history. The sample was selected so that the level of education of the parents represents the level of the population in the Catalan environment, according to the Institut d'Estadistica de Catalunya (2012). Children diagnosed with a relevant clinical condition and/ or children who are at risk for developmental delay (premature birth, small for gestational age, severe attachment disorders) were excluded from the sample.

The clinical sample and the control group sample for this study are part of a larger study to validate the Spanish adaptation of Bayley-III Scales that "Pearson Education, SA" has leased to the "Fundacio Parc Tauli", and that will be published in 2014.

The study was approved by the Ethics Committee for Scientific Research from the Fundacio Parc Tauli.

Instruments

Bayley Scales of Infant and Toddler Development (Bayley-III; Bayley, 2006) are intended to assess the developmental functioning of infants and children between 1 and 42 months. They consist of five scales: Cognitive, Language (including the Receptive and Expressive communication subtests), Motor (including the Fine and Gross Motor subtests), Socio-Emotional, and Adaptive Behavior.

McCarthy Scales of Children's Abilities (MSCA; McCarthy, 2006) are a battery of tasks organized into 6 scales: Verbal (VS), Perceptual-Performance (P-PS), Quantitative (QS), General Cognitive (GCS), Memory (MS), and Motor (MS). They evaluate the skills profile of children between 2.5 and 8.5 years of age.

Kaufman Assessment Battery for Children (K-ABC; Kaufman, 2005) provides a measurement of intelligence and knowledge. It considers the degree of skill of each style of information processing (sequential-simultaneous) Sequential Processing Scale and a Simultaneous Processing Scale. Both comprise the Mental Processing Scale Composite (MPC). It also has an Achievement Scale (ACH) and Nonverbal Scale (NV). Application ages: from 2.5 to 12.5-year-olds.

Illinois Test of Psycholinguistic Abilities (ITPA; Kirk, 2004) evaluates the psycholinguistic functions involved in the communication process. It distinguishes between psycholinguistic skills when the information flows through the auditory-vocal channel or through the visual-motor channel. It also distinguishes between the representational level and the automatic level of the psycholinguistic functions. Ages of application: from 3 to 10-year-olds.

Procedure

All children evaluated had received LD or speech sound disorder diagnostic hypothesis, based on the diagnostic criteria of DSM-5 (APA, 2013). The process of diagnosis and therapeutic monitoring in our service for children with communication disorder diagnostic hypothesis consisted of a periodic evaluation (every six months) by a paediatric neurologist and a clinical psychologist specialized in neurodevelopment, and weekly speech therapy sessions. The psychological evaluation procedure included a psychometric assessment consisting of the application Cognitive and Language Scales of Bayley-III before the age 3.5 years and a subsequent measurement with other scales of different psychological functions (MSCA and /or K-ABC) from 4--4.5 years, and of psycholinguistic functions (ITPA) after 4.5 years. All tests were administered by a team of 6 psychologists specialized in psychodiagnosis in early childhood who share clinical and technical criteria. Each test was administered in two sessions and the choice of MSCA or K-ABC in the follow-up obeys the clinical judgment and the overall interest of the research team to check whether the MSCA underestimate children with LD in relation to the K-ABC.

The control group sample was evaluated with Bayley-III from 3-3.5 years.

Data analysis

SPSS.20 was used to: (a) obtain general descriptive statistics; (b) compare means between different groups of communication disorder and the control group by mean of the analysis of variance (ANOVA) with post hoc Bonferroni; and (c) obtain Pearson's correlations and simple linear regressions between the results obtained through Bayley-III with those obtained through MSCA, K-ABC and ITPA.

Results

In relation to the first objective, in the data analysis of the comparison of means between the different communication disorder subgroups and the control group, significant differences were found between the means of the scores obtained for all subtests and all studied compounds of Bayley-III. It also shows that the discrepancy between the means of the Cognitive Scale and Language Composite is higher the more severe the communication disorder is: (a) speech sound disorder = 2.86-point scale ([t.sub.(31)] = 2.41; r = .022, 95% CI [0.45, 5.42]); (b) expressive language disorder = 5.81-point scale ([t.sub.(76)] = 7.74; r = <.001, 95% CI [4.08, 6.90]); and (c) receptive-expressive language disorder = 8.46-point scale ([t.sub.(58)] = 11.14; r = <.001, 95% CI [6.98, 10.04]) while, at the same time, the cognitive level is lower the more severe the communication disorder is, but remains within the normal range in all groups. This data suggests that Bayley-III is capable of detecting discrepancies between cognitive and linguistic level.

The analysis of Language Composite subtests of Bayley-III (see Table 1) indicates that the receptive-expressive language disorder group obtained the lowest scores on the Receptive Communication subtest (m = 7.60, s = 1.43), almost a standard deviation below the average. A positive correlation was found between the Receptive Communication subtest of the BayleyIII and the Auditory Reception subtest of ITPA ([R.sup.2.sub.a] = .354). This data supports the validity of Bayley-III for detecting verbal comprehension deficits. Tables 2 and 5 show the correlations and regressions between the scores of the subtests and the compound scores of Bayley-III obtained before 3.5 years and the scores of the auditory-vocal channel tests from ITPA obtained from 4.5 years onwards. The comparative analysis between these two evolutionary stages indicates that the receptive-expressive language disorder group obtained the lower yields in all tests of auditory-vocal channel ITPA (representational level and automatic level) and shows that from 4.5 years difficulties with verbal comprehension scores persist with scores significantly below the average in the Auditory Reception subtest of ITPA (m = 28.22, s = 3.82) and in the Grammatical Closure (m = 28.17, s = 3.07). Speech sound disorder and expressive language disorder groups evolve maintaining verbal comprehension levels within normal and difficulties persist in Grammatical Closure and Auditory Sequential Memory, suggesting that their difficulties are found more often in the automatic level of the psycholinguistic functions and not so much in the representational level (ITPA).

The analysis of the development of cognitive and linguistic profiles of communication disorders, between two evolutionary stages, assessed with Bayley-III and MSCA supports our third objective. A cognitive and linguistic suggestive profile of communication disorder at 4.5 years will tend to keep within normal range the perceptual-performance organizational capabilities (P-PS = 50.24, s = 6.38), while difficulties will persist in verbal areas (VS = 42.97, s = 7.47), quantitative areas (QS = 44.84, s = 7.29), and of memory (MS = 43.28, s = 6.92) more related to language, except from the speech sound disorder group, which evolves with good yields in all areas, as detailed in Table 3. The data shows a significant correlation between Bayley-III Cognitive Scale and MSCA's General Cognitive Scale (R2a = .344) and between the Bayley-III Language Scale and MSCA's Verbal Scale (r = .536) for the total of subjects with communication disorder.

Regarding our fourth objective, we see in Table 4 that the analysis of the two evolutionary stages assessed with Bayley-III and K-ABC, suggests that a cognitive and linguistic suggestive profile of communication disorder at 4.5 years to evolve towards disharmonious cognitive profiles with higher sequential processing difficulties than of simultaneous processing of information processing. The differences in scores between the two types of processing are of 10.43-point scale ([t.sub.(19)] = -4.15; r = .001, 95% CI [-19.48, -6.42]), 16.85-point scale ([t.sub.(41)] = -9.06; r = <.001, 95% CI [-22.95, -14.58]), 17.82-point scale ([t.sub.(33)] = -6.79; r = <.001, 95% CI [-19.34, -10.43]) for the speech sound disorder, the expressive language disorder and the receptive-expressive language disorder (a = 15). The results show a significant correlation between the Bayley-III Cognitive Scale and the K-ABC's MPC Scale ([R.sup.2.sub.a] = .529) for all subjects with communication disorder.

Discussion and conclusions

The neuropsychological diagnosis in toddlerhood is often a process over time in which the initial diagnostic hypotheses are modulating and completing as neuropsychological functions are maturing and symptomatology becomes more specific. There is evidence suggesting that early language delays indicate later difficulties, however, this finding does not easily translate to identification at an individual level (Law, Rush, Anandan, Cox, & Wood, 2012).

The results obtained from this longitudinal study show the Bayley-III is a useful instrument in the early detection and early diagnosis of children with known or suspected LD providing quantitative and qualitative information in relation to the criteria of exclusion, specificity, evolution and discrepancy. We believe that, despite the difficulties in establishing criteria which preclude different types of likely communication disorder at an early age, Bayley-III allows a functional assessment of communication skills and difficulties presented by children before 3.5 years in a continuum level of proficiency that facilitates evolutionary studies beyond the diagnostic boundaries and enables the establishment of therapeutic programs tailored to the real needs, while changing, for each of the children with communication disorder diagnostic hypothesis.

The evolutionary analysis of the various cognitive and linguistic profiles of this study supports the hypothesis that Cognitive and Language scales of the Bayley-III are able to discriminate the most serious forms of communication disorder. The psycholinguistic profiles obtained with ITPA from 4.5 years onwards indicate that the greatest difficulties in verbal comprehension and mastery of the grammar presented by the group with clinical and psychometric receptive-expressive language disorder could already be detected and treated before

3.5 years. In this sense, results suggest that deficits in receptive language components before 3.5 years are a clear indicator of more severe language disorders.

The correlation between the scores of the Bayley-III Cognitive Scale and the K-ABC Mental Processing Composite Scale ([R.sup.2.sub.a] = .529) is higher than the relationship between the Bayley-III Cognitive Scale and the MSCA General Cognitive Scale ([R.sup.2.sub.a] = .344). This data suggests that K-ABC is a more appropriate instrument in the cognitive assessment of children with communication disorder as they were designed in order to use oral language as little as possible.

Despite the discrepancies between the scores of the Cognitive and Language scales in all the studied communication disorder groups suggesting specific language problems, we must also assess the role of the cognitive component of language when verbal comprehension is affected because the receptive-expressive language disorder group obtains the lowest cognitive performance in all tests (Bayley-III, MSCA and K-ABC) (see Tables 1, 3 and 4). Still, one must be cautious in the differential diagnosis because their cognitive profile differs from a lower normal cognitive capacity profile in which some areas remain more independent from language within the normal, such as: the Bayley-III Cognitive Scale, the MSCA Perceptual-performance Scale, the Simultaneous Processing Scale, and the Non-Verbal K-ABC Scale. The cognitive profile obtained from K-ABC shows an underperformance in sequential processing relative to the simultaneous processing in all groups of communication disorder. Although these discrepancies cannot be interpreted as significant in children under 5 years (Kaufman & Kaufman, 2005), they reflect the tendency to be more pronounced the more severe the communication disorder is.

These results add to the controversy between positions defending the specificity of communication disorder (Chomsky, 1986; Pinker, 1995) and those considering it a heterogeneous disorder and that the linguistic differences presented by different subgroups may have origins in the different underlying causes (Goorhuis-Brouwer & Wijnberg-Williams, 1996; Leonard, 2002; van der Lely, 2005). In addition, this study has shown that the prevalence in boys over girls is greater the more severe the communication disorder is (54%, 62%, 80%) suggesting that different phenotypes of communication disorder may have different genetic correlations, as current communication disorder research suggests (Bishop, 2009).

More research is needed to identify key indicators that can predict which children may be at higher or lower risk of evolving into more serious forms of communication disorder, so that affected children can receive early attention to improve their prognosis. Also, it would be needed to improve the definition of criteria and levels of evidence regarding the effectiveness of treatment programs.

It should be noted that although the communication disorder sample size is sufficiently large, it has been opted for the assessment of potential differences between different types of communication disorder and this has meant that, especially in the speech sound disorder group, the sample remained smaller. Another limitation is related to the fact that the study analyzes in a retrospective way the different cases according to communication disorder diagnostic criteria between 4 and 5 years of age. It has not been taken into account the evolution of the false positives, that sharing communication disorder profile in the initial diagnostic hypothesis, have evolved into other forms of developmental disorder. Finally, it should be noted that although the clinical sample is large enough, the same ratio boys/girls has not been respected in the control group. The higher proportion of girls in the control group could bias the results.

doi: 10.7334/psicothema2014.29

References

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders; DSM-5 (5th ed). Washington, DC: American Psychological Association.

American Speech-Language-Hearing Association (1980). Definitions for communicative disorders or differences. Language, Speech and Hearing Services in the Schools, 22, 317-318.

Bayley, N. (1969/1977). BSID: Escalas Bayley de desarrollo infantil [Bayley Scales of infant development]. Madrid: TEA.

Bayley, N. (1993). BSID-II: Bayley Scales of infant development. Second edition. San Antonio: Hartcourt Brace & Company.

Bayley, N. (2006). Bayley-III: Bayley Scales of infant and toddler development. Third edition. San Antonio, TX: Pearson.

Bishop, D.V.M. (1992). The underlying nature of specific language impairment. Journal of Child Psychology and Psychiatry, 33(1), 3-66.

Bishop, D.V.M. (2009). Genes, cognition, and communication insights from neurodevelopmental disorders. The Year in Cognitive Neuroscience, 1156, 1-18. doi: 10.1111/j.1749-6632.2009.04419.x.

Bishop, D.V.M. (2010). Overlaps between autism and language impairment: Phenomimicry or shared etiology? Behavior Genetics, 40, 618-629. doi: 10.1007/s10519-010-9381-x.

Carlsson, LH., Norrelgen, F., Kjellmer, L., Westerlund, J., Gillberg, Ch., & Fernell, E. (2013). Coexisting disorders and problems in preschool children with autism spectrum disorders. The Scientific World Journal. doi : 10.1155/2013/213979.

Chomsky, N. (1986). Knowledge of language: Its nature, origin and use. New York: Praeger.

Fresneda, M.D., & Mendoza, E. (2005). Trastorno especifico del lenguaje: concepto, clasificaciones y criterios de identificacion [Specific language disorder: Concept, classifications and criteria of identification]. Revista de Neurologia, 41(1), 51-56.

Goorhuis-Brouwer, S.M., & Wijnberg-Williams, B.J. (1996). Specificity of specific language impairment. Folia Phoniatrica et Logopaetica, 48, 269-274. doi: 10.1159/000266421.

Hack, M., Taylor, H.G., Drotar, D., Schluchter, M., Cartar, L., WilsonCostello, D., et al. (2005). Poor predictive validity of the Bayley Scales for cognitive function of extremely low birth weight children at school age. Pediatrics, 116(2), 333-341. doi: 10.1542/peds.2005-0173.

Hagberg, B.S., Miniscalco, C., & Gillberg, Ch. (2010). Clinic attenders with autism or attention-deficit/hyperactivity disorder: Cognitive profile at school age and its relationship to preschool indicators of language delay. Research in Developmental Disabilities, 31, 1-8. doi: 10.1016/j. ridd. 2009.07.012.

Hill, E.L. (2001). Non-specific nature of specific language impairment: A review of the literature with regard to concomitant motor impairments. International Journal of Language & Communication Disorders, 36(2), 149-171. doi: 10.1080/13682820010019874.

Institut d'Estadistica de Catalunya (2012). Censo de poblacion: sexo, edad y estado civil (2011). Poblacion segun nivel de instruccion por sexo y edad [Census of population: sex, age and marital status (2011). Population by educational attainment by sex and age]. Barcelona: Generalitat de Catalunya. Retrievered January 9, 2013 from: http:// www. idescat. cat/territ/ BasicTerr?TC=5&V 0=3&V 1=0&V3=319&V4= 16&ALLINFO=TRUE&PARENT=1&CTX=B.

Kaufman, A., & Kaufman, N. (2005) K.ABC: Bateria de evaluacion de Kaufman para ninos [Kaufman Assessment Battery for Children]. Madrid: TEA.

Kirk, S., McCarthy, J., & Kirk, W. (2004) ITPA: Test Illinois de aptitudes psicolinguisticas [Illinois Test of Psycholinguistic Abilities]. Madrid: TEA.

Law, J., Rush, R., Anandan, Ch., Cox, M., & Wood, R. (2012). Predicting language change between 3 and 5 years and its implications for early identification. Pediatrics, 130, e132-e137. doi: 10.1542/peds.20111673.

Leonard, L. (2002). Children with specific language impairment (4th ed). Boston: MIT Press.

Levy, S., Giarelli, E., Ching, L., Schieve, L., Kirby, R.S., Cunniff, Ch., et al. (2010). Autism spectrum disorder and co-occurring developmental, psychiatric, and medical conditions among children in multiple populations of the States. Journal Developmental Behavoir Pediatrics, 31, 267-275.

McCarthy, D. (2006). MSCA: Escalas McCarthy de aptitudes y psicomotricidad [McCarthy Scales of Children's Abilities]. Madrid: TEA.

Pinker, S. (1995). El instinto del lenguaje [The language instinct]. Madrid: Alianza.

Puyuelo, M., Lorente, I., & Brun, C. (2001). Caracteristicas de lenguaje en sindromes con deficit cognitivo de Base Genetica [Language features in syndromes with cognitive deficits genetic basis]. In Puyuelo, M. (Eds.), Casos clinicos en Logopedia III [Clinical Cases in Speech therapy III] (pp. 1-26). Barcelona: Masson. 84-458-1043-X.

Rapin, I., & Allen, D. (1983). Developmental language disorders: Nosologic consideration. New York. Kirk U.

Van den Bergh, B.R.H. (2011). Developmental programming of early brain and behaviour development and mental health: A conceptual framework. Developmental Medicine & Child Neurology, 53 (Suppl. s4), 19-23. doi: 10.1m/j.1469-8749.2011.04057.x.

Van der Lely, H.K.J. (2005). Domain-specific cognitive systems: Insight from Grammatical-SLI. TRENDS in Cognitive Sciences, 9(2), 53-59.

Montserrat Torras-Mana (1,2), Montserrat Guillamon-Valenzuela (1), Ariadna Ramirez-Mallafre (1), Carme Brun-Gasca (1,2) and Albert Fornieles-Deu (2)

(1) Corporacio Sanitaria Parc Tauli and (2) Universitat Autonoma de Barcelona

Received: February 7, 2014 * Accepted: June 3, 2014

Corresponding author: Montserrat Torras-Mana

Centre de Desenvolupament Infantil i Atencio Precoc (CDIAP) Parc Tauli Servei de Medicina Pediatrica.Corporacio Sanitaria Parc Tauli 08208 Sabadell (Spain)

e-mail: MTorras@tauli.cat
Table 1
Mean performance of communication disorder and control group

                                        Communication disorder

                       Composite         Mean     SD
                       ([micro] = 100
                       [sigma] = 15)
                       Subtests
                       ([micro] = 10,
                       [sigma] = 3)

                       Cog              100.29   8.18
Speech sound           Lang             97.43    5.51
disorder               RC               10.40    1.28
(n = 35)               EC                8.69    0.96

Expressive language    Cog              96.29    6.08
disorder               Lang             90.48    7.19
                       RC                9.48    1.36
(n = 85)               EC                7.17    1.63

Receptive Expressive   Cog              91.19    4.69
language disorder      Lang RC          82.73    7.14
(n = 67)                                 7.60    1.43

                       EC                6.40    1.49

Total communication    Cog              95.19    6.90
disorder               Lang             89.98    8.68
                       RC                9.01    1.74
(n = 186)              EC                7.20    1.67

                                        Control group (a)

                       Composite         Mean      SD
                       ([micro] = 100
                       [sigma] = 15)
                       Subtests
                       ([micro] = 10,
                       [sigma] = 3)

                       Cog              104.63   10.60
Speech sound           Lang             108.98   10.28
disorder               RC                11.48    1.61
(n = 35)               EC                11.47    2.14

Expressive language    Cog              104.63   10.60
disorder               Lang             108.98   10.28
                       RC                11.48    1.61
(n = 85)               EC                11.47    2.14

Receptive Expressive   Cog              104.63   10.60
language disorder      Lang RC          108.98   10.28
(n = 67)                                 11.48    1.61

                       EC                11.47    2.14

Total communication    Cog              104.63   10.60
disorder               Lang             108.98   10.28
                       RC                11.48    1.61
(n = 186)              EC                11.47    2.14

                                            Difference of means

                       Composite         DIF      LL      UL      Sig
                       ([micro] = 100
                       [sigma] = 15)
                       Subtests
                       ([micro] = 10,
                       [sigma] = 3)

                       Cog               4.32    0.10    8.56     .042
Speech sound           Lang             11.55    7.13   15.99   < .001
disorder               RC                1.08    0.28    1.89   < .005
(n = 35)               EC                2.78    1.84    3.72   < .001

Expressive language    Cog               8.32    5.04   11.61   < .001
disorder               Lang             18.50   15.00   22.01   < .001
                       RC                2.00    1.36    2.64   < .001
(n = 85)               EC                4.30    3.56    5.04   < .001

Receptive Expressive   Cog              13.42    9.95   16.90   < .001
language disorder      Lang RC          26.25   22.50   30.01   < .001
(n = 67)                                 3.88    3.20    4.57   < .001

                       EC                5.06    4.27    5.86   < .001

Total communication    Cog               9.44    7.16   11.70   < .001
disorder               Lang             19.00   17.20   22.44   < .001
                       RC                2.47    1.98    2.96   < .001
(n = 186)              EC                4.27    3.74    4.78   < .001

Note: Cog = Cognitive, Lang = Language Composite, RC = Receptive
Communication, EC = Expressive Communication, SD = Standard
Deviation, LL = Lower Limit, UL = Upper Limit, na = 66

Table 2
Scores' correlations between the Bayley-III before
the age 3.5 years and auditory-vocal channel ITPA at 4.5 years

                                     Correlation Bayley-
                                     III / ITPA and
                                     mean scores ITPA
                                     ([micro] = 36,
                                     [sigma] = 6)

                        Composite/        Representational
                         Subtest                level

                                       AR        AA        VE

                        Cog           .184      .185      -.096
                        Lang          .262      .381      .146
Speech sound disorder   RC            .013      .427      .411
(n = 10)                EC            .456      .256      -.132
                        Mean ITPA     38.86     35.86     35.29
                        SD            6.91      2.85      1.38
                        Cog           .106      .294      .106
                        Lang          .196     .356 *     .257

Expressive language     RC           .357 *     .306      .121
disorder                EC            -.013     .270      .279
(n = 32)
                        Mean ITPA     35.88     35.77     35.19
                        SD            5.23      3.69      6.37
                        Cog          .382 *     .326      .189
                        Lang         .422 *    .624 **    .375

Receptive-Expressive    RC           .411 *    .531 **    .422*
language disorder       EC            .268     .473 *     .199
(n = 27)
                        Mean ITPA     28.22     30.43     32.52
                        SD            3.82      4.69      6.22
                        Cog          .449 **   .458 **    .214
                        Lang         .531 **   .591 **   .323 **

Total communication     RC           .598 **   .582 **   .303 *
disorder (n = 69)       EC           .295 *    .415 **   .248 *
                        Mean ITPA     33.11     33.59     34.11
                        SD            6.44      4.79      5.99

                                     Correlation Bayley-
                                     III / ITPA and
                                     mean scores ITPA
                                     ([micro] = 36,
                                     [sigma] = 6)

                        Composite/   Automatic level
                         Subtest

                                       GC        ASM

                        Cog           -.059      .409
                        Lang          -.049      .533
Speech sound disorder   RC            -.012      .340
(n = 10)                EC            -.076      .611
                        Mean ITPA     33.57     31.14
                        SD            5.31       5.04
                        Cog           .045       .236
                        Lang         .436 *      .092

Expressive language     RC           .480 **     .144
disorder                EC            .229       .045
(n = 32)
                        Mean ITPA     32.73     33.65
                        SD            3.99       4.25
                        Cog           .004       .151
                        Lang         .511 **    -.032

Receptive-Expressive    RC            .355      -.018
language disorder       EC           .432 *     -.013
(n = 27)
                        Mean ITPA     28.17     30.04
                        SD            3.07       4.35
                        Cog           .229      .302 *
                        Lang         .537 **     .169

Total communication     RC           .556 **     .211
disorder (n = 69)       EC           .348 **     .090
                        Mean ITPA     30.96     31.86
                        SD            4.43       4.64

                                     Bayley-III
                                     ([micro] = 10,
                                     [sigma] = 3)
                                     ([micro] =
                                     100, [sigma]
                                     = 15)

                        Composite/   Mean     SD
                         Subtest

                        Cog          99.29   4.49
                        Lang         96.57   5.02
Speech sound disorder   RC           10.14   0.90
(n = 10)                EC           8.71    0.95
                        Mean ITPA
                        SD
                        Cog          97.12   5.13
                        Lang         90.85   5.84

Expressive language     RC           9.54    1.24
disorder                EC           7.27    1.31
(n = 32)
                        Mean ITPA
                        SD
                        Cog          93.26   4.15
                        Lang         84.70   5.80

Receptive-Expressive    RC           7.91    1.24
language disorder       EC           6.74    1.32
(n = 27)
                        Mean ITPA
                        SD
                        Cog          95.56   5.61
                        Lang         89.06   7.18

Total communication     RC           9.00    1.49
disorder (n = 69)       EC           7.18    1.49
                        Mean ITPA
                        SD

Note: Cog = Cognitive, Lang = Language Composite, RC = Receptive
Communication, EC = Expressive Communication, AR =Auditory Reception,
AA = Auditory Association, VE = Verbal Expression, GC = Grammatical
Closure, ASM = Auditory Sequential Memory, SD = Standard Deviation. *
= signification <0.05, ** = signification <0.01

Table 3
Scores' correlations between the Bayley-III before the age 3.5 years
and MSCA at 4-4.5 years

                                     Correlation Bayley-III /
                                     MSCA and mean scores MSCA
                                     ([micro] 50, [micro] = 10) EGC =
                                     ([micro] = 100, [sigma])
                                     (p = 15)

                        Composite/     VS       P-PS       QS
                        Subtest

                        Cog           .380      .427     .496 *
                        Lang          .370      .246     .495 *
Speech sound disorder   RC            .341      .244     .462 *
(n--22)                 EC            .249      .117      .328

                        Mean MSCA     48.50     51.80     48.65
                        SD            6.40      5.72      6.34
                        Cog          497 **    .576 **   .324 *
                        Lang         .390 **    .174      .092
Expressive language     RC           .409 **    .246      .179
disorder                EC           .277 *     .052      -.019
(n--53)
                        Mean MSCA     44.41     51.00     47.31
                        SD            6,07      5.83      6.56
                        Cog           .265      .123      .257
                        Lang          .280      -.190     .178

Receptive-Expressive    RC            .244      -.165     .299
language disorder       EC            .255      -.169     .096
(n--46)
                        Mean MSCA     38.38     49.95     41.14
                        SD            6.49      6.64      7.21
                        Cog          .524 **   .381 **   .451 **
                        Lang         .536 **    .089     .366 **
                        RC           .536 **    .127     .425 **

Total Communication     EC            .419      .020     .216 *
disorder
(n = 121)
                        Mean MSCA     42.97     50.24     44.84
                        SD            7.47      6.38      7.29

                                     Correlation Bayley-III /
                                     MSCA and mean scores MSCA
                                     ([micro] 50, o = 10) EGC =
                                     ([micro] = 100, [sigma])
                                     (p = 15)

                        Composite/     GCS        MS
                        Subtest

                        Cog           .538 *     .293
                        Lang          .461 *    .456 *
Speech sound disorder   RC             .416      .426
(n--22)                 EC             .307      .296

                        Mean MSCA     101.10     48.40
                        SD             9.74      5.92
                        Cog          .616 **    .421 **
                        Lang         .369 **    .356 **
Expressive language     RC           .424 **    .287 *
disorder                EC             .217     .338 *
(n--53)
                        Mean MSCA     95.43      44.08
                        SD            10.20      6.23
                        Cog            .265      .246
                        Lang           .139      .132

Receptive-Expressive    RC             .157      .083
language disorder       EC             .91       .167
(n--46)
                        Mean MSCA     87.38      40.12
                        SD             9.80      6.20
                        Cog          .581 **    .431 **
                        Lang          477 **    .435 **
                        RC           .504 **    .404 **

Total Communication     EC           .33 7 **   .379 **
disorder
(n = 121)
                        Mean MSCA     93.25      43.28
                        SD             11.0      6.92

                                     Bayley-III ([micro] = 10,
                                     [sigma] = 3) ([micro] =
                                     100, [sigma] = 15)

                        Composite/   Mean     SD
                        Subtest

                        Cog           100    6.88
                        Lang         96.70   5.52
Speech sound disorder   RC           10.25   1.29
(n--22)                 EC           8.60    1.04

                        Mean MSCA
                        SD
                        Cog          96.76   4.98
                        Lang         91.27   6.87
Expressive language     RC           9.53    1.28
disorder                EC           7.39    1.56
(n--53)
                        Mean MSCA
                        SD
                        Cog          92.14   4.29
                        Lang         83.76   6.72

Receptive-Expressive    RC           7.79    1.27
language disorder       EC           6.57    1.45
(n--46)
                        Mean MSCA
                        SD
                        Cog          95.33   6.07
                        Lang         89.50   8.11
                        RC           9.00    1.60

Total Communication     EC           7.33    1.59
disorder
(n = 121)
                        Mean MSCA
                        SD

Note: Cog--Cognitive, Lang--Language Composite, RC--Receptive
Communication, EC--Expressive Communication, VS--Verbal Scale, P-PS-
-Perceptual-Performance Scale, QS -Quantitative Scale, MS--Memory
Scale, GCS--General Cognitive Scale (VS+P-PS+QS), SD--Standard
Deviation *--signification < 0.05, **--signification < 0.01

Table 4
Scores' correlations between the Bayley-III before the age 3.5 years
and K-ABC at 4-4.5 years

                                     Correlation Bayley-III / K-ABC
                                     and mean scores K-ABC ([micro]
                                     = 100, [sigma] = 15)

                        Composite/
                        Subtest       Sequ.    Simul.      MPC
                                       Pr        Pr

                        Cog          .682 **   .694 **   .823 **
                        Lang          .517      .467     .586 *
                        RC            .502      .437     .561 *
Speech sound disorder
                        EC            .435      .397      .491
(n = 14)
                        Mean K-ABC    98.14    108.57    104.71
                        SD            18.80     13.26     17.83
                        Cog          .667 **   .700 **   .790 **
                        Lang         .499 *    .670 **   .718 **

Expressive language     RC            .260     .458 *    .445 *
disorder                EC           .615 **   .702 **   .801 **
(n = 28)
                        Mean K-ABC    87.92    104.77     96.08
                        SD            10.81     11.54     10.95
                        Cog           -.152     .246      .098
                        Lang          -.139     .077      .012

Receptive-Expressive    RC            .192      .090      -.016
language disorder       EC            .005      .068      .116
(n = 26)
                        Mean K-ABC    79.18     97.00     85.64
                        SD            10.34     9.16      7.72
                        Cog          .580 **   .646 **   .732 **
                        Lang         .453 **   .533 **   .594 **
                        RC           .353 **   .454 **   .488 **
Total communication
disorder                EC           .496 **   .523 **   .612 **
(n = 68)
                        Mean K-ABC    86.50    104.18     94.78
                        SD            11.66     12.21     12.88

                                     Correlation Bayley-III / K-ABC
                                     and mean scores K-ABC ([micro]
                                     = 100, [sigma] = 15)

                        Composite/
                        Subtest        ACH       NV

                        Cog          .662 *    .888 **
                        Lang          .319     .733 **
                        RC            .346     .784 *
Speech sound disorder
                        EC            .192      .453
(n = 14)
                        Mean K-ABC   100.71    107.71
                        SD            10.88     16.52
                        Cog          .510 *    .616 **
                        Lang          .418     .558 *

Expressive language     RC            .146      .399
disorder                EC            .515*    .532 *
(n = 28)
                        Mean K-ABC    92.69    102.08
                        SD            11.40     14.68
                        Cog          .457 *     -.162
                        Lang          .407      -.308

Receptive-Expressive    RC            .470      -.184
language disorder       EC            .194      -.328
(n = 26)
                        Mean K-ABC    77.91     91.55
                        SD            13.68     11.54
                        Cog          .603 **   .616 **
                        Lang         .616 **   .457 **
                        RC           .571 **   .405 *
Total communication
disorder                EC           .538 **   .420 *
(n = 68)
                        Mean K-ABC    89.15     98.54
                        SD            13.22     15.22

                                     Bayley-III ([micro] = 10,
                                     [sigma] = 3) ([micro] =
                                     100, [sigma] = 15)

                        Composite/
                        Subtest       Mean     SD

                        Cog          105.00   12.91
                        Lang         98.00    6.33
                        RC           10.71    1.38
Speech sound disorder
                        EC            8.57    1.13
(n = 14)
                        Mean K-ABC
                        SD
                        Cog          95.77    6.07
                        Lang         91.08    4.53

Expressive language     RC            9.69    1.03
disorder                EC            7.15    1.40
(n = 28)
                        Mean K-ABC
                        SD
                        Cog          88.64    5.04
                        Lang         79.45    9.24

Receptive-Expressive    RC            7.45    2.25
language disorder       EC            5.45    1.63
(n = 26)
                        Mean K-ABC
                        SD
                        Cog          94.41    8.26
                        Lang         89.05    9.87
                        RC            9.16    2.00
Total communication
disorder                EC            7.04    1.74
(n = 68)
                        Mean K-ABC
                        SD

Note: Cog = Cognitive, Lang = Language Composite, RC = Receptive
Communication, EC = Expressive Communication, Sequ., Pr = Sequential
Processing, Simul., Pr = Simultaneous Processing, MPC = Mental
Processing Composite, ACH = Achievement, NV = NonVerbal, SD =
Standard Deviation * = signification < 0.05, ** = signification < 0.01

Table 5
Scores' regressions between the Bayley-III before the age 3.5 years
and MSCA, K-ABC, ITPA at 4-4.5 years

Criterion              Predictors          B (IC95%)
(adjusted R.sup.2)

GCS MSCA (.344)      Cog Bayley-III    1.132 (.85; 1.42)
MPC K-ABC (.529)     Cog Bayley-III    1.141 (.88; 1.40)
AR ITPA (.354)       RC Bayley-III     2.546 (1.71; 3.39)
AR ITPA (.275)       Lang Bayley-III    .467 (.28; .65)
AA ITPA (.343)       Lang Bayley-III    .398 (.26; .53)
VE ITPA (.090)       Lang Bayley-III    .265 (.07; .46)
GC ITPA (.280)       Lang Bayley-III    .327 (.20; .46)
ASM ITPA (.014)      Lang Bayley-III    .108 (-.50; .27)

Criterion            [beta]     P           F (p)
(adjusted R.sup.2)

GCS MSCA (.344)       .592    < .001   62.440 (< .001)
MPC K-ABC (.529)      .732    < .001   76.146 (< .001)
AR ITPA (.354)        .603    < .001   36.575 (< .001)
AR ITPA (.275)        .535    < .001   25.656 (< .001)
AA ITPA (.343)        .594    < .001   34.983 (< .001)
VE ITPA (.090)        .324     .010     7.148 (.010)
GC ITPA (.280)        .540    < .001   25.549 (< .001)
ASM ITPA (.014)       .171     .176     1.872 (.176)

Note: Cog = Cognitive, Lang = Language Composite, RC = Receptive
Communication, GCS = General Cognitive Scale, PMC = Mental Processing
Composite, AR =Auditory Reception, AA = Auditory Association, VE =
Verbal Expression, GC = Grammatical Closure, ASM = Auditory
Sequential Memory
COPYRIGHT 2014 Colegio Oficial De Psicologos Del Principado De Asturias
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2014 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Title Annotation:articulo en ingles
Author:Torras-Mana, Montserrat; Guillamon-Valenzuela, Montserrat; Ramirez-Mallafre, Ariadna; Brun-Gasca, Ca
Publication:Psicothema
Date:Jul 1, 2014
Words:6102
Previous Article:Prevalence of psychological and physical intimate partner aggression in Madrid (Spain): a dyadic analysis.
Next Article:Assessment and detection of peer-bullying through analysis of the group context.
Topics:

Terms of use | Privacy policy | Copyright © 2019 Farlex, Inc. | Feedback | For webmasters