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Development and Validation of Nomogram-Based Prediction Models for Developmental Language Disorder in Bilingual Children.

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Title: Development and Validation of Nomogram-Based Prediction Models for Developmental Language Disorder in Bilingual Children.
Authors: Lam, Joseph Hin Yan1 jhylam@uci.edu, Ramos, Michelle N.2, Wang, Jiali3, Iglesias, Aquiles4, Peña, Elizabeth D.1, Bedore, Lisa M.5, Gillam, Ronald B.6
Source: Journal of Speech, Language & Hearing Research. Sep2025, Vol. 68 Issue 9, p4337-4357. 21p.
Subject Terms: *Human services programs, *Language disorders, *Speech evaluation, *Language acquisition, *Inter-observer reliability, *Children, Multilingualism in children, Prediction models, Receiver operating characteristic curves, Research funding, Evaluation of human services programs, Questionnaires, Logistic regression analysis, Descriptive statistics, Spanish language, English language, Semantics, Data analysis software, Sensitivity & specificity (Statistics)
Abstract: Purpose: The challenges of language assessment in bilinguals include a lack of assessment tools and bilingual speech-language pathology services. Additionally, the weighting of subtests in standardized tests has not been empirically explored to maximize sensitivity and specificity. Language exposure might also inform the decision to diagnose bilinguals with developmental language disorder (DLD). This study uses a nomogram, a user-friendly prediction tool, to explore the weighting between bilingual language tasks for diagnostic accuracy and single-language assessment feasibility with language exposure information. Method: Four hundred nine Spanish--English bilingual children aged 4--7 years completed a standardized bilingual language assessment with six subtests, and caregivers reported language exposure. Additional 326 and 296 Spanish--English bilingual children completed the Spanish or English portions of the assessment, respectively. Nomogram-based prediction models were constructed to evaluate the probability of DLD. Classification accuracy, calibration curves, and decision curve analysis were reported. Results: The nomogram for the bilingual language assessment was generalizable to another sample, with varying subtest weightings. The addition of bilingual exposure did not improve the classification accuracy of the bilingual assessment, but it was an important variable when assessment was in one language only. Spanish-only assessment with bilingual exposure achieved the minimum acceptable sensitivity and specificity, whereas English-only assessment with bilingual exposure did not. Conclusions: This study suggests that subtest weighting ratios can help classify Spanish--English bilingual children with DLD. The feasibility of single-language assessment and the clinical use of nomograms are discussed. Supplemental Material: https://doi.org/10.23641/asha.29874254 [ABSTRACT FROM AUTHOR]
Copyright of Journal of Speech, Language & Hearing Research is the property of American Speech-Language-Hearing Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Education Research Complete
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  Data: Development and Validation of Nomogram-Based Prediction Models for Developmental Language Disorder in Bilingual Children.
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  Data: <searchLink fieldCode="AR" term="%22Lam%2C+Joseph+Hin+Yan%22">Lam, Joseph Hin Yan</searchLink><relatesTo>1</relatesTo><i> jhylam@uci.edu</i><br /><searchLink fieldCode="AR" term="%22Ramos%2C+Michelle+N%2E%22">Ramos, Michelle N.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Wang%2C+Jiali%22">Wang, Jiali</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Iglesias%2C+Aquiles%22">Iglesias, Aquiles</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Peña%2C+Elizabeth+D%2E%22">Peña, Elizabeth D.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Bedore%2C+Lisa+M%2E%22">Bedore, Lisa M.</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Gillam%2C+Ronald+B%2E%22">Gillam, Ronald B.</searchLink><relatesTo>6</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+Speech%2C+Language+%26+Hearing+Research%22">Journal of Speech, Language & Hearing Research</searchLink>. Sep2025, Vol. 68 Issue 9, p4337-4357. 21p.
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  Data: *<searchLink fieldCode="DE" term="%22Human+services+programs%22">Human services programs</searchLink><br />*<searchLink fieldCode="DE" term="%22Language+disorders%22">Language disorders</searchLink><br />*<searchLink fieldCode="DE" term="%22Speech+evaluation%22">Speech evaluation</searchLink><br />*<searchLink fieldCode="DE" term="%22Language+acquisition%22">Language acquisition</searchLink><br />*<searchLink fieldCode="DE" term="%22Inter-observer+reliability%22">Inter-observer reliability</searchLink><br />*<searchLink fieldCode="DE" term="%22Children%22">Children</searchLink><br /><searchLink fieldCode="DE" term="%22Multilingualism+in+children%22">Multilingualism in children</searchLink><br /><searchLink fieldCode="DE" term="%22Prediction+models%22">Prediction models</searchLink><br /><searchLink fieldCode="DE" term="%22Receiver+operating+characteristic+curves%22">Receiver operating characteristic curves</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Evaluation+of+human+services+programs%22">Evaluation of human services programs</searchLink><br /><searchLink fieldCode="DE" term="%22Questionnaires%22">Questionnaires</searchLink><br /><searchLink fieldCode="DE" term="%22Logistic+regression+analysis%22">Logistic regression analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Spanish+language%22">Spanish language</searchLink><br /><searchLink fieldCode="DE" term="%22English+language%22">English language</searchLink><br /><searchLink fieldCode="DE" term="%22Semantics%22">Semantics</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Sensitivity+%26+specificity+%28Statistics%29%22">Sensitivity & specificity (Statistics)</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Purpose: The challenges of language assessment in bilinguals include a lack of assessment tools and bilingual speech-language pathology services. Additionally, the weighting of subtests in standardized tests has not been empirically explored to maximize sensitivity and specificity. Language exposure might also inform the decision to diagnose bilinguals with developmental language disorder (DLD). This study uses a nomogram, a user-friendly prediction tool, to explore the weighting between bilingual language tasks for diagnostic accuracy and single-language assessment feasibility with language exposure information. Method: Four hundred nine Spanish--English bilingual children aged 4--7 years completed a standardized bilingual language assessment with six subtests, and caregivers reported language exposure. Additional 326 and 296 Spanish--English bilingual children completed the Spanish or English portions of the assessment, respectively. Nomogram-based prediction models were constructed to evaluate the probability of DLD. Classification accuracy, calibration curves, and decision curve analysis were reported. Results: The nomogram for the bilingual language assessment was generalizable to another sample, with varying subtest weightings. The addition of bilingual exposure did not improve the classification accuracy of the bilingual assessment, but it was an important variable when assessment was in one language only. Spanish-only assessment with bilingual exposure achieved the minimum acceptable sensitivity and specificity, whereas English-only assessment with bilingual exposure did not. Conclusions: This study suggests that subtest weighting ratios can help classify Spanish--English bilingual children with DLD. The feasibility of single-language assessment and the clinical use of nomograms are discussed. Supplemental Material: https://doi.org/10.23641/asha.29874254 [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Journal of Speech, Language & Hearing Research is the property of American Speech-Language-Hearing Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1044/2025_JSLHR-25-00076
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      – Code: eng
        Text: English
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        PageCount: 21
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      – SubjectFull: Human services programs
        Type: general
      – SubjectFull: Language disorders
        Type: general
      – SubjectFull: Speech evaluation
        Type: general
      – SubjectFull: Language acquisition
        Type: general
      – SubjectFull: Inter-observer reliability
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      – SubjectFull: Children
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      – SubjectFull: Multilingualism in children
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      – SubjectFull: Prediction models
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      – SubjectFull: Questionnaires
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      – SubjectFull: Spanish language
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      – TitleFull: Development and Validation of Nomogram-Based Prediction Models for Developmental Language Disorder in Bilingual Children.
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              Text: Sep2025
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