Using Q-BEx to Identify Risk for Language Impairment in Bilingual Children

Purpose: Clinical triage, but also inclusive population sampling in research, requires efficient detection of children likely to be at risk for language impairment (LI), a significant challenge in the case of bilingual children. Our goal was to derive automatic risk factor indices from a parental questionnaire and compare their usefulness in initial identification of children at risk for LI.Method: Alternative risk factor indices were derived from the Q-BEx online questionnaire backend calculator, differing in the weight and detail given to language proficiency. Each index was applied to two datasets comprised of five- to eight-year-old children: one with independent diagnosis of DLD/TD (109 bilingual children tested in France) and one of largely all-comer children (278 bilingual and monolingual children tested in France, the Netherlands, and the United Kingdom). We compared how these alternative indices predicted (likely) DLD/TD status, and structural language outcomes, assessed with LITMUS tools, designed for bilingual children). Results:RF4-min, a risk factor index composed of four equally weighted components (age of first word, age of first sentence, early development concerns, and strongest speaking skills between the HL and the SL), satisfactorily separated bilingual children according to developmental status, and was a significant predictor of language outcomes. This composite score showed the best balance between separability, sensitivity, and predictive value compared to indices without a proficiency component or with a more heavily weighted/detailed proficiency component.Conclusion:RF4-min, a Q-BEx automatically derived composite risk factor index, yielded promising results, indicating usefulness as part of first-level triage for LI.