The accuracy of a Spanish dynamic assessment of narrative language in identifying developmental language disorder: A cross validation study / La precisión de una evaluación dinámica del lenguaje narrativo en español para identificar el trastorno del desarrollo del lenguaje: un estudio de validación cruzada

Introduction and objectives: This cross-validation study investigated the extent to which a Spanish narrative language dynamic assessment accurately identified students with and without developmental language disorder across two separate samples of monolingual Spanish-speaking students from Guatemala and Mexico.Materials and methods: Students with developmental language disorder and students with typically developing language were administered a Spanish narrative dynamic assessment. A test–teach–retest format of dynamic assessment was followed. Posttest scores and measures of student modifiability were gathered and examined.Results and conclusions: Results indicated that the most predictive dynamic assessment variables for the Guatemalan sample were posttest scores and two modifiability measures. These same variables were applied in the cross-validation analysis of the Mexican sample with high classification accuracy achieved when posttest scores and an overall modifiability rating were combined. The results of this study indicate that a Spanish narrative dynamic assessment may be a culturally appropriate diagnostic tool in identifying Spanish-speaking students with developmental language disorder.(AU)

Introducción y objetivos: Este estudio de validación cruzada investigó hasta qué punto una evaluación dinámica del lenguaje narrativo en español identificó con precisión a estudiantes con y sin trastorno del desarrollo del lenguaje en dos muestras separadas de estudiantes monolingües de habla hispana de Guatemala y México.Materiales y métodos: Se administró una evaluación dinámica narrativa en español a estudiantes con trastorno del desarrollo del lenguaje y a estudiantes con un desarrollo típico del lenguaje. Se siguió un formato de evaluación dinámica de tipo test-enseñanza-retest. Se recogieron y examinaron las puntuaciones posteriores a la prueba y las medidas de modificabilidad de los estudiantes.Resultados y conclusiones: Los resultados indicaron que las variables de evaluación dinámica más predictivas para la muestra guatemalteca fueron las puntuaciones postest y dos medidas de modificabilidad. Estas mismas variables se aplicaron en el análisis de validación cruzada de la muestra mexicana y se logró una alta precisión de clasificación cuando se combinaron las puntuaciones del postest y una calificación global de modificabilidad. Los resultados de este estudio indican que una evaluación dinámica narrativa en español puede ser una herramienta de diagnóstico culturalmente apropiada para identificar a los estudiantes de habla hispana con trastorno del desarrollo del lenguaje.(AU)

Assessing the Reliability of Reported Medical History in Older Adults.

BACKGROUND: Age-associated increases in medical complexity, frailty, and cognitive impairment may compromise reliable reporting of medical history. OBJECTIVE: To evaluate the influence of increasing age and cognitive impairment on concordance between reported history of stroke and cerebral infarction, and reported history of diabetes and elevated hemoglobinA1c in community-dwelling older adults. METHODS: The association between participant-specific factors and accurate reporting of stroke or diabetes was evaluated using multivariable logistic regression in 1,401 participants enrolled in longitudinal studies of memory and aging, including 425 participants with dementia (30.3%). Stroke and diabetes were selected as index variables as gold standard measures of both were obtained in all participants: magnetic resonance neuroimaging for cerebral infarcts and hemoglobinA1c (≥6.5%) for diabetes. RESULTS: Concordance between reported history of stroke and imaging-confirmed cerebral infarction was low (sensitivity: 17.4%, 8/46; specificity: 97.9%, 799/816). Small infarcts were strongly associated with inaccurate reporting (OR = 265.8; 95% CI: 86.2, 819.4), suggesting that occult/silent infarcts contributed to discordant reporting. Reporting accuracy was higher concerning diabetes (sensitivity: 83.5%, 147/176; specificity: 96.2%, 1100/1143). A history of hypertension (OR = 2.3; 95% CI: 1.3, 4.2), higher hemoglobinA1c (OR = 1.9; 95% CI: 1.5, 2.4), and hemoglobinA1c compatible with impaired glucose tolerance (OR = 3.1; 95% CI 1.8, 5.3) associated with increased odds of discordant reporting. Cognitive impairment and increased age were not independently associated with reliable reporting. CONCLUSION: Factors beyond advancing age and cognitive impairment appear to drive discordance in reported medical history in older participants. Objective testing for cerebral infarcts or diabetes should be performed when relevant to diagnostic or therapeutic decisions in clinical and research settings.