Screening Beyond First Words: A Scoping Review of Speech and Language Screening Tools and Approaches for 2- and 3-Year-Olds

Purpose: The task of being able to accurately and efficiently identify children in the early years at risk of future speech sound and/or language disorders remains elusive. To progress toward more accurate identification, the breadth of skills examined in current screening tools and approaches needs to be determined. Our purpose was to (a) understand the key characteristics of screening tools and approaches for children aged 2–3 years, (b) determine the psychometric quality of screening tools and approaches, and (c) identify the early years health and education professionals who screen toddlers' speech and language skills. Method: A scoping review was conducted following Arksey and O'Malley's (2005) methodological framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension guidelines. A systematic search of the literature was conducted, and the data were described through data extraction, quality appraisal, percentage and frequency counts, and a narrative synthesis. Results: There were 101 studies that met the inclusion criteria, with screening more commonly occurring with 2-year-olds. Of the 114 unique tools and approaches identified, most screened expressive language, particularly vocabulary and/or word combinations. When speech skills were screened, intelligibility was the primary skill examined. Across these tools, indirect measures were most common. There was low reporting on the psychometric quality of tools and the professional completing the screening, which impacted the conclusions that could be drawn. Conclusions: This review highlights the diversity of tools available for screening speech and/or language development between the ages of 2;0 and 3;11 (years; months), as well as the need to consider the child's age at the time of administration and the content of the tools being used when screening beyond first words.