Concurrent validity of the fluharty preschool speech and language screening test–second edition at age 3: Comparison with four diagnostic measures

Purpose: The aim of this study was to examine the concurrent validity of the Fluharty Preschool Speech and Language Screening Test–Second Edition (Fluharty-2; Fluharty, 2001) for mass screenings of language at age 3 years. Method: Participants were sixty-two 3-year-old children, 31 who had failed and 31 who had passed the Fluharty-2. Performance on the screening was compared to 4 diagnostic measures: Structured Photographic Expressive Language Test–Preschool, Second Edition; mean length of utterance in morphemes (MLU_m ), finite verb morphology composite, and Index of Productive Syntax (IPSyn). Results: Children who failed the Fluharty-2 scored significantly lower on each of the diagnostic measures than children who passed the Fluharty-2, but the effect size for MLU_m was small. Scores on the Fluharty-2 were significantly correlated with scores on the diagnostic measures. There was significant agreement for pass/fail decisions between the Fluharty-2 and diagnostic measures only for IPSyn. However, even for the IPSyn, the agreement rate for passing was only moderate (80%) and the agreement rate for failing was only fair (68%). Conclusion: The Fluharty-2 showed limited agreement for pass/fail decisions with all 4 of the diagnostic measures. There was reason to question the validity of 2 of the diagnostic measures—Structured Photographic Expressive Language Test–Preschool, Second Edition and MLU_m—for diagnosing language impairment in 3-year-old children. However, there were no such concerns about finite verb morphology composite or IPSyn to account for the limited agreement. Thus, it seems reasonable to conclude that the Fluharty-2 would refer both too few at-risk children and too many nonrisk children for a follow-up assessment, making it an inefficient tool for mass screenings of language.