Parent questionnaire found to be sensitive for learning disabilities

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1. Among children referred for neuropsychiatric assessment, the Colorado Learning Difficulties Questionnaire was found to be highly sensitive, but with low specificity in detecting children with math and reading learning disabilities. 

Evidence Rating Level: 2 (Good) 

Study Rundown: Until now, physicians have lacked an efficient and effective office-based screening tool for detecting learning disabilities (LD). Early diagnosis is essential for ensuring prompt behavioral and medical treatment. The Colorado Learning Difficulties Questionnaire (CLDQ) is a validated, eleven-item questionnaire that screens for learning disabilities and can be completed by parents before a primary care office visit. The current study assessed the validity of the CLDQ in identifying LD in a school-age population referred for neuropsychological assessment. By comparing the results of the CLDQ to normative values and scores on other validated achievement tests, researchers found that the sensitivity of the CLDQ for reading and math LD was high, meaning that a child testing as negative on the screening test had a high likelihood of not having a LD.  However the specificity was low, meaning that a child testing positive on the screening questionnaire alone was not a strong indicator of having a learning disability. As the study focused on a population referred for neuropsychological assessment, it may be limited in its generalizability. However, the sensitivity seen in this study in addition to prior population-based studies suggests that the CDLQ may be used as an office-based screening resource with reasonable reliability.  However, the potential context-specific influences on a positive result must be considered and additional, confirmatory testing should be completed.

Click to read the study, published today in Pediatrics

Relevant Reading: Colorado Learning and Difficulties Questionnaire: validation of a parent-reported screening measure

In-Depth [cohort study]: Data from 440 children, ages five to seventeen  who were referred to a clinic for neuropsychological assessment was included for analysis. The CLDQ asks parents to rate their child’s frequency of difficulties in reading and math on a Likert-type scale, with scores ranging from 1 (never/not at all) to 5 (always/a great deal). The results of the CLDQ were considered diagnostic for LD if a child’s score was ≥1 standard deviation (SD) above the normative mean. These results were compared with other standardized subtests given to the child in the clinic, including the Woodcock-Johnson Tests of Achievement, Third Edition or the Wechsler Individual Achievement Test, Third Edition, in which a LD was considered ≤1 SD below the mean. The sensitivity of the CLDQ was between 81.82%-93.90% for reading and 68.57-82.67% for math.  The specificity ranged from 48.23%-55.84% for reading and 43.02-48.11% for math.  .

By Laurel Wickberg and Leah H. Carr

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