Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Review Folia Phoniatr Logop 2011;63:247–263 DOI: 10.1159/000321000 Population-Based Screening of Children for Specific Speech and Language Impairment in Germany: A Systematic Review Jürgen Kasper   a, b Julia Kreis   c Fülöp Scheibler   c Delia Möller   d Guido Skipka   c Stefan Lange   c Olaf von dem Knesebeck   a a  Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, b  Unit of Health Sciences and Education, University of Hamburg, Hamburg, c  Department of Non-Drug Interventions, Institute for Quality and Efficiency in Health Care, Köln, and d  Voice, Speech and Hearing Disorders, University Medical Center Hamburg- Eppendorf, Hamburg, Germany against later initiation of treatment. Most studies were of lim- ited quality. We found indications of short-term positive ef- fects from language therapies in children with SLI. Long- term outcomes were not investigated. No evidence support- ing the advantage of earlier treatment initiation was identified. Conclusions: The benefit of population-based language screening of preschool children with SLI is not proven. Controlled screening studies are therefore neces- sary. For Germany, the accuracy of existing diagnostic instru- ments has not yet been sufficiently examined. Copyright © 2011 S. Karger AG, Basel Introduction Acquisition of speech and language is a core process in the general development of the child. Therefore, disor- dered speech or language is likely to indicate a risk of a wide range of serious secondary problems during school age. This applies for instance to school performance, to reading or writing and to social and emotional quality of life. Depending on a child’s age and developmental stage, the natural course of speech and language disorders im- Key Words Speech and language delay  Specific language impairment  Primary language disorder  Preschool children  Screening  Systematic review Abstract Objective: The study was aimed at evaluating the effective- ness of a systematic population-based screening pro- gramme for specific language impairment (SLI) in preschool children in Germany. Methods: The study question was di- vided into a review of (1) evidence from studies evaluating screening programmes, (2) diagnostic instruments in the German language, and (3) studies evaluating speech and language interventions. A systematic database search was conducted between June and October 2007 and was updat- ed in January and again in May 2008. Relevant studies were identified by 2 independent reviewers based on screened titles/abstracts and full texts. Results: 4,806 studies were screened. The only existing controlled screening study did not provide data for SLI. No diagnostic study met the inclu- sion criteria. Sixteen randomized intervention studies were included, 3 studies contributed to the appraisal of earlier Published online: February 8, 2011 Jürgen Kasper University of Hamburg, Unit of Health Sciences and Education Martin-Luther-King-Platz 6 DE–20146 Hamburg (Germany) Tel. +49 40 42838 7231, Fax +49 40 42838 3732, E-Mail k  @  sper.info © 2011 S. Karger AG, Basel 1021–7762/11/0635–0247$38.00/0 Accessible online at: www.karger.com/fpl