Peer-reviewed article

Estimated Prevalence of Developmental Language Disorder Risk in West Virginia Schools.

Megan Israelsen-Augenstein, Michelle W Moore, Tracy Toman, Allison Rosborough · 25 Aug 2026

Abstract

PURPOSE: Developmental language disorder (DLD) is linked to long-term academic and social difficulties. Despite these lasting impacts, state-level prevalence estimates are limited. This study estimated prevalence among early-elementary students in West Virginia who may be at risk for DLD and examined variation by grade, locale, and assessment instrument. METHOD: A cross-sectional screening battery was administered to 252 students in Grades 1-2 across six Title I schools. Children with Kaufman Brief Intelligence Test-Second Edition Matrices standard scores ≤ 70 were excluded prior to analysis. A dual-criterion definition of DLD risk was used: ≤ 80 on the Clinical Evaluation of Language Fundamentals-Fifth Edition (CELF-5) core composite and ≤ 92 on the Test of Narrative Language-Second Edition (TNL-2). Descriptive statistics and mixed-effects logistic regression (random intercept for school) tested effects of grade, gender, and locale. RESULTS: Using the dual-criterion definition, 72 of 252 students (28.6%) met criteria for being at risk for DLD. Adjusted models showed higher odds of DLD risk in town versus urban schools (odds ratio = 3.06, 95% confidence interval [1.31, 7.15], p = .010), whereas grade and gender were not significant predictors after accounting for school-level clustering. Instrument-specific classification rates diverged substantially, with the TNL-2 identifying a higher proportion of students relative to the CELF-5. CONCLUSIONS: Although based on a relatively small yet representative sample of West Virginia students, prevalence estimates substantially exceed commonly cited large-scale population estimates. Results underscore the influence of instrument choice on suspected prevalence and the need for locally calibrated screening protocols and targeted service planning.