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Aim  This study aimed to develop a concise tool with acceptable predictive properties to identify young children with specific language impairment ( SLI ).    Methods  In this nested case–control study children with  SLI  attending two special needs schools for severe speech and language difficulties in the Netherlands were matched by date of birth and sex with control children attending mainstream education. This study analysed the predictive validity for having  SLI  at a mean age of eight years and three months (range 4–11 years) using combinations of six language milestones that were registered at 24, 36 and 45 months and retrieved from the children's healthcare files in 2012.    Results  We included 253 pairs of children with and without  SLI . During a single visit, combinations of two milestones at one age achieved a specificity of at least 97% and sensitivities ranged from 32% to 64%. However, the concise tool, which combined five milestones at three different ages – 24, 36 and 45 months – had a specificity of 96% (95% confidence interval 94–99%) and a sensitivity of 71% (95% confidence interval 66–77%).    Conclusion  Combining milestones at different ages provided a concise tool that could help to detect children with  SLI  at a young age.

Concise tool based on language milestones identifies children with specific language impairment at 24–45 months of age