Background: The term ‘specific language impairment’ (SLI), in use since the 1980s, describes children with language impairment whose cognitive skills are within normal limits where there is no identifiable reason for the language impairment. SLI is determined by applying exclusionary criteria, so that it is defined by what it is not rather than by what it is. The recent decision to not include SLI in DSM‐5 provoked much debate and concern from researchers and clinicians.Aims: To explore how the term ‘specific language impairment’ emerged, to consider how disorders, including SLI, are generally defined and to explore how societal changes might impact on use the term.Methods & Procedures: We reviewed the literature to explore the origins of the term ‘specific language impairment’ and present published evidence, as well as new analyses of population data, to explore the validity of continuing to use the term.Outcomes & Results and Conclusions & Implications: We support the decision to exclude the term ‘specific language impairment’ from DSM‐5 and conclude that the term has been a convenient label for researchers, but that the current classification is unacceptably arbitrary. Furthermore, we argue there is no empirical evidence to support the continued use of the term SLI and limited evidence that it has provided any real benefits for children and their families. In fact, the term may be disadvantageous to some due to the use of exclusionary criteria to determine eligibility for and access to speech pathology services. We propose the following recommendations. First, that the word ‘specific’ be removed and the label ‘language impairment’ be used. Second, that the exclusionary criteria be relaxed and in their place inclusionary criteria be adopted that take into account the fluid nature of language development particularly in the preschool period. Building on the goodwill and collaborations between the clinical and research communities we propose the establishment of an international consensus panel to develop an agreed definition and set of criteria for language impairment. Given the rich data now available in population studies it is possible to test the validity of these definitions and criteria. Consultation with service users and policy‐makers should be incorporated into the decision‐making process.

Every 3 years, the Australian Government conducts a developmental census across the entire population of children in their first year of full-time schooling (median age 5 years). The first developmental census was conducted in 2009, including 261,147 children, and in 2012 data were collected on 289,973 children-representing 97.5% and 96.5% of the estimated eligible population, respectively. The questionnaire is completed by teachers on the basis of at least 1 month's knowledge of the child, including aspects of physical, social, emotional, language and cognitive development, as well as data on special needs. Teachers are also asked to include details of the child's care arrangements and attendance in early education programmes in the years preceding school. Demographic and geographical data are recorded at the individual and area levels.

OBJECTIVES: Nurse home visiting (NHV) may redress inequities in children’s health and development evident by school entry. We tested the effectiveness of an Australian NHV program (right@home), offered to pregnant women experiencing adversity, hypothesizing improvements in (1) parent care, (2) responsivity, and (3) the home learning environment at child age 2 years. METHODS: A randomized controlled trial of NHV delivered via universal child and family health services was conducted. Pregnant women experiencing adversity (≥2 of 10 risk factors) with sufficient English proficiency were recruited from antenatal clinics at 10 hospitals across 2 states. The intervention comprised 25 nurse visits to child age 2 years. Researchers blinded to randomization assessed 13 primary outcomes, including Home Observation of the Environment (HOME) Inventory (6 subscales) and 25 secondary outcomes. REULTS: Of 1427 eligible women, 722 (50.6%) were randomly assigned; 306 of 363 (84%) women in the intervention and 290 of 359 (81%) women in the control group provided 2-year data. Compared with women in the control group, those in the intervention reported more regular child bedtimes (adjusted odds ratio 1.76; 95% confidence interval [CI] 1.25 to 2.48), increased safety (adjusted mean difference [AMD] 0.22; 95% CI 0.07 to 0.37), increased warm parenting (AMD 0.09; 95% CI 0.02 to 0.16), less hostile parenting (reverse scored; AMD 0.29; 95% CI 0.16 to 0.41), increased HOME parental involvement (AMD 0.26; 95% CI 0.14 to 0.38), and increased HOME variety in experience (AMD 0.20; 95% CI 0.07 to 0.34). CONCLUSIONS: The right@home program improved parenting and home environment determinants of children’s health and development. With replicability possible at scale, it could be integrated into Australian child and family health services or trialed in countries with similar child health services.

This article aims to contribute to the ongoing evaluation of the Australian Early Development Index (AEDI) by investigating its construct and concurrent validity with a subsample of 642 children aged 4 to 5 years drawn from the Longitudinal Study of Australian Children (LSAC). Construct validity was examined by considering the theoretical consistency of the network of correlations between the AEDI subconstructs and the independently reported multimethod measures of early learning skills and development collected contemporaneously by the LSAC. Concurrent validity was examined by assessing the extent to which children who were “developmentally vulnerable” on the AEDI domains corresponded with the LSAC outcome indices classification of children as “developmentally at risk.” Moderate to large correlations were observed between each of the AEDI domains and subconstructs when compared to analogous teacher-rated LSAC measures, with lower levels of association observed for parent-rated LSAC measures. Concurrent validity was explored; however, with no criterion measure with which to assess the AEDI, findings are inconclusive prior to predictive validity assessment. Future waves of the LSAC will collect information on the children's abilities at school and developmental outcomes, enabling further interpretation of these concurrent and construct validity findings by triangulation and predictive validity analyses.