Assessment of Pre-school and School-age Children with Language Impairment Flashcards

1
Q

Introduction to Assessment

A

Teamwork:
○ Thorough assessment, weigh various options, thoughtful
recommendations for therapy
○ Complex procedure:
○ Finding baseline, determining PLOP
◉ Assessment is ongoing
○ Not sequential! Not assessment→treatment
○ SLP: why/what/how of assessment
○ Continuum: formal→informal; structured→less structured
○ Data collection: unbiased, objective

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2
Q

Psychometric vs. Descriptive Procedures

A

Two major philosophical approaches to effective communication assessment:
○ Normalist philosophy
○ Neutralist/Criterion referenced

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3
Q

Normalist/Norm referencing

A

Norm (average)
○ Average performance level (i.e. zero) on a normal distribution
○ Addresses a broad spectrum of content
○ Performance Measured: Comparisons across norm–standard scores, percentile scores

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4
Q

Neutralist/Criterion referenced

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Comparing present performance to past performance/specific criteria
○ Descriptive in nature
○ Addresses a clearly defined criteria, aspect of language
○ Performance Measured: summarized meaningfully; measures such as percent correct

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5
Q

Standardized:

A

Standardized: consistent, standard way to administer the test, to present
and to mark the child’s responses
■ Specific directions to child
■ Repetitions: Number/allowed or not allowed

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6
Q

Normed:

A

Normed: Test created/administered to group of children (sample
representing all children)
■ Gender, racial, ethnic, geographic, and socioeconomic differences
represented in norming group
■ Test appropriate for all? Linguistic/cultural differences?

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7
Q

Reliability:

A

Reliability: repeatability of measurement
■ Accuracy/precision –consistently a test measures a characteristic
■ Does the assessment give consistent/dependable results?
■ Internal consistency: measure of reliability
● Degree of relationship between items & overall test
● *High internal consistency-(i.e. children who do well should have
same performance on individual items & perform similarly among
themselves)
Reliability: repeatability of measurement

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8
Q

Test-retest reliability

A

Test-retest reliability: child administered same test (with time interval
between the administration)
● Two test scores are comparable; consistency of scores

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9
Q

Interjudge reliability

A

Interjudge reliability: 2 scoring same behavior the same way
● Criterion: specific responses as correct
● SLP needs to use these kinds of tests

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10
Q

Validity

A

Validity: Tests ability to assess what it purports to assess
■ Effectiveness of the test!
■ Must be proven
○ Three Types:
■ Criterion validity
■ Content validity
■ Construct validity

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11
Q

Three Types of validity

A

Criterion validity: Effectiveness or accuracy with which a measure predicts
performance
○ Content validity: Faithfulness of the sample/measure representing an
attribute or behavior
○ Construct validity: Extent to which a measure describes or measures some
trait (construct)

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12
Q

Normed tests: Test specific attributes/skills;

A

Normed tests: Test specific attributes/skills; less complex than functional
language
○ Cautiously….not exclusively! ONE tool!
○ Can ONLY use scores when administered in standard form
◉ SLP must research tests carefully before administering
◉ SLP must be careful not to misuse testing instruments–BE CAREFUL NOT TO:
○ Use scores as a summary of child’s performance
○ Use inappropriate norms
○ Make inappropriate assumptions based on test results
○ Use specific test items for planning intervention goals
○ Use tests to assess therapy progress

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13
Q

Standard Error of Measurement

A

◉ Misuse of scores–SLP must be familiar with test and testing manual.
◉ Standard Error of Measurement (SEm): Confidence of test scores
○ Standard score of 75 on 2 tests; Test A: SEm of 2, Test B: SEm of 6
○ Test A: confidence 73-77; Test B: confidence 69-81.
○ Test A: SLP can be more confident of score on Test A closer to child’s
performance
◉ Error scores: Two children with same error scores could have responded completely
differently (i.e. no response vs. syntactic error)
◉ Test items may carry the same weight for scoring, but have great differences
developmentally (i.e. functional language)
◉ Normal distribution: score on the bell-shaped curve
○ ⅔ of population should score within 1 standard deviation (SD) on either side of
the mean score

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14
Q

Issues of Standardized Testing (

A

Inappropriate norms: represent population for whom you are using the test
◉ Cultural/linguistically diverse groups
◉ Test manuals: need to reflect differences; SLP needs to understand/check
◉ Modifying administration procedures—can’t compare scores to norms
○ Clinical judgement!
○ **Must state changes/modifications in written evaluation report!
◉ Incorrect Assumptions: Performance overall assessed, not just test scores
○ No global language assumptions from one test
■ PPVT: receptive vocabulary; only tests this!
◉ Identifying Intervention Goals: Variety of assessments, more than one standardized test
◉ Measuring Therapy Progress:
○ Single, few items on each skill; unable to determine progress
○ Child learning the test–artificially high results
■ Different forms of test, spacing between tests, **highly correlated tests
■ **Criterion-referenced tests-better choice for individual progress monitoring

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15
Q

Variables in Test Selection

A

Choosing Test:
○ Characteristics: Check Test Manual for accuracy of scoring
○ Does this test:
■ Correctly detecting impairment when it is present (true positive result)
■ Detect impairment when not present (a false positive result)
■ Correctly identifying typical language; no LI (a true negative result)
■ Identify the child as TLD, but LI is present (a false negative result)
◉ SLPs:
○ Familiarity with test/procedure
○ Overall opinion of measure
○ Clinical experience test/task selection
○ Relative importance from data from different measures

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16
Q

Test Selection: Problems (

A

SLPs and Standardized Testing:
○ Required: often part of evaluative process; scoring, reporting
○ “Overdependence”
○ “Poor interpretation of the results of testing”
○ Cultural/linguistic differences must be addressed
○ Socioeconomic factors must be addressed
○ Norm-referenced test results: inconsistent for determination of
intervention area
○ **Needed: Many measures of assessment!!

17
Q

Descriptive Approaches
advantages and disadvantages

A

Important approach: Observation, language sample-analysis
◉ Advantages:
○ Naturalistic
○ Contextual integrity
○ Individual differences
○ Flexible: attuned to student’s needs
○ *SLP apply his/her professional and theoretical knowledge to assessment
◉ Disadvantages:
○ SLP: level of expertise for elicitation/analysis of language
○ Time! Collecting/analyzing the language sample
○ Reliability/validity of the sample
○ Susceptible to SLP bias (not scored according to norm)

18
Q

Descriptive Approaches

A

Objective descriptions of actual behaviors-good
◉ Should not be giving subjective judgements of causes/reasons for behaviors
◉ Reliability-Descriptive:
○ Explicit behaviors to observe: Selection of behaviors to be observed (i.e.
identify gestures, rather than recording intentions)
■ Interjudge reliability (2 observers–same behavior)
○ Make judgements on one type of behavior at one time: Increase accuracy
■ Video/audio-recording, digital recording (replay/review)
○ Don’t make summation judgements while observing ‘online’:
■ Observations/recordings only
■ Analysis after all data collected

19
Q

Descriptive Approaches
Productivity and Intelligibility A

A

Validity-Descriptive:
○ Productivity: Amount of language produced by child
■ Varies: Young child’s language changes based on person, setting, mood
■ Minimal output–minimal information
■ Prepared elicitation tasks to increase output in older children (i.e. “Tell me
about…”
○ Intelligibility Amount understood by listener
■ Agreement between what child says/SLP understands from sample
■ Too few utterances–problem for analysis
■ SLP: control content (topic) to increase his/her understanding of child output

20
Q

Descriptive Approaches (cont.) (Owens, 2014)
Validity-Descriptive:
○ Representativeness and reactivity

A

○ Representativeness Typicality of sample
■ Does the language sample reflect the child’s typical behavior?
■ *Spontaneity: child establishes topic/content/activity
● Varied materials elicit different forms/functions
■ *Variability of context
● Different setting, communication partners
● Child-based conversational topics
■ Stability of structure/function sampled
● Different tasks yield different samples (i.e. storytelling→longer
utterances, picture description→ language quantity)
○ Reactivity Response of the child to different stimuli
■ Reaction of child can affect overall validity
■ SLP: too much/little control over questions and sample
SLP—>Flexibility and variability is key!

21
Q

Descriptive Approaches (cont.) (Owens, 2014)
◉ Overall:
○ Descriptive Assessment:

A

Overall:
○ Descriptive Assessment:
■ Discuss range of topics of interest to child
■ Be flexible with various topics/contexts
■ Vary different kinds of samples; elicit in different ways
■ Video-audio recording for later analysis

22
Q

Integrated Functional Assessment Strategy

A

GOAL! Most thorough, individualized assessment process
◉ Psychometric + Descriptive (language sample included)–>Formal/informal
◉ Referral, parent questionnaire
◉ Multiple measures
◉ SLP must consider:
○ Chronological age (CA) and functional age
○ Background information (vision, hearing…)
○ Cultural/linguistic background
○ Cognitive functioning
○ interests/materials appropriate and available
○ Activity level
○ Ability to attend to stimulus items
○ Caregiver concerns

23
Q

Questionnaire, Interview, & Referral

A

Other sources of information:
○ Caregivers
■ Perspective: continual interaction, willingness to assist, participate in
therapy
■ Checklists: Good at some reports
● i.e. vocabulary checklists correlate well with language
screening tests
■ Face-to-face interviews
○ Teachers
○ Medical professionals

24
Q

Observation

A

Observe in naturalistic settings, in various activities
○ School–various settings, various communication partners
○ Clinic–naturalistic with parent, favorite, familiar toys
○ SLP: observes from afar, as possible—increase naturalistic setting
○ Main question: “How does the child use language to interact with others?”
◉ Representative sample: routine play with familiar toys can elicit
◉ SOUL: Silence, Observation, Understanding, Listening (INREAL/Outreach
Program of U. of Colorado; Owens, 2014, 116)
◉ Recording of observation–very beneficial! Examine, reexamine…
○ Accuracy
○ Objectivity

25
Q

Observation: What the SLP Needs to Note

A
  1. FORM of language:
    ○ Words, phrases, sentences primarily?
    ○ S-V-O structure?
    ○ Negatives? Interrogatives? Passive sentences?
    ◉ 2.SEMANTIC INTENT: understanding the intent
    ○ Relational words used correctly? Prepositions? Conjunctions?
    ○ Frequent fillers or empty words? (i.e. thing, stuff)
    ○ Responding to different types of questions correctly?
    ◉ 3.Language USE:
    ○ Meaningful conversational turns? Topic maintenance? Repair communication breakdowns?
    ○ Display illocutionary functions, such as requesting, commenting, asking for information?
    ◉ 4. RATE of Speaking:
    ○ Inordinately fast/slow? Child use fillers frequently? Pause before producing certain words?
    ○ Noticeable or lengthy pauses between conversational turns? Between child’s own adjacent
    utterances?
    ◉ 5. SEQUENCING
    ○ Relating events in sequential order? Recall recent past/narrate stories? Cohesive ties? Easy to
    follow
26
Q

Assessing ALL Aspects of Language

A

Pragmatics
◉ Semantics
◉ Syntax
◉ Morphology
◉ Written Language

27
Q

Formal Testing: Assessing: PRAGMATICS

A

Holistic view of child’s language: Best to use more than one formal test
◉ Problem: Formal testing for pragmatics
○ Lack of assessment instruments
○ Formal testing: rigid structure; differs greatly from appropriate pragmatics
○ TOPL–Test of Pragmatic Language (Phelps-Teraski & Phelps-Gunn, 1992)
○ CCC-Children’s Communication Checklist (Bishop, 2002, 2006)
■ Parent checklist–assessment tool
■ Includes clinically significant pragmatic impairments
■ Owens (2014, 121): CCC identifies pragmatics difficulties of child with
ASD rather than TOPL

28
Q

Formal Testing: Assessing: SEMANTICS

A

Problem: Focus on receptive/expressive language
○ What about language acquisition? Storage? Retrieval?
○ Formal tests–vocabulary word is present/absent; not accurate!
○ Focus: Semantic use!
○ Most semantic tests:
■ PIcture identification
■ Word definitions
■ Word categories
○ Record errors/ focus on incorrect linguistic features
○ Double-naming technique–naming task administered 2x; error analysis
■ Two errors -’double error words’ to determine word finding difficulties
■ Procedure:
■ 1. General open-ended question: “Can you think of another word for this?”
■ 2. Semantic/phonemic facilitator: CUES…Semantic cue “It’s something you sit on” and
phonemic cue: “It’s called a /__/” and produce initial phoneme
■ 3. Verification–if child incorrect, SLP models for child and discusses item–new word in
repertoire?

29
Q

Formal Testing: Assessing: SYNTAX

A

Problem: Complexity/diversity of syntax: Tests are insufficient
◉ Using a full test battery or various subtests from different tests–may be beneficial
◉ Considerable variety across syntactical texts
◉ Syntactic production tested using:
○ Structured elicitation-child asked to describe picture, following model
○ Sentence imitation-immediate imitation (problems with validity)
○ Word ordering
○ Correction judging-metalinguistic task (for children over 5)
Functional???

30
Q

Formal Testing: Assessing: MORPHOLOGY

A

Most testing focuses on bound inflectional morphemes (past tense -ed, plural -s)
◉ Suffixes: inflectional vs. derivational
○ Inflectional: grammatical meaning only, indicating possession, gender, and
number in nouns, comparison in adjectives (-er, -est) etc.
○ Derivational: Not addressed in most tests; change meaning or part of
speech (i.e. -ful, -tion)

31
Q

Formal Testing: Assessing: WRITTEN LANGUAGE

A

Collect written language sample–literacy difficulties suspected
◉ Assess narrative writing, fiction/non-fiction, expository writing
◉ Writing sample:
○ SLP can assess:
■ Phonological awareness
■ Linguistic awareness
■ Vocabulary use
■ Sequential writing, cohesive ties
■ Organization, presentation of ideas
■ Syntactic use, morphology…

32
Q

Assessing: Information Processing Deficits
Dynamic assessment:

A

Dynamic assessment:
○ Test-teach-test (Owens, 2014, 126)
■ Ex. Teach–how to identify main idea, how to narrate
■ Retest-kinds of change/effort required
○ Goal: child’s ability to learn (not level of past learning)
◉ Information Processing: looking for child’s ability to attend, perceive, recall information,
understand explanations, relate past information to new information, infer, and generalize
◉ Working memory: Variety of Tasks to assess
○ Listening span task: listen to sentences increase in number
■ Respond to correctness of sentence
■ Process sentences
■ Storage task: Recall as many sentence final words
○ Non-word repetition: measure phonologic processing (independent of lexical
knowledge)

33
Q

Summary: Assessment

A

Preparation is KEY–familiarity, how to administer
◉ Test: Reliability and Validity
◉ Never accept test scores at face value–never the sole tool in your toolbox!
◉ Descriptive + Psychometric
◉ Combination of interviewing, observation, testing and sampling—->holistic
approach!