Language Development- Test 2 Assessment

Assessment of gesture

Can be compared to norms via MBCDI and CSBS Can also be observed informally during play Note frequency, types, functions, and combinations Clinical significance: less frequent or varied gesture use is associated with various disorders (autism) Benchmarks: Gesture+ vocalization typically occurs by 15 mo (point + grunt) Gestures + words around 16 mo (hands up "mama") words predominate by around 20 mo

Diagnostic accuracy

How well does the test identify presence/absence of disorder? Sesitivity, specificity >.9 good .8 -.89 fair <.8 don't use for therapy purposes

Who is referred to EI?

Immediate: Nicu babies, born with hl, born with syndrome- at an effort to decrease gap - providing services because they are high risk from birth Late referral: normal birth/pregnancy- parents concerned 1. Immediate/early vs later referrals 2. high risk infants: pre/peri/postnatal complications prematurity, lbw (less than 5.5 pounds), VLBW (less than 3.3 pounds) Syndromes/disorders 3. Evidence developmental delay- later referral, close to a year no babble 4. How are the process and objectives of assessment the same or different for these scenarios? 1. Minimize or avoid delays- early/immediate referral. 2. late referral- documenting a delay/trying to close a gap

A child's score is 3 standard deviations below the mean. Does this fall within the average range?

No

Norming Sample

is the sample representative of your client? (geography, SES)

early stages of language development

preintentional period (1-8 months)- not using intentional communication Transition to intentionality (9-18 months) Emerging language (18-24 months)

Second vs First Language Acquisition

● Significant amount of language learning has already taken place in all domains. ● Suddenly, it all changes. ● At the same time, social support for early language learning (e.g. motherese) has changed. ● Demands of communicative situations have changed. ● Rate of L2 learning increases as child learns to use L1 to bootstrap learning of L2. ● Asynchronous development: child learns structures previously acquired in L1 more quickly than those that are entirely new. ● Larger groups of peers ● Adults require child to use academic-specific discourse rules ● More decontextualized language ● More complex language ● Specialized vocabulary

Bilingual clinet- High Stakes: Accuracy Counts

● The stakes are high. Accurate diagnosis matters. So, how do we do it? ● In order to properly and accurately assess a bilingual child, many factors need to be considered. The following slides outline some of these factors.

Typical Processes of Second Language Acquisition

● Silent Period (Tabors, 2008) ○ Much listening/comprehension and minimal output in second language ○ Can be place, person, or language specific (doesn't talk at school at all/doesn't talk in English/only talks to other children) ○ Talks normally at home in first language ○ Can last anywhere from 3-6 months ○ Can be mistaken for an expressive language delay/impairment ● Language Transfer ○ Sometimes called "interference" ○ Rules of syntax, morphology, phonology, pragmatics and semantics are applied to the second language ○ E.g. "The house blue" (syntax) ○ E.g. "Eschool" (phonology) ● Interlanguage ○ Learner starts to produce language in the second language ○ Combines rules from first language with new second language rules ○ Learner tests hypothesis ○ Dynamic system ○ Slowly moves closer to target language system ● Fossilization○ Specific errors remain firmly entrenched despite good overall proficiency in the second language ● Language Loss (Brice, et al, 2010; Riquelme & Rosas, 2014) ○ If use of the first language decreases, learners often lose skills in that language ○ Second language proficiency may still be limited as first language proficiency decreases (or hadn't been fully developed in the first place due to young age) ○ During this period, a child may demonstrate errors in both languages. ○ These children may be referred for evaluation as both parent and teacher may notice errors ○ It is TRICKY to assess during this period ● Code-switching ○ Alternation between two languages within a single word, sentence, or discourse ○ Used by typical, proficient bilinguals throughout the world (Frick & Rijonheimo, 2013; Paradis et al., 2011) ○ Not a sign of confusion or impairment ● Distributed Characteristic (Oller & Pearson, 2002) ○ The tendency of bilingual individuals to have certain words/structures in one language, but not in the other. ○ E.g. In the lexical domain, a bilingual child may know both members of a pair (cat/gato), or may know only one of the two. ○ Applies to both languages (know some words/structures in English, but not Spanish and vice versa). ○ Result is that bilingual children tend to test low in both languages on vocabulary assessments when compared to monolingual peers in each language ● BICS-CALP/CILF-FALF Gap ○ Basic Interpersonal Communication Skills (BICS) vs. Cognitive-Academic Language Proficiency (CALP) ○ Conversational Interactive Language Fluency (CILF) vs. Formal Academic Language Fluency (FALF) ○ Social language proficiency develops before academic language proficiency ○ The Gap: A child may appear to be a proficient English speaker based on social interactions, but may not have acquired academic language proficiency-may struggle academically and be referred for evaluation

Comprehension: SLAM (Crowley and baigorri)

Can use to assess comprehension as well as to elicit a language sample a picture with questions to ask

How do you know a test is a good test?

Diagnostic accuracy, reliability, validity

Standardized scores: what are they?

Makes it possible to interpret score based on comparisons to scores of others on same measure Makes it possible to compare scores from different tests Z score: how far is score from mean Z= (score-mean)/SD Z-score for score of 55? 137.5 Many uncomfortable with z scores (your child obtained a z score of 0 for overall language abilities) Conversion to 100/15 scale (mean=100, SD=15) Multiply z score by 15, add 100 A way of interpreting individual scores based on how others did on this task

High point analysis

Narrative benchmarks By age 3.5: combine two events (two- event narrative By age 4: more than 2 events but out of sequence (leap frog narrative) By age 5: sequence events but end prematurely (at climatic event) Age 6 and up: classic narrative (setting, character, sequence with climax, resolution)

Psychometrics

Theories and techniques in the measurement (metrics) of psychological (psycho) attributes

nana for banana

unstressed syllable deletion- appropriate until age 3

Bilingual Assessment: Concerns

● ELLs with a language disorder may go unidentified because problems are assumed to be SLA-related. ● ELLs with a language disorder may go unidentified because SLPs feel unqualified or uncomfortable assessing/treating them, and therefore avoid doing so. ● ELLs experiencing typical SLA may be misidentified as having a language disorder. ● Research indicates that ELL students are disproportionately represented in all domains of special education due to inappropriate diagnosis. (National Education Association, 2007)

Simultaneous Bilingualism

● Two languages acquired simultaneously from infancy ● More likely to result in balanced bilingualism ● The quantity and quality of the exposure to either language is highly variable. ● Consequently, their level of performance in each language will vary (Balanced vs. Spanish/English dominant) ● Innate abilities also play a role. Language develops differently in bilingual children than it does in monolingual children. ● Within each language, course of development is similar to monolingual speakers of each language ● However, because bilingual children's language exposure is divided between 2 languages, rate of development is slightly slower, initially ● Total language development rates are similar between monolinguals and bilinguals.

How is intuition honed?

"clinical judgement" blink by malcolm gladwell- automatic and intuitive thinking- intuitively know which kids to be concerned about and how to document areas of weakness /process- takes 4-5 years of practice Clinical judgement is key in the assessment process- need to use training and education in area of child language rather than relying on standardized tests alone- tests provide some information but not the whole picture

Assessing comprehension

"he understands everything" May be using strategies (order, probable event) but they don't always work Test comprehension of: 1). single words without nonlinguistic cues (no pointing) "give me baby" "where's your nose?" 2). Verbs- kiss, hug, throw, bite "throw it" "pat it" 3). Two term combination (noun-verb 18-24 mo) Unusual "kiss the apple" 4. Agent-action-object combinations (2-3 year) Have a child act out sentences. Work around usual reliance on probable event strategy "baby feeds mommy"

Transition to intentionality (9-18 mo)

"learning how to mean" illocutionary- convey, purpose, intent, an idea without language you want to know about the range, frequency, and means: what kinds of intents (requesting, getting adult's attention, greeting/calling)? look at range How often? How are intents conveyed (looking, grunting, pointing, vocalizing, verbalizing) parental report instruments, informal procedures (play)

Comprehension: "shared book reading"

1. Book selection: simple story, simple picture, minimal/no text 2. Easier: yes/no questions 3. Harder: wh questions based on age 4: Hardest: complex what (what would you do if..what will happen next?) Question word. Age what 2-0 where 2-6 who 3-0 whose 3-0 why 3-0 how many 3-0 how 3-6 when 4-6 or older

SLP role in nicu

1. Feeding and early interation critical for discharge feeding is about more than nutrition explore options whether or not oral feeding is possible Kangaroo care- skin to skin with mom, closeness settles the baby (hr settle, temp stabilize) non nutrive sucking, oral stimulation- not for nutrition, gentle strocking face around mouth figure out ways to optimize mom/baby interaction 2. assess child's behavior and readiness for interaction- help parents read baby, give parents what they need 3. Parent's awareness of and sensitivity to child's cues

Diagnostic practice

1. I want to get an idea of what words Joey understands and uses at home. Use CDI- gives a list of words 2. I don't expect Anna to be producing words bit want to gather information about other foundational skills she should be developing related to expressive and receptive language.- Use REEL- starts at 0, great way to track expressive and receptive skills 3. Liam will probably not cooperate with structured testing but I'd like to evaluate his language, play skills, and ability to imitate by watching him play with his mother.- Use Rossetti- flexible test 4. I'm a new SLP and looking for a free, quick screening tool that can help me identify early signs of language delay and/or autism.- Use CSBSDP- checklist is free and good indicator of language dealy/autism 5. I'm following an 8 mo old child recently discharged from the NICU who doesn't seem to vocalize much. I'd like to see whether she is at the stage I'd expect for her age.

Critical range

1. Purpose? To save time, avoid fatigue- just enough easy items to encourage success and just enough difficult items to test abilities without causing stress or discouragement 2. Starting point- Not diagnostic in any way- suspect delay start at an earlier age 3. Basal- a certain number of items answered correctly in a row- we assume that all items before would have been answered correctly if they had been administered- hit an error in first 8 items go back to make sure to establish a basal 4. Ceiling- certain number of incorrect items in a row- tells us child has reached limit and we stop test- assume all items beyond this point would be incorrect if we administered them 5. Double basal/ceiling rules- find 2 basals in test data #25 correct but child had 8 correct responses before and child answers next 8 correct- depends on each test- take later basal and ceiling 6. Assumption of basal/ceiling, scoring

Deriving Standardized Score

1. Raw score- total number of correct items (tells us nothing) 2. Normal distribution: Mean- SD- 3. Standard scores- raw scores that are converted into scores that have same mean and sd 4. Percentiles- percentage of sampled population scores falling at/below given score 5. T score (convert 50/10)- conversion scale has a mean of 50 and sd of 10 6. Age/grade equivalent- least informative and most misunderstood

Asking good questions

1. Use case history forms appropriately 2. What are the objectives of diagnostic session: For SLP? Focus on information you need for planning treatment For parent? How far behind, is there hope, what are areas of concern or strength For child? who is this, what should i expect 3. Ask open ended questions to get information that can guide intervention- understand childs abilites, strength/weakness

Language sampling

50 utterances= around 4 min usually relaxed, natural setting conversation (play based for preschoolers), narratives clinician or parent for play based, age appropriate toys/props: keep it simple video recording record, transcribe, analyze collect child's language as playing with toys want a toy that prompts imaginitive/engaging conversation ex: play dough, baby no noisy toy

A child achieved a standard score of 100- what percentage of the population achieved a score above this child?

50%

Approximately what percentage of scores falls between z scores of -2 and +2

95%

Administering standardized tests

Administered to large group of children across the country and there data has been compiled to data of average scores of typically developing kids at different ages- norms 1. Standardized procedures 2. Prompts can invalidate results- test has to be administered in exactly same way. 3. Critical range- narrow range of items that need to be administered to child- where to start testing based on CA and ends at a specific point based on how the child is doing 4. Scoring- constantly score and be careful how you mark responses so child cannot interperet

A child's score is equivalent to a percentile rank of 70%. How is this result interpreted?

Age appropriate Between .5 and 1 standard deviation of mean

Preintentional period (1-8 month)

Assessments avaliable before intention The rossetti: infant toddeler language scale: 0-3, behaviors can be observed, elicited, or reported skills assessed: play, interaction-attachment, gesture, pragmatics, langauge- beyond language criterion referenced= predetermined criteria- is child demonstrating age appropriate brhaviors? lots of flexibility can watch child and take notes or elicit behavior or ask mom if kid does things Receptive expressive Emergent language test (REEL 3): 0-3 standardized questions are dicussed with parent receptive and expressive language specific to language MBCDI: 0-3 parent report instrument early receptive/expressive vocabulary, gestures word combinations and early grammar easiest to give widely used in research very simple checklist getting an inventory

Interpreting results

Average range- 1 sd below or above Scores >1.5 or 2 SD below mean are clinically significant Lower than what percent of population? Compare receptive and expressive vocab scores Reading scores: comprehension vs letter word ID Relative strengths? Relative weaknesses?

Limitations of standardized tests

Biased: CLD, SES Many require child participation/cooperation Contrived vs naturalistic: don't resemble real life language demands May overestimate skills (PLS) May underestimate skills (if biased)

Reliability

Can you repeat the test and get the same score? Inner rater reliability and test retest reliability: above .90 is good

Assessing phonology

Collect speech sample: at clinic or at home Parent diary Note whether words were spontaneous, imitated, and whether there were errors

Narrative assessment example

Designed for preschool and elementary school aged children Use to elicit language sample (no scores included with picture) a. What happened? may need to give support to get the idea of what went on. If student does not know subways or trains, say that it is an elevator that has some seats. b. How did this happen? c. Did this ever happen to you? If no, then evaluator tells a short personal narrative about seeing someone get stuck or getting own bag stuck. Then often student has own story. d. What would you do is this happened to you?

Staying focused

Distractions we face: 1. Outside stimuli 2. Judgements, criticism, assumptions 3. Internal chatter, negative self talk "Putting aside your biases and tuning into the speaker is like tuning in a radio station to receive a clear signal with no distortion." Rebecca Shafir, The Zen of Listening Importance of focused and active listening

Takeaway

Do use standardized tests Interpret results cautiously Don't rely solely on results of standardized tests What alternatives do we have? Focus on functional impacts.... gather critical info from parents, teachers, and clients: interviews See how child responds to instruction: dynamic assessment Use LSA (language sample) and use it effectively Dynamic assessment: administer test, teach skills, retest- if they have skills now this is not a language disorder Never be absolute confident on 1 number from a single test Get insight on functional impact of language disorder- how is child's language in his/her life?

Validity

Does the test measure the skill it's designed to measure? Concurrent validity .70-1.0 strong .50-.69 moderate .30-.49 weak

CELF- P2: what is this subtest measuring

Expressive vocabulary: What is this called? Word structure: finish this sentence" this bird eats. this bird blank." morphology Point to the spotted dog in the box= receptive syntax

Determining ELL Status

Federal law requires that states identify ELLs and place them in programs that meet their linguistic and educational needs. ● Most states send home a parent survey. ● If survey indicates that the child's English may be influenced by another language, he/she is assessed to determine whether his/her English skills will prevent him/her from reaching proficiency on state tests or succeeding in an English-led classroom. ● Binary decision: proficient vs. not proficient ● No consideration given to the child's skill in L1. ● Contextually-loaded assessments- abstract & conceptually loaded situations are rarely assessed (BICS-CALP gap)

Useful benchmarks for infants and toddlers

Frequency of communicative intents: 12 mo/ 1 min 18 mo/ 2 min 24 mo/ 5 min age: 24 mo, at risk if not using any words age 27 mo, at risk if not using at least 20 verbs age 30 mo, at risk if not using variety of verbs, subject verb sentences at 36 mo, at risk if not using tense morphemes or has limited productivity of tense morphemes 13-20 mo: first words, consistent communicative gestures, single play schemes (child feeds self with spoon) 20-24 mo: word combinations, combine single play schemes (child feeds self with spoon then drinks from cup) 28 mo: learning the rules for syntax, thematic play sequences (give doll bath, put in bed, cover with blanket) verbs= building blocks for sentences

Reliability vs validity

Galton's anthropometric measures of intelligence Does the test tell you anything about what you are measuring? Measuring what we intend to be measuring. Validity- more critical piece

Low birth weight linked to communication problems in children

Goes well into childhood By age 10, children of all 3 low birthweight categories were more likely to be diagnosed with a speech language disorder and to have received speech language services than a child born at a normal birthweight

Narratives: standardized tests

I'm going to show you five pictures that go together to tell a story. I'd like you to look at them carefully, then tell me the story that goes with the pictures. Make your story as long and as complete as you can. You can start anytime you are ready.

Bilingual Assessment: Dangers

Inappropriately diagnosing a child with an impairment and placing them in special education can have long-lasting and detrimental effects: ● Limited and less rigorous curriculum ● Lowered expectations ● Diminished academic & post-secondary opportunities ● Higher dropout rates ● Social stigma/Self-esteem At the same time, failing or delaying the diagnosis of an impairment can lead to: ● Behavioral challenges ● Emotional problems ● Reading difficulties ● Academic failure ● In-grade retention ● Drop out

"Reading" neonates: sleep states

Infant behavior states have implications for caregiving Quiet/deep sleep: body/face still, eyes closed, regular breathing, high stimulus threshold- wait to feed or interact Light/active sleep: some movement, eyes flutter, brief smile/cry, irregular breathing, may respond to stimulus but drowsy- largest part of newborn sleep patterns, brief fussing may prompt feeding or interaction before baby is ready Drowsy: variable activity, open/close eyes, dull, still face, breathing irregular, delayed stimulus reaction- may return to sleep if left alone, may be aroused to more responsive state is stimulated

Critical Questions

Information gathered from the parent is fundamental to the validity of a disability evaluation. Language/dialect acquisitonal history Parents highest education level Family history of speech language problems? Family history of academic problems? Significant changes in the family structure? How do student's communication skills compare to peers or siblings at same age? Were child's language skills in the evaluation representative or typical for him? Is child clumsy? 10 examples of best communications and where it breaks down This parent interview must take place in person or by phone to allow for reframing of questions, follow up, and clarifications to collect essential data. Best done before evaluator assesses the child. Without the answers to the critical questions, we cannot distinguish a disorder from "something else"

Breaking down status barrier

Introduce self, clarify role- make interaction with family as genuine as possible 1. Put aside ego, step out of 'role' 2. "Swinging lingo" alienates you from parent/patient 3. Typical listener reaction? 4. Assumption of professional?

Consider: when analyzing a narrative

Is the sequence logical? Is there sufficient detail, are details relevant? Appropriate sentence complexity for age? Syntactic errors? Is vocabulary immature or unspecific? Are story parts connects with temporal markers (next?) Appropriate insight into character's feelings, beliefs, thoughts?

Language Development: English vs. Other Languages

Language development in other languages is not the same as English language development. There are differences in ● Existence and importance of a grammatical structure in conveying meaning. ● Frequency of use of a grammatical structure. ● Level of complexity of a grammatical structure. ● Communicative expectations

Selecting a diagnostic instrument

Many areas to consider! Some test assess a variety of areas; others are narrowly focused Use parents and teachers concerns as your starting point (interview is critical): focus on the functional deficits and real life impact of the child's disorder A test can help you capture or document areas of weakness....does not "identify" the problem Do not select a test simply because it is appropriate for the child's age Always use a combination of formal and informal assessments broad test- will take less time, do not get in depth information Receptive picture vocabulary test- nice sample of receptive but this is all you know never rely on only 1 test Test is just a way of documenting the problem Informal assessment draws upon my knowledge/skills

Bilingual vs. ELL

Many of the bilingual children you will be asked to screen/evaluate will be referred to as ELLs (English Language Learners). ● All ELLs are bilingual (to varying degrees), but not all bilingual students will be classified as ELLs. ● If a child is bilingual, regardless of ELL status, both languages should be considered. ● LEP=Limited English Proficiency

Commonly used standardized measures: late preschool, early elementary

PLS CELF- preschool Token test Test of auditory comprehension of langauge Test of phonological awareness Test of auditory processing skills SCAN tests for auditory processing Test of narrative development

Standardization and real life testing: finding a balance

PLS: 1. How to provide instructions 2. Keep feedback general, not item specific 3. Use manipulatives flexibly to obtain necessary information 4. When do you need to report variations from standardized procedures? Did your variations alter childs results? How you changed standardized procedures (skittles after every response) 5. Don't ignore behaviors that are not in response to stimuli (child pulling mother to desired toy) 6. The more you practice, the more natural/flexible you will be

Useful narrative types for assessment

Personal narratives: memorable experience (trip) Script narratives: routine series of events (how to... make chocolate milk) Fictional narratives: generates story Story retell: retell story using wordless picture books Frog where are you, Pookins gets her way, Doctor desoto

Some basic info

Preterm birth categories Term (37 weeks) Preterm (<37 weeks) Very preterm (<32 weeks) Extremely preterm (<28 weeks) Birth weight Normal (>5.5 pounds) Moderately low (3.3-5.5) Very low (2.2 to 3.3) Extremely low (<2.2) Child at risk, can't make any predictions Adjust age of premature baby 2 months premature= 6 month old as a 4 month old baby- do this for two years then stop

Bilingual clients- What does ASHA require? (ASHA, 2013)

Prohibits discrimination in the provision of services based on race or ethnicity, gender, age, religion, national origin, sexual orientation, or disability. ● To provide bilingual assessment and remediation services, the speech-language pathologist or audiologist should be able to: ● describe the process of normal speech and language acquisition for both bilingual and monolingual individuals and how those processes are manifested in oral and written language; ● administer and interpret formal and informal assessment procedures to distinguish between communication differences and communication disorders in oral and written language;

Asking good questions

Questions you would not want to ask 1. What's your child's diagnosis? 2.When did she produce first words? 3. What were the results of her preschool evaluation Questions you would want to ask 4. How do you know your child is smart? 5. What do you see your child accomplishing in the future? 6. What is a typical day like for your child?

"reading" neonates: waking states

Quiet alert: little movement, calm, organized, eyes/face open, bright, regular breathing, attending to stimuli - ideal for interaction! provides stimulus for looking, listening, sucking Active alert: much movement, eyes open, less bright, facial movement, irregular breathing, sensitive to stimuli- aim for less aroused state: cuddle, console Crying: increased activity, color changes, grimacing, eyes open or tightly closed, irregular breathing, highly sensitive to stimuli- reached limit! feed, hold, console Teach mom and dad how to read interaction states

Age and grade score "trap"

Raw score approximated was most close to the average raw score for a particular age group. Does not tell you whether it was qualitatively similar to others in age group Conversion tables included in most tests Least useful score What do they mean? Misinterpretations: Similar score=similar performance Score below average for particular age range may still be within normal variation for that group

Commonly used standardized measures: toddlers and preschoolers

Rossetti infant toddler language scale (0-36 mo) MacArthur bates communicative development inventory (8-37 mo) Receptive/expressive one word picture vocabulary test (2-90) Preschool language scale (0-7:11) Boehm preschool (3-5:11) Clinical evaluation of language fundamentals preschool (3-6) Preschool language assessment instrument (3-6)

"reading" neonates

STOP: averting gaze turning head away arching back grunting Time out

Confidence intervals

Score is always only an estimate of childs true abilities- no way of knowing true ability- always some measurement error Confidence interval: represents likelihood that the true score falls within a range of scores around score you obtained You select different intervals, depending on desired level of certainty: 1. 68%- narrow interval, 32% chance does not include true score 2. 90%- wider band of scores, less precise but less risky 3. 95%- still wider, least risky (5%) Confidence interval of 95% conventionally used for critical decisions

What does standardized administration mean?

Small variations in tested can make a big difference. Candy (rewards) kids received improved kids scored significantly.

Vocal assessment stages

Stage 1 (0-2 mo): vegetative sounds, vowel like sounds Stage 2 (2-4 mo): cooing, pleasure sounds "mmmm" Stage 3 (4-6): laughter, raspberries, trills, lip smacks, yells, squeels, growls Stage 4 (6-10 mo): canonical babbling, short exclamations Stage 5 (10-12 mo): variegated babbling, prosodic contour

Assessment of play (informal)

Stages (presymbolic, symbolic) Presents toys that lend themselves to pretend play Use play interaction to collect language sample and assess other behaviors (gesture, comprehension) Play looks at skills going hand and hand with language Play is a context in which you are evaluating language Collect language sample and other skills Pre symbolic play- not pretending

Validity: Types

Test of "language ability": Child imitates and points to pictures. Is this test valid? No. Imitating doesn't require language ability. Pointing to pictures is only receptive language. 1. Construct validity (most important)- degree to which a test measures the theoretical constructs- memory, language that it is intended to measure. Can be measured on convergent and divergent validity- test results that you get on this new assessment should convert to results from similar measures- should see very high correlations on related constructs and divergent on unrelated constructs 2. Content validity: appropriateness of items- very careful review of test items- they fully cover content being assessed 3. Criterion related validity: predicts other outcomes- concurent validity: present performance on a standard mesaure- vocabulary related to reading. Predictive validity: future related outcome (high score on tests should be correlated to strong clinic skills)

Standardized scores...what are they?

Test score of 55- what does it mean? More info needed: total # of points, how did others do? Suppose: Total points 85 Mean 50 Range 30 SD=2 (spread: average distance of score from mean) 68% of scores were between 48-52 (SD=2) 95% of scores fall between ..... What does your score mean? Score is above class average but do not know where it falls in spread of scores. What is the Need to know mean and spread of scores in order to interpret a score meaningfuly Standard deviations provide information needed to fully place score in a meaningful context. Standard deviations are a measure of how dispersed the values for a group are from the mean value for that group. Once you have the mean and sd for a set of scores you can form a picture of the set of scores collectively. 68% of scores fall 1 sd below and 1 sd above the mean. 95% of scores fall between 2 sd below and above the mean.

Bilingual clients- What Does IDEA Require?

The Individuals with Disabilities Education Improvement Act of 2004 (IDEA) specifically addresses students who speak languages other than English. The "determination of eligibility" section of the law stipulates that "a child may not be determined to be eligible under this part if the determinant factor for that eligibility determination is limited English proficiency". The unique linguistic features that many ELL students exhibit are not considered a disability under IDEA. IDEA further stipulates: ● the "materials and procedures used to assess a child with limited English proficiency are selected and administered to ensure they measure the extent to which the child has a disability and needs special education, rather than measuring the child's English language skill" and, ● "Are provided and administered in the child's native language...". ● IDEA also requires that information provided to parents must be presented in their native language. (This includes IEPs and related documents)

Assessing pragmatics: "peanut butter protocols"

There are many intents conveyed by older children Structure interaction in a way that elicits communication Note whether child "rises to communicative bait?" do they convey intent in some way does child ask for help when needed requesting clarification= conveying intent

"Swinging the lingo"

Try to use simple and straight forward words- try to pause and check in... "does that make sense to you?" 1. Your child is demonstrating receptive and expressive langauge deficits- your child is having a hard time understanding spoken language 2. Your child is omitting grammatical morphemes in spontaneous speech- your child is leaving out these small words that add grammatical information to sentences 3. Therapy will focus on pragmatic skills.- we are going to help your child behave appropriately in social situations

Purchase this test?

Want to know that test measures what it claims to measure and that scores are reliable. - poor inter rater reliability 1. Test administrators have trouble agreeing on whether responses are correct or not. Poor test-retest reliability 2. Clients perform somewhat differently on the test each time it is administered. Poor alternate form reliability 3. Scores tend to be higher on form B of this test than on form A. Poor construct validity 4. Unclear whether test examines reading comprehension or memory processes. Poor construct validity 5. Test was normed on 200 normal white children from Idaho. Poor external validity

Narrative assessment

What it is: extended monologue on a topic, bridges oral and written language Can be a familiar story, movie, personal experience Useful materials: sequencing cards, wordless picture books Story grammar analysis: evaluate elements (proficient, emerging, immature/minimal) Story grammar element. description Setting. Reference to time and place Problem. Complication, sets story in motion Internal response: how character feels in response to problem Attempt: action to solve problem Consequence: Events following attempt Resolution/reaction: final situation Ending: statement/phrase that clearly states story is over Internal plan: idea that may fix problem

Standardized language tests: that score might not mean what you think it means

Why not? Standardized tests sometimes just get it wrong Language is complex and hard to capture in a single measure Many standardized tests are flawed Diagnostic accuracy (sensitivity and specificity) vary at different cut points...but eligibility decisions are generally based on single cutoff across tests Some test samples may not be representative of the child you are assessing Sensitivity: how well does it pickup the disorder Specificity: how well it identifies people without disorder

A child's score falls at the 2nd percentile for his age level. Is there cause for concern?

Yes 98% scored better

A child's raw score is converted to a z score of -.4. Is this within the average range?

Yes. 68% of population falls between 1 above and 1 below SD

Semantic relations

accounts for majority of word combinations in toddlers spontaneous speech very useful therapeutically Semantic relation Example Attribute entity. Big shoe Possessor possession. Mommy nose Agent action. Daddy hit Action object. Hit ball Agent object. Daddy ball Demonstrative entity. This ball Entity locative. Mommy house action locative. Sleep bed recurrence entity More milk negation entity. no milk dissapearance entity. all gone cookie "other" typically around 30%

Vocal assessment benchmarks

cannonical babbling present by 10 mo rate of vocalizations ( total vocalizations/total time in min) should increase with age Proportion consonants: C>V by 16 mo Multisyllabic babbling: should increase over first 1.5 year vocalizations with >1 consonant: should begin appearing by end of year 1 babbling= clear consonant vowel production

Vocal assessment

collect "comfort state" vocalizations (sounds made while baby is alert and content)- listening, recording, taking notes aim for 20 min, around 70 vocalization sample analyze in real time, or record use to determine baby's stage of vocalization

Phonological awareness

emerges over preschool years ability to reflect on sounds in words: larger-smaller units tapping out syllables in words, breaking syllables down to individual sounds, blending sounds, rhyming strong predictor of reading ability comprehensive test of phonological processing (CTOPP), Phonological awareness profile, phonological awareness test (PAT), lindamood auditory conceptualization test

Assessing semantics

estimate vocabulary size- ask parent to make a list (too many words to count is a good sign!) when expressive vocabulary around 50 words= combinations look at relative frequency of word combinations (how many total utterances are combinations) Appropriaxately 50% is typical of 24 mo level look at range of semantic roles and relations try to elicit verbs

Corrected/adjusted age

in premature baby chronological age(CA)- number of weeks premature most suggest adjusting age until the baby is at least 2

Assessment of WM and processing skills

markers for SLI free of cultural/language bias underlying ability to process verbal information can help differentiate LI vs ADHD, CAPD, difference vs disorder underlying cognitive abilities for language Free of cultural and language bias What is their ability to learn?

SLP role in nicu: NIDCAP model

mimics womb environment in "primitive nicu" evidence based approach with improved medical, neurophysiological , and neurodevelopmental outcomes slp therapist- how to bring womb like setting in nicu

How every IEP meeting should start

remember we are working with someones child-they have strengths, talents, special characterisitcs that make them unique

Assessment of intent (informal)

same play interaction Communication intent worksheet: early vs later functions, frequency/function/means Early intentions: request object/action, protest, comment Later intentions: request information, answer, acknowledge

What you get from language ability

semantics, morphology, syntax, narrative ability

Dynamic assessment

setting up a task where you are interesting in learning how much a child can learn how to do something not interested in static assessment

Things an SLP should focus on if a baby can eat/drink

speech/langauge intent, play, babbling, first words, joint attention

"Emerging langauge" 19-36 mo

stage at which "late talkers" will be identified apparently "specific" language delays Ex: Macarthur bates communication development inventory <50 word expressive vocab, no word combinations 24 mo Do these children need EI? EI can focus on parent training (langauge facilitation) helping parents help children- look at risk factors What factors predict outcomes? Risks: preterm, low ses, extreme parent concern, family history

CSBS DP- Communication and symbolic behavior scales developmental profile

wetherby and prizant 1993 norm referenced screening tool of communicative competence checklist avaliable as free download 7 key language predictors: emotion and eye gaze, communication, gestures, sounds, words, understanding, object use functional communication 6-24 mo 3 components: checklist, caregiver questionaire, 30 min behavior sample early detection of asd, ld, dd at 1 year checkup normative sample: 2188 for checklist, 790 questionaire, 337 sample

Sequential Bilingualism

● First exposed to one language (L1) and then to the second language (L2). ● Significant variation in timing and conditions under which the L2 is introduced. ● Variation in quantity and quality of exposure to either language. ● Most consistent exposure occurs at or just before entering school. (Iglesias & Rojas, 2012) ● Innate abilities also play a role. ○ Greater diversity in rates and stages of acquisition (Guiverson, 2006) ○ Some students acquire second language with minimal interference, others may experience difficulties (Gibson, Oller, Jarmulowicz,& Ethington, 2012) ○ If second language is introduced before a basic foundation has been reached in the first language, the development of the first language may stall or regress while the child focuses on learning the second language ○ Proficiency in second language is partially a function of competence in first language (Cummins, 1992b, 2000) ○ Possible for a student to not fully develop either language; referred to as limited bilingualism ○ Different degrees of proficiency in the two languages-the proficiency changes over the lifespan

English Language Learners: Some Facts

● Lack sufficient mastery of English to successfully achieve in an English classroom without additional support. May be simultaneous or sequential bilinguals. ● Significant variability in Spanish and English skills at school entry. ● Fastest growing segment of the U.S. student population ● In 2012 10% of elementary school population in U.S ● By 2030, projected to be 40% of U.S. student population (ASHA, 2013) ● Majority of ELLs (75%) are Spanish-speaking ● Most live in linguistically isolated households ● More than 60% of ELLs come from low-income homes and half of the adults in these households do not have a high school education (SES & maternal education effect). ● In Latino families, the typical language-learning context is multiparty conversation in which the child is a passive listener (vs. dyadic interactions between mother and child.) ● The risk for academic underperformance across all areas increases when children are ELLs and receive English-only instruction. ● Significant variability in language development due to the interaction of multiple factors.

Factors Affecting Bilingualism

● Sequential vs. Simultaneous ● Parental language use patterns (mother's language is the best predictor of the child's later language use). ● Parental beliefs about language acquisition ● Birth order (first-born children are more likely to speak the minority language than their later-born siblings) ● Prestige of the language ● Siblings and peers (siblings rarely speak to each other in the non-prestigious minority lang). ● Acculturation ● Maternal Education and SES (same effect as with monolinguals) ● Length of time in the U.S. ● Value placed on bilingualism (primarily affects L1)