social pragmatic language | Smart Speech Therapy

Posted on November 3, 2014January 5, 2022 by Tatyana Elleseff — 3 Comments

Review of Social Language Development Test Adolescent: What SLPs Need to Know

A few weeks ago I reviewed the Social Language Development Test Elementary (SLDTE) and today I am reviewing the Social Language Development Test Adolescent (SLDTA) currently available from PRO-ED.

Basic overview

Release date: 2010
Age Range: 12-18
Authors:Linda Bowers, Rosemary Huisingh, Carolyn LoGiudice
Publisher: Linguisystems (PRO-ED as of 2014)

The Social Language Development Test: Adolescent (SLDT-A) assesses adolescent students’ social language competence. The test addresses the students ability to take on someone else’s perspective, make correct inferences, interpret social language, state and justify logical solutions to social problems, engage in appropriate social interactions, as well as interpret ironic statements.

The Making Inferences subtest of the SLDT-A assesses students’ ability to infer what someone in the picture is thinking as well as state what visual cues aided him/her in the making of that inference.

The first question asks the student to pretend to be a person in the photo and then to tell what the person is thinking by responding as a direct quote. The quote must be relevant to the person’s situation and the emotional expression portrayed in the photo.The second question asks the student to identify the relevant visual clues that he used to make the inference.

Targeted Skills include:

detection of nonverbal and context clues
assuming the perspective of a specific person
inferring what the person is thinking and expressing the person’s thought
stating the visual cues that aided with response production

A score of 1 or 0 is assigned to each response, based on relevancy and quality. However, in contrast to the SLDTE student must give a correct response to both questions to achieve a score of 1.

Errors can result due to limited use of direct quotes (needed for correct responses to indicate empathy/attention to task), poor interpretation of provided visual clues (attended to irrelevant visuals) as well as vague, imprecise, and associated responses.

The Interpreting Social Language subtest of the SLDT-A assesses students’ ability to demonstrate actions (including gestures and postures), tell a reason or use for an action, think and talk about language and interpret figurative language including idioms.

A score of 1 or 0 is assigned to each response, based on relevancy and quality. Student must give a correct response to both questions to achieve a score of 1.

Targeted Skills:

Ability to demonstrate actions such as gestures and postures
Ability to explain appropriate reasons or use for actions
Ability to think and talk about language
Ability to interpret figurative language (e.g., idioms)

Errors can result due to vague, imprecise (off-target), or associated responses as well as lack of responses. Errors can result due to lack of knowledge of correct nonverbal gestures to convey meaning of messages. Finally errors can result due to literal interpretations of idiomatic
expressions.

The Problem Solving subtest of the SLDT-A assesses students’ ability to offer a logical solution to a problem and explain why that would be a good way to solve the problem.

To receive a score of 1, the student has to provide an appropriate solution with relevant justification. A score of 0 is given if any of the responses to either question were incorrect or inappropriate.

Targeted Skills:

Taking perspectives of other people in various social situations
Attending to and correctly interpreting social cues
Quickly and efficiently determining best outcomes
Coming up with effective solutions to social problems
Effective conflict negotiation

Errors can result due to illogical or irrelevant responses, restatement of the problem, rude solutions, or poor solution justifications.

The Social Interaction subtest of the SLDT-A assesses students’ ability to socially interact with others.

A score of 1 is given for an appropriate response that supports the situation. A score of 0 is given for negative, unsupportive, or passive responses as well as for ignoring the situation, or doing nothing.

Targeted Skills:

Provision of appropriate, supportive responses
Knowing when to ignore the situation

Errors can result due to inappropriate responses that were negative, unsupportive or illogical.

The Interpreting Ironic Statements subtest of the SLDT-A assesses sudents’ ability to recognize sarcasm and interpret ironic statements.

To get a score of 1, the student must give a response that shows s/he understands that the speaker is being sarcastic and is saying the opposite of what s/he means. A score of 0 is given if the response is literal and ignores the irony of the situation.

Errors can result due to consistent provision of literal idiom meanings indicating lack of
understanding of the speaker’s intentions as well as “missing” the context of the situation. errors also can result due the the student identifying that the speaker is being sarcastic but being unable to explain the reason behind the speaker’s sarcasm (elaboration).

For example, one student was presented with a story of a brother and a sister who extensively labored over a complicated recipe. When their mother asked them about how it came out, the sister responded to their mother’s query: “Oh, it was a piece of cake”. The student was then asked: What did she mean?” Instead of responding that the girl was being sarcastic because the recipe was very difficult, student responded: “easy.” When presented with a story of a boy who refused to help his sister fold laundry under the pretext that he was “digesting his food”, he was then told by her, “Yeah, I can see you have your hands full.” the student was asked: “What did she mean?” student provided a literal response and stated: “he was busy.”

The following goals can be generated based on the performance on this test:

Long Term Goals: Student will improve social pragmatic language skills in order to effectively communicate with a variety of listeners/speakers in all social and academic contexts
Short Term Goals

Student will improve his/her ability to make inferences based on social scenarios
Student will improve his/her interpretation of facial expressions, body language, and gestures
Student will improve his/her ability to interpret social language (demonstrate appropriate gestures and postures, use appropriate reasons for actions, interpret figurative language)
Student will his/her ability to provide multiple interpretations of presented social situations
Student will improve his/her ability to improve social interactions with peers and staff (provide appropriate supportive responses; ignore situations when doing nothing is the best option, etc)
Student will improve his/her ability to interpret abstract language (e.g., understand common idioms, understand speaker’s beliefs, judge speaker’s attitude, recognize sarcasm, interpret irony, etc)

A word of caution regarding testing eligibility:

I would also not administer this test to the following adolescent populations:

Students with social pragmatic impairments secondary to intellectual disabilities (IQ <70)
Students with severe forms of Autism Spectrum Disorders
Students with severe language impairment and limited vocabulary inventories
English Language Learners (ELL) with suspected social pragmatic deficits
Students from low SES backgrounds with suspected pragmatic deficits

I would not administer this test to Culturally and Linguistically Diverse (CLD) students due to significantly increased potential for linguistic and cultural bias, which may result in test answers being marked incorrect due to the following:

Lack of relevant vocabulary knowledge will affect performance
Lack of exposure to certain cultural and social experiences related to low SES status or lack of formal school instruction
- How many of such students would know know the meaning of the word “sneer”?
- How many can actually show it?
Life experiences that the child simply hasn’t encountered yet
- Has an entire subtest devoted to idioms
Select topics may be inappropriate for younger children
- Dieting
- Dating
Culturally biased when it comes to certain questions regarding friendship and personal values
- Individual vs. cooperative culture differences

What I like about this test:

I like the fact that unlike the CELF-5:M, the test is composed of open-ended questions instead of offering orally/visually based multiple choice format as it is far more authentic in its representation of real world experiences
I really like how the select subtests (Making Inferences) require a response to both questions in order for the responder to achieve credit on the total subtest

Overall, when you carefully review what’s available in the area of assessment of social pragmatic abilities of adolescents this is an important test to have in your assessment toolkit as it provides very useful information for social pragmatic language treatment goal purposes.

Have YOU purchased SLDTA yet? If so how do you like using it? Post your comments, impressions and questions below.

Helpful Resources Related to Social Pragmatic Language Overview, Assessment and Remediation:

Disclaimer: The views expressed in this post are the personal opinion of the author. The author is not affiliated with PRO-ED or Linguisystems in any way and was not provided by them with any complimentary products or compensation for the review of this product.

Posted on October 19, 2014January 5, 2022 by Tatyana Elleseff — 7 Comments

Review of Social Language Development Test Elementary: What SLPs Need to Know

As the awareness of social pragmatic language disorders continues to grow, more and more speech language pathologists are asking questions regarding various sources of social pragmatic language testing. Today I am reviewing one such test entitled: Social Language Development Test Elementary (SLDTE) currently available from PRO-ED.

Basic overview

Release date: 2008
Age Range: 6:00-11:11
Authors:Linda Bowers, Rosemary Huisingh, Carolyn LoGiudice
Publisher: Linguisystems (PRO-ED as of 2014)

This test assesses the students’ social language competence and addresses their ability to take on someone else’s perspective, make correct inferences, negotiate conflicts with peers, be flexible in interpreting situations and supporting friends diplomatically.

The test is composed of 4 subtests, of which the first two subtests are subdivided into 2 and 3 tasks respectively.

The Making Inferences subtest (composed of 2 tasks) of the SLDT-E is administered to assess student will’s ability to infer what someone in the picture is thinking (task a) as well as state the visual cues that aided the student in the making of that inference (task b).

On task /a/ errors can result due to student’s difficulty correctly assuming first person perspective (e.g., “Pretend you are this person. What are you thinking?”) and infering (guessing) what someone in the picture was thinking. Errors can also result due to vague, associated and unrelated responses which do not take into account the person’s context (surroundings) as well as emotions expressed by their body language.

On task /b/ errors can result due to the student’s inability to coherently verbalize his/her responses which may result in the offer of vague, associated, or unrelated answers to presented questions, which do not take into account facial expressions and body language but instead may focus on people’s feelings, or on the items located in the vicinity of the person in the picture.

The Interpersonal Negotiation subtest (composed of 3 tasks) of the SLDT-E is administered to assess the student’s ability to resolve personal conflicts in the absence of visual stimuli. Student is asked to state the problem (task a) from first person perspective (e.g., pretend the problem is happening with you and a friend), propose an appropriate solution (task b), as well as explain why the solution she was proposing was a good solution (task c).

On task /a/ errors can result due to the student’s difficulty recognizing that a problem exists in the presented scenarios. Errors can also result due to the student’s difficulty stating a problem from a first person perspective, as a result of which they may initiate their responses with reference to other people vs. self (e.g., “They can’t watch both shows”; “The other one doesn’t want to walk”, etc.). Errors also can also result due to the student’s attempt to provide a solution to the presented problem without acknowledging that a problem exists. Here’s an example of how one student responded on this subtest. When presented with: “You and your friend found a stray kitten in the woods. You each want to keep the kitten as a pet. What is the problem?” A responded: “They can’t keep it.” When presented with: “You and your friend are at an afterschool center. You both want to play a computer game that is played by one person, but there’s only one computer. What is the problem?” A responded: “You have to play something else.”

On task /b/ errors can result due to provision of inappropriate, irrelevant, or ineffective solutions, which lack arrival to a mutual decision based on dialog.

On task /c/ errors can result due to vague and inappropriate explanations as to why the solution proposed was a good solution.

The Multiple Interpretations subtest assesses the student’s flexible thinking ability via the provision of two unrelated but plausible interpretations of what is happening in a photo. Here errors can result due to an inability to provide two different ideas regarding what is happening in the pictures. As a result the student may provide vague, irrelevant, or odd interpretations, which do not truly reflect the depictions in the photos.

The Supporting Peers subtest assesses student’s ability to take the perspective of a person involved in a situation with a friend and state a supportive reaction to a friend’s situation (to provide a “white lie” rather than hurt the person’s feelings). Errors on this subtest may result due to the student’s difficulty appropriately complementing, criticizing, or talking with peers. Thus students who as a rule tend to be excessively blunt, tactless, or ‘thoughtless’ regarding the effect their words may have on others will do poorly on this subtest. However, there could be situations when a high score on this subtest may also be a cause for concern (see the details on why that is HERE). That is because simply repeating the phrase “I like your ____” over and over again without putting much thinking into their response will earn the responder an average subtest score according to the SLDT-E subtest scoring guidelines. However, such performance will not be reflective of true subtest competence and needs to be interpreted with significant caution.

The following goals can be generated based on the performance on this test:

Long Term Goals: Student will improve social pragmatic language competence in order to effectively communicate with a variety of listeners/speakers in all conversational and academic contexts

Short Term Goals

Student will improve ability to make inferences based on social scenarios
Student will improve ability to interpret facial expressions, body language, and gestures
Student will improve ability to recognize conflicts from a variety of perspectives (e.g., first person, mutual, etc.)
Student will improve ability to resolve personal conflicts using effective solutions relevant to presented scenarios
Student will improve ability to effectively justify solutions to presented situational conflicts
Student will ability to provide multiple interpretations of presented social situations
Student will provide effective responses to appropriately support peers in social situations
Student will improve ability to engage in perspective taking (e.g., the ability to infer mental states of others and interpret their knowledge, intentions, beliefs, desires, etc.)

A word of caution regarding testing eligibility:

I would also not administer this test to the following populations:

Students with social pragmatic impairments secondary to intellectual disabilities (IQ <70)
Students with severe forms of Autism Spectrum Disorders
Students with severe language impairment and limited vocabulary inventories
English Language Learners (ELL) with suspected social pragmatic deficits
Students from low SES backgrounds with suspected pragmatic deficits

Lack of relevant vocabulary knowledge
Lack of exposure to certain cultural and social experiences related to low SES status or lack of formal school instruction
Life experiences that the child simply hasn’t encountered yet
- For example the format of the Multiple Interpretations subtest may be confusing to students unfamiliar with being “tested” in this manner (asked to provide two completely different reasons for what is happening ina particular photo)

What I like about this test:

I like the fact that the test begins at 6 years of age, so unlike some other related tests such as the CELF-5:M, which begins at 9 years of age or the informal Social Thinking Dynamic Assessment Protocol® which can be used when the child is approximately 8 years of age, you can detect social pragmatic language deficits much earlier and initiate early intervention in order to optimize social language gains.
I like the fact that the test asks open-ended questions instead of offering orally/visually based multiple choice format as it is far more authentic in its representation of real-world experiences
I really like how the select subtests are further subdivided into tasks in order to better determine the students’ error breakdown

Overall, when you carefully review what’s available in the area of assessment of social pragmatic abilities this is an important test to have in your assessment toolkit as it provides very useful information for social pragmatic language treatment goal purposes.

Have YOU purchased SLDTE yet? If so how do you like using it?Post your comments, impressions and questions below.

NEW: Need an SLDTE Template Report? Find it HERE

Helpful Resources Related to Social Pragmatic Language Overview, Assessment and Remediation:

Posted on October 13, 2014March 12, 2022 by Tatyana Elleseff — 4 Comments

Test Review of CELF-5 Metalinguistics: What SLPs Need to Know

In mid-2014, I purchased the Clinical Evaluation of Language Fundamentals®, Fifth Edition Metalinguistics (CELF®-5 Metalinguistics), which is a revision of the Test of Language Competence–Expanded.

Basic overview

Release date: 2014
Age Range: 9-21
Author: Elizabeth Wiig and Wayne Secord
Publisher: Pearson

Description: According to the manual CELF–5M was created to “identify students 9-21 years old who have not acquired the expected levels of communicative competence and metalinguistic ability for their age” (pg. 1). In other words the test targets higher level language skills beyond the basic vocabulary and grammar knowledge and use. The authors recommend using this test with students with “subtle language disorders” or “those on the autism spectrum”.

The test contains 5 subtests:

The Metalinguistics Profile subtest of the CELF-5:M is a questionnaire (filled out by caregiver or teacher) which targets three areas: Words, Concepts, and Multiple Meanings; Inferences and Predictions; as well as Conversational Knowledge and Use. Its aim is to obtain information about a student’s metalinguistic skills in everyday educational and social contexts to complement the evidence of metalinguistic strengths and weaknesses identified by the other subtests that comprise the CELF-5:M test battery.

Questions address such topics as the child’s comprehension of idioms and abstract language, their predicting and inferencing abilities, their ability to deal with unpleasant situations, participate in group discussions, as well as understand jokes and sarcasm, just to name a few. A maximum of four points can be obtained on each of it 30 questions. The following is the rating criteria: a score of one is obtained when a child ‘never’ does something in a particular category (e.g., doesn’t get the punchline of jokes). A score of two is given when a child is capable of understanding or using something ‘some of the time’. A score of three is given when a child is able to understand or perform something ‘often’. Finally, a score of four is given when a child is capable of comprehending something ‘always’ or ‘almost always’.

A word of caution, when giving this profile to either teachers or parents to fill out, the SLP must ensure that no overinflation or underestimation of scores takes place. Frequently, some parents may not have a clear understanding of the extent of their child’s level of deficits. Similarly, some teachers, especially those who may not know the child very well, or those who have worked with a child for a very short period of time, may overinflate the scores when filling out the questionnaire. However, the opposite may also occur. A small group of parents may underestimate their children’s abilities, and provide poor scores as a result also not providing an objective picture of the child’s level of deficits. In such situations, the best option may be for the SLP to fill out the questionnaire together with the parent or teacher in order to provide explanations of questions in a different categories.

The Making Inferences subtest of the CELF-5:M evaluates the student’s ability to identify and formulate logical inferences on the basis of existing causal relationships presented in short narrative texts. The student is visually and auditorily presented with a particular situation by the examiner. S/he is then asked to identify the best two out of four written answers for the ending and come up with her own additional reason other than the ones listed in the stimulus book.

On the multiple choice portion of the subtest errors can result due to provision of contradictory, unrelated and irrelevant responses. On the open ended questions portion of the subtest errors can result due to vague, confusing, incomplete, unlikely or illogical responses as well as due to contradictory and off topic answers.

I must say that this is my least favorite subtest. Here’s why. In real life students are not provided with multiple choices when asked to make predictions or inferences. That is why I do not believe that performance on this subtest is a true representation of the child’s ability in this area.

The Conversational Skills subtest of the CELF-5:M evaluates the student’s ability to initiate a conversation or respond in a way that is relevant and pragmatically appropriate to the context and audience while incorporating given words in semantically and syntactically correct sentences. S/he are presented with a picture scene that creates a conversational context and two or three words which are also printed above the pictured scene. S/he are then asked to formulate a conversationally and pragmatically appropriate sentence for the given context using all of the target words in the form (tense, number, etc.) provided.

Errors on this subtest can result due to pragmatic, semantic or syntactic errors. With respect to pragmatics errors can result due to illogical, nonsensical, vague or incomplete sentences as well as due to sentence formulation which does not take into account presented scenes. With respect to semantics errors can result due to missing or misused target words as well as due to vague, incorrect or misused verbiage. With respect to syntax errors can result due to use of sentence fragments, morphological misuse of target words (changing word forms) as well as syntact deviations on non-target words.

The Multiple Meanings subtest of the CELF-5:M evaluates the student’s ability to recognize and interpret different meanings of selected lexical (word level) and structural (sentence level) ambiguities. S/he are presented a sentence (orally and in text) that contained an ambiguity at either the word or sentence level. S/he are then asked to describe two meanings for each presented sentence.

Errors can result due to difficulty interpreting lexical and structural ambiguities as well as due to an inability to provide more than one interpretation to presented multiple meaning words.

The Figurative Language subtest of the CELF-5:M evaluates the student’s ability to interpret figurative expressions (idioms) within a given context and match each expression with another figurative expression of similar meaning given verbal and written support.

Errors on this subtest can result due to difficulty explaining the meanings of idiomatic expressions, as well as due to difficulty selecting the appropriate meaning from visually provided multiple choice answers containing related idiomatic expressions.

Based on testing the following long-term goal can be generated:

LTG: Student will improve his/her metalinguistic abilities (thinking about language) for academic and social purposes

It can also yield the following short-term goals

Student will improve ability to make social inferences with an without written support
Student will improve ability to to make social predictions with and without written support
Student will produce (choose one/all: syntactically, semantically, pragmatically) appropriate compound and complex sentences with and without visual support
Student will improve ability to explain context embedded multiple meaning words
Student will improve ability to explain ambiguously worded language
Student will improve ability to explain figurative language and idiomatic expressions

A word of caution regarding testing eligibility:

What I am concerned about:

It is rather costly with a sticker price of $376, which is far above other tests assessing similar abilities on the market.
Test administration begins at 9 years of age. However, metalinguistic abilities develop in children much earlier than nine years of age. Children and young as 6 years of age can present with glaring metalinguistic deficits but unless the examiner has access to another testing which could assess the children’s metalinguistic abilities we have to wait until the child is nine and is clearly behind his or her peers in their metalinguistic development in order to confirm the presence of deficits.
I also don’t understand the presence of visual and written stimuli on select testing subtests. Children are not provided with multiple-choice answers or written support in daily social and academic situations. As a result of the presence of these aids score overinflation may occur with those children who do well given compensatory strategies but who have difficulty generating novel spontaneous responses.
Similarly, I am concerned that higher functioning yet socially clueless students may be administered this test because the examiners may believe that it would accurately assess their higher functioning social pragmatic language abilities. However many higher functioning students will pass this test with flying colors, which is why I urge considerable caution when selecting student population for testing administration
- Very Important: See the sensitivity and specificity details of CELF-5M above.

Consequently the CELF-5: M administration is not for everyone. As mentioned before I would only administer portions of this test to higher functioning (but not too high functioning) students undergoing language assessment for the first time or to higher functioning students receiving a re-evaluation, who have previously passed the Clinical Evaluation of Language Fundamentals-5 with ease. This test would not be appropriate for Severely Challenged and Challenged Social Communicators (see Winner, 2015)

I would also not administer this test to the following populations:

Students with intellectual disabilities
Students with severe language impairment and limited vocabulary inventories
English Language Learners (ELL) with suspected language deficits
Students from low SES backgrounds*

I would not administer the CELF-5:M to the latter two groups of students due to significantly increased potential for linguistic and cultural bias stemming from lack of previous knowledge and exposure to popular culture as well as idiomatic expressions.

I would also not administer this test to Nuance Challenged Social Communicators (Winner, 2015). Specifically to Socially Anxious and Weak Interactive Social Communicators (Winner, 2015). These are the students with average or above average verbal language abilities most of whom did not have language delays when they were young. They have a ‘well-developed social radar’ and they’re highly aware of other people feelings and thoughts. However they have difficulties navigating subtle social cues of others. As a result this particular group of students tends to score quite on metalinguistic and social pragmatic testing of reduced complexity yet still present with pervasive social pragmatic language deficits.

Consequently, Clinical Assessment of Pragmatics (CAPs) administration would better suit their needs.

What I do like about this test:

This test allows me to identify more subtle language-based difficulties in verbal children with average to high average intelligence (or Emerging Social Communicators as per Winner, 2015) who present with metalinguistic and social pragmatic language weaknesses in the following areas:

Social predicting and inferencing
Conversational rules and breakdown repairs
Knowledge of high-level and abstract vocabulary words
Identification and usage of ambiguous and figurative language
Coherent and cohesive discourse and narrative formulation
Knowledge and use of multiple meaning words in a variety of conversational and text-embedded contexts

Overall, this is an nice test to have in your assessment toolkit. Consequently,if SLPs exercise caution in test candidate selection they can obtain very useful information for metalinguistic and social pragmatic language treatment goal purposes.

NEW: Need a CELF-5M Template Report? Find it HERE

3-1-19 Update: Since this review was written in October 2014, I have reviewed other tests, including the Clinical Assessment of Pragmatics (CAPs), which can be substituted and effectively used to delve into metalinguistic abilities of students with social communication difficulties. As such, while I still use the Multiple Meanings and the Figurative Language subtests of the CELF-5M rather frequently due to its suitability for a select number of students that I assess, given its described limitations, I would approach its purchase with caution, if it were the only test to be owned by the therapist for the purpose of assessment (it’s perfectly suitable as part of a battery but not as a standalone and only option).

Helpful Resources Related to Social Pragmatic Language Overview, Assessment and Remediation:

Disclaimer: The views expressed in this post are the personal opinion of the author. The author is not affiliated with Pearson in any way and was not provided by them with any complimentary products or compensation for the review of this product.

Posted on June 20, 2014January 5, 2022 by Tatyana Elleseff — Leave a comment

What is ND-PAE and how is it Related to FASD?

The DSM-5 was released in May 2013 and with it came a revision of criteria for the diagnosis and classification of many psychiatric disorders. Among them a new proposed criteria was included relevant to alcohol related deficits in children, which is Neurobehavioral Disorder Associated With Prenatal Alcohol Exposure (ND-PAE) (DSM-5, pgs 798-801). This proposed criteria was included in order to better serve the complex mental health needs of individuals diagnosed with alcohol related deficits, which the previous diagnosis of 760.71 – Alcohol affecting fetus or newborn via placenta or breast milk was unable to adequately capture. Continue reading What is ND-PAE and how is it Related to FASD?

Posted on June 18, 2014January 5, 2022 by Tatyana Elleseff — 7 Comments

Why is FASD diagnosis so important?

Recently, I’ve participated in various on-line and in-person discussions with both school-based speech language pathologists (SLPs) as well as medical health professionals (e.g., neurologists, pediatricians, etc.) regarding their views on the need of formal diagnosis for school aged children with suspected alcohol related deficits. While their responses differed considerably from: “we do not base intervention on diagnosis, but rather on demonstrated student need” to “with a diagnosis of ASD ‘these children’ would get the same level of services“, the message I was receiving loud and clear was: “Why? What would be the point?” So today I decided to share my views on this matter and explain why I think the diagnosis matters.
Continue reading Why is FASD diagnosis so important?

Posted on June 4, 2014January 5, 2022 by Tatyana Elleseff — 3 Comments

Why Developmental History Matters: On the Importance of Background Information in Speech-Language Assessments

Lately I’ve been seeing quite a few speech language therapy reports with minimal information about the child in the background history section of the report. Similarly, I’ve encountered numerous SLPs seeking advice and guidance relevant to the assessment and treatment of difficult cases who were often at a loss when asked about specific aspects of their client’s background family history in order to assist them better. They’ve never delved into it beyond a few surface details! Continue reading Why Developmental History Matters: On the Importance of Background Information in Speech-Language Assessments

Posted on May 30, 2014January 5, 2022 by Tatyana Elleseff — 2 Comments

Why Do I Have to Tell You What’s Wrong with My Child? Or On the Importance of Targeted Assessments

A few days ago I received a phone call from a parent who was seeking a language evaluation for her child. As it is my policy with all assessments, I asked her to fill out an intake and a checklist to identify her child’s specific areas of difficulty in order to compile a comprehensive and targeted testing battery. Her response to me was: “I’ve never heard of this before? Why do I have to tell you what’s wrong with my child? Why can’t you figure it out?” Similarly, last week, another parent has questioned: “So you can’t do the assessment without this form?” Given the above questions, and especially because May is a Better Hearing and Speech Month #BHSM, during which it is important to raise awareness about communication disorders, I want to take this time to explain to parents why performing targeted speech language assessments is SO CRUCIAL.

To begin with it is very important to understand that speech and language can be analyzed in many different ways beyond looking at pronunciation, vocabulary or listening and speaking skills.

Targeted areas within the scope of practice of pediatric school based speech language pathologists include the assessment of:

SPEECH
- The child may have difficulties with pronunciation of sounds in words, stutter, clutter, have a lisp or have difficulties in the areas of voice, prosody, or resonance. For the majority of the above difficulties completely different tests and testing procedures may be needed in order to appropriately assess the child.

LANGUAGE
- Receptive Language
  - Ability to follow directions, answer questions, recall sentences, understand verbal messages, as well as comprehend orally presented text
- Memory and Attention
  - Also see executive function skills
- Expressive Language
  - Vocabulary knowledge and use, formulation of words and sentences as well as production of narratives or stories
- Problem Solving
  - Verbal reasoning and critical thinking skills are very important for successful independent decision making as well as for interpretation of academically based texts and complete assignments
- Pragmatic Language
  - Successful use of language for a variety of communicative purposes
    - Initiate and maintain topics, maintain conversational exchanges, request help, etc
- Social Emotional Competence
  - Effective interpersonal negotiation skills, compromise and negotiation abilities, as well as perspective taking are integral to academic and social success. These abilities are often compromised in children with language disorders and require a thorough assessment
- Executive Functions (EFs)
  - These are higher level cognitive processes involved in inhibition of thought, action and emotion, which are located in the prefrontal cortex of the frontal lobe of the brain.
  - Major EF components include working memory, inhibitory control, planning, and set-shifting. EFs contribute to child’s ability to sustain attention, ignore distractions, and succeed in academic settings.
READING DISABILITIES AND DYSLEXIA
- Phonological Awareness
- Reading Ability
- Writing
- Spelling

One General Language Test Does Not Fit All!

Children with speech and language disorders do not necessarily display weaknesses in all affected areas but may only display difficulties in selected few.

To illustrate, high functioning students on the autistic spectrum may have very strong academic skills related to comprehension and expression of language but may display significant social pragmatic language weaknesses, which will not be apparent on general language testing (e.g., administration of Clinical Evaluation of Language Fundamentals -5). Thus, the administration of a general language test will be contraindicated for these students as it will only show typical performance on these tests and will not qualify them for targeted language based services that they need. However, by administering to them a testing battery composed of tests sensitive to social pragmatic language competence will highlight their areas of difficulty and result in a creation of a targeted intervention plan to improve their abilities in the affected areas.

Similarly, children at risk for reading disabilities will not benefit from the administration of general language testing either, since their deficits may lie in the areas of sound discrimination, isolation, or blending as well as as impaired decoding ability. So the administration of tests sensitive to phonological awareness and emergent reading ability would be much more relevant.

This is exactly why taking an extra step and filling out a simple form will result in a much more targeted and beneficial speech language assessment for the child. The goal of any competent professional assessment is to eliminate the administration of unnecessary and irrelevant tests and focus only on the administration of instruments directly targeting the areas of difficulty that the child presents with. Given the fact that assessment of language covers so many broad areas, it makes perfect sense to ask parents to fill out relevant checklists/intakes as a routine part of a pre-assessment procedure. Otherwise, even after observations in school setting, I would still just be blindly ‘fishing’ for deficits without really knowing whether I will ‘accidentally stumble upon them’ using a general test at hand.

Of course, even checklists need to be targeted by age and areas of functioning. Here’s how I use mine. When performing comprehensive fist time assessments I ask the parent to fill out the comprehensive checklists based on the child’s age. These are broken down as follows:

However, oftentimes when I perform reassessments or second opinion evaluations, I may ask the parent to fill out checklists pertaining to specific, known, areas of difficulty. These currently include:

After the parent fills the checklist out, the child’s areas of difficulty literally jump out from the pages. Now, all I need to do is to choose the appropriate testing instruments, which will BEST help me determine the exact nature and cause of the child’s deficits and I am all set. I administer the testing, interpret the results and write a comprehensive report detailing which therapy goals will be targeted. And this is why pre-assessment checklist administration is so important.

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