Language Delays & Disorders Assessment

Speech & Language Delays & Disorders

Assessment

Brackenbury, T., & Pye, C. (2005). Semantic deficits in children with language impairments: Issues for clinical assessment. Language, Speech, and Hearing Services in Schools, 36, 5-16.

Usefulness to Clinical Practice

Description of language learning
difficulties

Suggestions for assessing semantic
knowledge

Characteristics of Review
Population	Speech impairments
Review Type	Narrative
Country	USA
Number of studies	117 referenced

Children with language impairments demonstrate a broad range of semantic difficulties, including problems with new word acquisition, storage and organization of known words, and lexical access/retrieval. Unfortunately assessments of children’s semantic skills are often limited to measures of receptive and expressive vocabulary size. As a result, the semantic deficits of these children may not receive the attention they need. This article explores the word-learning, lexical storage and lexical access skills of children with language impairments and the theories that account for their performance. Our review culminates with specific recommendations for speech-language pathologists to improve the breadth of their semantic assessment. (Journal Abstract).

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Eisenberg, S. L., Fersko, T. M., & Lundgren, C. (2001). The use of MLU for identifying language impairment in preschool children: A review. American Journal of Speech-Language Pathology, 10, 323-342.

Usefulness to Clinical Practice

Guidelines for evaluating
assessment tools

Evidence-based methods for
eliciting & scoring language samples

MLU for identifying children with
impairments

Characteristics of Review
Population	Language impairments
Review Type	Narrative
Country	USA
Number of studies	2 included

from Authors' Discussion

Ultimately, valid use of any assessment tool is up to the user. Language samples must be gathered and scored in a way that is consistent with whatever reference database will be used, controlling for setting, participants, activity, type of material, and sample size, and following the specific guidelines for determining utterances and morphemes. Adequate time must be allotted to collect a sufficient number of usable utterances. MLU should not be used for sample sizes that are smaller than the minimum for those reference data, preferably at least 100 utterances and never fewer than 50. MLU should also not be used if more than half of a child's utterances must be included. Low MLU may be used as one piece of evidence supporting a diagnosis of language impairment in preschool children, but should never be used alone for this purpose (Lahey, 1988; Leadholm & Miller, 1992; Miller, 1981; Nelaon, 1998, Owerns, 1999).

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Laing, S. P., & Kamhi, A. (2003). Alternative assessment of language and literacy in culturally and linguistically diverse populations. Language, Speech, and Hearing Services in Schools, 34, 44-55.

Usefulness to Clinical Practice

Problems with norm-referenced
testing for diverse populations

Examples of alternative assessment
tools

Characteristics of Review
Population	Culturally & linguistically diverse children
Review Type	Narrative
Country	USA
Number of studies	71 referenced

Over- and underdiagnosis of language and literacy problems are common with low-socioeconomic status ethnically and racially diverse children. In recent years, a number of alternative assessment procedures have been developed that reduce some of the biases inherent in norm-referenced standardized tests. Problems and recent solutions to the use of norm-referenced testing will be discussed, with a focus on processing dependent and dynamic assessment procedures. (Journal Abstract).

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Rvachew, S., Hodge, M., & Ohberg, A. (2005). Obtaining and interpreting maximum performance tasks from children: A tutorial. Journal of Speech-Language Pathology and Audiology, 29, 146-156.

Usefulness to Clinical Practice

Protocol for maximum performance
testing (phonation, fricative,
repetition, etc.)

Describes software for calculating
maximum performance

Characteristics of Review
Population	Motor speech disorders
Review Type	Narrative
Country	Canada
Number of studies	13 referenced

The diagnosis of motor speech disorders in children can be aided by the use and interpretation of measures of maximum performance tasks. These tasks include measuring how long a vowel can be sustained or how fast syllables can be repeated. This tutorial provides a rationale for including these measures in assessment protocols for children with speech and sound disorders. Software developed to motivate children to cooperate with these procedures and to expedite recording of sound prolongations and syllable repetitions is described. Procedures for obtaining maximum performance measures from digital sound file recordings are illustrated followed by a discussion of how these measures may aid in clinical diagnosis. (Journal Abstract).

FULL TEXT

Schlosser, R. W. (2004). Goal attainment scaling as a clinical measurement technique in communication disorders: A critical review. Journal of Communication Disorders, 37, 217-239.

Usefulness to Clinical Practice

Goal attainment scaling with clinical
examples

Benefits & limitations of goal
attainment scaling

Characteristics of Review
Population	Communication disorders
Review Type	Narrative
Country	USA
Number of studies	64 referenced

Evaluation of client progress is an important topic in communicative disorders research and clinical literature. Goal attainment scaling (GAS) is a technique for evaluating individual progress toward goals. Despite recognition of GAS as a clinical-outcome assessment technique in other clinical professions, the current debate on measuring client progress and outcome measurement in communication disorders has largely ignored GAS. The purpose of this paper is threefold: (a) to introduce GAS to the field of communication disorders, (b) to offer a critical review, and (c) to explore directions for harnessing the value of GAS for the field. In addition to the ability of GAS to evaluate individualized longitudinal change, it offers the following positive attributes: (a) grading of goal attainment, (b) comparability across goals and clients through aggregation, (c) adaptability to any International Classification of Functioning, Disability, and Health levels and domains, (d) versatility across populations and interventions, (e) linkage tied to expected outcomes, (f) facilitator of goal attainment, and (g) a focal point for team energies. The unique value of GAS could render this technique as a welcomed addition to the present set of options available to clinicians interested in assessing progress and evaluating change. Reliability and validity of GAS will be discussed. Finally, directions for harnessing the potential of GAS for communication disorders are offered for clinical practice and clinical-outcome research.
Learning outcomes: (1) As a result of this activity, the participant will be able to delineate the steps involved in GAS. (2) As a result of this activity, the participant will be able to describe the positive attributes of GAS as a method for assessing client progress. (3) As a result of this activity, the participant will be able to identify issues that enhance the reliability and validity of GAS. (Journal Abstract).

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Sell, D. (2005). Issues in perceptual speech analysis in cleft palate and related disorders: A review. International Journal of Language & Communication Disorders, 40, 103-121.

Usefulness to Clinical Practice

Perceptual speech assessments

Graphically depicts place & manner
of speech production

Characteristics of Review
Population	Cleft palate
Review Type	Narrative
Country	United Kingdom
Number of studies	87 referenced

Background: Perceptual speech assessment is central to the evaluation of speech outcomes associated with cleft palate and velopharyngeal dysfunction. However, the complexity of this process is perhaps sometimes underestimated. Aims: To draw together the many different strands in the complex process of perceptual speech assessment and analysis, and make recommendations for practice.
Main Contributions: This review examines issues such as data sampling, data collection/recording, archiving, the advantages and disadvantages of lay and specialist listeners, approaches to data analysis, reliability, and data interpretation.
Conclusions: The need to capture meaningfully the sound of speech based on detailed phonetic analysis is argued. Also described are some of the differences in measuring speech for clinical, audit and research activities. Blind independent analysis of speech data by specialist therapists is recommended as the gold standard methodological approach when reporting audit and research outcomes. The requirement for ongoing training in listening skills for specialist therapists is advocated. The limitations of an impairment-based-only approach to measurement are also illustrated, indicating the need to develop outcome measures that incorporate more functional issues that affect quality of life. (Journal Abstract).

FULL TEXT

Togher, L. (2001). Discourse sampling in the 21st century. Journal of Communication Disorders.Special Issue: Clinics Issue: Peering into the Future, 34, 131-150.

Usefulness to Clinical Practice

Description of discourse analysis

Clinical examples of discourse
analysis

Characteristics of Review
Population	Neurogenic disorder
Review Type	Narrative
Country	Australia
Number of studies	62 referenced

This paper examines the importance of evaluating discourse in individuals with a neurogenic language disorder. Discourse analysis is acknowledged as an important tool for speech-language pathologists, although it is often not the assessment tool of choice due to its apparent time-consuming nature and the overwhelming number of options available. The wide range of analyses available to clinicians such as the number of T-units and total words produced or Pragmatic Protocol checklists make it difficult to choose assessment measures. Even more difficult is the decision of where to direct treatment efforts. This paper aims to show that there are a number of levels of discourse analysis available to clinicians and that it is possible to sample a number of different genres in a clinical setting. The significance of the communication partner’s contribution is discussed, particularly with regard to the limitations of the therapeutic interaction and the need to assess clients with a range of communication partners. The discourse opportunities we make available to people with communication problems will influence what is possible for them. To achieve this, the benefits of a theory of linguistic analysis, namely, Systemic Functional Linguistics (SFL) [Halliday, M.S.K. (1994). An introduction to functional grammar (2^nd ed.). London: Edward Arnold.] will be explored. (Journal Abstract).

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