Posted in Assessment, Perspectives from the Field

Perspectives from the Field: A Private Practice SLP’s Take on Assessment

I recently spoke to a private practice SLP with great insights regarding the assessment process. Due to this SLP’s extensive experience in the field prior to working in private practice (some of her previous experience includes working in the school board, at the Geneva Centre for Autism, as part of a preschool speech and language initiative, in acute and long-term care facilities, etc.), the information she shared with me was based on many years of experience working with a diverse population of clients.

Before seeing the child and parent, this SLP conducts a phone screening to gather information when she receives a new referral. This is especially helpful in cases where the child’s L1 (Native of first language) may not be English, so that she can learn about the child’s exposure to English and other language(s) as well as the child’s expression style (i.e., communicates in L2 but understands L1) prior to the assessment. She will occasionally use parents as translators (when the parents have good mastery of English, and after providing careful instruction regarding what the parent can and cannot say to the child) during the assessment of bilingual/multilingual children, but will note this in the report since there could be issues with reliability using this method. Sometimes she will conduct informal observation during language-based play for most of the first visit with the child, in order to determine which areas need to be investigated further using the appropriate standardized test(s). However, she mentioned that tests like the CELF-4 (or even using a few of the subtests of the CELF) are helpful to get an idea of a wide variety of language skills.

One important consideration which impacts this SLP’s assessment process is the family’s financial resources (i.e., if a family has limited insurance coverage for SLP services, and cannot afford to pay for more services beyond this coverage). For this reason, the SLP stated that she approaches assessment as “diagnostic therapy” – similar to what we have been discussing in class as ‘dynamic assessment’. I think this is a good strategy to ensure that too many hours and dollars aren’t spent on assessment, since many parents bring their children to my course partner’s private practice because their child is not receiving/did not receive direct intervention in the school board (the SLP mentioned that many school board SLPs in the GTA only provide consultation and Tier 1 or Tier 2 intervention).

The SLP also stressed the importance of observing children during assessment because these observations can reveal valuable information beyond raw scores. For example, if you asked a child to complete a written sample in two minutes and the child only produced two sentences, this may have been due to motivation (child quickly wrote two sentences and then was looking around and fidgeting for the rest of the time) rather than actual difficulties with production (child took two minutes to slowly write out each word in the sentences), or vice versa. Beyond observation, she mentioned that we should listen and ask children what they find difficult too, because sometimes they are able to effectively describe why they find a certain task or skill difficult.

Posted in Assessment

Culturally & Linguistically Appropriate Assessment

Many schools in Ontario and Canada now have a culturally diverse population of students, which means that speech-language pathologists need to consider how to provide assessments which are culturally and linguistically fair. In the case of students referred for assessment who are English Language Learners (ELLs), SLPs will need to consider the child’s expressive and receptive knowledge in both their Native language and English to determine how to proceed with the assessment.

These are some questions I had when learning about how to conduct a culturally and linguistically appropriate assessment. I think the answers provide ways that SLPs can make assessment fair for all students:

What is a “silent period” and is it normal?
A “silent period” is a common second-language acquisition phenomenon. It occurs when children are first exposed to a second language, and focus on listening and comprehension. During this period children are often very quiet and speak little in order to focus on understanding the new language. According to the American Speech-Language-Hearing Association, the younger the child, the longer the silent period tends to last (older children may remain in the silent period for a few weeks to a few months, while preschoolers may be relatively silent for a year or more).

Can I still use norm-referenced standardized tests to assess ELLs?
Yes, but interpret the results with caution and supplement the test with other assessment tools. The child’s scores compared to the norms would also be invalid (since certain items on the test may be culturally or linguistically specific to North America/English), and thus the tests could not be used to gain conclusive quantitative data. However, they may give an SLP some preliminary information about the areas where a child may excel or need more practice. It is important to supplement standardized tests with other information, such as a language sample, observation of the child in the classroom, a review of the child’s classwork, information about the child’s expressive and receptive abilities in English and/or other languages from teachers and parents, etc.

White & Jin (cited below in the Additional Resources) discuss a variety of assessment procedures which can be used with bilingual children, including the following:
• Dynamic assessment, which commonly involves a test-teach-retest format, can be a good option for assessing bilingual children. This type of assessment integrates both assessment and therapy simultaneously, to provide information on the child’s level of performance and the impact of intervention on performance, to shed light on the strategies which would best support the child’s learning.
• Criterion-referenced (CR) measures, or measures of the child’s level of performance on a particular skill, can also be good alternative to norm-referenced standardized measures. CR measures tend to be informal (i.e., language sampling, probing, etc.) and allow the clinician to use materials which are familiar to the child, thus reducing cultural and linguistic bias.
• A sociocultural approach to assessment, although more time-consuming and intensive, takes a holistic view of the child’s developing speech and language skills in the context of their social and cultural environment.
• The RIOT procedure is one representation of the sociocultural approach, which includes the following components:
Review all documentation, client records, clinical history and educational records.
Interview parents, teachers, and relevant others to glean the child’s language history, family dynamics, interactions, cultural differences, etc.
Observe the child in multiple settings with a variety of different people.
Test all languages which the child speaks using (modified) formal and informal assessments (i.e., language sampling, dynamic assessment, etc.).

What should I say to bilingual parents or parents of ELLs in terms of Native language (L1) vs. English language use?
• Parents should know that learning two languages at home (i.e., English and a Native language like Hindi or Mandarin) does not cause confusion or a language problem in young children
• Children with language delay can also learn two languages (without the languages being kept separate, i.e., only L1 at home and only English at school), and will not become more delayed if they hear or learn two languages (However, speech and language difficulties will be heard in both languages)
• Even if a child has a language delay, parents should still continue to use both their L1 and/or English, to increase the child’s opportunities to talk, play, and get to know friends and family members who speak either language
• If the parents are not fluent or comfortable speaking in English, they should speak and read books with the child in L1 to ensure the child still has exposure to good language models

In terms of language use, what might I expect of children who are learning two languages?
Hoff & Core (cited below in the Additional Resources) provide some “need to know” facts about the language development of bilingual children:
• A measure of total vocabulary provides the best indicator of young bilingual children’s language learning capacity.
• Bilingual children can have different strengths in each language.
• Learning two languages takes longer than learning one. Thus, on average, bilingual children lag behind monolingual children in single language comparisons.
• The quantity and quality of bilingual children’s input in each language influence their rates of development in each language.

It is normal for children learning a second language to:
• Use one language more than the other
• Mix words from both languages in the same sentence (aka “code-switching”)
• Make mistakes in the new language until they learn all the rules
• Lose language skills and fluency in their L1 as they learn English (in order to prevent this, parents should be encouraged to reinforce and maintain L1 by using it at home, even if the child chooses to respond in English)

For more information, check out these additional resources:
De Lamo White, C., & Jin, L. (2011). Evaluation of speech and language assessment approaches with bilingual children. International Journal of Language & Communication Disorders / Royal College of Speech & Language Therapists, 46(6), 613.

Eriks-Brophy, A. (2014). Assessing the language of Aboriginal Canadian children: Towards a more culturally valid approach. Canadian Journal of Speech-Language Pathology and Audiology, 38(2), 152-173.

Hoff, E., & Core, C. (2015). What clinicians need to know about bilingual development. Seminars in Speech & Language, 17;36;(2), 089-099.

Language Background Questionnaires in Different Languages:
http://nhlrc.ucla.edu/nhlrc/data/questionnaires

Intelligibility in Context Scale in Different Languages:
http://www.csu.edu.au/research/multilingual-speech/ics

University of Alberta’s Child English as a Second Language Resource Centre:
https://www.ualberta.ca/linguistics/cheslcentre

Red Flags for Speech-Language Impairment in Bilingual Children:
http://leader.pubs.asha.org/article.aspx?articleid=2578642&utm_source=asha&utm_medium=enewsletter&utm_campaign=leaderlive110216

Bilingualism in Ontario
http://www.botte-boot.com/
A website with information and a blog about bilingualism in Ontario, created by a speech-language pathology faculty member at Laurentian University

Posted in Assessment, Perspectives from the Field

Perspectives from the Field: Speaking to a School Board SLP (Part II)

I recently spoke to an SLP in the Peel District School Board about her thoughts on assessment. Assessment and intervention varies across school boards, so I was interested to hear about what the approach is like in Peel.

On the “standard assessment”…
The SLP mentioned that the following tests and tools are typically used in an assessment battery:
• Peabody Picture Vocabulary Test (PPVT)
• Expressive Vocabulary Test (EVT)
• Clinical Evaluations of Language Fundamentals (CELF)
• A reading and/or writing assessment (i.e., Phonological Awareness Test)
• An informal spelling test
• A review of writing samples (i.e., past assignments the child has completed)

A full language assessment can take 8-10 hours, and thus the SLP stated that it is important to carefully consider when it is or is not appropriate to complete an extensive, formal assessment. She also stated that she likes that the CELF is comprehensive in the sense that it “covers a little bit of everything”.

On assessing English language learners (ELLs)…
The SLP explained that she works with a diverse population of students where bilingual and multilingual students are the norm at her schools, rather than the exception. Many of these children have enough exposure to English that they can be tested using standardized tests such as the CELF. However, in the case of children who are not as proficient in English, she explained that she will often administer the CELF, but will not report the child’s percentile scores. Instead, she interprets the CELF results as a “starting point” in her assessment. She observes the child in the classroom, reviews the child’s class work, and consults with teachers and parents about the child’s strengths and weaknesses to gather more information for her assessment. She stated that even without standardized test results, she is still able to set intervention goals to target for these children based on the abovementioned sources of information.

I think this highlights the importance of assessment beyond standardized tests, since there may not always be a test or set of norms which is best suited for each child, especially when working with children from a highly diverse background of cultures and languages. Standardized tests are important, but usually need to be supplemented with other information in order to fully understand the child’s capabilities.

Since this SLP works in a diverse school board, she has the advantage of being able to access translators when a child and/or the child’s parents do not know very much English. Thus, information can still be reliably gathered from the child and their parents. This resource may be more difficult to acquire in a school board where encountering multilingual children is less common.

On writing effective assessment reports…
I also wanted to get the SLP’s thoughts on the “Strategies and Recommendations” section of the assessment report, since we discussed the issues surrounding generic or redundant recommendations (i.e., Almost identical/vague recommendations across both the psychoeducational assessment report and the speech and language assessment report) in class. The SLP agreed that strategies included in assessment reports are often too generic to be meaningful for educators. She mentioned that she tries to address this issue by recommending apps, programs, or workbooks to teachers (i.e., Explode the Code phonics program) because teachers often prefer hands on materials. I think this is a great approach because both teachers and parents can then have tangible resources to help the child develop their speech and language skills.

Expect some future blog posts where I delve deeper into assessment tests, tools, and resources!