A case for the assessment of gestures

We know that early gesture use is strongly related to language outcomes in toddlers. This study by O’Neill et al. found that, in fact, two-year-olds’ performance on standardized measures of gesture comprehension and use were correlated with expressive language skills at kindergarten entry.

Unfortunately, many of our traditional language assessments don’t dive deeply into this nonverbal form of communication. So how can an Early Intervention SLP measure early gesture use?

In this study, they used standardized play-based assessments of comprehension and use of gestures and symbols—the Communication and Symbolic Behavior Scales and the Early Sociocognitive Battery (not yet commercially available; coming late 2019). These assessments use structured but flexible activities that provide the child with opportunities to use or interpret gestures or symbols. For instance, the assessor gestures the use of an object (such as pretending to use a hammer or comb one’s hair), which then prompts the child to find the appropriate item and roll it down a chute. These tasks are nonverbal, which may help the child to feel successful. 

Although the use of a standardized measure of gesture use and comprehension provides valuable insight into how children are communicating nonverbally compared to their peers, using these formal assessments obviously isn’t required. SLPs could easily develop their own informal tool based on these important prerequisite skills for communication.

As the authors point out, assessment of gesture provides a ton of useful information, including:

  • How the child functionally communicates

  • The child’s communicative intent

  • The frequency, type, and means by which the child compensates for their communication delay

  • Where to start with intervention

  • Prediction of later language outcomes

Thus, gesture use is more than just a meaningful way for nonverbal toddlers to communicate. It is a clinically useful measure of nonverbal skills that correlate with later language outcomes and should be considered in our Early Intervention evaluations.

 

O’Neill, H., Murphy, C., & Chiat, S. (2019). What our hands tell us: A two-year follow up investigating outcomes in subgroups of children with language delay. Journal of Speech, Language, and Hearing Research. doi:10.1044/2018_JSLHR-L-17-0261