The kids missing from our caseloads

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Kids with developmental language disorder (DLD) can fly under the radar for years without anyone flagging their language weaknesses, including their parents. Hendricks et al. looked into whether parents of first and second graders (6–9-year-olds) with DLD were concerned about their children’s language skills and whether a quick, whole-class screening could distinguish children with and without DLD accurately.

For the language screening, children heard 16 sentences from the Test for Reception of Grammar (TROG-2) and circled picture responses in a booklet. This method meant that it only took 15–20 minutes to screen each class of kids. Children also completed additional language and reading testing, and their parents filled out a questionnaire.

The researchers found that parents of children with DLD rarely reported concerns about their language skills—although parents of children with DLD were twice as likely to have concerns if their children struggled with reading, too. Also, the quick, whole-class screener showed promise for identifying DLD. At the best cutoff score, 76% of children with DLD were correctly flagged, while 25% of children without DLD were incorrectly flagged. While these values aren’t quite at an acceptable level, the trade-off of spending 20 minutes or fewer to screen an entire class of children means that the screener warrants more research.

In summary, if we wait for parents of children with DLD to raise concerns about their language, we might be waiting too long, and parents of children with DLD and average reading skills are especially unlikely to notice that anything is wrong. Screening all children’s language could help identify them sooner; fortunately, efficient screeners show promise!

 

Hendricks, A. E., Adlof, S. M., Alonzo, C. N., Fox, A. B., & Hogan, T. P. (2019). Identifying children at risk for developmental language disorder using a brief, whole-classroom screen. Journal of Speech, Language, and Hearing Research. doi:10.1044/2018_JSLHR-L-18-0093

Dynamic assessment = Crystal ball for reading skills?

Helping kids become proficient readers is a big deal. Schools often screen children’s decoding skills (the ability to sound out words) to figure out who needs help. But what do screening results mean for children’s future reading ability? Petersen et al. followed a diverse group of children from kindergarten to fifth grade to find out.

The authors administered a quick dynamic assessment task at the beginning of kindergarten. Children were asked to decode four nonsense words, taught how to decode them, and asked to decode them again. Examiners scored children’s accuracy and how easily they responded to teaching. The task took only three minutes to administer on average. (The task is described more in this article, and it’s similar to the decoding tasks on the PEARL.) The children’s schools also screened their ability to name letters and sounds at the beginning of kindergarten and their oral reading fluency at the end of each year.

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Performance on the dynamic task in kindergarten classified children into average vs. struggling reader categories in fifth grade with 75–80% accuracy. The 3-minute dynamic task was better at predicting reading skill than the traditional static (one-time) screening, especially for the Hispanic students in the sample, many of whom were English language learners.

The task wasn’t perfect at predicting fifth grade reading skill, but it was pretty good, especially considering how fast it was to administer. These findings suggest that, compared to the static measures, dynamic assessment of decoding could save a ton of intervention time. Dynamic tasks are less likely to pick up children who just lack reading exposure, saving us time for working with the kids who will continue to need help with reading (AKA, making RTI less of a massive undertaking).

 

Petersen, D. B., Gragg, S. L., & Spencer, T. D. (2018). Predicting reading problems 6 years into the future: Dynamic assessment reduces bias and increases classification accuracy. Language, Speech, and Hearing Services in the Schools, 49(4), 875–888.

What test do you want 30% of kindergarteners to fail? A language screener

Did you ever add a child to your caseload and think, “Why haven’t I seen this kid sooner?!” You’re not alone. Underidentification of developmental language disorder in young children is a major issue. So, how can we deal with this? One way is to identify good screening tools. Previous research shows that effective language screeners should result in a failure rate close to 30%, meaning that 30% of the children don’t pass, and you’ll capture the children most likely to have a language disorder.

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The authors of this study found that probing for past-tense grammar was an effective way to screen for language disorder in kindergarten students. Specifically, they gave a large group of kindergarten students a screener of grammatical tense marking— the Rice Wexler Test of Early Grammatical Impairment (TEGI) Screening Test—which included past tense and third-person singular probes. Only the past-tense probes resulted in a failure rate close to 30%, showing their potential use as an effective screening tool. If children* fail past-tense probes, this is a red flag and tells us that close monitoring or a formal evaluation may be the next appropriate step.

The students were also screened for nonverbal intelligence, articulation, and emergent literacy skills. Interestingly, the children who failed the past-tense probe often had age-appropriate skills in these areas. What does this tell us? We can’t rely on screeners of related skills to identify children at risk for language disorder—we have to screen oral language directly. If we don’t, we may miss kids who fly under the radar due to their relatively stronger articulation or literacy abilities.

Want to know the best part? The TEGI Screening Test is FREE and available here!

*One very important note: the TEGI is only valid for children who speak Standard (Mainstream) American English. Students who speak African American English or Spanish-influenced English should not be screened with this tool. Check out this review for an alternative.

Weiler, B., Schuele, C. M., Feldman, J. I., & Krimm, H. (2018). A multiyear population-based study of kindergarten language screening failure rates using the Rice Wexler Test of Early Grammatical Impairment. Language, Speech, and Hearing Services in Schools49, 248–259. doi: 10.1044/2017_LSHSS-17-0071.

Teacher ratings as a language screening for dialect speakers

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In the last review, we shared research on a potentially valid tool to screen Mainstream English-speaking kindergarteners for language disorders. But what about our kiddos who speak other dialects of English, like African American English (AAE) or Southern White English (SWE)? In this study, researchers gave a group of AAE- and SWE-speaking kindergarteners a handful of language and literacy screeners, to see which one(s) could best identify possible language disorders, while avoiding “dialect effects.”

Their most successful screener (and TISLP’s winner for best acronym of the month) was the TROLL, or Teacher Rating of Oral Language and Literacy—available here for free. And yes, that’s a teacher questionnaire, rather than another individually-administered assessment for our students who spend so much time testing already. Importantly, the teachers completed the ratings and the end of the kindergarten year, not the beginning, so they had time to really get to know the students and their abilities.

The researchers calculated a new cut score of 89 for this population, since the TROLL itself only suggests cut scores through age 5. This resulted in sensitivity of 77% for identification of language disorders. Now, 77% isn’t really high enough—we want a minimum of 80 for a good screener. But it may be a starting place until better tools come our way.

Gregory, K. D., & Oetting, J. B. (2018). Classification Accuracy of Teacher Ratings When Screening Nonmainstream English-Speaking Kindergartners for Language Impairment in the Rural South. Language, Speech, and Hearing Services in Schools, 49(2), 218–231. https://doi.org/10.1044/2017_LSHSS-17-0045.

Using group screening to find students at risk of DLD and dyslexia

If you work in a school that uses a response to intervention (RtI) framework, you can probably relate to the balancing act associated with screening: you want to use tools that accurately identify students needing additional assessment, but that also make good use of your time and are relatively easy to administer. 

What if you could screen a whole class at the same time?

The authors of this study administered two screeners to groups of second graders:

  • The Test of Silent Word Reading Fluency (TOSWRF), to screen for word reading difficulties
  • The Listening Comprehension subtest of the Group Reading Assessment and Diagnostic Evaluation (GRADE LC), to screen for developmental language disorder (DLD)**
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The researchers analyzed 381 students’ performance on the screeners as well as additional, individual standardized testing (CELF-4, the Word Identification and Word Attack subtests of the WRMT-III, and the TONI-4). The screeners, in combination, could reliably classify children as being at risk for (a) language disorder, (b) dyslexia, or (c) both, as determined by their scores on the individual assessments. Accuracy was somewhat higher for predicting risk for dyslexia vs. language disorder, which makes some intuitive sense, because the screeners chosen were both geared toward reading. Interestingly, only about a third of the parents of the identified children had reported concerns about their child’s language or reading abilities. We can’t rely on individual referrals to catch everyone!

Although the efficiency of screening groups of students is certainly appealing, it is important to remember we don’t yet know what results the TOSWRF and GRADE LC screeners would yield with children in other age groups or populations. SLPs should be cautious and consider their individual contexts when applying these findings.

**Note: Most of the children in this study were those with Specific Language Impairment (SLI), which is a child with Developmental Language Disorder (DLD) and normal nonverbal intelligence. We use DLD throughout our website for consistency purposes (read more here).

Adlof, S. M., Scoggins, J., Brazendale, A., Babb, S., & Petscher, Y. (2017). Identifying children at risk for language impairment or dyslexia with group-administered measures. Journal of Speech, Language, and Hearing Research, 60(12): 3507-3522. doi: 10.1044/2017_JSLHR-L-16-0473.

Preschool predictors of kindergarten reading skills

This study helps us figure out how to get a leg up on our students who will have reading difficulty in kindergarten. 
Tests were given to 136 children with low language skills and language disorders, then examined retrospectively to see which skills might predict reading performance one year later. Skills confirmed to predict kindergarten reading ability were:

  • alphabet knowledge (single best predictor)
  • phonological awareness
  • name writing
  • oral language (surprising, because kindergarten reading is decoding)

 Many of us are used to thinking of phonological awareness as *the* predictor of reading skills in kindergarten. But perhaps not so… The authors found that, “phonological awareness did not predict any unique variance in reading status when oral language and alphabet knowledge were in the model.” They further hypothesize, that “for preschool children, language and phonological awareness may have so much in common that phonological awareness does not add to the prediction of reading beyond the contribution of language.”

Clinicians can replicate the testing protocol used, which includes common measures such as the PALS (Phonological Awareness Literacy Screening) and core Language score of the CELF-P:2 (Clinical Evaluation of Language Fundamentals: Preschool–Second Edition).
 
Murphy, K.A., Justice, L.M., O'Connell, A.A., Pentimonti, J.M., Kaderavek, J.N. (2016). Understanding Risk for Reading Difficulties in Children With Language Impairment. Journal of Speech, Language, and Hearing Research59, 1436–1447.

Simplifying stuttering measurement in schools

In this article, Mirawdeli and Howell investigate whether all three elements of the commonly-used Stuttering Severity Instrument (SSI) are necessary in order to categorize children as fluent vs. dysfluent. These three measures are:

  1. frequency of non-fluent events (percentage of stuttered syllables, %SS, from a sample of 200 syllables)
  2. duration of the three longest non-fluent events
  3. physical concomitants (facial and bodily movements with speech) 

Data from 10–15-minute speech samples from 879 children aged 4–6 indicate that (1) alone (above) is sufficient to make this determination. The authors explain why, both statistically and clinically, it makes sense to drop the use of (2) and (3) in screening procedures. Conclusions are drawn from both the current data and previous research. The authors highlight some pros of using Riley’s SSI method of counting %SS (Riley, 1994), such as that it doesn’t include whole-word repetitions as stuttered events. This is particularly helpful in schools with English-learning students who may have word-finding difficulties, which often present in the form of whole-word repetitions. The authors also compare the newer SSI-4 to the SSI-3, and discuss why you may choose to continue using SSI-3 (see more here).

See: Mirawdeli, A., & Howell, P. (2016). Is it necessary to assess fluent symptoms, duration of dysfluent events, and physical concomitants when identifying children who have speech difficulties? Clinical Linguistics and Phonetics. Advance online publication. doi: 10.1080/02699206.2016.1179345.