Unlocking a child’s linguistic potential is crucial in school assessments, especially for evaluating receptive and expressive language skills. In this post, we explore the best practices and methods used by school speech pathologists to assess these essential components of communication. From standardized tests to observational techniques, educators and speech-language professionals use various strategies to thoroughly understand a student’s language abilities.

A language delay refers to a temporary lag or slower-than-typical development in a child’s ability to understand and/or use spoken language. My intent in writing this post on language delays was to provide some parent education on diagnostics. If your child has been found eligible for speech and language services because he or she has a language delay, then this finding was likely based on several factors.

Standardized Evaluations: Assessing Receptive and Expressive Language Skills in Children

One essential tool in determining eligibility for language services is a standardized evaluation, which would yield standard scores to assist in comparing your child’s results to his or her peer population. When a child is initially referred for language assessment, speech pathologists should conduct a comprehensive evaluation that includes all aspects of communication (medical history intake, hearing, vocabulary usage and comprehension, speech articulation, fluency, voicing, and expressive and receptive language.)

Receptive Language

Testing receptive language in school-aged children helps us understand how well they comprehend spoken language. Receptive language is about how children understand words, sentences, and instructions. During testing, a speech-language pathologist might ask the child to follow directions, answer questions about a story, or point to pictures that represent specific words or actions. These activities help assess how well the child understands vocabulary, grammar, and overall meaning. Identifying difficulties in receptive language is crucial because it can affect a child’s ability to follow classroom instructions, understand lessons, and engage in conversations. Early identification and intervention can support the child’s language development, enhancing their ability to learn and interact effectively with others.

Expressive Language

Testing expressive language in school-aged children is an important part of understanding their communication abilities. Expressive language refers to how children use words and sentences to express their thoughts, needs, and feelings. During testing, a speech-language pathologist will evaluate various aspects of the child’s speech, such as vocabulary, grammar, sentence structure, and the ability to convey ideas clearly. This might involve asking the child to name objects, describe pictures, tell stories, or answer questions.

The goal is to identify any difficulties the child may have in forming sentences or finding the right words, which can impact their academic performance and social interactions. Early identification of expressive language issues allows for timely intervention, helping children improve their communication skills and succeed in school and daily life.

Enhancing Expressive Language in Children: Understanding Content, Form, and Use

Understanding the different aspects of language development in children is crucial for identifying and addressing any challenges they may face. In speech therapy, we focus on three main areas: content, form, and use. Content involves the meanings of words and how we use semantics to create phrases and sentences that make sense. Form refers to the structure of sentences, including word order and length, ensuring that children can construct grammatically correct sentences.

Use encompasses the various communicative intents, such as naming objects, making requests, and greeting others. Each of these components plays a vital role in effective communication, and our clinical sessions aim to enhance these skills through targeted strategies and tools. Let’s delve into each of these areas to better understand how they contribute to a child’s language development.

CONTENT:

Content refers to word meaning, otherwise known as semantics.  We use semantics to construct phrases and sentences that make sense to others.  This requires an ability to comprehend vocabulary terms and concepts such as multiple meanings, synonyms, and antonyms.  Some children have difficulty learning vocabulary and using terms appropriately; therefore, clinical sessions would focus on teaching strategies such as categorization, associations, and graphic organizing (visual diagram that maps definitions, associative words, pictures and more) to improve both comprehension and word retrieval.

FORM:

Form is the process of attaching a symbol, such as a word, picture, or sign to the content/meaning.  It also refers to word ordering (syntax) in sentences and length (number of words) in sentences.  Some children are challenged by constructing syntactically correct sentences that use an appropriate pattern such as, noun-verb-noun, or noun-verb-adjective-noun.  These sessions would focus on practicing a variety of patterns appropriate for the child’s age and ability levels given visual supports (pictures) and/or verbal prompting.  We may do this through worksheets, games, and computer programs.

There are a variety of applications for phones and tablets that we can recommend for home practice too.  For example, Rainbow Sentences by Mobile Education Store is an app that works in levels and visual supports to teach putting words in order to construct sound sentences.  During clinical sessions, we may also work on increasing the number of words in a production to include terms like adjectives or adverbs.

USE:

Finally, use refers to the many communicative intents:

• Naming (ball)
• Requesting objects (want bubbles), actions (go), assistance (help)
• Responding to questions
• Making comments (I like it)
• Protesting (No more)
• Attention seeking (Look!)
• Greetings (hi/bye)

Common Standardized Evaluations for Assessing Expressive and Receptive Language

Preschool:

• Clinical Evaluation of Language Fundamentals-Preschool- third edition (CELF Preschool-3)
• Receptive-Expressive Emergent Language Test-third edition (REEL-3)
• Rossetti Infant-Toddler Language Scale
• Preschool Language Assessment Instrument- second edition (PLAI-2)
• Preschool Language Scale- fifth edition (PLS-5)
• Structured Photographic Expressive Language Test-Preschool- second edition (SPELT-P 2)
• Test of Early Language Development- fourth edition (TELD-4)

School-aged:

• Clinical Evaluation of Language Fundamentals- fifth edition (CELF-5)
• Comprehensive Assessment of Spoken Language- second edition (CASL-2)
• Fullerton Language Test for Adolescents- second edition
• Functional Communication Profile (FCP-R)
• Oral-Written Language Scale-2 (OWLS-2)
• Test of Adolescent and Adult Language- fourth edition (TOAL-4)
• Test of Language Development-Primary: fifth edition (TOLD-P:5)
• Test of Language Development-Intermediate: fourth edition (TOLD-I:4)

When speech pathologists assess language skills, we also test expressive (use) and receptive (understanding) of vocabulary. Vocabulary delays can significantly impact language structure and use. Therefore, we need to evaluate vocabulary in determining if formal treatment goals are indicated. Here are some examples specific to vocabulary assessment:

• Assessing Semantic Skills through Everyday Themes (ASSET)
• Comprehensive Receptive and Expressive Vocabulary Test-third edition (CREVT-3)
• Expressive One-Word Picture Vocabulary Test- fourth edition (EOWPVT-4)
• Expressive One-Word Picture Vocabulary Test-Upper Extension (EOWPVT-UE)
• Expressive Vocabulary Test- third edition (EVT-3)
• Peabody Picture Vocabulary Test-fourth edition (PPVT-4)
• Receptive One-Word Picture Vocabulary Test- fourth edition (ROWPVT-4)

Informal Observations of Receptive and Expressive Language

Other factors that help determine eligibility are informal observations. Speech pathologists may note how a child converses during less structured situations and transitions from one setting to another. An informal observation often includes a language sample analysis.  Since language sampling is not a standardized test, it can be completed several times over the course of therapy to document progress.

Speech pathologists use language sampling to analyze a child’s conversational, open-ended speech. We strive to write down fifty sentences or utterances that your child produces during free play and then we calculate the mean length of utterance (MLU) or average number of words and structures used per sentence. During this sample, we refrain from asking questions; rather, we set up items within your child’s reach or ask them to discuss a few topics with minimal prompting. We also use language sampling to assess a child’s language form, content, and use.

Parent Report

Finally, the last component in determining eligibility is parent report. This unit of information is key since caregivers know their children best while examiners are only getting a brief snapshot of a child in a new setting. Caregivers can provide information pertaining to social skills development, self-care skills, and communication ability in a variety of settings.

Using formal assessment, informal observations, and a caregiver report, speech pathologists strive to develop a plan of care to address language deficits. These goals should be measurable and achievable within a year’s time. After a year, your child may continue to need support services, therapy frequency may need to be increased or reduced, or a discharge plan may be indicated.

Closing Thoughts

To maintain test validity, we cannot repeat the same test battery with a child sooner than one year. While assessments are ongoing using logs and data charting at sessions, it is best practice to formally review goals with caregivers after one year of therapy. Schools require speech pathologists to rate progress on each goal on a quarterly or semester basis, while these reviews may happen more frequently with children receiving private services.

I hope that this post helped provide some information about how speech pathologists assess and design treatment plans for children with language delays. Caregivers are one of the most vital members of their child’s special education team; therefore, it is essential that you are just as knowledgeable about your child’s needs and treatment strategies as any other team member. Your comprehension and support fuels and sustains your child’s progress.