Best Practice School Assessment of Expressive & Receptive Language

Unlocking a child’s linguistic potential is at the heart of every comprehensive school assessment, particularly when it comes to evaluating expressive and receptive language skills. In this post, we delve into the best practices and methodologies employed by school speech pathologists to assess these vital components of communication development. From standardized tests to observational techniques, educators and speech-language professionals employ a range of strategies to gain a thorough understanding of a student’s language abilities. Join us as we explore the intricate process of evaluating expressive and receptive language skills in the school setting.

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 delay 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 EVALUATION:

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.)

Sometimes, a teacher may notice a child struggling with understanding vocabulary or a parent may have difficulty understanding the sentences his/her child produces, but there could be other, contributing factors for these delays.  To determine all areas needing intervention, speech pathologists must use a comprehensive test battery.  Below are some examples of comprehensive language tests for preschoolers and school-aged children:

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:

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.

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.  There are four, main language areas that are evaluated and addressed as indicated: content, form, use, and understanding.

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.  Form 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)

Often, caregivers are primarily concerned about their child’s limited speech production to request desired items, and naturally, caregivers spend time prompting children to “say” or “repeat” words to increase speech output.  This method is not as successful in teaching words because imitation is not considered a communicative intent.  We do not spend our days telling other adults what to say, so why tell our children?  That is not to say that we do not have children repeat words to teach new vocabulary; rather, we find natural ways for them to say a word again.

For example, as a child looks towards a dog, we can start a communication exchange by saying, “Can you see that dog? That is a big dog.  There goes the dog.  Say, bye dog.” In this way, we just stimulated naming and greetings, and maybe after hearing “dog” four times, the child will naturally repeat the word.  Our goal as communication professionals is to help your child use and understand a variety of intents while socializing with others.

UNDERSTANDING:

Language comprehension refers to one’s processing and understanding of verbal information.  Speech pathologists formally assess receptive language skills by evaluating your child’s ability to perform tasks such as:

• Following single step (Show me the ball), related (First, get your socks, then your shoes), and unrelated (Get your cup, then put away your coloring book) directions.
• Identifying picture or word answer given choices for targeted questions about sentence structure (Point to: I can eat this); concepts (Point to the one who is big); and groups (Show me the two pictures that go together.)
• Understanding questions (responding to a where question with the name of a place.)

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.