Questions and Answers

If you have any questions or concerns that relate to speech language pathology in any way, at any level....just ask.
I will answer them to the best of my ability on my blog.
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Tuesday, July 21, 2009

Assessment Question: Higher Level Language

I recently received the following question after a Speech Language Pathology graduate student glanced at my blog. I hope my response was able to help her out. Please comment with any other opinion sor suggestions I may of left out. I'd be interesting in knowing what other tests SLP's like to use.

I just read about higher level langauge skills on your website.
I am a speech pathology graduate student working on a question, and was wondering if you could give me some guidance.
Here's the situation:
I am a school SLP that needs to make an assessment plan for a 12 year old girl who sustained traumatic brain injury in a car accident 2 months ago. She received care at an inpatient rehab facility. The rehab report states she has residual mild executive functioning difficulties as well as difficulty with higher level langauge skills, including mild response delays, word finding and circumlocutions.
So, in order to develop her IEP, I must have standardized test results. But where I am getting stuck is choosing an appropriate test. I don't want to test this girl to death but I think I may have to give her a couple of different tests so that I can set goals for her langauge skills as well as the executive function skills. Do you have any recommendations?
Thank you,

Hi B,
Thanks for taking a look at my blog. Lets see if I can give you some good suggestions. First thing I would do is look over old school reports to see if this child had any difficulities in school before the injury. I would then pour over any post injury testing. In these situations or similiar (outside evals) I always try to include previous testing if I think it is valid rather than re-test using different measures. In my report I usually include past findings again only if I think they are credible.

As far as the executive functioning goes, your school psychologist should be able to focus on that either through her testing or interpreting past testing. At my school my school psych is much better at explaining/brainstorming around this area. The school psyc should also be able to shed more light on the response delays.

Remember, most kids are still developing their higher level language skills at this age. What I am finding now is most of my students (without significant disabilities) who have difficulty with higher level language development sometimes come from homes that are not very enriching, stimulating or lack expectations. So I guess my point is you have to also consider the environment in which the child was exposed to before the injury. That probably won't impact your findings and I might not add it to a report but it is good for you to know this.

12 is a tricky age to assess higher level language because most tests cut off around 12 so are too easy for most 11 year olds. And the adolscent versions 12 and up, sometimes have content that is not appropriate to present to a 12 year old. I run into that a lot with the Test of Problem Solving. I do like the TOPS but I am careful how I interpret when the kids are around 12. I have recently begun using the Test of Auditory Perception Skills-cohesion portion to screen or confirm higher level language difficulities. However, that is almost too easy for older children and does not pick up the specific problems in the older children. The WORD test might be an option. However, I have not used it in years or review either elementary or adolscent versions.

I haven't tested for word retrieval in years. I use clinical observations, comparision of PPVT and EVT and sometimes the CELF rapid naming. I seem to remember the WORD test being good for clinical observations around word retrieval.

For a general test battery I use the CELF but that does take some time to administer. In my building we have a reading specialists for reading issues and as far as writing goes our school psych and special ed teachers assess that. I often comment on difficulty with organization of verbal language impacting writing.

Let me see if I can put together some samples of how I write up my evals. I will e-mail those separately. Hope this was helpful. If you don't mind I may post your e-mail-editing your name out on my blog.

Thank you very much! Your suggestions really helped to solidfy what I was thinking in terms of types of tests and directions I should go. I was thinking that I might like to use the Test of Language Development as well as the Expressive & Receptive One Word tests to help substantiate the resulsts of the TOLD. What do you think?
I absolutely don't mind if you post my question. I hope that it can help someone else!
Thank you again,