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Language Disorders

Test 2 Lessons 12-16

What are the appropriate uses for standardized norm-referenced tests? They are necessary to make a diagnosis (i.e., to qualify a child for special services)
What are the limitations of standardized norm-referenced tests? -They do NOT help you decide what to target -They do NOT help you develop the treatment plan
What are the appropriate uses of criterion referenced tests? -Are designed to determine what skills a child possesses, and the degree to which he possesses these skills. -Tells what pt can & cannot do. -Helps you develop treatment goals
What are the limitations of criterion referenced tests? -They generally do not provide any norms, therefore you are not comparing the child’s performance to any other child. -Therefore they do not give you the information necessary to enroll the child in therapy.
Inter-examiner Reliability Do different examiners, testing the same child, get the same results?
Intra-examiner Reliability Does the same examiner, testing the same child on different occasions, get the same results?
Temporal reliability/ Test-retest Reliability -Are resullts the same if same children, same test at different times
Test Validity -Does the test measure what it was intended to measure? -Does interpretation of the test lend itself to accurate clinical decisions?
Content validity Are the items on the test representative of the skill being measured? (do they look like lang questions)
Criterion (Predictive) Validity Do test scores allow you to make accurate clinical decisions? (draw a square doesn't tell about language)
Construct Validity Does the test actually assess some psychological construct? (language, phonology, cognition, hearing, etc.) -If it’s a language test does it actually test language? Are you actually tapping language skills or only asking them to repeat?
Sensitivity -Does the test correctly identify those disordered as disordered? =true positives/ true positives + false negatives
Specificity -Does the test accurately identify those who are normal as normal =true negatives/ true negatives + false positives
What role, if any, should language age equivalent measures play in clinical decisions? (Can you qualify a child for speech-language services on the basis of a language age score? -None/absolutely not. -A child is determined to have a disorder on the basis of how he compares to peers his age peers, NOT how he compares to younger children.
How is a “disorder” determined? -Using standardized norm-referenced tests which, through an examination of means and standard deviations for his age, indicate the degree to which a child’s score (regardless of how low) can be explained by normal variation among other children his age.
When examining a child’s test data, what types of comparisons should be made when making clinical decisions (i.e., with whom are you comparing the child’s performance and why)? -You compare the child’s performance with normal children his age (test norms) -Lawrence points out, unless you have a measure of avg variability (normal variance) for children your pt age, you have no way to determine if he performs within normal limits
How much latitude does the clinician have in altering the administration of a standardized, norm-reference test when attempting to evaluate a difficult-to-test child? -None Once you change how thw test is administered, you no longer have a legit comparison w/ your pt, b/c you have no way of knowing how the other children would have performed had they been exposed to your altered procedures
Why are measures of normal variability on different tests important for clinical decision-making? -Standard deviations, percentiles, z-scores, etc. – anything that measures the normal variation in scores for his age group. -If you don’t have a measure of variation, then you don’t know what a low score is.
What care should the SLP take to avoid cultural and linguistic biases in standardized testing? -Is the test been normed on children like your pt? -Does the author present any special scoring advice for non-mainstream speakers? -Does the Examiner’s Manual say that the test does NOT over identify children who are cultural/linguistically different?
What is the rationale for language sampling analysis (i.e., why not base all your clinical decisions on standardized test data)? Standardized test purpose is to see if a child is normal or disordered. Tests does not allow you to observe how the child performs in a norm setting. A lang sample is the only to evaluate the child’s conversations, how he functions as a communicator.
According to Leonard, what's the difference between normal language-learning children and those with language-learning disorders? -The difference lies in the frequency of occurrence of various structures. -It is NOT the presence or absence of certain structures, as it's rare that a normal child is correct 100%, or that a disordered child omits a structure 100% of the time.
Why do we need to get pragmatic, semantic AND structural information from a language sample? -These help make our intervention relevant. -Is the only means we have for evaluating a child’s use of language for communicative purposes.
What's the purpose of a pragmatic analysis? -It allows you to observe when & why a child chooses to communicate -The fewer reasons a child talks the more impaired their language is -If limited area, goal may not be to teach more words, but to teach how to use the words he knows for more reasons
What's the purpose of a semantic analysis? -It allows you to observe what words does the child use when he talks and what topics does he discuss -Asks: If child is putting words together what kind of word combination do they have?
What's the purpose of a structural analysis? -It allows you to look at the child’s utterance for evidence in the development of different morphological markers (e.g., past tense, plurals, possessives, progressive ing, etc.) and syntactic rules. -Uses MLU and Brown’s 14 Grammatical Morphemes
What types of procedures and instruments should the SLP use to assess the effectiveness of therapy/progress of client? -Use data collected during therapy sessions to calculate freq of occurrence of target skills. -Lang probes R good for assessing performance levels & progress -Single sub design probe targeted & non-targeted skills. If targeted skill only improves proof
When is mean length of utterance most useful? -Between ages 2-4 -After the age of 4 years, language development becomes dominated by the acquisition of syntax. -MLU is less predictive of language skills from age 4 on b/c many syntactic rules actually shorten the utterance.
What is didactic interaction? -One person speaks and everyone else listens. The speaker is in charge, controls the subject, etc. -Ex: lecture or sermon. -Parents with children with language impairments tend to use this.
What is Dyadic interaction? -It is a communicative interchange where everyone involved is an equal partner (and has the right to change the subject). -No one person dominates the interaction. -Ex: conversation
What does LEP stand for? -Refers to children for whom English may be a second language. -There may be nothing wrong with their language-learning abilities, simply not enough exposure to English. -Stands for Limited English Proficiency
What does CLD stand for? -Refers to native English speakers who have acquired a non-mainstream dialect. -They do may have nothing wrong with their language-learning abilities. -Cultural and Linguistically Diverse
What does Treatment Efficacy require? Accountability Effectiveness of Therapy -Improvement alone is NOT evidence of effectiveness could just be spontaneous recovery
Effectiveness implies? -Efficiency: Not only did improvement occur, but it occurred during a reasonable time period. -Ecological validity: The change generalizes to other environments -Social validity: Other people are able to witness the improvement/change?
What does Effectiveness NOT imply? -A cure: Many of our clients will never be cured. They will always have some type of handicapping condition -Dismissal from therapy:Many clients need long-term care. But, improving a child’s communication, may make him a better learner needing less servc
Conditions for showing effectiveness: 1.Selection of appropriate targets. 2.Selection of valid measures. 3.Reliable and valid criteria for improvement. 4.Evidence that therapy was THE CAUSE of improvement.
Created by: aramos139



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