Early Identification of Children at Risk of Communication Disorders: Introducing a Novel Battery of Dynamic Assessments for Infants.

PURPOSE: Many children with communication disorders (CDs) experience lengthy gaps between parental reporting of concerns and formal identification by professionals. This means that children with CDs are denied access to early interventions that may help support the development of communication skills and prevent possible negative sequelae associated with long-term outcomes. This may be due, in part, to the lack of assessment instruments available for children younger than 3 years of age. This study therefore reports on promising preliminary data from a novel set of valid dynamic assessment (DA) measures designed for infants. METHOD: We recruited 53 low-risk children and two groups of children considered to be at high risk for CDs (n = 17, social high risk, and n = 22, language high risk) due to family members with language and social communication difficulties. The children were between 1 and 2 years of age and were assessed using a battery of five DA tasks related to receptive vocabulary, motor imitation, response to joint attention, turn taking, and social requesting. A set of standardized measures were also used. RESULTS: The DA tasks showed high levels of interrater reliability and relationships with age across a cross-sectional sample of children from the low-risk group. Three tasks showed moderate to strong correlations with standardized measures taken at the same age, with particularly strong correlations between the DA of receptive vocabulary and other receptive language measures. The DA of receptive vocabulary was also the only task to discriminate between the three risk groups, with the social high risk group scoring lower. CONCLUSIONS: These results provide preliminary information about early DA tasks, forming the basis for further research into their utility. DA tasks might eventually facilitate the development of new methods for detecting CDs in very young children, allowing earlier intervention and support.

Two clinical markers for DLD in monolingual Italian speakers: what can they tell us about second language learners with DLD?

A large number of children worldwide are only exposed to their L2 around 3 years of age and can exhibit linguistic behaviours that resemble those of a child with Developmental Language Disorder (DLD). This can lead to under- or over-identification of DLD in this population. This study endeavors to contribute to overcoming this problem, by determining whether two specific clinical markers used with the Italian monolingual population can also be used with early L2 acquiring children, namely clitic production and non-word repetition. Our study involved two groups of 5-year-old L2 learners of Italian from various language backgrounds; 18 children had been referred to Speech and Language Therapy (SLT) services (EL2_DLD), and 30 children were typically developing (EL2_TD). The participants completed an Italian clitic production task and a non-word repetition task based on Italian phonotactics. Data was also collected from the participants' caregivers with the ALDeQ Parental Questionnaire to obtain information about the children's L1. Our results suggest that non-word repetition and clitic production in Italian are potentially useful for identifying L2 learners of Italian with DLD, at the age of 5 years. The repetition of non-words is highly accurate in identifying children with DLD among the participants, while clitic production is somewhat less discriminative in this sample. This study is a first step towards uncovering clinical markers that could be used to determine the presence of DLD in children acquiring their L2.

Dynamic assessment of word learning skills of pre-school children with primary language impairment.

Dynamic assessment has been shown to have considerable theoretical and clinical significance in the assessment of socially disadvantaged and culturally and linguistically diverse children. In this study it is used to enhance assessment of pre-school children with primary language impairment. The purpose of the study was to determine whether a dynamic assessment (DA) has the potential to enhance the predictive capacity of a static measure of receptive vocabulary in pre-school children. Forty pre-school children were assessed using the static British Picture Vocabulary Scale (BPVS), a DA of word learning potential and an assessment of non-verbal cognitive ability. Thirty-seven children were followed up 6 months later and re-assessed using the BPVS. Although the predictive capacity of the static measure was found to be substantial, the DA increased this significantly especially for children with static scores below the 25th centile. The DA of children's word learning has the potential to add value to the static assessment of the child with low language skills, to predict subsequent receptive vocabulary skills and to increase the chance of correctly identifying children in need of ongoing support.

Beyond static assessment of children's receptive vocabulary: the dynamic assessment of word learning (DAWL).

BACKGROUND: Children's low scores on vocabulary tests are often erroneously interpreted as reflecting poor cognitive and/or language skills. It may be necessary to incorporate the measurement of word-learning ability in estimating children's lexical abilities. AIMS: To explore the reliability and validity of the Dynamic Assessment of Word Learning (DAWL), a new dynamic assessment of receptive vocabulary. METHODS & PROCEDURES: A dynamic assessment (DA) of word learning ability was developed and adopted within a nursery school setting with 15 children aged between 3;07 and 4;03, ten of whom had been referred to speech and language therapy. OUTCOMES & RESULTS: A number of quantitative measures were derived from the DA procedure, including measures of children's ability to identify the targeted items and to generalize to a second exemplar, as well as measures of children's ability to retain the targeted items. Internal, inter-rater and test-retest reliability of the DAWL was established as well as correlational measures of concurrent and predictive validity. CONCLUSIONS & IMPLICATIONS: The DAWL was found to provide both quantitative and qualitative information which could be used to improve the accuracy of differential diagnosis and the understanding of processes underlying the child's performance. The latter can be used for the purpose of designing more individualized interventions.