identifying young children with language impairments: measurement issues mabel l. rice presentation...
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Identifying Young Children with Language Impairments:
Measurement IssuesMabel L. Rice
Presentation at ASHA Conference for Speech-Language Pathologists in Schools
Nashville, TennesseeSaturday, July 13, 2002
The Problem of Identification Kindergarten children with Specific Language
Impairments (SLI) can be difficult to identify (cf. Only 29% of kindergarten children known to have SLI were enrolled in intervention; Tomblin et al., 1997)
Variation in rates of language acquisition among young unaffected children adds to the complexity of identification of affected children
Conventional Measures, and the Normal Curve Assumption for Language Assessment
Assumption of an age-referenced normal distribution of children on a general language dimension
Num
ber
of
Child
ren
Performance Level
Related properties About 16% score 1 SD or more below the
mean About 2% score 2 or more SD below the
mean About 66% score within 1 SD of the mean
Positive applications Determine the prevalence of SLI (about 7%
in 5-year-olds; Tomblin et al., 1997) Determine the likelihood of speech
impairments with language impairment (less than 2% in the general population of 5-year-olds; Tomblin et al., 1997)
Determine long-term prognosis (individuals are likely to remain in the low levels of performance; Johnson et al., 1999)
Limitations No intrinsic cut-off score for “affected” No obvious way to interpret the test score in
terms of particular linguistic content No way to interpret a child’s progress toward
the adult grammar
A Grammatical Marker Approach Obligatory properties of clausal
structure These balls/*these ball She is walking/*she walking She walks outside/*she walk outside Yesterday she walked
outside/*yesterday she walk outside Does she like to walk?/*she like to walk?
Distributional Properties of a Grammatical Marker
Sensitivity and Specificity Sensitivity: rate of identifying true cases of
affectedness Specificity: rate of identifying true cases of
unaffectedness
Clinical Characteristics of a Grammatical Marker
By a certain age, grammatical markers would show little variation across unaffected children
Affected children would perform below the unaffected children
High levels of sensitivity and specificity Content would be meaningful for interpretation
of a child’s language deficits Child’s performance would be interpretable in
terms of the adult grammar Markers could persist over time
A Finiteness Grammatical Marker Theoretical Linguistics
Morphology and syntax are related in the area of morphosyntax
Finiteness is a property of clause structure that shows up as verbal forms inflected for tense and/or subject/verb agreement
Examples of finiteness markers Patsy walks home (third person singular subject, present
tense) Patsy walked home yesterday (no subject agreement,
regular past tense) Patsy ran home yesterday (no subject agreement, regular
past tense) Patsy is walking (third person singular subject, auxiliary
present tense) Patsy is happy (third person singular subject, copular
present tense) Does Patsy walk home? (third person singular, auxiliary
present tense)
In English, young children grow into consistent use of finiteness markers, during a period of Optional Infinitives (Wexler, 1994), evident in dropped finiteness markers, thought to be related to the need to mark grammatical tense (TNS).
Research with Young Children with SLI
Criteria for SLI in Rice Longitudinal Study Inclusionary
Expressive language: Low MLU Receptive language: Low comprehension
vocabulary (PPVT) Low performance on standardized omnibus
language test
Exclusionary No hearing loss Nonverbal IQ in normal range or above No known neurological or psychosocial problems Passed a phonological screening
Outcomes of Research
SLI children start later, and show slower acquisition timing although similar growth curves
Composite Tense
Age in Years
87;676;665;654;643;63
Me
an
Pe
rce
nt C
orr
ect
100
80
60
40
20
5N
3N
SLI
Grammatical marker is apparent in judgments as well as productions
A' Adult Versus OI Grammar
Age in Years
87;676;665;654;64
Mea
n A
' S
core
s
1.0
.9
.8
.7
.6
5N
3N
SLI
Young children show variation that disappears by age 5 years, at adult grammar
Composite TNS Scores Over Time
Age in Years
87;676;665;654;643;63
Sco
re
100
80
60
40
20
0
3N
SLI
OI A': Growth Curve
Age in Years
87;676;665;654;64
A' S
co
res
1.0
.8
.6
.4
.2
0.0
3N
SLI
SLI children show variation in a range far below age expectations
At the same time of variation as TNS-marking, other elements of morphosyntax are unaffected
Regular -s Plurals
Age in Years
87;676;665;654;643;63
Mean P
erc
ent C
orr
ect
100
80
60
40
20
5N
3N
SLI
Lexical indices show consistent variation across the growth curve, and do not differentiate SLI from younger language-equivalent children
PPVT Raw Scores
Age
8.07.06.05.04.03.0
Score
120
100
80
60
40
20
0
5N
3N
SLI
Timing of acquisition differs for morphosyntactic and morphophonological components of TNS-marking Past tense variables
Regular (e.g., walked) Finite (e.g., fell/falled) Irregular (e.g., fell)
Past TNS probe: SLI Group
Round
7654321
Mean P
erc
enta
ge
100
80
60
40
20
0
Regular past probe
% correct
Irregular past probe
% finite
Irregular past probe
% correct
Past TNS probe: 3N Group
Round
7654321
Mean P
erc
enta
ge
100
80
60
40
20
0
Regular past probe
% correct
Irregular past probe
% finite
Irregular past probe
% correct
Past TNS probe: 5N Group
Round
7654321
Mean P
erc
enta
ge
100
80
60
40
20
0
Regular past probe
% correct
Irregular past probe
% finite
Irregular past probe
% correct
Growth curve components and predictors of growth are similar for TNS/finiteness indices, but differ from morphophonological index TNS productions
Linear and quadratic components for SLI and MLU groups; same curves for both groups
Non-predictors: Intelligence, vocabulary (PPVT-R), mother’s education
Predictor: MLU
Grammaticality Judgments: OI Grammar/Bad Agreement Grammar Linear and quadratic components for SLI and
MLU groups; same curves for both groups Non-predictors: Intelligence, vocabulary (PPVT-
R), mother's education Predictor: MLU
Irregular past tense Linear growth only, for both groups Non-predictors: Mother's education Predictors: MLU, vocabulary, intelligence
Finite Past Tense Linear and quadratic components for SLI and
MLU groups; same curves for both groups Non-predictors: Intelligence, vocabulary,
mother's education Predictor: MLU
Conclusions: TNS/AGR marking (finiteness) follows growth curves that are linear + quadratic in shape and growth is not predicted by intelligence, vocabulary or mother's education, and is positively predicted by MLU, although not strongly. When morphophonological accuracy is included in the measurement, the growth curve becomes linear only and the predictors shift to include a child's vocabulary and non-verbal intelligence.
Rice/Wexler Test of Early Grammatical Impairment
Advantages compared to other language measures Focus on finiteness is conceptually sound in
terms of the linguistic properties of adult grammar
Performance can be directly interpreted as describing fundamental properties of what a child knows about grammar
Performance can be interpreted in terms of a child's progress toward the adult grammar
Content focuses on a property of English grammar that is known to be well mastered by children before they enter school
Focuses on a property of grammar known to be difficult for children with language impairments
Can identify affected children whose sole developmental deficit is language impairment (i.e., SLI)
Well suited to identify children of school-entry age who need early intervention
High levels of sensitivity and specificity, leading to accurate identification of affected children, without a high rate of false identification of unaffected children
Includes a screening version
General Overview Consists of five probe tasks and screener:
Phonological Third person singular Past tense BE/DO Grammaticality judgment Screener portion is average of third person
singular and past tense
For children ages 3 to 8 years Normed to two groups of children per 6-
month age interval: Language impaired group and control (normal) group
Procedures not usually found in conventional language tests Phonological probe as screening for test
appropriateness Attention to the syntactic context for
morphological assessment Focus on a morphological class instead of an
individual item (e.g., regular verb morphology and class of these verbs instead of a particular lexical item)
Differentiation of grammatical functions of a given morpheme (e.g., BE copula vs. auxiliary, questions vs. statements)
Percentage correct of "attempted structures" instead of items correct/total items (i.e., partitioning of off-task or irrelevant items out of scoring)
Calculation of multiple outcomes scores, to form composites and to be considered individually
Video demonstration of procedures
Tryout and Standardization Sampling
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Outcomes
Growth curves – percentiles and means per age, with reference to normal samples
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Specificity/selectivity, with reference to normal and affected samples (bimodal distribution) percentage children per age group above or below a given level of performance
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Criterion Scores Suggested "cut points" for performance
within the normal range, referenced to affected group as well as normal group, with at least 80% sensitivity Example: For screening subtests for age range
of 4.06 to 4.11, criterion = .65
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Further Data Reporting
Means and standard deviations per measure, per group, per age level
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Box and whiskers plot to show within group variation per measure per age level
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Reproduced by Permission. Rice, M. L., & Wexler, K. (2001). Rice/Wexler Test of Early Grammatical Impairment. San Antonio, TX: The Psychology Corporation.
Using the Rice/Wexler in Clinical Practice
Establishing eligibility for services As a screening tool Interpreting the Rice/Wexler scores
Elicited grammar composite Phonological probe Third person singular Past Tense BE/DO Grammaticality Judgments
Comparisons with related test data Interpreting children's performance
relative to nonverbal intelligence and parental education levels
Concluding Comments A "marker" approach to identification adds
a valuable clinical resource to assessment tools
Estimates of sensitivity and specificity provide valuable reference points for establishing criteria for identification and tracking a child's progress level
Theoretically motivated research can generate new evidence that leads to new clinical instruments and new approaches to assessment
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