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Speech-Language Assessment Introduction

Speech and language pathologists (SLPs) are nationally certified by the American Speech, Language and Hearing Association (ASHA).

Overview of Instruments

To practice in the state of Texas, SLPs must also hold a Texas state license. Because autism spectrum disorder (ASD) is a social communication disorder, children identified with autism require the service of an SLP. In its 2006 Principles for Speech-Language Pathologists in Diagnosis, Assessment, and Treatment of Autism Spectrum Disorders across the Life Span [Technical Report], the ASHA stated, “Given the importance of social communication in the diagnosis of ASD, the SLP plays an important role in both screening and diagnosis” (p. 1). Therefore, SLPs should be specifically trained in areas that assist with the diagnosis of autism spectrum disorder, including social communication, social interaction, restricted and repetitive patterns of behavior, interests and activities.

As a member of the multidisciplinary team, the SLP administers standardized assessment tools in the areas of speech and language functioning and should be skilled in providing informal assessments of social communication to determine a disability in the area of speech, language, or social communication. Social communication moves beyond words and grammatical correctness. It includes such skills as back-and-forth social interaction, pointing, sharing information, conversation, perspective-taking, and understanding social situations. Many children with ASD can regulate their caregiver’s behaviors by requesting or protesting; they may also label objects and events in the environment or talk in full sentences. Despite these peripheral linguistic skills, they fail to share information with others and communicate within a social context (Rollins, 2014). Some of these children can perform within normal limits on standardized tests of speech or language, particularly if the assessment only requires them to look at and respond to static pictures. Therefore, in the determination of a disability in the area of autism, standardized assessment tools are only a starting point and should be used in conjunction with parent and teacher interviews, observations in multiple context (e.g., 1:1 and group interactions with familiar and unfamiliar persons, interactions with adults and with peers), and informal communication and language samples. For example, an informal communication assessment could include the range of communicative intentions, cohesion, responsiveness to speech (i.e., the proportion of adult utterances to which the child responds), mean length of utterance (MLU), echolalia, pronoun use, discourse management (e.g., topic maintenance, turn taking, appropriate topic shifts), register variation (i.e., using appropriate language forms with different conversational partners and in varying situations), and presupposition (i.e., the understanding of what it is reasonable to assume the communication partner knows) (Paul, 2007). What is analyzed is determined by the student’s age and language abilities.

Language and communication assessment for young students with preverbal/prelinguistic skills should include an assessment of the prelinguistic predictors of language and communication. Prelingusitic predictors include the use of communicative gaze and gestures, quality of vocalizations, joint attention, vocabulary comprehension, and quality of play (Paul, 2007; Rollins, 2014). In addition, rate of communication, range of communicative functions expressed (i.e., behavior regulatory functions versus social functions), and responsiveness to speech and gestures can be measured, and an assessment for use of an augmentative communication device (AAC) can be performed.

The following table lists assessments that are appropriate for use with students who are verbal and those who have prelinguistic/preverbal skills.

Assessment Name

Preverbal/ Prelinguistic

Verbal/ Linguistic

Children’s Communication Checklist – Second Edition

X

Clinical Evaluation of Language Fundamentals – Fifth Edition

X

Clinical Evaluation of Language Fundamentals-Preschool – Second Edition

X

Communication and Symbolic Behavior Scales Developmental Profile

X

The Communication Matrix

X

Comprehensive Assessment of Spoken Language

X

Language Curriculum-Referenced Assessment

X

Informal Language Sample

X

X

Preschool Language Scale-5

X

Receptive-Expressive Emergent Language Scale-3

X

X

The Rossetti Infant-Toddler Language Scale

X

Test of Language Development: Intermediate-4

X

Test of Language Development: Primary-4

X

The Test of Pragmatic Language – Second Edition

X

Test of Problem Solving 2-Adolescent

X

Test of Problem Solving –Third Edition, Elementary

X

Misconceptions

Myth Reality
If the child tests within normal limits on a language assessment, including the pragmatics subtest on a standardized assessment tool, the child cannot qualify as speech impaired. The child may have underlying communication deficits that these standardized assessment tools do not directly identify as autism spectrum disorder. “There are few methods for identifying pragmatic difficulties other than clinical opinion; most published language tests do not assess language use across multiple communicative contexts” (Bellon-Harn & Harn, 2006, p. 4). Although standardized assessments are typically helpful in determining present levels of performance, they often result in a deficits profile that does not translate well to interventions that are family-centered and focused on real-life activities (Diehl, 2003).
If the child gets passing grades and is not struggling academically, there is no need for speech therapy interventions. The child may still be failing at the underlying social communication/social interaction curriculum in the educational setting. For children with ASD, the goals of communicating, socializing, and conforming to societal rules and expectations are the most important part of a child’s curriculum (Klin & Volkmar, 1995).
The child appears to chat with some friends, so he must be social and has good social skills. “He talks to his friends in the cafeteria.” “… a short encounter or routine interaction will not reveal anything unusual. However, over time and in unexpected situations, it appears that the façade of normality cannot be kept up” (Frith, 2004, p. 675).
“Echolalia is just a normal part of language development.” “Echolalia peaks at around age 30 months in normal children, and then decreases” (Lovaas, 1981, p. 5, cited in Heffner, 2000).
The use of spontaneous language in ASD often does not naturally occur. “Persons with autism can get stuck at any point in the continuum and language may not progress beyond echolalia” (Heffner, 2000, p. 7).

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