We know that standardized tests are not perfect. They explore a sample of behaviors within a given domain. Sometimes our students and clients do well on a portion of the items and poorly on other items within the domain. That can lead to an average score that is within normal limits and doesn’t highlight a problem. And that’s where our professional opinion overrides a test score.
Below, I will share excerpts from three different cases where this happened so you can see exactly how to write this up in a report and copy the text for your reports. One was for receptive language, one was for expressive language, and the other was for speech.
Test Item Analysis is Important
We know that Expressive Language and Receptive Language are large domains that encompass a wide range of skills. We can break both domains down into Content and Form, and we can break those down even further. One of the things we want to explore when our gut says we should override a test score that is within normal limits is the profile of correct and incorrect items within the expressive language domain or receptive language domain. For example, if a child correctly answers items related to language content but struggles with items related to language form, that can indicate a disorder related to a domain of receptive or expressive language.
Dynamic Assessment is a Critical Component when Test Scores do Not Match Concerns and Observations
You’ll see in the case studies below that dynamic assessment was implemented. While a dynamic assessment approach is always beneficial when a child demonstrates below average behaviors to help differentiate lack of experience or understanding from a true disorder, it is critical in the case where test scores do not align with observations and parent or teacher concerns. If you need a quick course on how to implement quick and effective dynamic assessments, check our the hourlong online course Dynamic Assessment: Getting Real, Usable Information from our Testing in the Bilinguistics course library (or SLP Impact library for members).
Formal Receptive Language Testing Within Normal Limits
In this example, we had a student who scored within normal limits with a 92 on the receptive language portion of a standardized test. That said, he struggled with answering story comprehension questions and engaging in conversation. Both teachers and parents expressed concerns as well.
Student demonstrated a receptive language disorder. Although he obtained a standard score of 92 on the receptive language portion of the PLS-5-Spanish, placing him in the 30th percentile relative to children of his age and language background, he struggled to comprehend stories and conversations. He was successful on structured tasks that were presented at the single sentence level with visuals but when asked to listen to a story and answer questions, he had great difficulty answering the questions correctly. This was consistent with his teacher’s report that he has difficulty comprehending classroom lessons and following instructions in class. It was also consistent with his mother’s concerns about following multistep directions at home. Dynamic assessment results supported these findings.
Strengths in Student’s receptive language skills were noted in the following areas. In the area of content, Student demonstrated the ability to identify categories of objects in pictures, identify colors, understand quantitative concepts (e.g., cada/each and todos/all), and identify pictures that did not belong in a group. He also demonstrated the ability to answer qué/what questions, dónde/where questions and cuándo/when questions related to pictures or recent experiences (e.g. “What did you eat for lunch?” or “When do you brush your teeth?”). It should be noted that he struggled with questions that required him to listen to a passage or story and then answer. This is addressed below. In the area of language form, he understood complex sentences and modified nouns.
Areas of difficulty in Student’s receptive language skills were noted the following areas. In the area of content, Student demonstrated difficulty answering questions following a story or short passage read aloud to him. He inconsistently answered Quien/Who, Qué/What and Dónde/Where questions. He did not successfully answer Qué pasó/What happened, Cuándo/When or Por qué/Why questions initially. A Dynamic Assessment was implemented to determine whether visual supports would support his ability to answer questions. When visual information was provided to facilitate his responses, he still did not get any Qué pasó/what happened questions correct. He got 1/3 Cuando/When questions correct and 1/3 Por qué/Why questions correct. Student also struggled to understand time/sequence concepts such as Primero/First and Ultimo/Last. He had difficulty identifying a story sequence, making inferences based on a story, making predictions, and identifying the main idea of the story. These areas of difficulty are consistent with his struggles in the classroom and appear to be having a negative impact on his academic performance. In the area of language form Student struggled to follow directions. On the formal test he was asked to follow several 3-step directions. He consistently followed one out of three steps. This was also an area of concern expressed by his teacher. Gestures were added to the instructions to see if his ability to follow instructions would improve with such visual supports. When given visual prompts with instructions, he completed 2 out of 3 steps in 3/3 attempts. His improvement with visual cues indicates that adding visual prompts will be an important element of his intervention program.
Formal Expressive Language Testing Within Normal Limits
In this example, we had a student who scored within normal limits with an 88 on the expressive language portion of a standardized test. Although this is within the average range, he was noted to have difficulty with possessive pronouns. He was noted to use possessive pronouns correctly in 2 out of 5 attempts in his initial telling of the story. This is a student who has been exposed to both English and Spanish throughout his life but uses only English expressively.
Excerpt from Expressive Language Section of the Report
Language samples were elicited in English. Spanish was also attempted but Student had difficulty telling a story in Spanish. Narrative samples were elicited using an 8-picture storyboard, as well as sequencing pictures of 3 and 4 pictures. Transcripts are below.
The got a blue blanket and then it started raining. And then he got dripped and then, and then he tell his sister, and then he got a, and the dog is like getting wet so they make a house for him. And then they worked super hard making the house and then and then and then sister said the dog didn’t like it but he only got his blanket. And then he put it in he house with the sister. And the sister and the brother thought the dog didn’t like he house. And that, and then the dog came back and get he blanket. And then he put it in the house. And then he get in the house so he didn’t get wet.
2/5 Posessive prounouns correct
Dynamic Assessment (DA) focused on the use of possessive pronouns. During testing and during his language sample, Student was noted to use “he” as a possessive pronoun instead of “his” and “she” instead of “her.” During the teaching portion of the DA, we talked about the form used for possessive pronouns and the meaning of them. We reviewed his story and talked about where he should use a possessive pronoun instead of a subject pronoun. He was then asked to retell the story.
The dog outside, got a blue blanket. Then it started raining. And then he got dripped. And then he tell him sister, “The dog is like getting wet.” So they make a house for him. And then they worked super hard making the house and then sister said the dog didn’t like it. He only got he blanket. He put it in he house with the sister. And the sister and the brother thought the dog didn’t like him house. And that, and then the dog came back and get his blanket. And then he put it in he house. And then he get in the house so he didn’t get wet.
Possessive Pronouns: 1/6 correct
Student demonstrated an expressive language disorder. He obtained a standard score of 88 on the expressive language portion of the PLS-5-Spanish (a bilingual test), placing him in the 21st percentile relative to children of his age and language background. Although his overall expressive language score fell within normal limits, his performance in the area of language form (syntax and morphology) was below average. His strengths in the area of language content elevated his score to within the normal range. Dynamic assessment results supported a diagnosis of expressive language disorder. Overall, the conclusions of this evaluation were consistent with teacher concerns. Teacher rated Student as below average for his use of grammar, ability to express himself when called upon, and ability to relate a sequence of events.
Relative strengths in Student’s expressive language skills were noted in the area of content. Student named objects that were described to him, formulated appropriate responses to questions about hypothetical events, named categories when given the names of objects in the category, responded to why questions by giving a reason, and repaired semantic absurdities. For example, when given the sentence, “The girl ate soup with a shoe,” he was able to correct the sentence to, “The girl ate soup with a spoon.” When asked to retell a story he included the basic content of the story and included a logical conclusion.
Areas of difficulty in Student’s expressive language skills were noted in the area of language form. Student was asked to repeat simple sentences in Spanish and English. For example, when asked in Spanish to repeat the sentence, “La niña que está cantando es mi hermana” (translation: The girl who is singing is my sister), he said, “The girl, he’s my sister.” When asked to repeat the sentence, “The girl who is singing is my sister,” he said, “Girl singing like my sister.” He was able to repeat 3-word phrases consistently and 4-word phrases inconsistently. At the 5+ word level, he was not able to repeat sentences accurately. Student produced many ungrammatical sentences in his narratives. He made errors in subject-verb agreement, subject pronouns, object pronouns, possessive pronouns, and articles. He also produced many incomplete sentences. He produced possessive pronoun errors with a high frequency so this was targeted in trial therapy/dynamic assessment.
Dynamic Assessment (DA) focused on the use of possessive pronouns. During testing and during his language sample, Student was noted to use “he” as a possessive pronoun instead of “his” and “she” instead of “her.” During the teaching portion of the DA, we talked about the form used for possessive pronouns and the meaning of them. We reviewed his story and talked about where he should use a possessive pronoun instead of a subject pronoun. He was then asked to retell the story. On the pretest he produced 2/5 posessive pronouns correctly. After a teaching session he produced 1/6 possessive pronouns correctly. His lack of improvement after a lesson indicates a need for intervention.
Formal Speech Testing Within Normal Limits
STUDENT achieved a standard score on the BAPA that placed her in the 40th percentile. Although her performance on the single word articulation test fell within the average range, she had difficulty as the complexity of words and utterances increased. Intelligibility in connected speech was judged to be 70% for a familiar listener and 60% for an unfamiliar listener in connected speech. Children her age are typically fully intelligible in connected speech for both familiar and unfamiliar listeners. Performance on the single-word articulation assessment indicated the use of a number of phonological processes that are typically suppressed by her age, including Assimilation, Cluster Reduction, Weak Syllable Deletion, and Fronting. She also used some phonological processes that are still age-appropriate, including Gliding and Flap/Trill Deviation. Examples of the phonological processes are presented in the table above. STUDENT’s use of phonological processes appeared to increase in continuous speech, which drastically impacted her level of intelligibility.
In trial therapy STUDENT was asked to repeat five 3-word phrases. First the examiner said the phrase and asked her to repeat it. Next the examiner tapped the desk with each syllable and asked STUDENT to do the same. She did not produce any of the phrases correctly with the model alone. She produced 2/5 correctly while tapping each syllable. Her improvement with auditory and tactile cues is a positive prognostic indicator for intervention.
Don’t be afraid to override the results of standardized tests!
We’ve all spent many years studying speech development, speech disorders, language development, and language disorders. We are experts and we need to trust our gut feelings in the assessment process. Tests are tools that we have available to support our decision making. The truth is though, they aren’t perfect. The tests can’t parse the intricate details. That’s our job. And when we effectively take into to account test results, item analysis, parent and teacher concerns, informal measures, and dynamic assessments, we will make diagnostic decisions that lead to our students and clients getting the support they need.