the control group, a difference of 25.8 points. We are especially concerned about the children with SELD who performed near the lower end of their group's ...
Second Opinion
Slow Expressive Language Development: A Call for More Data Nippold and Schwarz Respond
R
hea Paul has graciously responded to our request for more information about the group of children she describes as having slow expressive language development (SELD). Specifically, in her reply she reports that at first grade, the children with SELD, as a group, performed no differently from the children without SELD (control group) on the remaining subtests of the PIAT (Mathematics, Spelling, and General Information), and on the receptive quotient of the TOLD-P. She also indicates that the groups did not differ in performing a phonological segmentation task, addressing some of our concerns about the absence of metalinguistic tasks in the first grade assessment battery. This additional information is helpful in clarifying who these children are by describing more fully the nature and pattern of their language development. Given these more recent data, in combination with the data Paul reported in her original article, it does not appear that the children with SELD, as a group, are experiencing serious problems in receptive language or in basic academic skills at first grade. We hope that future evaluations of these children yield similarly positive results. Let’s assume momentarily that Paul’s interpretation is accurate regarding the children’s receptive language and academic skills at first grade. We still are left with questions concerning their expressive language skills. The results of Paul’s standardized testing indicate that at first grade, the children with SELD continue to differ from the control group as measured by the expressive quotient of the TOLD-P. For example, as shown in Paul’s Table 5, the subgroup of children described as having chronic expressive language delay (ELD) obtained a mean expressive quotient of 82.6 (SD = 11.4) on this test, which contrasted with a mean of 108.4 (SD = 9.0) obtained by
the control group, a difference of 25.8 points. We are especially concerned about the children with SELD who performed near the lower end of their group’s range on the expressive portion of the TOLD-P. In particular, we wonder about these children’s ability to communicate effectively in real-world contexts in comparison to other children their age with no history of language problems. Therefore, we continue to maintain that standardized testing should be supplemented by naturalistic observational data to determine if a child’s performance in real-world situations, such as the classroom, is consistent with his or her performance in less naturalistic conditions. We believe such information is essential before any recommendations should be made regarding the course of action to be taken with a child. We understand the importance of obtaining standardized test data for research purposes, but we also realize the limitations of these measures, particularly in deciding how to proceed with a child. For example, standardized tests do not directly examine critical receptive language skills, such as the child’s ability to follow directions in the classroom, to comprehend stories read by the teacher, or to understand the rules of a game, a science lesson, or the procedures to be followed during an upcoming field trip. Also, such tests do not directly examine critical expressive language skills such as asking and answering questions in class, explaining the rules of a game played at recess, offering directions on how to reach the cafeteria, or accurately reporting the details of a playground mishap. In the absence of naturalistic observational data, the speechlanguage pathologist will be unable to determine the extent to which a particular child experiences difficulty with these important activities. We maintain that any child who has difficulty in any of these areas should receive more than a “watch and see” monitoring approach. Part of Paul’s argument for recommending the “watch and see” approach is financial, given that the costs of providing direct services to children with language problems are high and are continuing to escalate. This is certainly a legitimate concern. However, when treatment is indicated for a particular child, there are alternatives to the “pull-out” model of individual or small-group intervention that speechlanguage pathologists traditionally have employed, alternatives that can take account of children’s needs in a more cost-efficient manner. For example, for children who exhibit receptive language problems in the classroom, the speech-language pathologist, collaborating with the teacher, could implement a program Nippold • Schwarz
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that systematically assists children to acquire more effective strategies for listening, understanding, and retaining new information in relation to specific domains of knowledge (e.g., science, social studies, music) they are expected to master during the academic year. For children who demonstrate expressive language problems, the speech-language pathologist and teacher could implement a program in which groups of children receive training that focuses on specific tasks, such as giving clear and accurate directions, asking and answering questions appropriately, and explaining the rules of a game in a way that takes into account the listener’s background. Following the training period, students who continue to experience difficulty could be coached by the speech-language pathologist or teacher as they attempt to perform those important tasks in the school environment. Students who demonstrate proficiency with the tasks could serve as models and as peer tutors for their classmates who continue to require assistance. We hope that future reports of children with SELD will examine these additional areas that address more directly the comprehension and production of language in real-world contexts. Admittedly, the examination of children’s language in natural settings may yield data that are less objective than what we now obtain via standardized tests. Nevertheless, when used in combination with standardized measures, naturalistic data can be an invaluable source of insight into a child’s success as a communicator. Such data can also provide vital assistance in deciding the best course of action to be taken with a child who demonstrates language problems. In future reports of children with SELD, we also would like to see more information on individual differences within groups. For example, the scores obtained by each child on every task administered in the study should be
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reported (in addition to the group means, ranges, and standard deviations) so that readers can examine the performance of individual children with and without a history of SELD. As is well known, group means can obscure important characteristics and behavioral patterns of individual subjects. As mentioned above, we are especially concerned about Paul’s children with SELD who fell at the lower end of their group’s range on the TOLDP expressive quotient. The communication abilities of these children could differ in important ways from those of other children in this group, and they could certainly differ from those of children in the control group. Moreover, given the absence of data on individual performance, the communication abilities of children with SELD in one study could differ greatly from those of children in another study (e.g., Bishop & Adams, 1990). Thus, we continue to argue that it is risky to predict a positive outcome for school performance in Paul’s children, followed only to first grade, by citing other studies in which children with SELD demonstrated successful school performance when evaluated beyond first grade. Rhea Paul has provided our profession with an extensive and informative program of research concerning late-talking children. This is a critical topic for continued research, and one which carries important implications for caseload selection and intervention strategies. We express appreciation to her for providing the springboard for this lively discussion and exchange of ideas. We look forward to continuing this dialogue.
References Bishop, D. V. M., & Adams, C. (1990). A prospective study of the relationship between specific language impairment, phonological disorders and reading retardation. Journal of Child Psychology and Psychiatry, 31, 1027–1050.
May 1996
