Introduction. All static assessments, including norm-referenced tests of language, are plagued by severe limitations in the interpretation of their results due to cultural and linguistic factors that lead to test bias. This limitation renders most static tests uninterpretable for the majority of the world’s population. Dynamic assessment promises to mitigate that test bias.
Aim. The purpose of this study was to examine and cross-validate how well a dynamic assessment of language can accurately identify a large sample of diverse school-age students with and without language disorder.
Method. This study included 362 students from kindergarten to sixth grade, of which 54 had a language disorder. Students were administered a dynamic assessment of narrative language, which took approximately 10-minutes. Language disorder was established at the outset for each participant using multiple sources of evidence.
Results. Hierarchical logistic regression indicated that the combination of modifiability scores and posttest scores from the dynamic assessment accounted for 70% of the variance in ability. ROC analyses yielding an AUC revealed good to excellent sensitivity and specificity-consistently above 85%.
Conclusions. This study addressed weaknesses in previous dynamic assessment research, where there were small sample sizes – 55 participants or less, a lack of a representative ratio of students with language disorder, examiners who were not blind to language ability prior to testing, and limited evidence of cross-validation. This is the largest dynamic assessment of language study conducted to date, and the results are consistent with the extant literature – dynamic assessment accurately identifies language disorder and mitigates bias.

dynamic assessment, diagnosis, language disorder, bias, diversity


Speech pathologists should reflect on the current state of research for dynamic assessment, gain a deeper respect for the biased results static assessments can yield for culturally and linguistically diverse students, and respond by adopting assessment practices that are better equipped to provide valid results for all students.

Abstract
Introduction: Past research highlights the limitations of relying on static, norm-referenced assessments of vocabulary knowledge; however, little research has explored vocabulary and word-learning assessment practices among speech-language pathologists (SLPs).
Aims: This pilot, exploratory study aimed to build understanding of current assessment practices of vocabulary and word-learning, and guide translation of research to practice among SLPs.
Methods: One hundred and twenty-seven SLPs from Australia, the United States and United Kingdom completed an online survey, which explored their methods and purposes for assessing vocabulary knowledge and word-learning skills in children. The survey also explored perspectives on assessment practices with individuals from culturally and linguistically diverse (CALD) backgrounds.
Results: Responses to binary, multiple choice, and open-ended questions were analysed using descriptive statistics, Chi-square tests, and content analyses. Regarding vocabulary assessment, 118 SLPs (93%) reported using norm-referenced tasks, and 27 reported additionally using non-normed tasks. Seventy-seven SLPs (61%) reported that they evaluate word learning skills, with 20 reporting that they use dynamic assessment procedures to do so. Most commonly, SLPs reported using data from both vocabulary and word-learning assessments for intervention planning purposes. Regarding the use of standardised, norm-referenced vocabulary assessments with individuals from CALD backgrounds, a key concern identified by SLPs was that they have limited access to alternative, culturally sensitive assessments.
Conclusions: We need to develop and disseminate accessible resources to support SLPs’ implementation of word-learning evaluations, including resources for dynamic assessment. This is critical given the issues with using standardised, norm-referenced tests with diverse groups who are underrepresented in standardisation samples.

Submission statement: While static, norm-referenced vocabulary tests can be useful, they may not allow SLPs to respond to, and respect, each individual child’s learning capacity and strengths. Just as this survey asked SLPs to reflect on assessment practices, those who attend this presentation will have the opportunity to consider their practices.

Introduction: Fluent word recognition is an essential component of skilled reading, yet most children with reading difficulty have impaired word recognition skills. Based on a large body of research highlighting the crucial role of phonological recoding (decoding – sounding out and blending) in early reading development, we developed a web app (WordDriver) which targets accurate decoding to support orthographic learning and the development of fluent word recognition.
Aim(s): To evaluate whether WordDriver, delivered via teletherapy, would result in gains in decoding and orthographic learning for targeted vowel digraphs.
Methods: Two single case experimental design studies examined changes in decoding accuracy (study 1) and orthographic learning (study 2) measured by researcher-developed nonword reading and spelling lists, and standardised nonword reading assessments. Participants were five children (aged 7 – 10 years) who, despite previous evidence-based intervention demonstrated persistent word recognition impairment.
Results: Statistical analyses and visual examination of graphed responses of the dependant variable showed that all participants made significant gains in mastery of accurate use of the decoding process, and in orthographic learning of targeted vowel digraphs. Further, these gains were made after 10 hours of intervention (thirty 20-minute sessions).
Conclusions: The results of this preliminary study suggest that the WordDriver apps may form an efficient component within interventions for children with persistent word recognition impairment. As these web apps are freely available and deliverable via teletherapy, access to this intervention may be incorporated into a range of service delivery options for students especially those with limited access to services.

Keywords: decoding; orthographic processing; dyslexia; decoding; telehealth

Submission Statement: The speech pathologist researchers reflected on their observation that many children on their caseload required support to develop essential skills for early reading success. They responded by developing and evaluating an intervention that respected the needs of students who may benefit from a freely available, evidence-based resource deliverable via teletherapy.

Introduction: Developmental Language Disorder (DLD) is estimated to affect 7.6% of the population in English-speaking countries (Norbury et al., 2016). Nonword repetition (NWR) tasks have been described as a clinical marker of DLD, and is one of the most sensitive measures in identifying bilingual children with DLD (Armon-Lotem, de Jong & Meir, 2015). In Australia, Cantonese is the fourth most commonly spoken home language other than English, with 1.2% of the total population using it as their home language (Australian Bureau of Statistics, 2022). Interestingly, Cantonese has been an apparent exception in NWR, where NWR was reported to not discriminate between children with and without DLD (Stokes et al., 2006).

Aim: This study re-examines the diagnostic potential of NWR for DLD in Cantonese.

Methods: Sixteen predominantly monolingual Cantonese-speaking children with DLD and sixteen age-matched, typically-developing (TD) children repeated four sets of nonwords varying in levels of lexicality: MORE and AddMORE (all syllables are morphemic in Cantonese but meaningless when combined), Crosslinguistic(CL)-NWR (Chiat, 2015; 57% of syllables are morphemic) and LESS (all syllables are non-morphemic).

Results: Children with DLD scored significantly below TD children on all sets of nonwords. Effect sizes suggested that nonwords of the highest lexicality levels (MORE and AddMORE) offered the greatest group differentiation.

Conclusions: NWR using stimuli with higher lexicality can discriminate children with and without DLD in Cantonese. These positive findings have laid necessary groundwork for further research on using NWR to identify DLD in Cantonese-speaking bilingual children, an important area largely lacking in assessment tools.

Nonword Repetition; Crosslinguistic Nonword Repetition Test; Developmental Language Disorder; Cantonese Chinese

We hope that participants of the presentation will be encouraged to respond boldly to the need of developing suitable screening and assessment tools for bilingual children speaking different languages, which is crucial to the early identification and intervention for developmental language disorder in young children.

Introduction/or rationale:
Providing culturally safe, high quality speech pathology intervention to school-aged, bilingual, Aboriginal children with language disorders living in rural and remote NSW via telehealth is a challenge. Much of the current literature and teaching focuses on what not to do, which can result in undermining existing clinical skills and meaning these children miss out on the full breadth of our toolkit. But it can be done. Developing and building on existing strong relationships, using regulation strategies and cultural safety is the first step. Add in participatory approaches in treatment design, coupled with evidence-based treatment approaches, and children can achieve or exceed anticipated therapy outcomes.

Evidence, implementation, and evaluation:
Lessons from a multiple-case study will be presented exploring how bilingual Aboriginal children with language disorder were engaged in effective language therapy via telehealth. The lessons will identify and synthesise cultural safety and evidence-based language therapy approaches used for successful speech pathology intervention via telehealth into schools.

Main outcomes:
Student empowerment and the use of evidence-based approaches in a culturally safe context support the achievement of language therapy outcomes in speech pathology delivered via telehealth.

Conclusion:
Much of the current literature focuses on what not to do. This presentation will focus on what clinicians already bring, and how to build on existing clinical skills and clinician strengths. It will focus on what can be done, and how, offering practical, culturally sensitive approaches to engage Aboriginal children and support the development of language skills.

Key words: Aboriginal, Aboriginal English, Language Disorder, Language therapy, paediatric,

Submission statement: Delegates will be challenged to reflect on and reconsider how they work with Aboriginal children. The current literature encourages timidity, restraint and fear, to the detriment of clinical outcomes. Delegates will leave empowered to consider what can be done, and how, when working with Aboriginal children.

Introduction: Children with dyslexia, compared to typically reading peers, are at elevated risk of internalising (e.g., anxiety) and externalising (e.g., aggression) mental health concerns; why this is the case is largely unknown.
Aim: To gain an understanding of self-esteem and mental health in the context of dyslexia by exploring child and parent perspectives on the socio-emotional experience of growing up with dyslexia.
Methods: We interviewed 17 children (aged 9-14 years) with a diagnosed reading difficulty and their mothers (interviewed separately) using a semi-structured interview protocol. We analysed the data using Braun and Clarke’s reflexive thematic analysis approach and took a neurodiversity lens to our analysis. We prioritised children’s voices, drawing on mother’s perspectives when needed to provide depth to the analysis.
Results: We developed three themes from the data to address the research aim which we titled: 1) Different in a good/bad way; 2) Exhausted and overwhelmed; and 3) It takes a community: Family-school connections.
Conclusions: Children described experiencing school-related stress and ambivalent feelings towards their dyslexia. Mothers described how children’s school-related emotions (e.g., stress, frustration, anxiety, and embarrassment) may be released at home as internalising (worries, school-refusal) and externalising (e.g., after-school meltdowns) behaviour. The results highlighted the importance of children’s friendships, parental support (emotional and academic support), and “school-connectedness” for children’s mental health. Furthermore, many families are taking a neurodiversity perspective and strengths-based approach to dyslexia to support their children’s self-esteem. The findings have implications for parents, teachers, and health professionals who live and work with children with dyslexia.

Keywords: dyslexia, mental health, self-esteem, neurodiversity

Submission Statement: This research provides an opportunity to listen to children’s and mother’s voices and reflect on factors that support their socio-emotional wellbeing. The language of neurodiversity (difference not deficit) and a strengths-based framework is a useful response during diagnosis and beyond that respects children’s differences and may support self-esteem.

Purpose: Speech-language pathologists (SLPs) support school-aged students with communication difficulties; however, it is unclear how they evaluate the effectiveness of interventions. This study aims to explore the outcomes being measured at each tier of intervention by SLPs who work with school-aged students, the tools being used and the factors that influence their choices.
Method: Fifty-four SLPs from Australia, New Zealand, Canada and the United Kingdom completed a survey distributed by their professional associations. Descriptive statistical analyses of frequency were completed for quantitative data. Open-response questions were analysed using inductive and deductive content analysis; deductive content analysis utilised the International Classification of Functioning, Disability and Health (ICF) framework.
Result: The majority of SLPs reported working at and using a variety of outcome measures at all tiers of intervention. Outcome measured were predominantly at the activities & participation and body functions domains of the ICF. Alignment was the most frequently reported factor influencing SLPs’ choice of measurement.
Conclusion: SLPs use a range of outcome measurements to gather information about the effectiveness of their intervention. Further use of parent/teacher/student feedback might ensure more holistic outcome measurement, there are challenges in gathering this data when working at whole class level; more research is required to inform evidence-based practice.

Keywords: School-aged students; children; communication difficulties; outcome measurement; measurement tools; qualitative

Submission Statement: Appropriate outcome measurement tools are important in helping SLPs determine whether their interventions are effective and respond to the needs of the school-aged population. This research study also required participating SLPs to reflect on current practice and will hopefully encourage other SLPs to reflect on their own practice.

Background
Reports from English speaking countries indicate approximately 1 in 14-15 children have difficulties with language learning. Generalisation of these findings is confounded by the age at which language was measured, the measure used to determine language levels, which language domains were measured, and whether language measures were repeated across ages. This is in the context of updates and debates to the diagnostic criteria and appropriate thresholds used to determine language disorder in children and adolescents.
Aims
This study compiled current estimates of the prevalence of low language in young people. Through a systematic review of population-based studies, we explored the potential impact of methodological and terminological variability on the prevalence of language disorder.
Methods
A systematic literature search was undertaken of six databases, including: CINAHL, PubMed, ProQuest, MEDLINE, EMBASE, and Scopus. Inclusion criteria were age range (0-18 years), no known concomitant diagnoses, papers were published in English, and calculated their own prevalence rate. Papers were excluded if not published in English and reported on clinical populations.
Results
Of the 1338 of records identified, 18 met inclusion criteria. There was variability in estimates across studies, and reasons for discrepancies will be presented.
Conclusions
Findings shed light on the number of children experiencing language disorder, internationally. Understanding the prevalence of low language in young people is essential to inform service provision, health and educational policy, and advocacy. Further, findings provide the foundation for future prospective studies investigating the origin and impact of language disorder.
Keywords
Language disorder, prevalence, systematic review

Submission statement: Despite increasing awareness of DLD internationally, we have reflected that estimates of low language around the globe are constrained. We responded to these constraints by compiling existing research to identify pathways for future prospective research which respects individuals’ experiences living with DLD, such as stakeholder informed measures of functional impact.