ACQ Vol 10 No 1 2008

Ethical Practice: PERSONAL CHOICE or moral obligation?

Table 2. Clinicians’ comments about assessment tools Preschool Language

Positive: less flipping from book to toy compared with the PLS-4; easy to administer

Scale – 3

Negative: less useful for 0–12 months

Preschool Language

Positive: observational; good basis for discussion; easy to administer and score; quick and doesn’t rely on parent report; play component useful; familiar with it; standardised; good for early receptive and expressive language; as a screen for younger; vocabulary checklist gives an idea of the cross section of words being used Negative: too constrictive and structured; can be very disjointed in administration; expensive score forms ($10.30 each!); difficult with Indigenous population; toy sections difficult to administer and score

Scale – 4

Receptive and Positive: gives standard score to help determine severity; good basis for discussion with parent; Expressive Emergent easy; gives a snapshot; for children who are difficult to assess; predictive of language delay in Language Scale - 3 < 12 months Negative: not useful for identifying areas for intervention: doesn’t take in the child as a whole Macarthur Positive: easy to administer and score; qualitative idea of semantic level; reliable as a parent report Communicative instrument Development Negative: not so happy with the norms; database beyond vocabulary understanding too thin Inventory Rossetti Infant Positive: good for planning clinical intervention goals; increases parent awareness of different modes Toddler Language of early communication; comprehensive including information about pragmatics, attachment and Scale play; easy to administer and doesn’t rely on child compliance; straightforward and gives narrow age brackets; good for parent interviewing; clear; parent friendly; option of a parent questionnaire; used for long-term research with special needs; its in the clinic; am used to it Negative: takes a while to administer

Hawaii Early

Positive: very visual and quick within multidisciplinary assessments

Learning Profile Pre-verbal communi-

Positive: good for very discrete behaviours

cation schedule Meeting Street School Positive: used for screening – Language Negative: not normed

Development Scale Communication and Symbolic Behaviour Scales

Positive: for research, enabled us to validate parent report to clinician observation

of interest. In this, the clinical utility of the ELM-2 is discussed as a screener and as part of a formal assessment. Conclusions Given the relatively small number of clinicians surveyed, this paper could be seen as a pilot for a more representative study of Australian clinicians about their early language assessment practices. However, results from this survey reveal that though there are numerous assessment tools available for use with 0–3 year olds, almost a third of surveyed clinicians indicated they were not happy with their current assessment/s. Perhaps there is a need to circulate more effectively the wealth of information that is available, both in terms of assessment tools and comments from those who have used them. This investigation may help to inform clinicians regarding the range and nature of assessment tools available. Few Australian clinicians reported awareness of the ELM-2, an assessment tool which the author has been using since 2004 for screening and as part of formal assessment. Clinicians can refer to part 1 for a comprehensive discussion of the strengths and limitations of this test. References Black, M. B., Freeland, C. A. B., Nair, P., Rubin, J. S., & Hutcheson, J. J. (1988). Language screening for infants prone to otitus media. Journal of Pediatric Psychology , 13 , 423–433.

simply reflect clinicians’ awareness of what is available or may reflect a limitation of this study as all Australian states were not equally represented in the survey. The list of assessment tools (table 2) may increase clinicians’ awareness and access to tools available for < 3 year olds. Practical comments made by respondents (table 3) may be useful for the 29% of clinicians who stated they were not happy with their current assessment tools It is worth knowing that some of the tools listed are easily accessible either via the internet (e.g., Wetherby and Prizant’s 2001 Communication and Symbolic Behaviour Scales Developmental Profile: Infant/Toddler Checklist) or in a journal article as in the case of Rescorla’s Language Development Survey (Rescorla, 1989). It is interesting to note the number of clinicians using self- formulated checklists. Perhaps this reflects dissatisfaction with single instruments, and the need therefore to combine elements from different assessment tools to meet clinicians’ needs, or this may reflect funding limitations. Some clinicians commented on the cost of assessment tools, particularly test forms. The many reasons clinicians gave for their choices of assessment tools indicates that a range of tools is necessary to account for client factors, reasons for testing, clinician preferences, and accessibility to parents. No single assessment instrument is comprehensive enough to cover all factors. Indeed, most clinicians (73%) reported using more than one procedure. For the majority of clinicians who expressed interest in knowing more about the ELM-2, part 1 of this paper may be

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S peech P athology A ustralia