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Ethical Practice: PERSONAL CHOICE or moral obligation?
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S
peech
P
athology
A
ustralia
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
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
Scale – 4
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
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
Positive:
for research, enabled us to validate parent report to clinician observation
Symbolic Behaviour
Scales