Assessing Language and Communication Skills of Young Children with Complex Communication Needs

Background: Accurate and meaningful assessment of language and communication skills to monitor child progress is the cornerstone to appropriate intervention for children with complex communication needs (CCN; Brady et al., 2016; Rowland et al., 2012). Despite this need, there is a lack of high quality and validated measurement of young children with CCN who are beginning communicators and have heterogeneous underlying etiology. Research Aims: This dissertation aims to understand the measurement of language and communication skills for children with CCN who use AAC through a scoping review. Specific research aims include: (a) describe what measures have been used, who were measured, and what language and communication skills were measured; (b) summarize how the identified measures measured language and communication skills of children with CCN; (c) identify reliability and validity evidence for these measures in children with CCN. Methods: This study employed a scoping review approach (Tricco et al., 2018). The systematic search and screening on four databases included a total of 282 studies published in peer-reviewed journals. Results: A total of 65 published measures were identified from this review. Existing studies that measured language and communication skills of children with CCN heavily depended on self-developed measures and published measures that do not have any validity evidence within children with CCN. Diagnoses of participants included a broad range; however, children with cerebral palsy were under-represented in single case design (SCD) studies. This study found existing studies primarily measured expressive aspects of language and communication skills, with only a few studies measuring receptive skills. Domain specific skills included pragmatics (84% of studies), semantics (52%), syntax (38%), and morphology (26%). Additionally, 7% of studies reported measuring AAC related operational skills and AAC symbol recognition skills. This study provides tree-maps summarizing how existing measures measured these domain specific skills. In terms of reliability evidence, most previous studies provided sufficient reliability evidence for self-developed measures; however, only 10 out of 65 published measures reported reliability evidence within children with CCN. Only 15 out of 65 published measures reported validity evidence for children with CCN with a primary focus on convergent validity and children with cerebral palsy. Conclusions: This study highlights the needs to measure receptive language skills and linguistic complexity, and to consider the influence of AAC related skills in future measures and interventions. Existing measures that showed validity evidence should be further tested with validity evidence from (a) other sources, such as content validity and construct validity, and (b) children with different etiologies in addition to cerebral palsy. Testing stimuli identified from the tree map could be explored in future tests and semi-structured observational measures. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]