Identifying speech and language delays with the New Reynell Developmental Language Scales at the University of Reading

Speech and Language Therapists at the University of Reading are finding it easier to identify children with language development issues, thanks to the New Reynell Developmental Language Scales.

Developing speech and language skills is a critical part of growing up but some children struggle to get to grips with these core skills, putting them at a severe disadvantage – the ramifications of which could last a lifetime.

Because of the importance speech and language has in a child’s ability to communicate, it is vital that delays and impairments to speech and language are diagnosed as early as possible, says Helen Marlow, a clinical tutor at the University of Reading’s School of Psychology and Clinical Language Sciences. Early intervention is the key to giving a child with problems the best possible chance in life.

The importance of speech and language development was starkly laid out by the Department for Education’s review of services for children and young people with speech, language and communication needs – the Bercow Review.

It found that 7% of children entering school in England have significant difficulties with speech and/or language and that up to half of children in some socio-economically disadvantaged populations have speech and language skills that are significantly lower than those of other children the same age.

As a speech and language professional, Helen typically sees children who have been identified as having potential problems by care workers, health professionals or teachers. Her task is then to diagnose which elements of speech and language the child is struggling with and devise an appropriate intervention plan.

Many of the children that come to see Helen are pre-schoolers. “Although parents are usually able to tell me how many words they can say they are very often unaware of possible comprehension difficulties. Delayed comprehension is a key indicator of whether children between the age of two and three years are likely to go on to have language difficulties or whether they are just a ‘late bloomer’,” says Helen.

“A standardised score using the New Reynell Developmental Language Scales helps explain these ‘hidden difficulties’ to parents, when they may previously only have been aware of the lack of speech output.”

The new edition

The New Reynell Developmental Language Scales (NRDLS) – authored by a respected academic team that includes speech and language therapy experts – provides therapists with state-of-the-art diagnostic tools, backed by the most up-to-date linguistic research.

Clinicians, educationalists and researchers have long relied on play-based assessment tools, such as the NRDLS, to help identify a young child’s speech and language problems. Play-based assessments help put children at ease and therefore help therapists draw-up correct and informative profiles of a child’s language.

It is important that therapists are able to compare the referred child’s profile with robust norms that are based on a representative sample of typically developing children. In order to do this, the assessment must be standardised using an appropriate population. Standardised assessments are also a critical element when evaluating the effectiveness of interventions.

The revisions to the new edition have been based on the most recent research around child language acquisition and indicators of language impairment, together with user feedback. The assessment has also been standardised on a sample of over 1,200 children.

As in the previous editions, there are two scales in the NRDLS: the Comprehension Scale explores aspects of a child’s understanding of selected vocabulary items and grammatical features, while the Production Scale examines the child’s production of the same features of language. Parallel sections within the scales aid comparison of a child’s comprehension and production skills.

“As trainers of future generations of SLTs, we stress the importance of evidencebased diagnosis to our students,” says Helen. “So it’s reassuring that we have assessment tools built on those same principles.”

The NRDLS helps Helen by providing a standardised approach to assessing a child’s speech and language development. And the new assessment has several clear advantages over previous editions – not least, it has streamlined the number of toys and pictures, making the package more appealing to children and therapists alike. “With previous versions, there were one or two toys that the children didn’t relate to, which means they might lose concentration,” says Helen. “But they really seem to take to the Monkey, Rabbit and Teddy characters in the new version.”

The NRDLS also comes with two updated full-colour picture books.The books make it easy to engage in tasks such as pointing to the correct image or describing a scene and are used to analyse a child’s understanding of vocabulary and grammar and their ability to use those features in their language.

Because children are more engaged with the stimuli used in the NRDLS assessment, therapists have a far greater likelihood of assessing a child’s true ability. It also helps maximise the use of a therapist’s time, ensuring that repeat sessions are not necessary.

There are, quite naturally, occasions where a child won’t sit through a complete assessment. NRDLS makes life easy for therapists by providing clear termination rules so it is very seldom that a child would complete both scales. “That makes sure I can get useful results from an assessment,” says Helen.

The streamlined assessment is also proving popular with therapists. “Previous versions of Reynell contained a great deal of material and carting around the case could sometimes be cumbersome,” says Helen. “For therapists that travel around a lot, it becomes a consideration. The new slimmed down pack is just so easy to carry around.”

The Multilingual Toolkit

A new addition to the assessment is The Multilingual Toolkit, a handbook that has been specifically designed to help therapists work in a multicultural environment.

It helps therapists deal with testing children for whom English is not a main language as well as making them aware of cultural issues which may mean some parts of the test – such as verbs that involve physical contact – need to be modified.

One of the complications of dealing with children with EAL is that it can make identification and diagnosis of impairments more complex, as characteristics the child shows when speaking English may be features of second language acquisition. This can lead to both under- and over-referral to speech and language therapists.

The Multilingual Toolkit has been produced to help adapt the concepts and materials of NRDLS to situations where there is linguistic diversity. It illustrates the sorts of adaptations that could be made, uses examples to indicate what an individual child’s performance might mean for assessment and also offers advice on adapting instructions, taking account of cultural differences and the differences in experience and language input across cultures and linguistic groups.

As one of the NRDLS authors, Dr Indra Sinka, explains: “Despite the fact that in the UK we are a multilingual and multicultural society, we do not yet provide a sufficiently equitable service in all areas of the country to bi- or multi-lingual children. The Multilingual Toolkit acknowledges this and goes some way to encouraging best practice in order that access to services for such children is not denied.”

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