Are we slipping them through the cracks? The insufficiency of norm-referenced assessments for identifying language weaknesses in children with hearing loss.
Krystal L Werfel, Michael Douglas
PMID 34079910WHAT IT FOUND
Standard test scores did not flag language weakness in 13 preschoolers with hearing loss, but spontaneous language samples showed fewer different words and more omissions than matched peers.
Use language samples before deciding services.
Key findings
01The groups did not differ on the TELD-3 overall spoken language score (CHL mean = 103.62, CNH mean = 109.92, p = .283), and all children with hearing loss scored within 1.5 standard deviations of the test mean.
02In spontaneous language samples, children with hearing loss used fewer different words (150.38 vs 188.23, p = .040) and had a higher percentage of utterances with omissions (15.09% vs 3.61%, p < .001).
03Children with typical hearing reached 80% mastery on all Brown grammatical morphemes, while children with hearing loss reached 80% only for present progressive, prepositions, and articles.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was small: 13 children with hearing loss and 13 children with typical hearing. Only one norm-referenced language test, the TELD-3, was used, so the finding may not hold for other standardized tests. The paper says there is no existing evidence in the literature to support the concern about children with hearing loss who use hearing aids or cochlear implants. The authors state that their current concerns can only be related to results of the TELD-3.
The easy way to misread this
Do not conclude that norm-referenced tests should be abandoned for children with hearing loss. This study compared 13 children with hearing loss to 13 children with typical hearing, used one norm-referenced test, and did not show that language sample analysis improves service decisions or outcomes.