As some of you may know, I am expecting my first baby (It's a BOY!) and will be taking some time off from work and blogging before and after his arrival. During that time, there will be several guest bloggers/SLPs that will be featured on my blog. I am so excited to share all of the amazing, informative posts they have come up with. I can not thank them all enough for taking the time to write these posts! Just another one of the many reasons I love being part of the SLP world. I hope you all enjoy reading everything over the next several weeks. Please feel free to leave comments and post questions.
The next guest post is written by Tatyana at Smart Speech Therapy! Enjoy!
The next guest post is written by Tatyana at Smart Speech Therapy! Enjoy!
The importance of narrative assessments in speech language pathologyAs speech language pathologists we routinely administer a variety of testing batteries in order to assess our students’ speech-language abilities. Grammar, syntax, vocabulary, and sentence formulation get frequent and thorough attention. But how about narrative production? Does it get its fair share of attention when the clinicians are looking to determine the extent of the child’s language deficits? I was so curious about what the clinicians across the country were doing that I created a survey and posted a link to it on various social media sites (e.g., Facebook). I wanted to find out how many SLPs were performing narrative assessments, in which settings, and with which populations. From those who were performing these assessments I wanted to know what type of assessments were they using and how they were recording and documenting their findings. Since the purpose of this survey was non-research based (I wasn’t planning on submitting a research manuscript with my findings), I only analyzed the first 100 responses (the rest were very similar in nature) which came my way, in order to get the general flavor of current trends among clinicians, when it came to narrative assessments. Here’s a brief overview of my [limited] findings. Of the first 100 clinician’s whose responses were analyzed, the two largest groups were composed of SLPs who had been practicing for over 15 years (39%) as well as those who had been practicing from 5-10 years (18%). Of course it was not a surprise that 76% of these practitioners were based in school setting followed by 23% of practitioners in private practice. Out of them only about 74% of clinicians had ever assessed narratives. These numbers went further on decrease when asked how often these narrative assessments took place: 40% of clinicians stated that they’ve done it rarely with <25% of students, followed by 28% who stated that they performed narrative assessments only some of the time with <50% of students. When asked if the clinicians favored standardized instruments, non-standardized instruments, or both, the responses were split. Out of those SLPs who performed narrative assessments (see above), 52% favored standardized instruments while a whopping 68% favored non-standardized instruments, indicating an overlap in what instruments were used by clinicians.
Let’s begin with NAP. Developed for children 3-6 years of age, it uses Mercer Mayer’s (1969) ‘Frog, Where are You?’ book to analyze the child’s story microstructure (e.g., sentence and phrase structures, modifiers, nouns and verbs). According to the manual, the macrostructure domain of the NAP is currently under development. However, since the most recent manual was last updated in August 2008, I am not quite certain how up-to-date this information really is. To continue NAP is fairly easy to use. The child is first shown a book then asked to tell a story using pictures as prompts. One of the advantages of NAP is that it does not require narrative transcription and manual utterance tallying, since the examiner scores the narrative as the story is being told. However, the lack of macrostructure analysis is a big disadvantage in my eyes, which is why I personally do not use this assessment when I analyze the narratives of preschool children. Next up is the NLM. Referred to by its authors as the free RTI focused assessment tool, the NLM has two developed versions: NLM:P and NLM:K for preschool and kindergarten children respectively. For the purposes of this post I’ll review the preschool version only, which according to the authors is the most researched one. The administration time per each subtest takes approximately 2–5 minutes. Subtests are scored in real time while the child is narrating. The scoring rubrics contain 0–2 or 0–3 point ratings and cover 2 critical subscales: story grammar and language complexity. Of course since this is a standardized test it does contain some limitations. Children who lack previous exposure to testing may do poorly, so cultural considerations are always an important factor. Authors also strongly urge that single subtest administration be avoided and if the child’s abilities are probed infrequently (e.g., seasonally), the administration of all 3 subtests is strongly recommended for validity purposes. However, to me the biggest issue is that the subtests lack norms or cut scores to help identify at risk children. Depending on the setting you are in, the administration of this test may make it difficult for you to qualify the child for services, which is why you might be better off with an informal assessment.
Well, in the words of Pookins from Helen Lester’s ‘Pookins Gets Her Way’: “Lots!”
- Sequencing Ability
- Is the story order appropriate or jumbled up?
- Working Memory
- Is the child using enough details?
- Are these details relevant to the story?
- Does the sentence structure contains errors such as run-on sentences or incorrectly produced words
- Is the child using temporal markers and cohesive ties to connect the story together
- Is the child’s sentence complexity adequate for their age?
- Is it immature or age-level?
- Does the child have word retrieval issues or is s/he maintaining lexical fluency?
- Is there story cohesion and coherence?
- Is there adequate use of anaphoric references (pronouns identifying characters)?
- Perspective Taking
- Does the child have appropriate insight into character’s feelings, beliefs, thoughts?
- Narrative Assessment Bundle
- Narrative Assessments of Preschool and School Aged Children
- Vocabulary Development: Working With Disadvantaged Populations
- Understanding Complex Sentences
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