The development of a parent report instrument of early communication and language skills of infants and toddlers in mainland China.

OBJECTIVE: This study was designed to produce a new parent-report measure, the Diagnostic Receptive Expressive Assessment of Mandarin-Infant Toddler Assessment of Communication and Language (DREAM-IT) in order to provide norms for the developmental skills of children aged 0-36 months in four areas: expressive language, receptive language, cognitive play and social skills. METHODOLOGY: The scale was designed to be both broader and deeper than existing instruments that neglect one or more of these significant domains involved in early language. Items were chosen by a group of specialists with clinical experience working with the age group and with attention to the developmental literature. Caregivers were tested individually by a trained person who asked the questions and provided examples. In addition to an extensive health questionnaire, caregivers answered questions in Mandarin about their child's behaviour using a scale of 'not yet', 'sometimes' or 'always' or listing out words and/or sounds understood or said by the child. The 476 participating caregivers were recruited at maternal and child healthcare clinics centred in Chengdu, China, 191 of whom were tested a second time seven months later. The children were sampled in three-month age-bands from 0 to 36 months. The sample was balanced for child gender by age band, and parental education was balanced. Caregivers of 0-24-month-old children and caregivers of 12-36 months were each asked a different set of questions, to determine the appropriate age range and cutoff points for each question, requiring the sample size to be doubled for children aged 12-24 months. RESULTS: The results were subject to item-response theory analysis to remove outlying items, and the resulting internal reliability was high for each domain (average Cronbach's alpha=0.87). The final instrument (between 67 and 113 questions in total) was refined to include the least redundant questions that had the highest intercorrelations, with attention paid to coverage of all domains across the age range. Two scales were developed: one for children 0-18 months, the second for children aged 18-36 months. The longitudinal design permitted the creation of growth curves and norms for each domain for six-month intervals from 0 to 36 months. A small sample of 32 parents of children with Down syndrome aged 18-36 months provided validation that the scales are highly sensitive to developmental delay. CONCLUSION: The instrument shows considerable promise for detecting early communication problems in children in China. WHAT THIS PAPER ADDS: What is already known on the subject In China, efforts were made in recent years to develop language assessments for infants and toddlers, but limitations existed with the domains included and number of items included per age group. Many clinical practitioners also continued to rely on language subtests of general developmental scales, which were limited in depth and breadth of language skills tested and were never intended for diagnosis of language delay. What this paper adds to existing knowledge This paper discusses the development of a valid caregiver report instrument for early communication and language skills of infants and toddlers in mainland China. The Diagnostic Receptive Expressive Assessment of Mandarin-Infant Toddler (DREAM-IT) includes foundational domains necessary for language and communication development in young children (receptive language, expressive language, cognitive play and social communication domains). The results show strong internal reliability (Cronbach's alpha) for each domain on a sample of 716 children sampled in three-month age bands from 0 to 36 months. The external validity proved strong when tested on a group of 32 young children with Down syndrome. What are the potential or actual clinical implications of this work? Besides helping to inform the diagnosis of language delays in infants and toddlers in China, the caregiver report instrument has special features to support clinical practitioners in a field that is just emerging in China. The unique support features include the automatic generation of a profile of relative strengths and weaknesses of the child on the report and the recommendation of child-specific caregiver coaching videos on a companion app.

The characteristics of spontaneous language in young children identified as language delayed in Mandarin.

BACKGROUND: Little is known about the spontaneous speech characteristics of young children with language delay in Mandarin, relative to their peers. Until the recent development of standardized language assessments normed in China on Mandarin-speaking children, it was difficult to independently identify atypically developing children to study their spontaneous speech, and only case studies have been available. AIM: To investigate which aspects of spontaneous speech might be distinctive for atypical development in a short play session. METHODS & PROCEDURES: A total of 86 Mandarin-speaking children, boys and girls aged 2;6-4;6, were tested using the new standardized assessment for Mandarin, Diagnostic Receptive Expressive Assessment of Mandarin-Comprehensive (DREAM-C), at a major urban hospital in China. Of the children, 39 were identified by DREAM-C as atypically developing in language development (Total Standard score M = 72, SD = 8.9), and 47 scored in the typical range (Total Standard score M = 103, SD = 10.8), using the four scales of Receptive, Expressive Semantics and Syntax. All children then took part in a 15-min semi-structured play session during which their spontaneous speech was recorded by professionals. A variety of games and pictures were used in an attempt to elicit spontaneous questions, negatives and descriptions. Their recorded speech samples were then coded by linguists directly into a database in FilemakerPro for different aspects of vocabulary, sentence variety and grammatical morphemes/structures heard. OUTCOMES & RESULTS: The results describe the characteristics of the speech samples for the typical and atypical groups for age groups 2;6-3.5 (N = 52) and 3;6-4.6 (N = 34). Vocabulary diversity was indicated on an ordinal scale ranging from simple communicative signals including headshakes and words such as 'hi' to 'a rich variety of different content words'. Grammatical diversity similarly ranged from 'only yes/no answers', through to the appearance of multi-clause sentences. Morphosyntax was coded in terms of which morphemes were observed at all in the session, such as aspect markers (LE, ZAI, GUO), and nominal morphemes (DE, GE), and also whether function words such as pronouns, Wh-questions and classifiers were singular or varied in the session. There is considerable optionality in morpheme expression in Mandarin, so measurements such as the percentage supplied in obligatory contexts, though useful for languages such as English, are harder to compute. Nevertheless, the data show change over age in all these aspects of language, and reveal what a typically developing child might be expected to produce in a 15-min sample in such a session. For example, it was rare for the typically developing children by age 3.5 not to have at least simple sentences with some function words, and to use adjectives, nouns and verbs, unlike the children with atypical scores. The morphemes DE, LE and GUO showed significant differences in likelihood across groups for both ages, but BA and ZAI were significantly different only for the older age group. In contrast, GE was common in all groups. The atypical group has markedly lower frequency in several grammatical aspects such as the use of diverse questions, classifiers and pronouns, with much less change across age groups, implying slower growth. The results provide useful information on the relative likelihood of observing different varieties of words, sentence types and morphemes in a short speech sample, which are substantially different in the typical versus atypical groups in both age bands, and change over age. CONCLUSIONS & IMPLICATIONS: These data validate the DREAM-C classifications, but the details can also be used to inform the choice of targets for intervention for young children who experience delays in Mandarin language acquisition. WHAT THIS PAPER ADDS: What is already known on the subject Spontaneous language samples have been used as a means of studying language in China. However, because of the amount of training and time required to transcribe and analyse spontaneous language samples, there is not yet a sufficient basis for identifying language differences between children with and without language disorder in mainland China. What does this paper add to existing knowledge After using DREAM-C to provide an objective measurement of children with and without language disorders, an easy-to-administer spontaneous language assessment protocol and scoring record form allowed the comparison of the spontaneous language of 39 children with atypically developing language with 47 children who scored in the typical range to observe language differences between those with and without typical language development. What are the potential or actual clinical implications of this work? The study documents differences in vocabulary and sentence variety, and use of different morphemes such as classifiers, passives and aspect markers to aid in choosing targets for intervention by demonstrating the path of development. In addition, the spontaneous language assessment protocol and scoring record form holds promise for allowing clinicians and researchers to more easily study the language of individual children to personalize intervention, but also of groups of children to understand the emergence of basic Mandarin linguistic features.

Assessing dual language learners of Spanish and English: Development of the QUILS: ES / Evaluación de los estudiantes bilingües de español e inglés: Desarrollo de QUILS: ES

Introduction and objectives: Developing a language screener for Dual Language Learners presents numerous challenges. We discuss possible solutions for theoretical and methodological problems often encountered in the development of such a test and illustrate possible solutions using a newly developed language screener for Dual Language Learners. Materials and methods: The process for developing, validating and norming the screener is also offered as a potential model for the development of other assessments for Dual Language Learners throughout the world. The twelve types of subtests are in three categories: Vocabulary, Syntax, and Process. Results and conclusions: Results from the Tryout and Norming phase on 362 Dual Language Learners aged 3–5;11 years are presented, together with the results of item selection via IRT, validity, and reliability testing. The advantage of using Best Scores is highlighted as a useful measure to identify children who are at risk for language difficulties that will impact their academic success. Importantly, knowledge is found to be distributed across the languages.(AU)

Introducción y objetivos: Desarrollar un evaluador del lenguaje para estudiantes bilingües presenta numerosas dificultades. Abordamos las posibles soluciones para problemas teóricos y metodológicos que se encuentran a menudo en dichas pruebas, e ilustramos las posibles soluciones utilizando un evaluador recientemente desarrollado para estudiantes bilingües. Materiales y métodos: El proceso de desarrollo, validación y normalización del evaluador se ofrece también como un modelo potencial para el desarrollo de otras evaluaciones de estudiantes bilingües a nivel mundial. Los 12 tipos de subpruebas se reúnen en tres categorías: vocabulario, sintaxis y proceso. Resultados y conclusiones: Se presentan los resultados de la fase de prueba y normalización en 362 estudiantes bilingües de tres a cinco; 11 años, junto con los resultados de la selección de ítems a través de las pruebas de IRT, validez y fiabilidad. La ventaja de utilizar las mejores puntuaciones destaca como medida útil para identificar a los niños con riesgo de dificultades lingüísticas, las cuales repercutirán en su éxito académico. De manera notable, se ha detectado que el conocimiento se distribuye entre los idiomas.(AU)