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McCauley, Rebecca J. (2001) Assessment of Language Disorders in Childhood. Lawrence Erlbaum Associates, ISBN: 0-8058-2562-2, xiv+364 pp. Phaedra Royle, Department of Linguistics, Universit� de Montr�al Chapter 1: Introduction This chapter outlines the goals of the text and methodologies used throughout it. McCauley states that the aim of this book is to familiarize students and researchers with the measurements used in order to assess language disorders; to teach them how to frame clinical questions in measurement terms; to show them alternative measurement approaches and to make them able to discriminate the relative merits of these different approaches. McCauley presents examples of different types of clinical decisions that must be taken during the treatment of language disorders and reminds us of the importance of successful decision-making by presenting us with two examples of common pitfalls in decision-making: the confirmatory strategy and the belief that small samples are linguistically representative. Part I: Basic concepts in assessment, presents the tools used for language assessment and the theoretical background underpinning their use. Chapter 2: Measurement of children's communication and related skills. In Chapter 2, McCauley discusses the theoretical concepts that underlie the measurement of language abilities. She presents Stevens' four levels of measurement (1951): nominal, ordinal interval and ratio and the use of and implications for the use of these types of measurement of communication skills. Statistical methods used to analyse central tendencies and variability in these measurements are also presented. In a discussion of correlation, McCauley points out that correlation and causality do not follow from each other because correlation can be the result of A causing B, vice versa or by both A and B being caused by an external factor. Finally, the author discusses the difference between norm- and criterion-referenced measures in establishing deviant behaviour. Chapter 3: Validity and reliability In this chapter, McCauley discussed the importance of choosing appropriate measurement tools for language evaluation and stresses that the tester is responsible for the choice and validation of the tool used. The author presents three types of evidence used for validation: construct validity, content validity and criterion-related validation. McCauley proposes different methods typically used in these validation processes. She discusses the concepts of validity and reliability and reminds us that reliability (consistency of measurement) is a necessary though not sufficient condition for validity. Part II: an overview of childhood language disorders, presents the etiology of different types of language disorders and problems related to language assessment within each of the four following types of disorders. Chapter 5: Children with specific language impairment McCauley commences this chapter on specific language impairment (or SLI) by discussing the problem of the definition of SLI using exclusionary criteria (where no specific cause can be determined as the cause of the linguistic deficit). In particular, the exclusion of children with mental retardation from the SLI group due to lowered IQ is problematic. She outlines different suspected causes for the impairment (genetics, brain morphology, environmental factors) and different accounts (cognitive, linguistic, ...) of SLI. Assessment of SLI is rendered more difficult due to lack of consensus by researchers on diagnostic methods and also to lack of communication between this group and clinicians in order to improve assessment based on theoretical findings. McCauley notes that SLI is often indistinguishable from late onset of language in young children. Children with SLI typically have difficulties with (English) morphology, syntax and phonology. Chapter 6: Children with mental retardation This chapter addresses the effects of mental retardation on language. Not surprisingly, different types of mental retardation (and their level of severity) have varying effects on language. For example, down syndrome can affect morphology and syntax while preserving semantics and pragmatics. McCauley stresses here the importance of assessment of language skills. She notes that it is important to accommodate the child with mental retardation, if needed -- rather than to stick to a rigid assessment method -- in order to fully reveal her linguistic capacity. Chapter 7: Children with autistic spectrum disorder McCauley notes that autistic spectrum disorder (or pervasive developmental disorder, PDD) is a generic term for four more specific types of autistic disorder (autistic disorder, Rett's disorder, childhood disintegrative disorder, Asperger's disorder and pervasive developmental disorder not otherwise specified, or PDD-NOS). As with mental retardation, these different disorders typically pattern with different types and levels of language impairment, from no or almost no language impairment (Asperger's) to limited or no language skills (Rett's). This heterogeneity, often combined with mental retardation and difficult social interaction on the part of children with PDD, can make diagnosis of the language impairment using standardised tasks difficult. Chapter 8: Children with hearing impairment This chapter deals with the assessment of children with permanent hearing loss ranging from mild to profound. Different types of deafness are described (conductive, sensorineural and mixed) as well as other factors affecting treatment such as the configuration of deafness (flat, high- frequency, low-frequency), laterality of deafness (bilateral or unilateral) and age of onset of deafness (acquired versus congenital deafness). This chapter also discusses issues of teaching oral languages to deaf children, oral versus signed culture and the oral versus signed assessment of language in deaf children. McCauley also mentions the relative lack of norms for the assessment of language development in deaf children, whether the norms are for oral or for signed language. Part III: Clinical questions driving assessment deals with the clinical practices of screening, description and evaluation of language change Chapter 9: Screening and identification: Does this child have a language impairment? In this chapter, a more thorough review of language screening procedures is presented along with a discussion of issues such as over- referral, cutoff scores, the comparison of scores across tests (which can have different levels of test error and correlation as well as different norming groups), and the rarity of some types of language disorders. Dialect use and use of English as a second language in conjunction with their implications for language testing are also discussed. Finally, the expanding use of parent questionnaires and language analyses (criterion- referenced measures) is discussed as an alternative to classic norm-referenced tests. Chapter 10: Description: What is the nature of this chid's language? This chapter presents the use of descriptive measures of language and methods used to do this type of assessment (standardized norm-referenced measures, standardized criterion- referenced measures, probes, rating scales, language analysis, on-line observations, dynamic assessment and other qualitative measures). This type of assessment has implications for the social communicative and educational integration of children with language impairments. Chapter 11: Examining change: Is this child's language changing? The examination of language change is an integral part of the treatment process and affects decisions on whether to continue, modify or terminate treatment. This type of assessment can also be used to verify the efficacity of given treatments. Effect size, social validation and the use of multiple measures are three methods used to verify whether language change is reliable and has an impact on the child's life. The major difficulty arising in this type of assessment is the confounding factor of growth and development. McCauley proposes the single-subject experimental design paradigm as the most effective means for examination of language change. This book is primarily designed as a textbook for a course in speech pathology with an emphasis of testing methodology. However, a number of chapters of this book can be useful to clinicians and researchers wanting to read up on issues pertaining to assessment methodology. They will find the discussions of issues related to assessment to be in depth and challenging. In particular, assumptions underlying the validity and reliability of language assessment are well put in perspective by McCauley. As a linguist with only a basic knowledge of statistical methodology, I especially appreciated the chapter on measurement due to its discussion of statistical concepts used in describing language performance. Each chapter stands on its own and contains a list of key concepts and terms, "study questions and questions to expand your thinking", recommended readings pertaining to the topics addressed in the chapter and a bibliography. In addition, this monograph has appendices and a number of lists within the text outlining different tests used for language assessment in the United States. Stevens, S. S. (1951) Mathematics, measurement and psychophysics. In S. S. Stevens (Ed.) Handbook of experimental psychology (pp.1-49). New York: Wiley. Phaedra Royle is a Ph.D. graduate from the D�partement de linguistique et de traduction of the Universit� de Montr�al. Her thesis was a psycholinguistic examination of word access in francophones with developmental language impairment. She presently works as an assistant researcher for the Bilingual Canadian Dictionary Project at the D�partement de linguistique et de traduction of the Universit� de Montr�al.Mail to author|Respond to list|Read more issues|LINGUIST home page|Top of issue