JOURNAL
OF COMMUNICATION
DISORDERS
11 (1978), 215-226
SPEECH AND LANGUAGE ASSESSMENT DEAF CHILDREN*
215
SCALES OF
DONNA S. GEFFNER St. John’s University, Jamaica, New York HARRY
LEVITT, LISA ROTHMAN FREEMAN, AND SR. ROSEMARY GAFFNEY
City University of New York, Graduate Center, New York City, New York
Six year old deaf children with an average PTA of 105.7 dB were evaluated for speech and language skills using rating scales. Five rating scales were designed to assess language production, sign ability, overall communication skills, speech reception and speech intelligibility. Each scale incorporated five categories ranging from inability to complete ability to demonstrate a given skill. For several ratings, classroom teachers, given instruction, were asked to make judgments which were later correlated with examiner’s scores. Mean ratings indicate that comprehension skills superceded performance skills. A hierarchy of ability among communication skills can be seen.
Introduction This article is an outgrowth of a project that involved a comprehensive study and assessment of the communication skills of 6-year-old deaf children. In the attempt to assess communication skills, a battery of tests was developed and other standard tests were modified to measure auditory ability, expressive and receptive language skills, receptive and productive speech skills, and a variety of communication skills such as speechreading and overall communication ability. Sixty-seven children in New York State, at state-supported or state-operated schools for the deaf, ranging in age from 6.0 to 6.11 years with an average age of 6.5 years were tested. Background data collected for each child revealed that pure tone averages were 105.7 dB for the right ear and 103.9 dB for the left ear. The average age of deafness onset was at 2 months. The age at which hearing loss was diagnosed was 18.7 months and aids were generally fitted at 32.5 months. For 62 children special education began at 37 months. Of the 67 children on whom information was available, 11 (16%) had deaf mothers, 18% had deaf fathers, and 12% had deaf siblings. For this population, English was the primary language spoken at home (72%), with 17% using sign as the home language and 11% having Spanish as the home language. The etiologies reported for deafness as culled from school records indicate that 50% are due to unknown causes, 24% related to genetic disease, and the remain* A segment of this paper was presented at the American Convention, Chicago, Illinois, November 2-5, 1977. o Elsevier North-Holland,
Inc.,
1978
Speech and Hearing Association
Annual
0021~9924/78/0011-0215$01.75.
216
DONNA
S. GEFFNER
ET AL
der of the etiologies due to meningitis, rubella, or other causes. Of the children tested, 64% were reported to have no other handicap. Twelve percent of the population had reported visual problems and small percentages were reported for motor or neurologic disorders. The average I.Q. for the 5 1 children on whom an intelligence test was administered was 106. The purpose of this article is to present a particular segment of the test battery, that of rating scales, used to assess speech, language, and communication skills of 6-year-old deaf children. With the absence of standardized speech and language tests for this population, rating scales were developed to facilitate the process of making judgments regarding each child’s ability. Rating Scales Oral Language
Production
To assess expressive linguistic ability, two pictures were used to stimulate spontaneous oral language production. Each child was shown the large, brightly colored picture from the Peabody Pre-school Kit depicting a city street with a lot of activity. The child was asked to tell the examiner as much as he could about the picture. The child was then shown a series of four pictures in sequence, developed by Dr. R. Stuckless, and asked to tell a short story about it. The picture shows a family preparing for and going on a picnic. A 5point rating scale was used to evaluate the child’s expressive language as seen in Table 1. The results of this scale indicate that 24% of the children had no measurable language, thereby receiving a rating of 1. There were 48% who received a rating of 2, producing such utterances as “mother,” “father,” “boy,” and “airplane. ” Category 3 contains 10% of the children tested. They produced two- and three-word utterances and used nouns, verbs, and other linguistic forms, for example, ‘ ‘mother cook, ” “boy father play. ” Only 6% of the children tested were rated as being in category 4. This includes those children who produced simple sentences with some errors such as “girl see cat, ” “children play in water,” and “boy love dog. ” The examiners did not find any child that merited a rating of 5, that is, production of substantial oral output with essentially complete structure, i.e., “The children are playing ball.” Since each child was evaluated for each of the two pictures, the average score for some subjects fell between categories: 1.5% between 1 and 2; 9% between 2 and 3; and 1% between 3 and 4. The children were also rated for oral language production by their classroom teachers. Figure 1 shows a comparison of the examiners’ and teachers’ ratings. The teachers gave 9% of the children a rating of 1, 39% a rating of 2, 26% a
SPEECH AND LANGUAGE
Language
TABLE Production
ASSESSMENT
SCALES
217
1 Rating Scale
1.
No measurable
2.
Some language-isolated
language
3.
Some language-use linguistic forms
4.
Language consisting of simple sentence structure three to four words in length including nouns, verbs, and other linguistic forms. Some errors-not complete thought
5.
Substantial
words, one-word
utterances,
of phrases, two- to three-word
output and essentially
holophrastic
utterances
utterances including nouns, verbs, and other
complete structure.
TABLE 2 Sign Language Rating Scale 1.
No useful output
2.
Isolate signs related to context
3.
Pairings of signs Groupings of two signs or sometimes
4.
Longer sequence of signs Not complete in thought Some errors
5.
Complete
sequence of signs conveying
three signs
a thought
rating of 3, 23% a rating of 4, and 3% a rating of 5. The mean of the examiners’ rating was 2.0 and the mean of the teachers’ rating was 2.7. The correlation between the teachers’ and examiners’ ratings was statistically significant at the 0.001 level of significance. A review of individual ratings indicates that 76% of the children were rated the same or within one category by both the teachers and examiners. Where differences occurred the teacher ratings were usually higher by one category. Sign Language
Production
Since the greater proportion of the children tested were in total communication programs, it was important to rate the children’s ability to communicate using sign language as another measure of their language proficiency. Table 2 presents this rating scale, which has five levels of proficiency similar to the oral language production scale. Simultaneous to receiving a rating for oral language production, the examiners rated the child according to the sign language rating scale. Results of the ratings are shown in Fig. 2. A rating of 1, no useful output, was given to 14% of the
218
DONNA
S. GEFFNER
LANGUAGE
ET AL.
PRODUCTION
RATINGS
too
80
1
1 Teacher
Rating
Examiner
lsszl
(meaw2.7)
Rating (mean=2.0~
z
P F
a
[L:
2.5
2
3
3.5
4
CATEGORY
KEY I.
No
measurable
2.
One
3.
2- 3
word
4.
Simple
5.
Complete
word
language.
utterances. utterances.
sentence. structure. Fig. 1
4.5
5
SPEECH AND LANGUAGE
ASSESSMENT
TABLE 3 Overall Communication 1.
Not able to communicate
2.
Just able to communicate
3.
Interaction
4.
Communicates
at minimum
,
spontaneously
219
Skills
level of proficiency.
for social and basic needs with a minimum
5. Communicates
SCALES
Makes basic needs known
of at least two social interactions
and freely with error or difficulty
freely and without error
subjects. The 41% in category 2 produced isolated signs related to context. The 17% who were given a rating of 3 used pairs of signs and sometimes three signs. At level 4, 6% of the children were rated as producing longer sequences of signs that were not complete in thought and contained some errors. Only 2% achieved a rating at level 5, indicating the ability to use complete sequences of signs conveying a thought. Again, some children received average ratings that fell between major categories: 2% were rated as being between category 1 and 2; 11% between category 2 and 3; and 7% between category 3 and 4. The mean rating was 2.3. The examiners gave 50% of the children equivalent ratings for sign and language production. For the remaining 50%, a higher rating for sign language ability was given. Overall Communication
Skills
The purpose of the overall communication skills rating was to assess the child’s ability to communicate an idea or thought as well as the child’s ability to understand the examiner and respond appropriately in a nonstructured way, taking into account any spontaneous social interactions that took place prior to and throughout the test situation. Table 3 presents this Spoint rating scale. In rating the children, the examiners took into consideration the child’s primary mode of communication, manual, oral, or total, and evaluated each child according to that mode. It should be noted that both the examiners were proficient in sign language and had an understanding of the various communication modes. There are five categories ranging from an inability to communicate to ability to communicate freely without difficulty or error in word usage, structure, or meaning. A rating was given upon conferment of the examiners after the testing of each child was completed. Results can be seen in Fig. 3: 16% of the children received a rating of 1, that is, not able to communicate; 3 1% received a rating of 2, indicating ability to communicate at a minimum level of proficiency, making basic needs known; 6% fell between 1 and 2; 6% received a rating of 3, which is interaction for social and basic needs with a minimum of at least two social interactions. A rating of 4, the ability to communicate spontaneously and
220
DONNA
SIGN
S. GEFFNER
LANGUAGE
ET AL.
RATING
SCALE
100
80
Mean =2.3
20
0
11, I
1.5
2
2.5
3
3.5
4
CATEGORY
I. No output. signs. 2. Isolated 3. 2 - 3 signs. 4. Longer sequence incomplete thought. 5. Complete sequence. Fig. 2
4.5
5
SPEECH AND LANGUAGE ASSESSMENT SCALES
OVERALL
COMMUNICATION
SKILLS
221
RATING
IOC
8C Mean = 2.2
z: ?
6C
8 l;
40
% 2c
C
nn I
1.5
2
2.5
3
3.5
CATEGORY KEY I.
No meaningful communication.
2.
Able to make basic needs
3.
Minimum social
4.
Interacts freely with error.
5.
Interacts
known.
of two interactions.
freely. Fig. 3
4
4.5
5
222
DONNA
S. GEFFNER
ET AL
freely with error or difficulty, was given to 5% of the children with a 2% falling between levels 3 and 4. No children were given a rating of 5, that is, able to communicate freely without error; however, 2% did fall between 4 and 5. The mean rating was 2.2. The distribution of proportions is most similar to that of the sign language ratings. Speech Reception The speech reception rating scale, as seen in Table 4, was used to estimate the language as communicated through all child’s ability to understand “spoken” modalities. This rating was given by the classroom teachers because it was felt that they were more familiar with the child’s receptive ability in a variety of settings. This S-category scale ranges from an inability to understand any speech to a complete ability to understand spoken discourse. The results of this rating, shown in Fig. 4, indicate that 2% of the children received a rating of 1, having no understanding of speech; 18% received a rating of 2, indicating an inability to understand speech except for a few spoken words; 25% received a rating of 3, indicating the ability to understand two- or threeword utterances; 54% were given a rating of 4, demonstrating the ability to understand sequences of words and simple sentences with some errors in comprehension apparent; and 2% received a rating of 5, showing complete understanding of connected discourse with no apparent errors. The mean rating was 3.4. The children obtained better ratings for this scale than any other scale used. One possible explanation for this finding is that this scale measured overall receptive skills which included speechreading and comprehension of sign language . Speech Intelligibility To assess the child’s speech production ability, the Speech Intelligibility Rating Scale, developed at the National Technical Institute for the Deaf, was used. Incorporating the procedure used to obtain an oral language production rating, that is, showing two pictures and asking the child to describe what he sees, TABLE 4 Speech Reception Rating Scale 1.
No understanding
of speech
2.
Unable to understand
3.
Able to understand
speech except for a few spoken words two- to three-word
4.
Able to understand
5.
Complete understanding
utterances
sequences of words and simple sentences. of connected
discourse
Errors in comprehension
with no apparent
errors
apparent
SPEECH AND LANGUAGE
TEACHER
80
ASSESSMENT
223
SCALES
RATING OF SPEECH
RECEPTION
. Mean = 3.4
60
40
.
20
0
n
n I
2
3 CATEGORY
jtEJ I . No understanding. 2. Understands few spoken words. 3. Understands 2 - 3 words. 4. Understands with difficulty. 5. Understands connected discour se. Fig. 4
5
224
DONNA S. GEFFNER
ET AL.
proved helpful in making an assessment of the child’s clarity of speech. Again, both examiners conferred with one another prior to recording a rating for each picture stimulus. Because a rating was given for each picture, average ratings often fell between two categories. The classroom teacher was also asked to evaluate each child’s speech intelligibility from her daily exposure to the children. Table 5 presents this Scategory rating scale, which ranges from totally unintelligible production to completely intelligible speech. Results as seen in Fig. 5 show that the examiners rated 49% of the children in category 1, producing no intelligible speech. For category 2, 27% of the children were found to be extremely difficult to understand, producing only a few intelligible words. For category 3, 2.5% of the children were found to produce enough intelligible speech to transmit the main idea to the listener. For the remainder of the group, 3% attained a rating of 4 and 1.5% received a rating between 4 and 5. What is interesting to note is the markedly low ratings the children received by the examiners (mean = 1.7): On the other hand, teachers rated the children higher with a mean rating of 2.3. The majority of the children received ratings in levels 1,2 and 3, but 7.5% received a rating of 4 and 3% received a rating of 5. Despite these differences, the correlation between teacher and examiner ratings was statistically significant at the 0.001 level. It should be noted that speech intelligibility received the lowest rating of all the abilities evaluated. The hierarchy of communication abilities for these children according to the mean ratings established by the examiners is speech intelligibility, oral language production, overall communication skills, sign language production, and speech reception. There were, however, only small average differences between oral language production, overall communication skills, and sign language production. Summary
and Conclusions
In closing,
the following
conclusions
can be made.
1. The average rating for oral language production given by the examiners was 2.0, whereas the average rating given by the teachers was 2.7, with the TABLE 5 Speech Intelligibility Rating Scale 1.
Speech cannot be understood
2.
Speech is very difficult
3.
Speech is difficult to understand; however, three-word utterances are intelligible
to understand
with only isolated words or phrases intelligible
4.
Speech is intelligible
with the exception
5.
Speech is completely
intelligible
the gist of the content can be understood.
of a few words or phrases
Two- to
SPEECH AND LANGUAGE
ASSESSMENT
225
SCALES
SPEECH INTELLIGIBILITY RATINGS
100
80
I
Teacher Rating (Mean - 2.3)
Examiner Rating (Mean - 1.7)
1
Key 1.
2. 3. 4. 5.
1.5
2
2.5
3
3.5
4
4.5
5
Category Not Understood Difficult to Understand Gist Understood Sane Errors Canpletely Intelligible
Fig. 5
teachers’ rating slightly higher. Agreement between the two assessments was significant at the 0.001 level. 2. The average rating for sign language production was 2.3, slightly better than the result for oral language production. 3. Results of ratings for oral language production, overall communication skills, and sign language production were similar, on the average.
226
DONNA S GEFFNER ET AL.
4. The lowest ratings obtained were for speech intelligibility, with a mean rating of 1.7 given by the examiners and a mean rating of 2.3 given by teachers. 5. The highest ratings were obtained on the Speech Reception Scale, indicating that these children did better in the reception of speech than in either speech, language, or sign production, a finding supportive of the notion that comprehension skills are superior to and presumably precede performance skills. In view of the fact that there are no tests currently available to adequately assess language, sign, and communication skills of young deaf children, these scales, while risking the element of subjectivity, may serve as a measure of ability. In addition, they can provide the classroom teacher with a yardstick with which to measure a child’s performance against his peers. This project was supported by the Cooperative Endeavors in the Education of the Deaf Program (CREED) of the New York State Department of Education under the title of Speech, Language and Communication Skills of Deaf Children. The authors would like to thank the superintendents, teachers, and students at the state-supported and state-operated schools for the deaf in New York who participated in this CREED Project.
OF COMMUNICATION
DISORDERS
11 (1978), 215-226
SPEECH AND LANGUAGE ASSESSMENT DEAF CHILDREN*
215
SCALES OF
DONNA S. GEFFNER St. John’s University, Jamaica, New York HARRY
LEVITT, LISA ROTHMAN FREEMAN, AND SR. ROSEMARY GAFFNEY
City University of New York, Graduate Center, New York City, New York
Six year old deaf children with an average PTA of 105.7 dB were evaluated for speech and language skills using rating scales. Five rating scales were designed to assess language production, sign ability, overall communication skills, speech reception and speech intelligibility. Each scale incorporated five categories ranging from inability to complete ability to demonstrate a given skill. For several ratings, classroom teachers, given instruction, were asked to make judgments which were later correlated with examiner’s scores. Mean ratings indicate that comprehension skills superceded performance skills. A hierarchy of ability among communication skills can be seen.
Introduction This article is an outgrowth of a project that involved a comprehensive study and assessment of the communication skills of 6-year-old deaf children. In the attempt to assess communication skills, a battery of tests was developed and other standard tests were modified to measure auditory ability, expressive and receptive language skills, receptive and productive speech skills, and a variety of communication skills such as speechreading and overall communication ability. Sixty-seven children in New York State, at state-supported or state-operated schools for the deaf, ranging in age from 6.0 to 6.11 years with an average age of 6.5 years were tested. Background data collected for each child revealed that pure tone averages were 105.7 dB for the right ear and 103.9 dB for the left ear. The average age of deafness onset was at 2 months. The age at which hearing loss was diagnosed was 18.7 months and aids were generally fitted at 32.5 months. For 62 children special education began at 37 months. Of the 67 children on whom information was available, 11 (16%) had deaf mothers, 18% had deaf fathers, and 12% had deaf siblings. For this population, English was the primary language spoken at home (72%), with 17% using sign as the home language and 11% having Spanish as the home language. The etiologies reported for deafness as culled from school records indicate that 50% are due to unknown causes, 24% related to genetic disease, and the remain* A segment of this paper was presented at the American Convention, Chicago, Illinois, November 2-5, 1977. o Elsevier North-Holland,
Inc.,
1978
Speech and Hearing Association
Annual
0021~9924/78/0011-0215$01.75.
216
DONNA
S. GEFFNER
ET AL
der of the etiologies due to meningitis, rubella, or other causes. Of the children tested, 64% were reported to have no other handicap. Twelve percent of the population had reported visual problems and small percentages were reported for motor or neurologic disorders. The average I.Q. for the 5 1 children on whom an intelligence test was administered was 106. The purpose of this article is to present a particular segment of the test battery, that of rating scales, used to assess speech, language, and communication skills of 6-year-old deaf children. With the absence of standardized speech and language tests for this population, rating scales were developed to facilitate the process of making judgments regarding each child’s ability. Rating Scales Oral Language
Production
To assess expressive linguistic ability, two pictures were used to stimulate spontaneous oral language production. Each child was shown the large, brightly colored picture from the Peabody Pre-school Kit depicting a city street with a lot of activity. The child was asked to tell the examiner as much as he could about the picture. The child was then shown a series of four pictures in sequence, developed by Dr. R. Stuckless, and asked to tell a short story about it. The picture shows a family preparing for and going on a picnic. A 5point rating scale was used to evaluate the child’s expressive language as seen in Table 1. The results of this scale indicate that 24% of the children had no measurable language, thereby receiving a rating of 1. There were 48% who received a rating of 2, producing such utterances as “mother,” “father,” “boy,” and “airplane. ” Category 3 contains 10% of the children tested. They produced two- and three-word utterances and used nouns, verbs, and other linguistic forms, for example, ‘ ‘mother cook, ” “boy father play. ” Only 6% of the children tested were rated as being in category 4. This includes those children who produced simple sentences with some errors such as “girl see cat, ” “children play in water,” and “boy love dog. ” The examiners did not find any child that merited a rating of 5, that is, production of substantial oral output with essentially complete structure, i.e., “The children are playing ball.” Since each child was evaluated for each of the two pictures, the average score for some subjects fell between categories: 1.5% between 1 and 2; 9% between 2 and 3; and 1% between 3 and 4. The children were also rated for oral language production by their classroom teachers. Figure 1 shows a comparison of the examiners’ and teachers’ ratings. The teachers gave 9% of the children a rating of 1, 39% a rating of 2, 26% a
SPEECH AND LANGUAGE
Language
TABLE Production
ASSESSMENT
SCALES
217
1 Rating Scale
1.
No measurable
2.
Some language-isolated
language
3.
Some language-use linguistic forms
4.
Language consisting of simple sentence structure three to four words in length including nouns, verbs, and other linguistic forms. Some errors-not complete thought
5.
Substantial
words, one-word
utterances,
of phrases, two- to three-word
output and essentially
holophrastic
utterances
utterances including nouns, verbs, and other
complete structure.
TABLE 2 Sign Language Rating Scale 1.
No useful output
2.
Isolate signs related to context
3.
Pairings of signs Groupings of two signs or sometimes
4.
Longer sequence of signs Not complete in thought Some errors
5.
Complete
sequence of signs conveying
three signs
a thought
rating of 3, 23% a rating of 4, and 3% a rating of 5. The mean of the examiners’ rating was 2.0 and the mean of the teachers’ rating was 2.7. The correlation between the teachers’ and examiners’ ratings was statistically significant at the 0.001 level of significance. A review of individual ratings indicates that 76% of the children were rated the same or within one category by both the teachers and examiners. Where differences occurred the teacher ratings were usually higher by one category. Sign Language
Production
Since the greater proportion of the children tested were in total communication programs, it was important to rate the children’s ability to communicate using sign language as another measure of their language proficiency. Table 2 presents this rating scale, which has five levels of proficiency similar to the oral language production scale. Simultaneous to receiving a rating for oral language production, the examiners rated the child according to the sign language rating scale. Results of the ratings are shown in Fig. 2. A rating of 1, no useful output, was given to 14% of the
218
DONNA
S. GEFFNER
LANGUAGE
ET AL.
PRODUCTION
RATINGS
too
80
1
1 Teacher
Rating
Examiner
lsszl
(meaw2.7)
Rating (mean=2.0~
z
P F
a
[L:
2.5
2
3
3.5
4
CATEGORY
KEY I.
No
measurable
2.
One
3.
2- 3
word
4.
Simple
5.
Complete
word
language.
utterances. utterances.
sentence. structure. Fig. 1
4.5
5
SPEECH AND LANGUAGE
ASSESSMENT
TABLE 3 Overall Communication 1.
Not able to communicate
2.
Just able to communicate
3.
Interaction
4.
Communicates
at minimum
,
spontaneously
219
Skills
level of proficiency.
for social and basic needs with a minimum
5. Communicates
SCALES
Makes basic needs known
of at least two social interactions
and freely with error or difficulty
freely and without error
subjects. The 41% in category 2 produced isolated signs related to context. The 17% who were given a rating of 3 used pairs of signs and sometimes three signs. At level 4, 6% of the children were rated as producing longer sequences of signs that were not complete in thought and contained some errors. Only 2% achieved a rating at level 5, indicating the ability to use complete sequences of signs conveying a thought. Again, some children received average ratings that fell between major categories: 2% were rated as being between category 1 and 2; 11% between category 2 and 3; and 7% between category 3 and 4. The mean rating was 2.3. The examiners gave 50% of the children equivalent ratings for sign and language production. For the remaining 50%, a higher rating for sign language ability was given. Overall Communication
Skills
The purpose of the overall communication skills rating was to assess the child’s ability to communicate an idea or thought as well as the child’s ability to understand the examiner and respond appropriately in a nonstructured way, taking into account any spontaneous social interactions that took place prior to and throughout the test situation. Table 3 presents this Spoint rating scale. In rating the children, the examiners took into consideration the child’s primary mode of communication, manual, oral, or total, and evaluated each child according to that mode. It should be noted that both the examiners were proficient in sign language and had an understanding of the various communication modes. There are five categories ranging from an inability to communicate to ability to communicate freely without difficulty or error in word usage, structure, or meaning. A rating was given upon conferment of the examiners after the testing of each child was completed. Results can be seen in Fig. 3: 16% of the children received a rating of 1, that is, not able to communicate; 3 1% received a rating of 2, indicating ability to communicate at a minimum level of proficiency, making basic needs known; 6% fell between 1 and 2; 6% received a rating of 3, which is interaction for social and basic needs with a minimum of at least two social interactions. A rating of 4, the ability to communicate spontaneously and
220
DONNA
SIGN
S. GEFFNER
LANGUAGE
ET AL.
RATING
SCALE
100
80
Mean =2.3
20
0
11, I
1.5
2
2.5
3
3.5
4
CATEGORY
I. No output. signs. 2. Isolated 3. 2 - 3 signs. 4. Longer sequence incomplete thought. 5. Complete sequence. Fig. 2
4.5
5
SPEECH AND LANGUAGE ASSESSMENT SCALES
OVERALL
COMMUNICATION
SKILLS
221
RATING
IOC
8C Mean = 2.2
z: ?
6C
8 l;
40
% 2c
C
nn I
1.5
2
2.5
3
3.5
CATEGORY KEY I.
No meaningful communication.
2.
Able to make basic needs
3.
Minimum social
4.
Interacts freely with error.
5.
Interacts
known.
of two interactions.
freely. Fig. 3
4
4.5
5
222
DONNA
S. GEFFNER
ET AL
freely with error or difficulty, was given to 5% of the children with a 2% falling between levels 3 and 4. No children were given a rating of 5, that is, able to communicate freely without error; however, 2% did fall between 4 and 5. The mean rating was 2.2. The distribution of proportions is most similar to that of the sign language ratings. Speech Reception The speech reception rating scale, as seen in Table 4, was used to estimate the language as communicated through all child’s ability to understand “spoken” modalities. This rating was given by the classroom teachers because it was felt that they were more familiar with the child’s receptive ability in a variety of settings. This S-category scale ranges from an inability to understand any speech to a complete ability to understand spoken discourse. The results of this rating, shown in Fig. 4, indicate that 2% of the children received a rating of 1, having no understanding of speech; 18% received a rating of 2, indicating an inability to understand speech except for a few spoken words; 25% received a rating of 3, indicating the ability to understand two- or threeword utterances; 54% were given a rating of 4, demonstrating the ability to understand sequences of words and simple sentences with some errors in comprehension apparent; and 2% received a rating of 5, showing complete understanding of connected discourse with no apparent errors. The mean rating was 3.4. The children obtained better ratings for this scale than any other scale used. One possible explanation for this finding is that this scale measured overall receptive skills which included speechreading and comprehension of sign language . Speech Intelligibility To assess the child’s speech production ability, the Speech Intelligibility Rating Scale, developed at the National Technical Institute for the Deaf, was used. Incorporating the procedure used to obtain an oral language production rating, that is, showing two pictures and asking the child to describe what he sees, TABLE 4 Speech Reception Rating Scale 1.
No understanding
of speech
2.
Unable to understand
3.
Able to understand
speech except for a few spoken words two- to three-word
4.
Able to understand
5.
Complete understanding
utterances
sequences of words and simple sentences. of connected
discourse
Errors in comprehension
with no apparent
errors
apparent
SPEECH AND LANGUAGE
TEACHER
80
ASSESSMENT
223
SCALES
RATING OF SPEECH
RECEPTION
. Mean = 3.4
60
40
.
20
0
n
n I
2
3 CATEGORY
jtEJ I . No understanding. 2. Understands few spoken words. 3. Understands 2 - 3 words. 4. Understands with difficulty. 5. Understands connected discour se. Fig. 4
5
224
DONNA S. GEFFNER
ET AL.
proved helpful in making an assessment of the child’s clarity of speech. Again, both examiners conferred with one another prior to recording a rating for each picture stimulus. Because a rating was given for each picture, average ratings often fell between two categories. The classroom teacher was also asked to evaluate each child’s speech intelligibility from her daily exposure to the children. Table 5 presents this Scategory rating scale, which ranges from totally unintelligible production to completely intelligible speech. Results as seen in Fig. 5 show that the examiners rated 49% of the children in category 1, producing no intelligible speech. For category 2, 27% of the children were found to be extremely difficult to understand, producing only a few intelligible words. For category 3, 2.5% of the children were found to produce enough intelligible speech to transmit the main idea to the listener. For the remainder of the group, 3% attained a rating of 4 and 1.5% received a rating between 4 and 5. What is interesting to note is the markedly low ratings the children received by the examiners (mean = 1.7): On the other hand, teachers rated the children higher with a mean rating of 2.3. The majority of the children received ratings in levels 1,2 and 3, but 7.5% received a rating of 4 and 3% received a rating of 5. Despite these differences, the correlation between teacher and examiner ratings was statistically significant at the 0.001 level. It should be noted that speech intelligibility received the lowest rating of all the abilities evaluated. The hierarchy of communication abilities for these children according to the mean ratings established by the examiners is speech intelligibility, oral language production, overall communication skills, sign language production, and speech reception. There were, however, only small average differences between oral language production, overall communication skills, and sign language production. Summary
and Conclusions
In closing,
the following
conclusions
can be made.
1. The average rating for oral language production given by the examiners was 2.0, whereas the average rating given by the teachers was 2.7, with the TABLE 5 Speech Intelligibility Rating Scale 1.
Speech cannot be understood
2.
Speech is very difficult
3.
Speech is difficult to understand; however, three-word utterances are intelligible
to understand
with only isolated words or phrases intelligible
4.
Speech is intelligible
with the exception
5.
Speech is completely
intelligible
the gist of the content can be understood.
of a few words or phrases
Two- to
SPEECH AND LANGUAGE
ASSESSMENT
225
SCALES
SPEECH INTELLIGIBILITY RATINGS
100
80
I
Teacher Rating (Mean - 2.3)
Examiner Rating (Mean - 1.7)
1
Key 1.
2. 3. 4. 5.
1.5
2
2.5
3
3.5
4
4.5
5
Category Not Understood Difficult to Understand Gist Understood Sane Errors Canpletely Intelligible
Fig. 5
teachers’ rating slightly higher. Agreement between the two assessments was significant at the 0.001 level. 2. The average rating for sign language production was 2.3, slightly better than the result for oral language production. 3. Results of ratings for oral language production, overall communication skills, and sign language production were similar, on the average.
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4. The lowest ratings obtained were for speech intelligibility, with a mean rating of 1.7 given by the examiners and a mean rating of 2.3 given by teachers. 5. The highest ratings were obtained on the Speech Reception Scale, indicating that these children did better in the reception of speech than in either speech, language, or sign production, a finding supportive of the notion that comprehension skills are superior to and presumably precede performance skills. In view of the fact that there are no tests currently available to adequately assess language, sign, and communication skills of young deaf children, these scales, while risking the element of subjectivity, may serve as a measure of ability. In addition, they can provide the classroom teacher with a yardstick with which to measure a child’s performance against his peers. This project was supported by the Cooperative Endeavors in the Education of the Deaf Program (CREED) of the New York State Department of Education under the title of Speech, Language and Communication Skills of Deaf Children. The authors would like to thank the superintendents, teachers, and students at the state-supported and state-operated schools for the deaf in New York who participated in this CREED Project.
