Gerard H. Poll

Background: Effective social communication is adapted to the context, the setting and the people involved. It is less clear how measures of adolescent social communication ability reflect these aspects of context. Social communication ability emerges from children's early experiences in varied contexts. Evidence is mixed on whether prior experience in the workplace, post‐secondary education or independent living, is associated with social communication ability for those settings. Aims: The purpose of the study was to empirically evaluate the associations between measures of adolescents’ social communication ability, the context of assessment, and the examinee's prior experience in the context. Methods and Procedures: One‐hundred fifty 14–21‐year‐old adolescents, 59 with developmental disabilities, participated in a cross‐sectional study. Researchers administered instruments to measure social communication for four post‐school settings. They also collected reports of prior experience in those settings. Rasch analysis was used to derive both item difficulty and social communication ability measures. Researchers evaluated the association between experience in a context and social communication ability for that context using regression models. Outcomes and Results: Social communication measures were highly correlated across contexts. Social communication ability was associated with experience in post‐secondary education, as was experience living independently for participants reporting disabilities. Conclusions and Implications: The results support conceiving of social communication as the ability to adapt one's communication to a context, an ability that is not bound to any one context. The varied findings on the association between prior experience in a context and social communication in that context can be interpreted as reflecting how difficult it is to learn the cues of that setting and generalize that learning to new situations, leading to potential differences in the amount and quality of experience required to successfully communicate in a context. WHAT THIS PAPER ADDS: What is already known on this subject For adolescents with communication disorders, developing social communication skills is important to their outcomes in adulthood. According to developmental models, social communication emerges from children's experiences in varied contexts. Different contexts elicit different language, but child measures of social communication ability from different contexts are correlated. What this study adds to existing knowledge Adolescent social communication ability measures for four post‐school contexts were highly correlated. Experience in the post‐secondary education context was associated with greater social communication ability for all adolescents, but only adolescents with developmental disabilities benefited from independent living experience. What are the potential or actual clinical implications of this work? Assessments of social communication across multiple contexts are likely to be correlated; the choice of contexts for assessment may be motivated by the student's goals and interests. The findings support offering programs designed to build adolescent social communication skills by providing experiences in independent living or post‐secondary education.

Purpose: Adolescents with developmental language disorder (DLD) are an underserved population. Having DLD affects adolescents' academic and eventual economic success, supporting the need for accurate, clinically feasible DLD screening tools for adolescents. The objective of this review is to identify clinically feasible screening tools for adolescents and to appraise the quality of the methods used in studies that report the classification accuracy of the identified screeners. Method: Records were included that described empirical studies of brief tasks to identify risk for DLD in 12- to 21-year-old participants with DLD or typical language. A systematic search of PubMed, PsycINFO, and Web of Science was conducted together with reviews of language disorder textbooks and four prior systematic reviews. In all, 15 records describing potential DLD screening tasks met the inclusion criteria and were summarized. Included records described studies with participant ages that overlapped the target age range, but none included only participants in the 12–21 year range. The quality of all included studies was appraised using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) protocol. Results: Six of 15 potential screening tasks reported diagnostic accuracy metrics, three of which demonstrated clinically useful levels of classification accuracy to screen adolescents at risk for DLD. None of the studies that evaluated the included screening tools fully met QUADAS-2 standards for avoiding risks of bias that may have affected diagnostic accuracy findings. Conclusions: Two commercially available screening tasks are available in English to screen adolescents for DLD. One task evaluated in the research literature is available in Danish. Other potentially useful screening tasks have not been fully evaluated for their diagnostic accuracy. The QUADAS-2 review identified opportunities for screener developers to employ more rigorous methods to determine the classification accuracy of screeners; this will allow clinicians to have more confidence in the reported findings. Supplemental Material: https://doi.org/10.23641/asha.30057850

Purpose: Sentence repetition (SR) is a promising task for identifying children at risk for developmental language disorder (DLD) but is unclear how to calibrate the task for adults. In verbal recall, the frequency of language structures affects adults with DLD differently from peers with typical language (TL), particularly near the limits of adults' processing capacity. We hypothesized that repetition accuracy for sentences with less frequent structures, passives, would better distinguish adults at risk for DLD from their peers with TL than sentences with more frequent structures, actives. Method: Forty-two adults (18–29 years old), including 17 classified as at risk for DLD, completed an SR task composed of active and passive sentences matched for lexical frequency and sentence plausibility. Sentences varied in length (eight to 16 words) and number of clauses (one to two). Repetition accuracy for matched active and passive sentences was evaluated for classification accuracy to determine whether the areas under the curve (AUCs) differed by structure. Results: Averaging repetition accuracy across all sentence lengths, the AUC for passives did not differ from actives. For sentences with 11 words and two clauses, the AUC for passive structures was significantly higher than for active structures. Conclusions: Given sentences long enough to challenge the capacity of adults to reconstruct sentences for recall, structural frequency affects those at risk for DLD differently than those with TL. Manipulating the frequency of sentence structures is a promising approach to developing an SR task suited to screening adults. Supplemental Material: https://doi.org/10.23641/asha.29218775

Purpose: This study evaluated the psychometric functioning of a new criterion- referenced assessment of adolescent social communication, the Transition Pragmatics Interview (TPI), based on the synthesis model of pragmatics. Two ways of interpreting item difficulty were explored: (a) as a function of the synthesis model elements of social communication ability that items were designed to assess, and (b) as a function of the developmental level required for a successful response based on an adapted situational-discourse-semantics (SDS) model (Norris & Hoffman, 1993). Method: Thirty-seven participants aged 14-22 years completed the TPI. Responses were analyzed using Rasch analysis to evaluate the functioning of the scale and to determine item difficulty. Items were coded for the SDS developmental level required for an adequate response. The mean Rasch item difficulty for items at each SDS developmental level was analyzed for the five adapted SDS domains. Results: Consistent with the first approach for interpreting item difficulty, TPI items varied in difficulty as a function of the element of social communication they were designed to assess (p p < .001). Interpreting item difficulty based on the adapted SDS model was not supported: Items requiring higher SDS developmental levels were not more difficult than those requiring less (p p = .55). Conclusions: The TPI responses fit the Rasch model, supporting the TPI as a unidimensional measure and supporting the use of all items together to compute a single number that summarizes the level of social communication for each examinee. The item ordering from least to most difficult was consistent with prior findings on adolescent social communication development. Supplemental Material: https://doi.org/10.23641/asha.26018545

There is little consensus on evidence-based practice guidelines for the selection of criterion-referenced assessments. Having confidence in scores from criterion-referenced assessments requires evidence that items align with their intended constructs. The purposes of these studies were to demonstrate evidence of content validity for the revised item set of a developing social communication assessment and to provide clinicians with a model of content validity evaluations that can be generalised to the review of other assessments. In Study 1, 10 experts rated 25 newly-developed items for how well they represented the intended construct. In Study 2, seven participants ages 14-20 were administered the Three Step Test Interview to assess their cognitive processes for responding to new items. Examinee responses were coded for construct-relevant and construct-irrelevant factors. Twenty-three of the 25 newly-developed items were deemed representative of the intended construct by experts and elicited construct-relevant response processes from examinees. The integration of expert review and examinee cognitive interviewing provides a more complete evaluation of the alignment of the items to their intended construct. Transparent reports of the methods and findings of content validity studies strengthen the ability of clinicians to select criterion-referenced assessments that support valid decisions.

Despite policies favoring delivery of interventions for children with communication disorders in the classroom, most school-based interventions are delivered outside the classroom. Both teachers and speech-language pathologists (SLPs) have been found to have positive attitudes toward classroom-delivered intervention and the collaboration skills required to implement it. The purpose of this study was to explore preservice teacher and SLP attitudes toward inclusive service delivery and perceptions of their collaboration skills. The study used convergent mixed-methods, two-group design with participants completing an assignment requiring interprofessional collaboration. Twenty-nine preservice teachers and SLPs consented to the preassignment survey, and 37 consented to the postassignment survey. Compared to preservice teachers, preservice SLPs more strongly agreed that interventions are best delivered in the classroom. After the collaborative assignment, participants more strongly agreed that SLPs should implement classroom-based interventions. The preservice SLPs more strongly agreed that they had skills to identify children's language needs in the classroom. Barriers to collaboration included differences in goals, role understanding, and level of preparation across the professions. The findings suggest that to foster more inclusive delivery, professional preparation programs require more focus on building skills in respectfully managing differences in what each professional brings to classroom-based language interventions.

Purpose: Theory of mind involves perceiving both the thoughts and emotions of others. Theory of mind skills continue to develop in school-age individuals. For children at risk for social communication difficulties, evaluating theory of mind is warranted to determine whether theory of mind should be a target of intervention. There are hundreds of tasks designed to evaluate theory of mind, but many evaluate a single facet of the construct and have uneven psychometric properties. Comprehensive assessments evaluate both cognitive and affective aspects of theory of mind. The purpose of this systematic review was to identify comprehensive theory of mind assessments for school-age individuals and to critically appraise their measurement properties. Method: Four databases were searched to identify 27 included records describing the measurement properties of comprehensive theory of mind assessments for 5- to 21-year-olds. Assessments appearing in at least three records were included. The methodological quality of the studies and the sufficiency of assessments' measurement properties were evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Results: Nine assessments were evaluated, and four met COSMIN standards for sufficient content validity and internal consistency to be recommended for clinical use. Conclusions: Comprehensive assessments enable examiners to develop a profile of children's theory of mind strengths and needs. Strengths of the identified assessments include sufficient convergent validity and internal consistency. Further research is required to develop higher quality evidence for the content validity, structural validity, and reliability of the included assessments. Supplemental Material: https://doi.org/10.23641/asha.23817495

Interventions to facilitate improvement in adolescent social communication are more effective when they are tailored to adolescents’ individual profiles of ability. Current social communication assessments for adolescents are not designed to identify their profiles of ability for settings beyond compulsory education. To address this gap, we developed the Transition Pragmatics Interview (TPI). The purpose of these studies was to evaluate the content validity of items developed for the TPI using expert review and cognitive interviewing. Cognitive interviewing is recommended in health-related measurement standards but is not widely reported for assessments of developmental language disorders. Six speech-language pathologists participated in the expert review, rating how well TPI items represented facets of social communication ability. All questions were rated as representative of their intended construct. Eight adolescents (age 14–21) of varied social communication abilities participated in the cognitive interview study to explore whether items were understood as intended by the developers. Participants responded to each item while a researcher observed their response process and asked questions to identify the respondents’ thinking about the items. Transcribed responses were classified based on whether they indicated a construct-irrelevant difficulty with the item. Nine of 52 items were identified with recall difficulties, ambiguous wording or potential sources of bias. Cognitive interviewing complemented expert review by identifying issues with content validity not identified by expert review. Items with construct-irrelevant barriers to response will be modified and re-evaluated prior to field testing.