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Clinical Measurement and Assessment

A 25-Year Retrospective

see also: References

cite as:
Wiig, E. H., & Secord, W. A. (2006, Feb. 7). Clinical measurement and assessment: A 25-year retrospective. The ASHA Leader, 11(2), 10-11, 27.

by Elisabeth H. Wiig and Wayne A. Secord

There are two sides to the coin that is a test: the author's side and the user's side. We will look at what we learned as clinicians, test developers, and test users during the past 25 years first by taking the perspective of a test author and then taking the perspective of a clinician. Let us first discuss our concepts and philosophies of what a test is.

Our collaboration began at the ASHA Convention in 1980 when Tom Hutchinson, acquisition editor for Charles E. Merrill, introduced us. He said that he thought we had complementary ideas and visions and that it would be fun to see what collaboration between us could lead to.

A language and communication test is not created out of thin air. It is usually based on a body of research and on a perceived need for evaluating behaviors that differentiate children with normal language development from children with language disorders (Wiig & Semel, 1976). For the same reasons, language tests develop new shapes and faces over time as a body of research expands and new perspectives are introduced (Stone, Silliman, Ehren & Apel, 2004).

A Test Lens

Behind the design and development of clinical tests there is an expression of the philosophy of the authors. Our philosophy of what a language test is can best be expressed metaphorically. A test provides a lens for examiners to observe behavioral segments of language and communication, within a narrow, wide-angle, or panoramic view. A test lens cannot and is not intended to provide a picture of the world of language and communication in its complexity. In our early years of collaboration, we created tests that gave an examiner primarily an inter- and intra-personal view of language and communication behaviors based on the test constructs. This resulted in norm-referenced language tests that consisted of specifically focused subtests with focused lenses on, for example, morphology, syntax, and semantics and interfaces with memory (Wiig, Secord & Semel, 2004).

We have used the intra-personal lens for years and it gave us a great deal of expertise in helping us to understand children's language systems and how these were affected by language disorders and learning disabilities. This expertise in turn translated into improvements in the test-development process, especially in the area of establishing diagnostic validity (Semel, Wiig & Secord, 2003). The inter- and intra-personal assessment lens allows examiners to view a student's strengths and weaknesses within a test construct with context removed. It can provide a powerful, reliable read on a student's language system and give evidence for decisions about the strengths and weaknesses of the system. It can provide an understanding of how the student's language abilities compare to those of age-level peers and provide directives for exploring other behaviors or underlying neuropsychological weaknesses that may not be easy to detect without using systematic probes.

Broadening Our Scope

Since then, our lens has broadened in scope. As neuroscience provided increasing information about brain-behavior relationships, this was reflected in focusing on phonological awareness and attention/executive functions (Semel, Wiig & Secord, 2003). We also learned from clinical experiences and feedback from clinicians that a contextual lens needed to be added to create a real-life picture of students' behaviors and academic performances. This resulted in adding criterion-referenced, naturalistic assessment tools to the already existing norm-referenced tests.

Broadening the test lens enriched our understanding of intra- and inter-personal language abilities and moved us in the direction of understanding performance in academic and social contexts and of how discoveries through the testing process can provide verification of real-life behaviors and observations. Students are usually referred for in-depth language evaluation due to academic and/or social difficulties. However, language assessment is often narrowly focused on the student using the inter- and intra-personal (measurement/testing) lens and performance in academic or social contexts is not verified with standard procedures. The combination of the two test lenses has proven to be powerful, especially because the examiner becomes an important variable as a multi-perspective observer of behavior when using this combination.

Our 25 years of collaboration have taught us to use tests that are well developed from multiple points of view with attention to language, culture, and neuropsychological constructs. Our experiences have told us that, as test authors and clinicians, we as observers must find and use ways to collect realistic performance data and to use norm-referenced and naturalistic data for cross-validation. Performance and assessments should serve to verify one another.

As an example, in her evaluation of a 7-year-old student, a clinician obtained a CELF-4 Core Language Score of 83, but the student showed significant discrepancies between Receptive and Expressive and Content and Structure Index scores. The clinician then asked if she should "qualify" the student for language intervention services. We were amazed that she had not considered using the "performance lens" to determine or verify patterns of strengths and weaknesses observed within the "measurement lens." After she was told how to collect some contextually relevant performance data, e.g., a teacher interview, a work sample analysis, and a focused classroom observation, the "performance lens" helped her uncover a number of expressive language and social communication behaviors that limited the student's ability to function in the second grade. The statistically significant differences observed through measurement were verified through the performance lens (descriptive performance-based assessment). Furthermore, norm-referenced measures that recorded the knowledge and use of structure were clearly reflected in the grammatical difficulties the student experienced in the curriculum. Again, we have learned a great deal about the connection between clinical measurement and performance-based (contextual) assessment and how one should serve to verify the other. We expect this notion of verification to have a profound impact on measurement and assessment processes in the future.

Linking Communication and Language

Finally, establishing literacy is a burning issue in today's society and children with language disorders have difficulties in crossing the bridge that leads to literacy. They encounter significant problems in acquiring both the skills and the strategies needed for mature reading and writing (Stone et al., 2004). As test authors, we have not yet built a strong connection from listening and speaking to reading and writing in our tests, although we and others have initiated that effort (Lombardino, Lieberman & Brown, 2005). Because many children are provided services based only upon the weaknesses found on norm-referenced tests, this need is great in our field. While we feel we have been part of making progress in providing multi-perspective assessments of student's language and communication needs, further advances are required. By broadening our understanding of and meeting students' language and communication needs, we can better ensure equity of access to the curriculum and effective participation in the everyday activities of the academic curriculum.

Over the years, we have made progress by creating and developing better tests, urging our peers to consider meta-linguistic abilities, neuropsychological aspects and brain-behavior relationships, and implementing a broad-based, multi-perspective assessment process. However, more is needed to address the needs of tomorrow's students in a global marketplace, but as good friends and colleagues now for more than 25 years, we love working together and continue to be inspired by the challenge.

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Elisabeth H. Wiig is professor emerita, Boston University and president of Knowledge Research Institute, an independent research and consulting firm. She is an ASHA Fellow, the recipient of the ASHFoundation 2001 Frank R. Kleffner Career Award, and the 2005 Honors of the Association. Contact her by e-mail at ehwiig@krii.com.

Wayne A. Secord is currently the Provost's Distinguished Service Professor in Communicative Disorders at the University of Central Florida. An ASHA Fellow, he has authored or co-authored numerous articles, books, tests, and intervention programs on assessment and treatment of speech and language disorders, and served as the editor of Language, Speech, and Hearing Services in Schools from 1992 to 1998. Contact him by e-mail at WSecord@aol.com.

Elisabeth Wiig and Wayne Secord will present at the 2006 ASHA Schools Conference. Visit ASHA Schools 2006 for more information.



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