Speech-language pathologists and educators face unique challenges in assessing the language skills of children with complex communication needs due to the wide array of impairments with which these individuals present. For example, most receptive language assessment tools require that children either point to or label line drawings to determine whether or not they comprehend the depicted concepts; task demands such as these preclude administering such assessment tools with children who are unable to physically point to or verbally label presented stimuli. In light of these challenges, the use of eye tracking technologies has become particularly appealing since this alternate response mode reduces the behavioral demands associated with standardized assessment procedures. Another challenge clinicians and educators face as they strive to ensure accurate receptive language assessment results with children who have complex communication needs is the type of stimuli utilized in such assessments. When individuals with cognitive delays are presented with stimuli that may not be comprehensible to them, there is a risk of under-estimating language comprehension abilities (Emerson, 2003). Given the documented challenges that individuals with disabilities often have in identifying constructs depicted by the types of line drawings typically included in receptive language assessment tools (e.g., Mirenda & Locke, 1989; Mizuko, 1987), there is a critical need to include recognizable stimuli in assessment tools in order to determine this population's true receptive language capabilities. Beyond this potential to improve the validity of receptive language assessments, improvement in assessment practices such as these also have potential positive implications for effective AAC technology selection and AAC treatment planning. The current investigation examined the effect of symbol type (color photograph symbols1 vs. SymbolStix©2 color line drawing symbols) on identification and naming of graphic symbols for nouns, verbs and adjectives in typically developing three, four, five and six-year old children. A quasi-experimental design was employed, with counterbalance for experimental stimuli (color photograph symbols1 vs. SymbolStix©2 symbols) and task (identification task vs. naming task). Eighty-nine participants completed the identification and naming tasks with both examined symbol types (color photograph symbols1 vs. SymbolStix©2 symbols) on two different days. Multivariate Analysis of Variance (MANOVA) was used to examine the effects of symbol type on both accuracy and rate of identification, and on accuracy of naming. Bivariate correlation was completed to determine the relationship between participants' touch and eye identification rates, and to determine the relationship between identification accuracy and eye rate. Mean scores revealed that all participants achieved higher accuracy for the identification and naming tasks with color photograph symbols1, and that participants evidenced faster touch and eye identification rates for the color photograph symbol1 condition. These findings suggest that color photograph symbols1 are more transparent and thus more easily identifiable. Therefore, potential future assessment modifications include the incorporation of color photograph symbols1 as stimuli and eye gaze as a selection option within AAC assessment tools. Overall, results of this study have the potential to change the way speech-language pathologists and educators assess the receptive language skills of children with complex communication needs to yield more accurate assessment results.


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Kent-Walsh, Jennifer


Doctor of Philosophy (Ph.D.)


College of Education and Human Performance

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Education; Communication Sciences and Disorders









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Doctoral Dissertation (Open Access)