Whilst scoring the Building Early Sentences Therapy (BEST) assessments, the LIVELY team noticed some small changes in the children’s language development were not being credited, for example, if a child who previously was using no agent is now using ‘mum’ for lady. An agent can be defined as the thing that causes, or instigates, the action in a sentence, e.g. ‘dad’ in the sentence ‘the dad is sitting‘. We looked at how we could increase the sensitivity of the spoken sentence scoring measure by combining the BEST scoring approach with elements from the Renfrew Action Picture Test (RAPT) scoring.
From the short, picture based BEST assessment, we wanted to be able to capture detailed and accurate measurements of vocabulary, morphology (a meaningful unit of language that cannot be further divided e.g. ‘the’ ‘ing’ ‘is’) and predicate argument structure (PAS). PAS refers to the arguments in the sentence, for example, ‘the dad is sitting’ consists of two arguments: ‘dad’ is the agent, ‘sitting’ is the verb. The team combined the scoring methods from BEST and RAPT and then went through several stages of refining the definitions and checking for inter-rater reliability.
The new combined scoring system was then used to score the children’s utterances across different time points (baseline, outcome and follow-up) and treatment conditions (BEST vs DLS) to track their progress.
Each sentence in the BEST assessment was given a total score to see what the child was getting right. For example, the target sentence ‘The teddy is sitting’, a child could score a maximum of 3/3 for morphology, 1/1 for predicate argument structure (PAS) and 2/2 for information.
The new scoring measure now captures and reflects the semantic, grammatical and morphological components of the children’s utterances and allowed us to analyse and evaluate changes in the children’s language development over time.
Our aim is that the new scoring system can be generalised to other sets of pictured-based expressive language assessments to capture meaningful information about children’s language skills.
Please see the below link for the pre-recorded lightning talk for the North East Speech and Language Therapy update meeting that was held on 7th July 2022.
https://research.ncl.ac.uk/lively/newsevents/nesltjuly2022/
Authors: Emily Preston, Elaine Ashton, Kate Conn, Christine Jack, Cristina McKean, Olivia Ridgeway, Naomi Rose