Purpose: To describe validation of the Intelligibility in Context Scale (ICS; McLeod, Harrison, & McCormack, 2012a) and ICS–Jamaican Creole (ICS-JC; McLeod, Harrison, & McCormack, 2012b) in a sample of typically developing 3- to 6-year-old Jamaicans. Method: One-hundred and forty-five preschooler–parent dyads participated in the study. Parents completed the 7-item ICS ( n = 145) and ICS-JC ( n = 98) to rate children's speech intelligibility (5-point scale) across communication partners (parents, immediate family, extended family, friends, acquaintances, strangers). Preschoolers completed the Diagnostic Evaluation of Articulation and Phonology (DEAP; Dodd, Hua, Crosbie, Holm, & Ozanne, 2006) in English and Jamaican Creole to establish speech-sound competency. For this sample, we examined validity and reliability (interrater, test–rest, internal consistency) evidence using measures of speech-sound production: (a) percentage of consonants correct, (b) percentage of vowels correct, and (c) percentage of phonemes correct. Results: ICS and ICS-JC ratings showed preschoolers were always (5) to usually (4) understood across communication partners (ICS, M = 4.43; ICS-JC, M = 4.50). Both tools demonstrated excellent internal consistency (α = .91), high interrater, and test–retest reliability. Significant correlations between the two tools and between each measure and language-specific percentage of consonants correct, percentage of vowels correct, and percentage of phonemes correct provided criterion-validity evidence. A positive correlation between the ICS and age further strengthened validity evidence for that measure. Conclusions: Both tools show promising evidence of reliability and validity in describing functional speech intelligibility for this group of typically developing Jamaican preschoolers.

Objective: The aim of this study was to establish the construct validity of the F ocus on the O utcomes of C ommunication U nder S ix (FOCUS^©). This measure is reflective of concepts in the International Classification of Functioning Disability and Health – Children and Youth framework. It was developed to capture ‘real‐world’ changes (e.g. communicative participation) in preschoolers' communication following speech‐language intervention.Method: A pre–post design was used. Fifty‐two parents of 3‐ to 6‐year‐old preschoolers attending speech‐language therapy were included as participants. Speech‐language therapists provided individual and/or group intervention to preschoolers. Intervention targeted: articulation/phonology, voice/resonance, expressive/receptive language, play, and use of augmentative devices. Construct validity for communicative participation was assessed using pre‐intervention and post‐intervention parent interviews using the FOCUS^© and the communication and socialization domains of the Vineland Adaptive Behavior Scales‐II (VABS‐II).Results: Significant associations were found between the FOCUS^©, measuring communicative participation, and the VABS‐II domains for: (i) pre‐intervention scores in communication (r = 0.53, P < 0.001; 95% CI 0.30–0.70) and socialization (r = 0.67, P < 0.001; 95% CI 0.48–0.80); (ii) change scores over‐time in communication (r = 0.45, P < 0.001; 95% CI 0.201–0.65) and socialization (r = 0.39, P = 0.002; 95% CI 0.13–0.60); and (iii) scores at post‐intervention for communication (r = 0.53, P < 0.001; 95% CI 0.30–0.70) and for socialization (r = 0.37, P = 0.003; 95% CI 0.11–0.50).Conclusions: The study provided evidence on construct validity of the FOCUS^© for evaluating real‐world changes in communication. We believe that the FOCUS^© is a useful measure of communicative participation.

Purpose: There is a shortage of information on evidence-based interventions for supporting young multilingual children. The purpose of this review was to identify interventions that have been evaluated with preschool-age multilingual children with a speech and/or language disorder or who are at risk of poor speech, language, literacy, and/or educational outcomes.Method: This review considered speech, language, and early literacy interventions evaluated with preschool-age multilingual children with a speech and/or language disorder or who have been identified as being at risk of language difficulties (PROSPERO ID: 165892). The following electronic databases were searched: EBSCO (CINAHL Plus, ERIC, PsycINFO, Medline, Education) and Linguistics, Language, and Behavior Abstracts. Data were extracted describing article, participant, methodological, and intervention variables, and effect sizes. The Council for Exceptional Children's (CEC) standards for evidence-based practice were used to examine the quality of studies.Results: Fifty-six relevant studies were identified in 52 articles and these studies described 4,551 participants who had speech sound disorder (six articles), developmental language disorder (11 articles), or were considered to be at risk (36 articles). The interventions targeted speech production (seven studies), language (45 studies), and early literacy (11 studies) skills. Most studies reported positive effects. Only 15 studies met all quality indicators specified by the CEC (2014) and these described 18 interventions targeting language and literacy skills. The only intervention with sufficient evidence to be considered an evidence-based practice was Nuestros Niños [Our Children] for children's early literacy and phonological awareness skills.Conclusions: A number of high-quality studies exist that describe speech, language and/or literacy interventions for preschool-age multilingual children with a speech and/or language disorder, or who have been identified as being at risk of language difficulties. However, there remains limited evidence for specific interventions as to their ability to inform evidence-based practices.Supplemental Material: https://doi.org/10.23641/asha.16632649

Purpose: The aim of this study was to investigate the appropriateness of standardized assessments of expressive grammar and vocabulary in a sample of preschool-age dual language learners (DLLs) who use Jamaican Creole (JC) and English. Adult models from the same linguistic community as these children were used to inform culturally and linguistically appropriate interpretation of children's responses to a standardized assessment.Method: JC-English–speaking preschoolers (n= 176) and adults (n= 33) completed the Word Structure and Expressive Vocabulary subtests of the Clinical Evaluation of Language Fundamentals Preschool–Second Edition. Adults' responses were used to develop an adapted scoring procedure that considered the influence of JC linguistic features on responses. DLLs' responses scored using the standard English and adapted JC procedures were compared.Results: JC–English DLLs and adults used similar linguistic structures in response to subtest questions. DLLs' scores differed significantly from the standardized sample on both subtests. Preschoolers received higher raw and corresponding standard scores with adapted scoring compared to standard scoring. Adapted scoring that made use of adult models yielded high classification accuracy at a rate of 93.8% for Word Structure and 92.1% for Expressive Vocabulary.Conclusions: Adapting standardized assessment scoring procedures using adult models may offer an ecologically valid approach to working with DLL preschoolers that can support a more accurate assessment of language functioning. These findings suggest that the use of standardized assessments for bilingual JC–English speakers requires a culturally responsive approach.Supplemental Material: https://doi.org/10.23641/asha.14403026

The present study investigated the sensitivity and specificity of the English Intelligibility in Context Scale (ICS) and the ICS-Jamaican Creole (ICS-JC) translation with bilingual preschool-aged Jamaican children. Participants in this study were 262 English-JC simultaneous bilingual children (aged 3;3 to 6;3; M = 4;11, SD = 7.8). The ICS and ICS-JC were administered to parents in auditory form, rather than written form. Although recent evidence has demonstrated the validity and reliability of the ICS as an assessment tool in various languages, further data are needed to determine diagnostic accuracy of the ICS and ICS-JC in Jamaican children. The sensitivity and specificity of both tools were high in this cohort of children, indicating that in the Jamaican context, these versions of the ICS could be used as screening tools to identify children who require further assessment of speech sound disorder. A cut-off score of 4.12 was used for both tools to achieve high sensitivity (0.84) and specificity (0.70) values for the ICS, as well as high sensitivity (0.84) and specificity (0.71) for the ICS-JC. The results of this study also demonstrate that administration of the auditory ICS is a valid way of collecting parent reports about children’s speech intelligibility, which has implications for use of the ICS in languages with no written form or with parents who have a low level of literacy in the languages they use. This investigation is relevant not only to this underserved population but broadens knowledge of research-based tools for working with bilingual children.

This study was conducted as a follow-up analysis to two prior studies using existing data gathered in those original studies. In the current study, we focus on those preschoolers who received one of two interventions that varied in terms of the level of visual supports for grammatical elements (n = 22 of the original 34 participants). Utilizing random selection for intervention, our study examined potential session-to-session differences in rate of progress between two interventions. One intervention provided visual support using color-coded screens and syntactic slots for grammatical and semantic sentence elements (Group 1, Computer-Assisted Intervention, n = 11). The other intervention provided visual support through objects in play, books, and picture cards with actions for semantic elements only (Group 2, Table-Top Intervention, n = 11). Both interventions targeted accurate production of a basic simple sentence (i.e., third person singular present progressive sentences). Twenty-two, 3- to 5-year-old preschoolers with specific language impairment (SLI) participated in 20-minute once weekly sessions. Both interventions included sentence breakdown (i.e., breaking sentences into subject, verb, object components that are trained to an 80% criterion) and build-up (i.e., putting the entire sentence together). Rate of progress in intervention was monitored for (a) efficiency (first session that the 80% criterion was achieved) and (b) syntactic growth (movement beyond the basic simple sentence level). Blinded assessors scored session-to-session data to establish potential differences in rate of progress between groups. The results showed that Group 1 outperformed Group 2 for efficiency and syntactic growth. This study demonstrated that use of multiple visual supports in expressive grammar training facilitated a therapeutic advantage in session-to-session grammatical learning for preschoolers with SLI.