Quiz 1: Diagnostic testing

What is diagnostics?

The comprehensive process of identifying, describing, and diagnosing communication, swallowing, or hearing disorders through integrated assessment.

What is a test?

A specific tool (formal or informal) used to measure knowledge and skills and identify/diagnose a disorder.

What is psychometrics?

The science of measuring human traits, abilities, and processes.

What is assessment?

diagnoses

Evaluation

judgement

What outcomes can assessment lead to?

Diagnosis, prognosis, recommendations for treatment, and next steps.

What does foundational integrity in assessment mean?

The assessment is thorough, uses a variety of methods, is evidence-based, and individualized.

What is the purpose of HIPAA (Health Insurance Portability and Accountability Act)?

To protect client health information; applies to healthcare practitioners who transmit information electronically.

What law covers SLPs in educational settings instead of HIPAA?

FERPA (Family Educational Rights and Privacy Act).

How does FERPA affect assessment reports?

It regulates how assessment reports are shared.

What are the key principles of psychometrics?

Sensitivity, specificity, reliability, validity, fairness/freedom from bias, and standardization.

What does sensitivity measure in psychometrics?

The percentage of individuals correctly identified as having a disorder (true positives).

What does specificity measure in psychometrics?

The percentage of individuals correctly identified as not having a disorder (true negatives).

What does reliability mean in psychometrics?

Replicability—whether a test is consistent over repeated administrations, test-takers, and settings.

What is test-retest reliability?

Consistency of scores over time when testing the same individual at different times.

What is inter-rater reliability?

Consistency of scores between different scorers or examiners.

What is internal consistency (split-half reliability)?

Consistency of responses within a test; both halves should be equal in difficulty, style, and scope.

What is parallel forms reliability?

Consistency between different forms of the same test (e.g., Form A vs. Form B).

What is validity in psychometrics?

The degree to which a test measures what it is intended to measure (truthfulness of a test).

What is construct validity?

Whether a test measures the theoretical construct it claims to measure.

What is criterion validity?

Whether a test correlates with an established outcome or external criterion.

What is concurrent validity?

Comparing a test to an established standard (e.g., new IQ test vs. standard IQ test).

What is fairness/freedom from bias in testing?

Ensuring equitable, nondiscriminatory outcomes for all participants.

What is item bias in testing?

Test items that favor certain groups over others.

What is cultural bias in testing?

Tests that do not account for cultural differences.

What is intrinsic bias in testing?

Tests that inherently favor one group over another.

What is extrinsic bias in testing?

Group score differences caused by societal inequalities.

What is standardization in psychometrics?

Ensuring consistency in how a test is administered, scored, and interpreted.

What does standardization ensure?

That test instructions are uniform for all test-takers.

What are components of standardization?

Test instructions, testing environment/materials, examiner qualifications, basal/ceiling/subtests, repetition, cues/prompts, and scoring procedures.

What is cultural responsiveness?

Appropriately responding to cultural diversity and creating spaces where diversity is valued

What is cultural competence?

Continuous cultural education, openness to others’ values, lifelong learning, and self-assessment.

What are the main assessment methods?

1) Obtaining information, 2) Observations, 3) Speech-language samples, 4) Dynamic assessment, 5) Standardized tests.

What is a case history?

A record of relevant background information (concerns, family, developmental, medical, education/occupation history).

What tools can be used to obtain client information?

Questionnaires, inventories, rating scales, checklists, interviews, and observations.

How does a traditional interview differ from an ethnographic interview?

Traditional: predetermined questions, clinician sets agenda.
Ethnographic: client sets agenda, open-ended, considers culture/experience.

Why are observations important in assessment?

They show client behavior in naturalistic settings.

What is the ideal length of a speech-language sample?

50–200 utterances (minimum 50–100).

Why use speech-language samples?

They are naturalistic, adaptable, useful for progress monitoring, and provide rich information.

How can speech samples be elicited?

Conversation, free play, pictures, personal stories, wordless storybooks, narratives, or story retell.

What can speech-language samples reveal?

Mean Length of Utterance (MLU), number of different words(NDW), type token ratio(TTR), grammatical errors, intelligibility, narrative skills, discourse, disfluencies.

What is dynamic assessment?

A test-teach-retest method emphasizing the learning process and helping identify goals.

How does standardized assessment differ from dynamic assessment?

• Standardized: static, observes current knowledge, standardized protocol.

• Dynamic: interactive, identifies learning potential, flexible protocol, examiner intervenes.

What are norm-referenced tests?

Tests that compare performance to age peers using representative samples, standard scores, or percentiles.

What are criterion-referenced tests?

Tests that compare performance to a defined criterion, identifying what a client can/cannot do.

Example of a criterion-referenced test?

Rossetti Infant-Toddler Language Scale.

What are accommodations in standardized assessments?

Minor adjustments that do not change content, expectations, or requirements; administration remains consistent.

Give examples of accommodations during standardized tests.

Large print, braille, scribe, typed responses, read aloud, text-to-speech, graphic organizers, separate location, extended time.

What are modifications in standardized assessments?

Changes that alter administration, content, expectations, or requirements; no longer standardized.

Give examples of modifications during standardized tests.

Reworded instructions, repetition/prompts when not allowed, skipping items, extra time on subtests, simplified reading level, changes in scoring.

What must be done when accommodations or modifications are used?

They must be documented and explained.

Can standardized tests be modified to collect qualitative information?

Yes, but scores cannot be used; modifications must be noted.

What are pros of standardized tests?

Objective, evidence-based, efficient, allows comparison to norms/criteria, widely recognized, instructions clearly specified.

What are cons of standardized tests?

Margins of error, static, unnatural, may not reveal functional impact, biased against culturally and linguistically diverse populations.

What is chronological age?

Exact age in years, months, and days; necessary to convert raw scores to normed scores.

How do you calculate chronological age?

Subtract the birthday from the test date.

What is a basal in testing?

The starting point of a test.

What is a ceiling in testing?

The ending point of a test.

Do basal and ceiling points stay the same across tests?

No; they vary across tests and should be checked in the test manual.

What is a language difference?

Differences in sentence structure, speech sounds, vocabulary, or pragmatics when a child is learning a new language.

What is a language disorder?

Deficits in understanding or using language evident in every language a child speaks, often linked to family history of language-learning impairments.

What are key features of a language disorder?

Difficulty producing/understanding language, using body language, communicating with own language/cultural group, forming grammatical sentences, academic progress; present in all languages spoken.

What are key features of a language difference?

Different pronunciation of English, understands home language rules, no difficulty communicating with own group, difficulties only in one language, may struggle academically.

What is a standard score?

Performance compared to the average and normal distribution; average is typically 85–115.

What is a raw score?

The initial score based on the number of correct/incorrect responses; needs conversion to be meaningful.

What is an age-equivalent score?

Reflects the average raw score for a given age or grade level; not reliable alone for decision-making

Why shouldn’t decisions be based solely on raw scores?

Raw scores don’t account for norms or variability; they must be converted to standard scores for meaning.