2. Preschool Language Scales-5 Assessing Children from Birth through 7
Nancy Castilleja, MA CCC-SLP
September 9, 2011
This presentation provides an overview of the new Preschool Language Scale—Fifth Edition. The authors developed this test as a measure of developmental language skills that are critical to preschool and early school success. PLS-5 is not an exhaustive inventory of all important developmental communication milestones that indicate if a child is developing language normally. The language behaviors on PLS-5 are behaviors in which there are significant differences in performance between typically developing children and children who have a language disorder.
The age range for the test has been extended to age 7 so that you are able to obtain standard scores for 7 year olds who have a moderate to severe language disorder, such as children with autism or developmental delays whose communication skills are like those of a younger child.

3. Course objectives
describe at least two principles identified by ASHA as best practices in early language assessment
identify three key differences between PLS-4 and PLS-5
describe two research studies conducted with the PLS-5

4. Agenda ASHA: best practices in early language assessment
PLS-5 vs. PLS-4
Start points
Age level placements
Scoring
PLS-5 Research Studies
Development
Minimizing Bias
Standardization
Reliability & Validity
Q & A

5. Roles and Responsibilities of SLPs in Early Intervention
/policy
Four guiding principles
family-centered and culturally and linguistically responsive
developmentally supportive and promote participation in natural environments
comprehensive, coordinated, and team based
based on the highest quality evidence available
ASHA has completed an update of the principles of early childhood intervention. ASHA’s principles address both assessment and intervention. This document was a starting point for us in developing the new test. We’ll provide a quick overview of how these principles were incorporated in the development of the PLS-5.

6. Family-centered and culturally and linguistically responsive
Caregiver participation in testing
Caregiver-selected and caregiver-identified social routines and vocabulary tested for very young children
Extensive bias review and widespread testing with a diverse sample has resulted in
Familiar home vocabulary and contexts
Dialectal, regional, and cultural variations to identify responses that are accepted as correct
Home Communication Questionnaire
Integrating ASHA’s early intervention principles

7. Sample from the Home Communication Questionnaire

8. Developmentally supportive and promote participation in natural environments
Observation of naturally-occurring behaviors for younger children
Credit given for spontaneous productions in and outside the assessment room
Developmentally appropriate skills assessed

9. Comprehensive, coordinated, and team based
Provides a survey of language skills in the areas of
Social communication
Semantics
Morphology
Syntax
Articulation
Useful for arena assessment; can be administered by professionals in child development teams

10. Based on the highest quality evidence available
Current review of research for item development
Expert review
Current normative data

11. What is new?
Current norms for a wider age range: based on the 2008 update of the U.S. Census for children birth through 7:11
Streamlined administration, with new suggested start points and test items that involve manipulatives grouped for smoother transitions during testing
New test items in the areas of play, understanding false beliefs, and literacy
New Growth Scale Values, Evidence-based scores you can use to track progress

12. Based on the performance of children in standardization…
New ceiling rule
Basal: 3 consecutive correct responses
Ceiling: 6 (not 7) consecutive errors
Because PLS-5 tests a variety of skills, a child could obtain one or more score points if you discontinue testing earlier

13. Score multiple test items with one procedure

14. New test items For ages 18-24 months additional items assessing play
For ages 3 through 4 years
new items assessing book
handling and concept of
print
For ages 5 through 7 years
new items testing
Theory of Mind
Integrated language skills such as use of synonyms
Emergent literacy skills such as naming letters and understanding prefixes
25% of the test items are new to PLS-5

15. New item: Uses synonyms
Here is an example of a new test item on PLS-5. The child is asked to think of another word that means the same thing as a target word. In this demonstration item, the child is asked to think of another word for “large.” The examiner tells the child “Look at this elephant. Elephants are really large animals. What is another word for “large.” Typical responses from children include “big” “huge” “gigantic” and “enormous.” Children with language difficulties often name the items in the picture, e.g., “elephant” , “Dumbo”, or “zoo”)

16. New Demonstration Item for Understands Size/Sequence Concepts (smallest, biggest)
Demonstration items have been added to some of the test items to show the child what he or she is expected to do. In this demonstration item, the examiner says: “Here are three dogs. I will point to the dogs in order, from the biggest dog to the smallest dog.” Then the examiner points to the dogs in the order described. During the demonstration item, the examiner provide any prompts that help the child understand the task. For example, the examiner can say “Here is the biggest dog, so I’ll point to him first. This dog is smaller, and this one is the smallest one.”

17. New Practice item: Uses Possessive Pronouns: hers, his
Practice items have been added to many of the test items to ensure that the child understands the test task. Before administering the test items testing use of the possessive pronouns his and hers, the examiner shows the child this picture and says, “This is his ice cream. This is….” If the child doesn’t say “hers” or “her ice cream” the examiner can cue the child to teach the task before continuing to the test items.

18. Items integrating Theory of Mind concepts
Some items requiring that the child make inferences about another’s feelings or intentions
Theory of Mind
Capacity to understand another’s mental state to explain and predict others’ behavior (Miller, 2006)
Child learns to take another person’s perspective
Link between Theory of Mind and communication (de Villiers & de Villiers, 2005)
Also important for comprehending narratives

19. Understanding false beliefs
This is a new test item specifically designed to assess one aspect of Theory of Mind: understanding false beliefs. [Demonstrate administration of this item.]

20. What is different?
Revised test items, based on clinicians’ and reviewers’ feedback
Updated Articulation Screener with picture stimuli
Start points
Age level placements of certain developmental skills
Normative scores
25% are unchanged, but 50% have been modified in some way, with new art, new administration directions, or new practice items

21. Revised Test Items
Approximately 25% of the PLS-5 test items have administration directions, test stimuli, and foils that are unchanged from PLS-4. For those items, art was redrawn to match the style of the new test items. For other items, administration directions were changed, sub-items were deleted or replaced, or the criterion changed

22. Modified Articulation Screener
The new Articulation Screener now has visual stimuli. The child names the pictures—if he or she does not name the picture using the target word, the examiner can say the word and ask the child to repeat it. Multiple phonemes are tested in most words, so the word set is smaller.

23. Frequently Asked Questions
AC 37

24. Why is “responds to speaker by smiling” now at age 6-8 months?
“Start Points” are not developmental age levels

25. “Start Points” are not developmental age levels

26. Why do so many of the PLS-5 test items appear at later age levels than PLS-4?
Some clinicians are confusing the Start Points with Developmental Levels
Criterion change for item placement
PLS-4 item placements differ from PLS-5. PLS-4 items were placed at the developmental age where 60-90% of children passed the item (average: 75%). We found in our market research that when clinicians were interpreting PLS-4 test results, their assumption was that almost all children passed all items within a developmental age band when this was not the case.
For PLS-5, test items were placed at the age level where at least 80-90% of the children in the standardization sample passed the item.

27. Review how PLS-4 items were put together; then explain PLS-5 Understands use of objects: AC 31 is 6 months later than on PLS-4. Criterion change: ¾ instead of 3/5

28. Why do so many of the PLS-5 test items appear at later age levels than PLS-4?
Some clinicians are confusing the Start Points with Developmental Levels
Criterion change for item placement at developmental levels
The items were modified in some way
The task is different
Sub-items are different
The number of sub-items has changed
The pass criterion has changed
Most have moved to the next 6 month level. A few have moved a year.

29. Uses past tense Age 4: 7% Age 4:6: 42% Age 5:0: 22% Age 5:6 58%

30. PLS-5 age level placements do not match placement from Brown’s studies
According to Owens (2008), the age of mastery for Brown’s developmental milestones is based on the research of:
Bellugi & Brown (1964)
Brown (1973)
Miller (1981)
Demographic characteristics of the sample in 2010
When you review performance of a high SES sample, performance on PLS-5 tasks match Brown’s seminal research
You are correct in stating the PLS-5 item placements do not match the milestones based on data collected in the research described in the references dated 1964 through Dr. Bellugi’s, Brown’s, and Miller’s research (who set mastery of a milestone at 90%).
PLS-5 research was conducted in Demographic characteristics of the U.S. have changed considerably since Dr. Bellugi’s, Brown’s, and Miller’s research was conducted (almost 40% of the PLS-5 sample is non-White; 34% of children in the sample have parents with a college degree; 34% have parents with 12 years of education or less). Typically, research conducted in the ‘60s and ‘70s was conducted at universities with convenience samples of children whose parents were very well-educated. Children whose parents have a high education level tend to achieve language targets early.
We see this same pattern of performance in our PLS-5 research. For certain morphological skills, 60-75% of children tested during PLS-5 standardization passed items at the earlier age level listed on PLS-4. The children passing these items early tend to be children who have parents with high education levels. However, PLS-5 test items were placed at the age when 80-90% of the children tested passed. This accounts for the shifts in developmental levels you are seeing for some items.
If you look at the sequence of acquisition, the placement of the PLS-5 items matches the developmental sequence described in the seminal research conducted by Bellugi, Brown, and Miller. Keep in mind that there is no static “difficulty” or “developmental age” for skills such as “verb + -ing”—the item difficulties can be influenced by the following:
test format (elicited in spontaneous speech? imitative task? cloze procedure? practice item?)
contexts and vocabulary targeted (emerging verbs? familiar context?)
response required (ability to score alternate words? alternate forms acceptable?)
Tests are developed to include tasks that provide a sample of abilities that represent children’s language ability, regardless of background. That being said, there are many children growing up in facilitative language environments who learn certain language skills early. There are also a number of children who are also typically developing who master the same skills a few months later. Our decision was to place PLS-5 items where 80-90% of children in the sample passed, in order to represent the entire range of typically developing children in the U.S.

31. Some children are scoring higher on the PLS-5
Some children are scoring higher on the PLS-5? I’m concerned that children will no longer qualify for services.
PLS-4/PLS-5 correlational study
N = 134
Average change:
AC: 1 point lower than PLS-4
EC: 1.5 points lower than PLS-4
Total Language: 1 point lower
Range of score change for individuals higher
Protocols we’ve reviewed after publication
Scores sometimes higher, sometimes lower
Performance differences
Item criterion differences
No change in eligibility unless a child qualified with a 77 on PLS-4
Confidence intervals; PLS-5, like PLS-4, provides one piece of information in your assessment. The scores indicate how a child performs relative to age level peers on specific developmental tasks.

32. On the EC scale, the child hardly needs to talk at all at age 2:0!
At age 2:0, 64-71% of the normative sample
Used words more than gestures to communicate
Used words for a variety of pragmatic functions
Used different word combinations
That means 29-36% of children did not…
By age 2:6 to 2:11, the majority of the children in the sample met criterion for these behaviors

33. Standardization Research
Over 1800 children were tested for standardization and related reliability and validity studies from December 2009 through August 2010
The standardization sample was collected by 189 clinicians in 42 states in the United States

34. Technical Information
Demographic Information
Validity Studies
Clinical studies
Ages 1-2:11 language delay study
Ages 3:0-7:11 language disorder study
Sensitivity/specificity
Positive/negative predictive power
Correlations with other assessments
PLS-4
CELF Preschool-2
Reliability Studies
Internal consistency: typical
Internal consistency: disorder
.96 to .98
Inter-rater reliability: .95 to .98
Inter-scorer agreement: .91 to 1.0
Case studies
Autism
Hearing Impairment
Technical information can be found in the PLS-5 Examiner’s Manual. A Technical Report will be posted on PLS-5.com at the end of June 2011)

35. Sample mirrors March 2008 Update of the U.S. Census: Race/Ethnicity
The PLS-5 was standardized using a very diverse sample in the United States. The PLS-5 standardization sample mirrors the percentages of the population represented in the March 2008 Update of the U.S. Census for race and ethnicity for children birth through 7 years, 11 months. These percentages represent a significant shift in demographics from the PLS-4 standardization sample in Minority populations now comprise 45% of the standardization sample.

36. Sample mirrors March 2008 Update of the U.S. Census: Parent Education
There have also been significant changes in the U.S. population in the level of education of children’s primary caregivers since data was collected in Overall, the population is becoming more educated, with a higher percentage of young children’s caregivers completing a college degree.

37. Sample mirrors March 2008 Update of the U.S. Census: Region

38. Where Children in the PLS-5 Sample Spend the Majority of their Day
Reported by the caregivers

39. Are children with disabilities included in the PLS-5 sample?

40. PLS-4/PLS-5 Correlations

41. CELF Preschool-2/PLS-5 Correlations
With typically developing children, the means are 2-3 standard score points higher on PLS-5 than they are on CP2.

42. Clinical Study: Developmental Delay

43. Clinical Study: Receptive-Expressive Disorder

44. Sensitivity/Specificity: NPP/PPP with 50% Matched SampleAC EC
Total
Cut Score SD and Predictive Power
Matched Sample 50%
-1 SD
PPP
.83
.86
.81
NPP
.77
.85
-1.5 SD
.93
.94
.92
.66
.75
.74
-2 SD
.96
.95
.60
.63
Note. PPP is Positive Predictive Power and NPP is Negative Predictive Power.

45. Minimizing Bias Current literature review Clinician surveys
Research studies
Pilot
Tryout (includes bias oversample)
Standardization
Statistical analyses of bias
Expert review

49. Questions related to the kit
Do I need to purchase the manipulatives or can I collect my own?
Why can’t we have a Picture Manual we can wipe clean?
Because more information was added to the Examiner’s Manual about special populations, administration, and scoring, the book became too large and heavy to include everything in it. The PLS-5 has separate Examiner’s and Administration Directions Manuals. You can collect the manipulatives on your own or purchase a PLS-5 manipulatives kit. The bear is plastic so that it can be cleaned after each use.

50. Questions related to the kit
How do you get the bear and the pitcher to fit in the box?
Because more information was added to the Examiner’s Manual about special populations, administration, and scoring, the book became too large and heavy to include everything in it. The PLS-5 has separate Examiner’s and Administration Directions Manuals. You can collect the manipulatives on your own or purchase a PLS-5 manipulatives kit. The bear is plastic so that it can be cleaned after each use.

51. I can’t get the bear to sit!

52. Questions, concerns, comments?