Thursday, November 12, 2020

Evaluating Part V of the German version of the Token Test as a screening of specific language impairment in preschoolers.

Schmoeger, M., Deckert, M., Eisenwort, B., Loader, B., Hofmair, A., Auff, E., & Willinger, U. (2019). Evaluating Part V of the German version of the Token Test as a screening of specific language impairment in preschoolers. Applied Psycholinguistics, 41(1), 237–258.

Children with Developmental Language Disorders (DLD) have a persistent problem learning language despite normal development. DLD is also associated with weak verbal working memory, which is the ability to store and process some aspect of language in mind, and other impairments related to cognition and attention. A valid and efficient screening tool for DLD is therefore critical.

One tool that may be well suited to screen for DLD is Part 5 of the Token Test (De Renzi & Vignolo, 1962). The Token Test is a simple and easy tool used to assess language. In the Token Test, the child listens to the command and then points to the sequence of shapes, with commands increasing in length and complexity each time. Commands in Parts 1 to 4 involve pointing to shapes by colour and size and increase in length (e.g., Part 1: Point to the circle; Part 4: Point to the small, red circle and the large, blue square). Part 5, on the other hand, draws on different skills because it requires understanding long and linguistically complex commands (“Instead of touching the white square, touch the yellow circle”). The authors were interested in whether the Token Test may be a reliable tool for screening language and cognitive difficulties in DLD.

In this study, 4-6 year old children with DLD and typically developing children completed the Token Test and a test of intelligence. Not surprising, children with DLD made more mistakes than typically developing children on all parts of the Token Test, including the easiest and hardest parts. When looking at the whole sample, Part 5 was not shown to be an effective screening tool, but results were more promising for 4- and 5-year-olds. Part 5 was able to correctly classify children between ages 4-5. Further, Part 5 may also be a good indicator for general cognitive abilities. Children with DLD who were correctly classified by Part 5 showed worse performance on the verbal and non-verbal scales of the intelligence test than incorrectly classified children with DLD, whereas only the verbal scale correlated with Part 5 for typically developing children. 

The authors suggest that there are several advantages to the use of Part 5 of the Token Test as a clinical tool. But more research is needed to determine whether Part 5 and the Token Test more generally can be seen as a valid and efficient tool for screening DLD and intellectual skills.

De Renzi, A., & Vignolo, L. A. (1962). Token test: A sensitive test to detect receptive disturbances in aphasics. Brain, 85,665–678.

Blogger: Theresa Pham is a student in the combined SLP MClSc/PhD program, supervised by Dr. Lisa Archibald.

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