Neuropsychol Rev (2012) 22:384–401
DOI 10.1007/s11065-012-9208-z
REVIEW
Language Development and Assessment
in the Preschool Period
Gina Conti-Ramsden & Kevin Durkin
Received: 1 March 2012 / Accepted: 29 May 2012 / Published online: 17 June 2012
# Springer Science+Business Media, LLC 2012
Abstract Most young children make significant progress in
learning language during the first 4 years of life. Delays or
differences in patterns of language acquisition are sensitive
indicators of developmental problems. The dynamic, com-
plex nature of language and the variability in the timing of
its acquisition poses a number of challenges for the assess-
ment of young children. This paper summarises the key
developmental milestones of language development in the
preschool years, providing a backdrop for understanding
difficulties with language learning. Children with specific
language impairment (SLI) are characterised illustrating the
types of language difficulties they exhibit. Genetic evidence
for language impairment suggests complex interactions
among multiple genes of small effect. There are few consis-
tent neurobiological abnormalities and currently there is no
identified neurobiological signature for language difficul-
ties. The assessment of young children’s language skills
thus focuses on the evaluation of their performances in
comparison to typically developing peers. Assessment of
language abilities in preschool children should involve an
evaluation of both expressive and receptive skills and
should include an evaluation of more than one dimension
of language. The use of a single measure of a language
G. Conti-Ramsden (*)
Human Communication and Deafness, The University
of Manchester,
Ellen Wilkinson Building, Oxford Road,
Manchester M13 9PL, UK
e-mail: gina.conti-ramsden@manchester.ac.uk
K. Durkin
School of Psychological Sciences and Health, University
of Strathclyde,
Graham Hills Building, 40 George Street,
Glasgow G1 1QE, UK
e-mail: kevin.durkin@strath.ac.uk
component, such as vocabulary, is considered inadequate
for determining whether preschool children have typical
language or language impairment. Available evidence sup-
ports the inclusion of measures of phonological short-term
memory in the assessment of the language abilities of pre-
school children. Further study of genetic, neurobiological
and early behavioural correlates of language impairments in
preschool children is needed.
Keywords Language development . Language assessment .
Preschool children . Specific Language Impairment (SLI) .
Phonological short term memory . Psychometric instruments
Introduction
One of the landmarks that parents look forward to is their
baby’s first words. Although a great deal of social-
communicative development has occurred prior to this stage
(Durkin 1995), the onset of use of the baby’s home language
signals an important advance in that child’s development.
Although it needs to be acknowledged that there is variation
in the developmental timing of babies’ first words, most
parents will begin to worry about their child if she or he
has not produced single words by 2 years of age.
There are many reasons why children may not produce
their first words as expected. What is known is that delays or
differences in patterns of language acquisition are sensitive
indicators of developmental problems in preschool children.
Difficulties with language can signal a number of problems,
including hearing impairments, general learning disabilities
and autism spectrum disorders. In addition, there are chil-
dren who have difficulties with language, i.e. producing
words to communicate and/or understanding what is said
to them, whilst “everything else” appears to be normal. That
Neuropsychol Rev (2012) 22:384–401
“everything else” has traditionally been defined to include
adequate input from the senses: normal hearing and normal/
corrected vision. It also includes an adequate biological
basis to develop language (they have no obvious signs of
brain damage) and an adequate basis for learning, i.e., their
nonverbal abilities as measured by IQ are similar to those of
their peers of the same age. A desire to engage socially is
also important: such children seek to interact socially with
adults and peers and as such are not like children with
autism who are not as socially engaged. These children are
usually referred to as children with specific language im-
pairment (Bishop 1997; Leonard 1998).
Given the importance of language to human behaviour, it
is not surprising to find that language difficulties are a risk
factor for associated difficulties in other aspects of child-
ren’s lives. For example, research indicates developmental
interactions between language impairments and difficulties
acquiring literacy skills, the development of memory skills
and more general nonverbal abilities throughout middle
childhood, adolescence and beyond (Conti-Ramsden and
Durkin 2007; St Clair et al. 2010). Still more broadly,
children with language difficulties are at risk of less suc-
cessful developmental and educational outcomes. There is
evidence that children growing up with language impair-
ment experience greater difficulties in social interaction than
do typical children and adolescents (Durkin and Conti-
Ramsden 2007). These children are more vulnerable to
academic failure, social exclusion, behavioural and emo-
tional difficulties, and to being bullied (Conti-Ramsden et
al. 2009; St Clair et al. 2011).
Within this context, the neuropsychological assessment
of preschool children’s language skills is of crucial impor-
tance. It enables us to identify accurately difficulties and
guide appropriate management of interventions and support
for children and their families – ideally, from an early age. In
this review, we summarise briefly the key developmental
milestones of language development in the preschool years
as a backdrop for understanding difficulties with language
learning, including what specific language impairment
entails. We then examine the neurobiological evidence for
language development and language impairments, conclud-
ing that there is currently no identified neurobiological
signature for language difficulties. This is followed by a
discussion of issues relevant to the assessment of language
abilities in preschool children. We include considerations of
context, content and commonly used instruments, as well as
limitations of particular approaches.
Language Development in the Preschool Years
Learning language is one of the key developmental tasks
facing children in the preschool years. Human infants have
385
evolutionarily adapted nervous systems that enable them to
attend to and perceive the acoustic and temporal character-
istics of spoken language. Soon after birth, infants can
discriminate all the sound contrasts languages of the world
use, even those which are not present in their home language
(Kuhl and Meltzoff 1997; McMurray and Aslin 2005).
Exposure to talk in the first year of life provides the neces-
sary input for the infant to develop sensitivity to the speech
sounds of her or his home language or, in the case of
multilingual families, languages (Krentz and Corina 2008).
During this period, speech sounds gradually emerge, fol-
lowed by babbling, with the infant developing long sequen-
ces of sounds reflecting the intonation contour of the adult
language (Locke 1989; Majorano and D’Odorico 2011;
Papousek and Papousek 1989; Saaristo-Helin et al. 2011).
Infants begin to use communicative gestures, such as point-
ing, showing and offering interesting objects to others
(Behne et al. 2012; Fusaro et al. 2012; Tomasello et al.
2007). During this period, infants also display the begin-
nings of language comprehension. They begin to respond to
their own name (Tincoff and Jusczyk 1999) and to associate
words with objects (Bernhardt et al. 2007; Gogate and
Hollich 2010; Masur et al. 2012), particularly within specif-
ic contexts, for example, when the adult says the word
“duck” at bathtime whilst playing with a toy duck. In
typically developing children, language comprehension usu-
ally precedes language production.
The above “prelinguistic” period ends with the child
uttering her or his first word, usually around the first birth-
day (Fenson et al. 1994; Majorano and D’Odorico 2011;
Saaristo-Helin et al. 2011). These first words can vary in
how close they are to the adult form. During the first months
after their first word, children add an average of 10 words
per month until they accumulate around 50 words. After that
there appears to be a “word spurt” and children’s vocabu-
laries increase at a much faster rate of over 30 words per
month (Benedict 1979; Goldfield and Reznick 1990),
though this can occur somewhat later in children with less
favourable circumstances, such as significantly pre-term
birth (Kern 2007a). Around their second birthday, children
show evidence of grammatical knowledge by combining
words together in multiword speech (Anisfeld et al. 1998;
Schipke and Kauschke 2011; Thordardottir et al. 2002),
though delays in expressive language are found in toddlers
who were born pre-term (Barre et al. 2011) or have suffered
maltreatment (Culp et al. 1991; Eigsti and Cicchetti 2004).
Typically developing toddlers begin to put words together in
utterances like “more juice”, “hurt nose” and “daddy car”
(Braine 1976). These first word combinations tend to be
missing function words and bound morphemes that mark
information such as possession (possessive +‘s), number
(plural +s) or tense (+ ing, + ed). Next, children begin to
produce longer utterances, combining three or more words
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usually in simple, active declarative utterances such as “I
want my book”. They begin to include function words such
as articles (a, the), auxiliary verbs (am, is, are, has, have),
and pronouns (him, her). Questions (marked in English by
change in word order rather than intonation, for example,
“Are you playing?”) and negative sentences that go beyond
the use of “can’t” and “don’t” which appear to function as
general negative markers (for example “I won’t go”) come
later (Tyack and Ingram 1977). Production of multiclause
utterances marks the later phases of language development
in young children (Kirjavainen et al. 2009). By the end of
the preschool period, and before most typically developing
children attend school at 5 years of age, the aforementioned
achievements in oral language growth have been completed
(Hoff 2009).
During this period, typically developing children are also
becoming more proficient in the interactional dimensions of
language use, mastering the subtle cues that signal turn-
taking in conversations (Rutter and Durkin 1987), discover-
ing how to find common ground and sustain discourse with
others (O’Neill et al. 2009; Short-Meyerson 2010), and how
to repair conversational misunderstandings (Laakso and
Soininen 2010). They develop skills in the production and
understanding of longer stretches of language (narratives
and stories; Griffin et al. 2004) and become increasingly
able to use language to discuss future events (Atance and
O’Neill 2005). In short, language is more than a system of
rules to be mastered (itself a remarkable achievement) but,
concomitantly, a vital means of engaging with the social
world and organizing one’s experiences within it.
This brief summary of language development has to be
qualified by the very important fact that there are substantial
individual differences in the timing of the course of lan-
guage acquisition within the population of typically devel-
oping children (Fernald and Marchman 2011; Hoff 2010;
Locke 1989). Much variability is observed in the timing of
children’s language gains.
Research has long documented the existence of “late
bloomers”. These are children who may have only a few
words by age 2 but a year later by age 3 have caught up with
their peers in expressive language skills (Fischel et al. 1989;
Thal et al. 1991; Wake et al. 2011). There are also consistent
findings from studies in Australia (Zubrick et al. 2007), the
United Kingdom (Roulstone et al. 2002) and the United
States of America (Bates et al. 1995) that approximately
one fifth (19 %) of typical infants are not combining
words by their second birthday at 24 months of age.
However, the majority of these children catch up with
their peers by 3 to 4 years of age. It appears that the
variation in early childhood language development is in-
deed great. This makes the assessment of language and
the identification of language difficulties in the preschool
years challenging.
Neuropsychol Rev (2012) 22:384–401
Difficulties with Language Learning
Preschool children who develop specific language impair-
ment (SLI) are usually characterized by having language
difficulties from the outset of the language-learning process.
Instead of reaching developmental language milestones on
schedule (first words around a child’s first birthday, word
combinations around the child’s second birthday), children
with SLI are slow from the beginning. It is a hallmark of SLI
that these children are late talkers: they are late in acquiring
their first words and in putting together their first word
combinations. It is not the case that children with SLI start
developing language normally and then stop and become
delayed or lose what they have learned. Occurrence of
“language loss” in infancy is reported in some children with
autism spectrum disorders (ASD) but not in children with
SLI. This appears to be a distinguishing feature between the
two disorders (Pickles et al. 2009) and hence can be partic-
ularly useful for the differential diagnosis between SLI and
ASD in the preschool period. In the preschool and early
childhood period, difficulties with the sound system of the
language, i.e., phonology, can co-occur with SLI but are not
considered to be a hallmark of the disorder. By middle
childhood, problems with sound production are usually
resolved or less evident (unless there is oral-facial motor
difficulty/apraxia) and most children with SLI are
intelligible.
Interestingly, children with SLI can also have difficulties
in understanding what is said to them. For example, follow-
ing instructions such as “bring me the big ball” (from
amongst an array of balls). Some researchers have identified
sub-types of SLI based on how impaired their comprehen-
sion abilities may be (Conti-Ramsden and Botting 1999a;
Rapin 1996), as difficulties with comprehension are a key
indicator, or red flag for risk and persistence of language
difficulties (Bishop et al. 2012; Bishop and Edmundson
1987; Conti-Ramsden and Durkin 2011; Nippold and
Schwarz 2002). Children with expressive SLI have more
difficulty with talking (producing words, also referred to as
expressive language) than with understanding what is said
to them (comprehending language, also referred to as recep-
tive language). Although difficulties with talking attract the
most attention to listeners and can occur in isolation, the
majority of children with SLI present with difficulties in
both talking and understanding. These children are referred
to as having expressive-receptive SLI or mixed SLI. It is
much more rare to see children who have problems under-
standing what is said to them but can talk relatively normal-
ly (except in the case of children with autism, and some
individuals with Williams Syndrome, who manifest relative-
ly fluent use of social talk in the context of relatively poor
social understanding and pragmatic impairments). In addi-
tion, there are some children with SLI who appear to have
Neuropsychol Rev (2012) 22:384–401 387

difficulties with social understanding but do not present with
the full cluster of deficits related to autism. These children
are referred to as having pragmatic language impairment
(Bishop 1998; Bishop and Norbury 2002; Botting and
Conti-Ramsden 2003). SLI is recognized by the ICD-10
(World Health Organization 1992), the DSM-IV-TR (American
Psychiatric Association 2000) and the clinical research defini-
tion of SLI (Tomblin et al. 1996). Table 1 presents each of these
definitions of SLI.
SLI is much more prevalent than other developmental
difficulties that have received more public attention, for
example, autism. SLI is a common disorder: although esti-
mates vary between 3 % and 7 % depending on definitions
and statistical criteria employed (Silva 1987; Tomblin et al.
1997), this is a much larger proportion compared to around
one percent for autism (Baird et al. 2006). More males
appear to be more affected than females. In referred samples
(i.e., children drawn to the attention of educational and
clinical practitioners), the sex ratio of affected males:
females is around 3 or 4:1 (Conti-Ramsden and Botting
1999b; Robinson 1991). Although it is often the case that
there are higher proportions of males in populations with
developmental disorders, the reason for the preponderance
of males with language impairments in clinical samples is
unknown. The picture is complicated by at least two con-
siderations. One is the fact that in non-referred, epidemio-
logical samples, the incidence of SLI among girls
approximates that of boys (Tomblin et al. 1997), suggesting
that other factors (which could include comorbid disorders,
behavioural/socialization differences, greater attention paid
to boys’ problems) play a role in referral. The second is that,
on average, females seem to show an advantage in the pace
of early language development (Bornstein et al. 2004; Eriks-
son et al. 2012; Lovas 2011), indicating that the calibration
and interpretation of ‘late’ talking need to be gender-
sensitive. To date, no associations have been found between
language impairments and genes on the sex chromosomes.
There is strong evidence that SLI runs in families. The
majority of children with SLI have a family history of lan-
guage difficulties, with a first degree relative usually affected.
The contribution of genetic factors is most clearly indicated in
twin studies, where identical twins have a much higher con-
cordance for SLI than non-identical twins (Bishop 2002).
There is research support for the heritability of two clinical
markers for SLI: phonological short-term memory difficulties
as indexed by poor performance on nonword repetition tasks
and difficulties with grammatical morphology, in particular
poor performance in tasks involving formation of the past
tense in English (Bishop 2006; Falcaro et al. 2008; Newbury
et al. 2009). However, no candidate gene sites of large effect
have been found for SLI. The evidence to date indicates that
patterns of inheritance appear to be complex involving inter-
actions among multiple genes of small effect (Bishop 2006).
Within this context, there are currently no specific genetic
markers for SLI that enable identification of the disorder via
genetic screening (Misyak and Christiansen 2011).
Until recently, SLI was thought to be a disorder of child-
hood. Follow-up studies into later childhood and adoles-
cence have revealed that although some appear to “grow
out of it”, for a significant proportion of children this disor-
der is persistent (approximately 3 % of adolescents experi-
ence SLI, Mckinley and Larson 1989). Those children who
appear to “grow out of it” tend to have good comprehension
abilities, but even this group of “resolved” children can
experience language-related and other information process-
ing difficulties in later childhood (Simkin and Conti-
Ramsden 2006; Miller et al. 2008; Stothard et al. 1998). In
this sense, SLI forms one of the largest groups of young
people with special needs that professionals are likely to
encounter.
The Neurobiology of Language Difficulties
In the 19th century, work with adults with brain lesions
provided the first evidence for the specific location of lan-
guage functions in the human brain. It was found that
language function was strongly lateralized to the left cere-
bral hemisphere. It was also suggested that the frontal cor-
tical area, later known as Broca’s area (Broca 1861), was
responsible for spoken or “expressive language” whilst the
posterior cortical area, later known as Wernicke’s area

Table 1 Definitions of SLI

International Classification of Diseases-10, ICD-10 (World Health Organization 1992) requires language difficulties greater than 2 standard
deviations (SD) below the mean, with verbal skills at least 1 SD below measures of non-verbal cognitive functioning.
Diagnostic and Statistical Manual of Mental Disorders-IV-TR, DSM-IV (American Psychiatric Association 2000) requires substantially worse
performance on measures of verbal abilities compared to non-verbal cognitive functioning. What constitutes ‘substantial’ is not defined
operationally, though functional impairment is required - i.e. SLI interferes with academic or occupational achievement, or with social interaction.
The clinical research definition of SLI (Tomblin et al. 1996) also uses threshold and discrepancy information to enable identification of SLI by
speech and language therapists. It requires a combination of language difficulties, assessed on a composite standardized language measure that
examines more than one dimension of language. The suggested threshold is that language abilities should fall 1.25 SD below the mean
(approximately, the 10th centile). Plus, adequate non-verbal cognitive functioning (i.e. a Performance IQ greater than 1 SD below the mean,
equating to a standard score of 85 or higher).
388
(Wernicke 1874) was responsible for comprehension or
“receptive language”. As shown in Fig. 1, these cortical
grey matter areas communicate via a major white matter
pathway known as the arcuate fasciculus (Catani et al.
2005).
The above classical model has continued to provide the
basic scheme for understanding language organization in the
brain. However, more recent findings using functional
(fMRI) studies with healthy adults suggest language pro-
duction and processing entails more widespread involve-
ment of brain structures. It has been demonstrated that the
temporal lobe projections of the arcuate fasciculus extend to
the left middle and inferior temporal gyrus (Powell et al.
2006), and that activation can extend to the fusiform and
angular gyri particularly in tasks involving receptive lan-
guage functions (Binder et al. 1997). These areas are beyond
the classical boundaries of Wernicke’s area. There is also
evidence of activation of left (lateral and medial) prefrontal
cortical areas outside the classical Broca’s area in tasks
involving language production but also in some tasks in-
volving receptive language (Binder et al. 1997). Other areas
of the brain have also been shown to be activated during
language tasks. Functional activation of the cerebellum has
been observed as well as the corpus callosum (De Smet et al.
2007; Binder et al. 1997).
More recent morphological analyses have further speci-
fied the nature of language lateralization in the left hemi-
sphere. Studies have shown that in healthy adults and
children with typical language there is greater grey and
white matter density in the left hemisphere structures sub-
serving language as well as left greater than right asymmetry
in the white matter pathways connecting the major language
areas (Powell et al. 2006). Language neural networks are
Fig. 1 Classical model of language organization in the brain
Neuropsychol Rev (2012) 22:384–401
more diffused, less specialized and lateralized in young
children than in adults; as is the case in other cognitive
domains. More recovery is observed in young children’s
language skills after early brain trauma than are observed
in adults with similar lesions (Feldman et al. 1992: Reilly et
al. 1998; but also see Chapman et al. 2003). Neurobiological
maturational, developmental processes continue from child-
hood to adulthood (Friederici et al. 2012). Available evi-
dence suggests that left hemisphere specialization begins
very early in development becoming more pronounced as
children’s language increases in complexity (Holland et al.
2007).
The examination of neurobiological profiles of children
and adults with language difficulties is relatively recent and
has not yielded a neurobiological signature for language
impairments that can be informative in the assessment of
preschool children. Indeed, few replicable atypicalities have
been identified (for a review see Webster and Shevell 2004).
In right handed individuals, the most consistent neuroimag-
ing findings suggest either reduced left-sided grey and white
matter density (Leonard et al. 2006) or absence of the
expected left greater than right asymmetrical pattern of
language cortex (Gauger et al. 1997; De Guibert et al.
2011). Additional, less consistent findings include unusual
brain gyri, i.e., the presence of an extra sulcus in the inferior
frontal gyrus (Clark and Plante 1998; Jackson and Plante
1996) and reduced volume of the caudate nucleus bilaterally
(Watkins et al. 2002). However, it is important to note that
the most consistent abnormalities have also been observed
in other developmental disorders, such as autism (Stefanatos
and Baron 2011). Further research is needed to identify
distinctive features of brain development in individuals with
language impairments.
Assessing Language Abilities in the Preschool Child
Why Assess Language Development?
An important initial consideration has to be the purpose of
the assessment. This may well be indicated in issues raised
in the course of referral. For example, attention may be
prompted by a caregiver’s observation that there is some-
thing amiss with the child’s language in particular; however,
other prompts may be concerns about general intellectual
progress, behavioural or emotional disturbance, or the sus-
picion of ASD. Furthermore, professionals working with
children in diverse contexts may have varied goals: to assess
timeliness of language development, to provide a thorough
profile of developmental abilities, to inform a therapeutic
programme, to assess readiness for a developmental or
educational opportunity (such as pre-literacy or pre-
numeracy activities), or for specific research goals. Clinical
Neuropsychol Rev (2012) 22:384–401
purposes may mandate a very detailed and wide ranging
language assessment; for some research purposes, a coarser
but still informative guide (such as Mean Length of Utter-
ance, MLU, Miller 1981) may be sufficient or all that is
practicable. In the present review, we concentrate on the
detailed assessment of preschoolers for clinical purposes.
Identification
There are a number of instruments designed to screen for
language problems. However, a comprehensive review of
screening tests for early language delay carried out by Law
and colleagues (Law et al. 1998) demonstrates that screen-
ing instruments are not sensitive enough nor specific enough
to identify language difficulties. They produce too many
false positives and false negatives, i.e., they do not distin-
guish sufficiently accurately those young children who do
have problems from those who do not. This is not surpris-
ing, given that there is great variability in the timing of early
language acquisition in the typical population (Bates et al.
1995), that there are few, if any, robust early predictors of
language difficulties (Reilly et al. 2009, 2010), and that
there are no strong, identifiable genetic or neurobiological
markers of language impairments (Bishop 2006; Webster
and Shevell 2004).
Currently, there is no policy for universal screening of
young children for language difficulties, for example in the
UK, USA or Australia. Consequently, practitioners are likely
to encounter young children for assessment when someone
who knows them has already expressed concern about their
language or other aspects of their development (Glascoe
1997). In the preschool child, this is usually parents, family
members or nursery/preschool staff.
Early identification, in addition to providing information
and support to adults who are concerned about a preschool
child’s language development, affords the opportunity for
early intervention. Language intervention with preschool
children has the potential to change the developmental
course of their language difficulties and improve long-term
outcomes. Evidence suggests that there is more fluidity in
language growth in the preschool and early school years:
some young children with language impairment experience
accelerated growth during this early period of development
(Bishop and Edmundson 1987). However, the available
literature also suggests that in older children and young
people with SLI the rate of growth in more global language
abilities in the expressive/receptive modalities is likely to be
stable (Conti-Ramsden et al. 2012). The above considera-
tions, coupled with evidence of the efficacy of speech and
language therapy treatment, particularly for interventions of
longer duration (see Law et al. 2003; 2010 for meta-analysis
and systematic review), make a strong argument for early
detection of language impairments.
389
How to Approach Language Assessment in Preschool
Children
Language assessment aims to provide a profile of a child’s
language difficulties. In order to achieve this aim, practi-
tioners need to establish the nature and extent of a child’s
language abilities in relation to the child’s age and develop-
mental expectations. In the case of the preschool child,
expertise in obtaining representative behaviours from young
children and in interpreting different sources of information
is of particular relevance.
There are both theoretical and practical issues to bear in
mind here. Theoretical assumptions about the nature of the
relationship between language and other cognitive capaci-
ties (e.g., modular versus domain general) may influence
approaches to assessment (see Karmiloff-Smith 1998; Rice
and Wexler 2001; Thomas and Karmiloff-Smith 2002). Fur-
thermore, it is an oversimplification (albeit sometimes a
necessary oversimplification) to assume that language is a
discrete and readily measured property that the child pos-
sesses, akin to his or her current height or weight. Language
use, for the most part and certainly in the preschool years,
involves interacting with others: hence, it is a joint product,
not a solely individual one (Durkin 1987; Tomasello 2003;
Veneziano and Parisse 2010). The quantity and quality of a
child’s language performances will vary according to inter-
actional contexts. Developmentalists are very familiar with
the notion of a zone of proximal development (the distance
between what a child can do alone and what he or she can do
in interactions with a more experienced partner (Vygotsky
1987). Even a basic measure such as MLU can differ, in the
same child, depending on with whom he or she is interacting
and with what goals. For example, Lovas (2011) found that
the gender of the child and the gender of the parent inter-
acted to affect MLUs. With 2-year-olds, the longest MLUs
were reported in father-daughter conversations and the
shortest in father-son dyads.
A closely related practical consideration is that preschool
children are known to behave differently in different con-
texts and with different interactive partners, depending on
level of familiarity, mood and the environment. Skilled and
experienced clinicians can do a lot to ensure that the child is
at ease but the testing context may still be substantially
different from the child’s everyday contexts of language
use. This may be particularly pertinent when assessing chil-
dren from socially disadvantaged backgrounds or shy chil-
dren, whose language performance may be especially
inhibited in unfamiliar settings.
Another important consideration facing assessors in
many communities is that the child (and/or his or her lin-
guistic environment) may not be monolingual (Crutchley et
al. 1997). As well as the direct complication of the lan-
guages used, there may well be associated cultural
390
variations in respect of how children interpret and respond
to interrogation by a strange adult. For an informative dis-
cussion of issues and strategies involved in the assessment
of bilingual children see De Lamo White and Jin (2011).
Comprehensive assessment and contextualized interpreta-
tion is needed; a model that takes a sociocultural perspec-
tive. This approach provides a more sensitive framework for
taking into consideration cultural and linguistic diversity by
encompassing not only norm-referenced and criterion-
reference measures but also dynamic assessment. The RIOT
procedure that advocates review, interview, observe and test
(Cheng 1990; 1997) illustrates how to put this framework
into practice.
Thus, an informative assessment usually requires not
only a multi-method approach, but an approach involving
multiple informants. The use of formal tools such as stand-
ardised tests complemented with more informal assessment
strategies, such as naturalistic observations, is likely to
provide a more meaningful evaluation of the child’s lan-
guage skills. In addition, complementing practitioner assess-
ments with information from other relevant informants, such
as caregivers, is likely to provide a more accurate assess-
ment of the language abilities of the preschool child. Most
preschool children requiring language assessment have a
relevant adult, usually a parent or guardian, who is
concerned about their development and will be accompa-
nied by them to the assessment sessions. Investigating the
concerns of the accompanying adult, i.e., what has led to the
referral, gathering their observations via interview techni-
ques and questionnaires can provide valuable information
that adds to the data obtained from direct observation and
assessment of the child.
Assessing Both Expressive and Receptive Language Skills
Learning language involves being able to produce as well as
understand language appropriately. As previously discussed,
neurobiological evidence suggests that expressive and re-
ceptive language abilities are likely to involve activation of
different cortical areas. Difficulties in one modality of lan-
guage do not necessarily predict difficulties in the other,
suggesting potential different neurobiological profiles for
different patterns of language impairments. It is known, for
example, that children can have expressive language diffi-
culties within the context of adequate receptive language
(Leonard 1998). It is therefore crucial to examine both
language understanding as well as language production in
preschool children if we are to achieve valid profiles of
children’s language abilities and/or difficulties.
There are three further considerations that underline the
need to include both language modalities in assessment.
First, many early signs of language difficulties rely on the
child’s productive abilities such as expressive vocabulary
Neuropsychol Rev (2012) 22:384–401
(how many words the child has) and expressive language
development (is the child putting words together?). There
are fewer markers of early receptive language delay which
can lead to under-detection of language difficulties involv-
ing understanding (Reilly et al. 2009, 2010). Second, the
assessment of receptive language abilities provides valuable
information as to the nature of the child’s problems. Diffi-
culties with language comprehension have prognostic value
and are indicators of potential persistent difficulties (Bishop
and Edmundson 1987; Conti-Ramsden and Durkin 2011).
Children with expressive difficulties only and good compre-
hension are more likely to progress well (Bishop and Adams
1990; Paul 1996). Third, children use cues from a variety of
sources to understand language. They have strategies at their
disposal that enable them to respond to language that they
only partially understand (Chapman 1978; Shatz 1978). As
mentioned previously, in the assessment of the preschool
child a multi-method, multi-informant approach is the gold
standard. In the case of language comprehension this is
particularly true. It is desirable to carry out more formal
assessments of language comprehension in the preschool
child as naturalistic observations do not always provide
enough constraints in the child’s environment to be able to
ascertain if it is the language per se that the child has
understood.
Assessing Different Dimensions of the Language System
Language is a complex system comprised of a number of
dimensions or components that enable an individual to com-
municate effectively. These include phonology (the sound
system), the lexicon (vocabulary), semantics (meaning),
grammar (structure), pragmatics (communicative functions
and conventions for language use), and discourse (the inte-
gration of utterances into longer stretches of conversation or
narrative). Language is also a dynamic system whereby dif-
ferent components work together and change throughout de-
velopment. There is evidence, for example, that early lexical
development and grammatical development are highly corre-
lated in typically developing children (Bassano et al. 2004;
Bates and Goodman 1997; Dionne et al. 2003; Szagun et al.
2006). There are also findings from children with language
problems suggesting that difficulties with a dimension of
language can have cascading effects on other components of
language. For example, it is known that delays in lexical
acquisition can affect the development of grammar in late
talkers and children with SLI (Conti-Ramsden and Jones
1997; Moyle et al. 2007).
Thus, the assessment of preschool children’s language
skills requires that the various dimensions of the language
system are considered in constructing a profile of the child’s
abilities. Measures of a single language dimension are inad-
equate in ascertaining the nature of a child’s difficulties and
Neuropsychol Rev (2012) 22:384–401
they are less reliable the younger the child, which is of
particular concern in the preschool period (Thal and Katch
1996). We stress that assessment of a single dimension of
language can also be misleading. Of particular concern is
the use of measures of vocabulary as the sole indicator of
language ability (Dockrell 2001). A 4 year old preschool
child may have adequate vocabulary for his/her age but may
still have problems with semantics and grammar (Gray et al.
1999). Longitudinal data also suggest that children can have
adequate vocabulary at an earlier point of development but
then demonstrate language difficulties later in the preschool
period (Reilly et al. 2009).
Language Assessment Instruments
Language assessment involves appraising the nature and
extent of a child’s difficulties. This entails establishing the
language skills a child has and evaluating them in relation to
what is expected of typically developing children of the
same age. Given the variability observed in early language
development, norm-referenced assessments are of particular
value in the preschool years. Table 2 below provides a
description of commonly used, norm-referenced instruments
for assessing preschool children’s language abilities.
As can be seen from Table 2, instruments vary on the size
and characteristics of the sample used to provide normative
data. The basis for the norms provided, along with the
validity and reliability of the instrument, are important con-
siderations in the interpretation of the results of any assess-
ment as the information is, to some extent, as good as the
instrument used (Dockrell 2001).
Standardised tests, based on direct child assessment, are
thought to be the most formal of assessments as they specify
controlled conditions under which the child can demonstrate
his/her abilities. The rationale behind standard conditions
for assessment is that it affords fair comparisons between the
performance of the child in question and his/her peers who
also experienced the “exact same” conditions when the
norms were being derived. Intelligence quotient (IQ) is
perhaps the most commonly known assessment of this type.
IQ tests for preschool children such as the Wechsler Pre-
school and Primary Scale of Intelligence – Third UK Edition
(Wechsler 2003) or the British Ability Scales Third Edition
(Elliot and Smith 2011) usually include subtests that mea-
sure language abilities. The Wechsler, for example, provides
information as to how to derive both a verbal IQ as well as a
non-verbal IQ (see Table 2). Nonetheless, given the avail-
ability of published standardised tests dedicated to the as-
sessment of language, these are more often the instruments
of choice for language assessment.
Language assessment instruments range from those that
sample the breadth of children’s language skills and provide
general language measures versus those that focus on
391
particular dimensions of language. Language assessments
that provide more general language measures usually cover
a number of language components, most commonly vocab-
ulary, semantics and grammar, and both modalities of lan-
guage, that is expression and comprehension. They afford
practitioners a profile of the child’s difficulties. For children
over the age of 3 years, one of the most commonly used
preschool assessments of this type is the Clinical Evaluation
of Language Fundamentals - Preschool2 UK (Semel et al.
2006). This instrument was originally designed and normed
in the US (Clinical Evaluation of Language Fundamentals –
Preschool, Wiig et al. 1992). Its popularity in the UK led to
its British standardisation (see Table 2). This instrument also
has an Australian and New Zealand version with its own
standardisation (Clinical Evaluation of Language Funda-
mentals - Preschool Second Edition, Australian and New
Zealand Standardised Edition, Wiig et al. 2006). It is always
best practice to use local norms if at all possible and this
entails checking what is available on a regular basis as
updated versions of commonly used instruments are contin-
ually being developed.
For children under 3 years, the Preschool Language Scale
is a popular instrument for directly assessing infants and
young children’s language skills. This tool was also origi-
nally designed and normed in the USA (Zimmerman et al.
1979) but also has a UK version and standardisation (see
Table 2). There is a language adaptation for Australian chil-
dren but no standardisation with this population (Preschool
Language Scale, Fourth Edition Australian Language Adap-
ted, Zimmerman et al. 2002).
Instruments that focus on specific dimensions of lan-
guage can be useful when practitioners want to examine a
component of language in more depth. One case in point is
the assessment of specific aspects of morphology and gram-
mar which characterise children with SLI. The Rice/Wexler
Test of Early Grammar Impairment (Rice and Wexler 2001)
included in Table 2 provides an in-depth analysis of prob-
lematic morphemes, such as past tense “ed” in 3 to 8 year
old children which has been shown to be heritable in chil-
dren with SLI (Falcaro et al. 2008). There are specific tests
that cover virtually all dimensions of the language system in
a particular modality (expressive versus receptive skills).
Instruments that measure receptive vocabulary such as the
British Picture Vocabulary Scale Third Edition (Dunn and
Dunn 2009) and the Peabody Picture Vocabulary Test
Fourth Edition (Dunn and Dunn 2007) are commonly used.
As previously mentioned, these types of single measures on
their own are inadequate for determining a full picture of the
language abilities of young children.
There are also standardised instruments that use parental
report and observation to assess the language abilities of pre-
school children. There is evidence that parents can distinguish
between verbal and non-verbal abilities and that they can
392
Table 2 Norm-referenced instruments for assessing language abilities in preschool children
Instrument and author
British Ability Scales Third
Edition (BAS3)
Elliot, C. D. & Smith, P.
British Picture Vocabulary Scale
Third Edition (BPVSIII)
Dunn, L. M., & Dunn, D. M.
Clinical Evaluation of Language
Fundamentals - Preschool 2
UK Edition (CELF-Preschool2 UK)
Semel, E., Wiig, E. H.,
& Secord, W.
Early Repetition Battery (ERB)
Seeff-Gabriel, B., Chiat, S.,
& Roy, P.
Expressive One-Word Picture
Vocabulary Test, Fourth
Edition (EOWPVT-4) and
the Receptive One-Word
Picture Vocabulary
Test, Fourth Edition
(ROWPVT-4)
Martin, N. A.
& Brownell, R. (2010a, b)
Expressive Vocabulary
Test (EVT-2)
Williams, K. T. (2007)
Neuropsychol Rev (2012) 22:384–401
Age range Norms Description
3 years to 17 years 1,480 children in Assesses cognitive ability and educational
11 months the UK achievement using two batteries:
The Early Years Battery assesses verbal
development, reasoning, perception and
memory, together with understanding of
basic quantitative concepts.
The School Age Battery assesses reasoning,
perception, processing speed and memory
using verbal, numerical and figural materials.
The latter include abstract shapes, pictures
and three-dimensional materials.
3 years to 16 years 3,278 children in Assesses receptive vocabulary in children.
the UK For each question the examiner says a word
and the child responds by selecting the
picture (from four options) that best
illustrates the word’s meaning. The questions
broadly sample words that represent a range
of content areas such as actions, animals, toys
and emotions and parts of speech such as
nouns, verbs or attributes.
3 years to 6 years 588 children in Measures a broad range of expressive and
11 months the UK receptive language skills in young children.
It provides seven norm-referenced
subtests in:
Sentence Structure
Word Structure
Expressive Vocabulary
Concepts and Following Directions
Recalling Sentences
Basic Concepts
Word Classes.
The following supplementary subtests can
be used to give additional information
about the child’s skills outside of the
testing situation:
Recalling Sentences in Context
Phonological Awareness
Pre-Literacy Rating Scale
Descriptive Pragmatics Profile.
2 years to 5 years 418 children in Consists of two expressive tasks: the Preschool
11 months the UK Repetition Test (PSRep), comprising real and
non-words controlled for length and prosodic
structure; and the Sentence Imitation
Test (SIT) comprising sentences controlled
for length and syntactic complexity.
2 years to 80+ years 2,394 individuals Co-normed tests to make comparisons
in the US of a child’s receptive and expressive
vocabulary skills.
The EOWPVT-4 requires the child to name
the object, action, or concept illustrated
on a test plate. With the ROWPVT-4, the
child identifies one of four illustrations
that depict the meaning
of a stimulus word.
2 years 6 months 3,540 individuals A test of expressive vocabulary and word
to 90+ years in the US retrieval that requires no reading
or writing.
Neuropsychol Rev (2012) 22:384–401
Table 2 (continued)
Instrument and author
MacArthur-Bates Communicative
Development Inventories (CDIs),
Second Edition
Fenson, L., Marchman, V. A.,
Thal, D. J., Dale, P. S.,
Reznick, S., & Bates, E.
MacArthur-Bates Communicative
Development Inventories
Third Edition (CDI III)
Fenson, L., Marchman, V. A.,
Thal, D. J., Dale, P. S.,
Reznick, S., & Bates, E.
New Reynell Developmental
Language Scales (NRDLS)
Edwards et al. (2011)
Peabody Picture Vocabulary
Test-IV (PPVT-IV)
Dunn, L. M. & Dunn, D. M.
Preschool Language Assessment
Instrument-Second
Edition (PLAI-2)
Blank et al. (2003)
Preschool Language Scale,
Fourth Edition UK (PLS-4UK)
Zimmerman et al. (2008)
393
Age range Norms Description
Designed to coordinate with the PPVT-4.
infant scale 8 to 1,461 children in A standardised parent reporting system
16 months; the US used to assess monolingual children’s
toddler scale 16 lexical growth. The infant scale looks at
to 30 months comprehension, word production and
aspects of symbolic and communicative
gesture. The toddler scale examines word
production and the early phases
of grammar.
30 to 37 months 356 children in The CDI III is a brief upward extension of
the US the CDI approach that is suitable for
assessing language skills in children
between 30 and 37 months. The first
component is a 100-item vocabulary
checklist. The second component
consists of 13 questions about the child’s
word combinations. The third component
consists of 12 questions, to be answered
“yes” or “no,” asking about various aspects
of comprehension, semantics and syntax.
2 years to 7 years 1,266 children in The Comprehension Scale explores aspects
5 months the UK of a child’s understanding of selected
vocabulary items and grammatical features.
The Production Scale examines the child’s
production of the same features of language.
Parallel sections within the scales aid
comparison of a child’s comprehension
and production skills.
2 years 6 months 3,540 individuals A measure of receptive vocabulary with a
to 90+ years in the US test that requires no reading or writing
Designed to coordinate with the EVT-2.
3 years to 5 years 463 children in The Norm-Referenced Assessment
11 months the US comprises six subtests that provide a
Discourse Ability Score:
Matching — linking of verbal and
perceptual information
Analysis — identification and/or combining
of perceptual components
Reordering — reduction or restructuring
salient perceptual cues
Reasoning — prediction of events and
justification of ideas
Receptive Mode — nonverbal response
Expressive Mode — verbal response.
The Non-standardized Assessment consists
of two pragmatic measures: Adequacy
of Response and Interfering Behaviors
birth to 6 years 800 children in Comprises two subscales: Auditory
5 months the UK Comprehension and Expressive
Communication.
The test includes tasks that assess skills in
the areas of preverbal behaviors, as well as
linguistic skills in the areas of semantics,
morphology, syntax, integrative language
skills, and preliteracy skills.
Provides Auditory Comprehension and
Expressive Communication subscale
scores and a Total Language score.
394
Table 2 (continued)
Instrument and author
Receptive-Expressive Emergent
Language Test Third Edition
(REEL-3)
Bzoch et al. (2003)
Renfrew Language Scales
Renfrew, C. (1998)
Rice/Wexler Test of Early
Grammar Impairment (TEGI)
Rice, M. L. & Wexler, K.
Sequenced Inventory of
Communication Development,
Revised (SICD-R)
Hedrick et al. (1984)
Structured Photographic Expressive
Language Test—Preschool 2
(SPELT-P 2)
Dawson et al. (2005)
Test of Early Language Development
Third Edition (TELD-3)
Hresko et al. (1999)
Neuropsychol Rev (2012) 22:384–401
Age range Norms Description
up to 3 years Parent reports Uses the behavioral observations of
describing the parents or guardians to identify major
behavior of language problems. It consists of two
1,112 infants core subtests, Receptive Language and
and toddlers Expressive Language and also a
in the US supplementary subtest, the Inventory
of Vocabulary Words.
3 years to 8 years 594 children in Action Picture Test assesses the age
the UK levels of the information content and
the grammatical usage from short
sentence answers to specified questions.
3 years to 8 years 573 children in Bus Story Test assesses the age level
the UK of consecutive speech used from
information content, sentence length
and grammatical usage in
retelling a story.
3 years to 9 years 741 children in Word Finding Vocabulary Test assesses
the UK the extent to which pictures of objects,
arranged in order of difficulty, can be
named correctly.
3 to 8 years 393 children with Identifies morphemes and syntactic
typical development structures that children diagnosed
and 444 with a with language disorders
diagnosed language characteristically lack.
disorder in the US
4 to 48 months 252 children in the US Receptive section includes behavioral
items that test sound and speech
discrimination, awareness,
and understanding.
Expressive section includes three types
of behavior (imitating, initiating,
and responding), as well as two
distinct areas of expressive
measurement (length and grammatical
and syntactic structures of verbal
output and articulation).
3 years to 5 years 1,747children in Probes a child’s ability to generate
11 months the US early developing morphological and
syntactic forms.
Photographs of everyday situations
and objects are paired with simple
verbal questions and statements to
elicit specific morphological and
syntactic structures.
Target structures include prepositions,
articles, plurals, possessive nouns and
pronouns, subject pronouns, auxiliary
verbs, copulas, present participles,
past tense, third person markers,
as well as negatives, conjoined
sentence, “wh” question, interrogative
reversal, infinitive phrase,
propositional complement, relative
clause, and front embedded clause.
2 years to 7 years 2,217 children in Yields an overall Spoken Language
11 months the US score and also scores for Receptive
Language and Expressive
Language subtests.
Neuropsychol Rev (2012) 22:384–401
Table 2 (continued)
Instrument and author Age range
Vineland Adaptive Behavior Scales, birth to age 90
Second Edition (Vineland-II)
Sparrow et al. (2005)
Wechsler Preschool and 2 years 6 months to
Primary Scale of 3 years 11 months;
Intelligence – Third UK 4 years to 7 years
Edition (WPPSI – III UK) 3 months
Wechsler, D.
provide reliable information on the language abilities of their
offspring (Klee et al. 1998; Saudino et al. 1998). These types of
instruments are particularly useful with very young children.
One of the most widely used tools is the MacArthur-Bates
Communicative Development Inventories Second Edition, bet-
ter known as the CDI (Fenson et al. 2007). This instrument is
designed to assess the language abilities of infants and toddlers
(see Table 2). The CDI has been translated/adapted and stand-
ardised in a number of languages, including Danish (Wehberg
et al. 2007), Finnish (Stolt et al. 2008), French (Kern 2007b),
German (Szagun et al. 2006), Icelandic (Thordardottir and Ellis
Weismer 1996), Irish (O’Toole and Fletcher 2010), Italian
(Camaioni et al. 1991), Spanish (Jackson-Maldonado et al.
1993), and Swedish (Eriksson and Berglund 1999). A number
of additional assessment materials have been developed, in-
cluding a two-page questionnaire (the CDI III) and scoring
software. For the latest developments on the CDI visit their
website at http://www.sci.sdsu.edu/cdi/
Phonological Short-Term Memory: Why It Should
Be Included in the Language Assessment of Preschool
Children
Why do some children have what appear to be more specific
language difficulties? Different approaches emphasize
395
Norms Description
5,013 individuals A measure of personal and social skills
in the US needed for everyday living in the
domains of: Communication, Daily
Living Skills, Socialization, Motor
Skills and Maladaptive
Behavior (optional).
The Communication domain evaluates
the receptive, expressive, and written
communication skills of the child.
805 children in Provides subtest and composite scores
the UK that represent intellectual functioning
in verbal and performance cognitive
domains, as well as providing a
composite score that represents a
child’s general intellectual ability.
Consist of 14 subtests: Block Design,
Information, Matrix Reasoning,
Vocabulary, Picture Concepts, Symbol
Search, Word Reasoning, Coding,
Comprehension, Picture Completion,
Similarities, Receptive Vocabulary,
Object Assembly, and Picture Naming.
Provides Verbal and Performance IQ scores as
well as a Full Scale IQ score. In addition,
the Processing Speed Quotient can be derived
for children aged 4–7 years 3 months, and a
General Language Composite can be
determined for children in both age bands.
deficits in different systems. Memory, information process-
ing, temporal auditory processing and specific linguistic
mechanisms involved in the representation of grammar have
all been proposed as influential in the aetiology of SLI. One
prominent approach highlights memory impairments in SLI.
In this special issue, the assessment of memory in preschool
children is discussed in more detail by Patricia Bauer. In this
paper, we will highlight one aspect of memory that appears
to be particularly relevant to the development of language
skills and SLI.
In an influential and evolving model of working memory,
Baddeley (1986, 2003, 2012) conceptualises phonological
short-term memory (PSTM) as a domain-specific area for
the temporary storage of verbal information. PSTM reports
to a domain-general central executive that oversees and
coordinates aspects of attention and memory in cognitive
tasks. Research into the memory capacity of children with
SLI has consistently shown deficits which appear predom-
inantly specific to the verbal domain as most children with
SLI perform within the normal range on visuospatial mem-
ory tasks (Archibald and Gathercole 2006b). Gathercole and
Baddeley (1989, 1990) were among the first to demonstrate
that nonword repetition, a measure of PSTM, was a fairly
reliable marker of SLI as it discriminated between children
with language impairments and either age or language
396
matched typically developing peers. As mentioned previ-
ously, PSTM as indexed by nonword repetition abilities has
also been found to be heritable as evidenced by twin and
family studies involving children with language impair-
ments (Bishop et al. 1996; Bishop 2006).
Measures of PSTM, particularly as indexed by nonword
repetition abilities, have since been widely used in research
with children with SLI. However, there is no clear evidence
that its utility has been translated into clinical practice. The
majority of studies have involved school-age children
(Archibald and Gathercole 2006a; Botting and Conti-
Ramsden 2001; Conti-Ramsden et al. 2001) and available
tools for measuring PSTM have also focused on children
over 4 years of age (Gathercole and Baddeley 1996). Re-
cently, nonetheless, research attention has turned to pre-
school children. Chiat and Roy (2007, 2008) studied
nonword and word repetition abilities in children as young
as 2 years of age. They found that early difficulties with
phonological processing and memory, as indexed by non-
word and word repetition at 2 to 3 years of age, were not
only correlated with concurrent language difficulties but
were also predictive of language problems 2 years later (at
4 to 5 years of age). These authors have now made available
an instrument, the Early Repetition Battery (Seeff-Gabriel et
al. 2008) that provides a tool for the assessment of PSTM
abilities in children as young as 2 years of age (see Table 2).
There is now an opportunity to add a measure of PSTM to
the assessment of preschool children. The inclusion of such
a measure can provide another source of evidence for the
presence of language difficulties in young children.
Furthermore, it has been argued that processing-dependent
tasks, such as nonword repetition, have more validity across
different languages (Campbell et al. 1997; Conti-Ramsden
2003). In the assessment of bilingual children and children with
differing backgrounds, - for example, children of migrant fam-
ilies who do not speak, or are less proficient in, the majority
language - the assessment of memory processes provides a
promising tool for differentiating language impairments from
linguistic differences attributable to experiential factors.
It is important to note that our recommendation is for the
inclusion of a measure of PSTM, in particular tasks involv-
ing nonword repetition, as an indicator of language difficul-
ties but not for its sole use. Although memory difficulties are
likely to be involved in language impairments (Bishop
2002; Gathercole and Baddeley 1990; Lum et al. 2012),
they are neither necessary nor sufficient for language diffi-
culties to occur. There are children who have typical lan-
guage and poor PSTM and there are children who have
language difficulties and typical PSTM abilities (Conti-
Ramsden et al. 2001). It is the identification of areas of
language difficulty and the presence of memory difficulties
together that is informative in the assessment of young
children’s language skills.
Neuropsychol Rev (2012) 22:384–401
Language is a complex system and its successful or
unsuccessful acquisition by children involves a number of
internal constitutional factors as well as a number of exter-
nal environmental factors interacting across development. In
the assessment of language abilities in children, this multi-
factorial model should always be kept in mind.
Concluding Remarks
In this review we have made a number of important assump-
tions that need to be made clear. We have taken it as given
that language assessment should be culturally appropriate,
taking into consideration linguistic, social and economic
factors. The case of children learning English as a second
language illustrates this point: some of the language diffi-
culties observed in this population can be similar to that
found in children with SLI (Paradis 2005). We have pre-
supposed that practitioners involved in the assessment of
preschool children have the relevant expertise in language
development, language difficulties and language assessment
to allow them to make appropriate selections, observations,
administrations and interpretations of information provided
by the tools and methods they use (Paul 2006). Within this
context it follows that language assessment of preschool
children should view the child as a whole and include a
thorough consideration of other areas of functioning.
The dynamic, complex nature of language and the variabil-
ity in the timing of its acquisition poses a number of challenges
for practitioners interested in the assessment of language diffi-
culties in preschool children. The evaluation of children’s
behaviours in relation to typically developing peers of the same
age forms the basis for assessment and requires careful consid-
eration of the context, content and instrumentation. Multi-
method, multi-informant approaches are considered best prac-
tice. Assessment of language skills in preschool children should
involve an evaluation of both expressive and receptive skills,
should include an evaluation of more than one dimension of
language and if possible also include a measure of phonological
short-term memory abilities. There are currently no genetic or
neurobiological markers for language impairment. The search
for early behavioural correlates of language impairment has
proved to be remarkably difficult. Progress in the assessment of
preschool children’s language abilities requires further research
on the genetic, neurobiological and behavioural underpinnings
of language development and language impairments.
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