The oral language skills of young offenders: a pilot invesitgation

Although there is a large body of evidence attesting to the poor social skills of juvenile offenders, few workers have examined the underlying language skills of this population. This pilot study investigated the language skills of a group of young offenders in comparison to non-offending school students. Data were gathered from 15 community-based young offender males, aged between 13 and 21 years (M = 16.5 years, SD = 2.1) from the Victorian southern region Juvenile Justice Units. The comparison group comprised 15 male students, aged between 15 and 17 years (M = I 6.4 years; SD = 0.5 I) from government high schools in south-eastern metropolitan Melbourne. Each participant completed a narrative discourse task and measures of speed of processing, and abstract language. It was hypothesised that the young offender group would perform more poorly on each of the language tasks than the comparison group. Independent t tests (with a modified alpha level to control for family-wise error rates) showed that there were significant differences in the expected direction, on all language measures. Notwithstanding the pilot nature of the investigation, implications of these findings for both further research and intervention/early intervention are described.

The validation of an Australian sign language instrument for outcome measurement of adults in mental health settings

Objective: There are currently no adult mental health outcome measures that have been translated into Australian sign language (Auslan). Without a valid and reliable Auslan outcome measure, empirical research into the efficacy of mental health interventions for sign language users is unattainable. To address this research problem the Outcome Rating Scale (ORS), a measure of general functioning, was translated into Auslan and recorded on to digital video disk for use in clinical settings. The purpose of the present study was therefore to examine the reliability, validity and acceptability of an Auslan version of the ORS (ORS-Auslan).
Method: The ORS-Auslan was administered to 44 deaf people who use Auslan as their first language and who identify as members of a deaf community (termed ‘Deaf’ people) on their first presentation to a mental health or counselling facility and to 55 Deaf people in the general community. The community sample also completed an Auslan version of the Depression Anxiety Stress Scale-21 (DASS-21).
Results: t-Tests indicated significant differences between the mean scores for the clinical and community sample. Internal consistency was acceptable given the low number of items in the ORS-Auslan. Construct validity was established by significant correlations between total scores on the DASS-21-Auslan and ORS-Auslan. Acceptability of ORS-Auslan was evident in the completion rate of 93% compared with 63% for DASS-21-Auslan.
Conclusions: This is the only Auslan outcome measure available that can be used across a wide variety of mental health and clinical settings. The ORS-Auslan provides mental health clinicians with a reliable and valid, brief measure of general functioning that can significantly distinguish between clinical and non-clinical presentations for members of the Deaf community.

Relationship between verbal working memory and the SCAN-C in children with specific language impairment

Purpose: An ongoing concern with the evaluation of auditory processing disorders is the extent that assessment instruments are influenced by higher order cognitive functions. This study examined the relationship between verbal working memory and performance on the Test for Auditory Processing Disorders in Children--Revised (SCAN-C; Keith, 2000b) in children with specific language impairment (SLI) and typically developing (TD) children.

Method: Sixteen children with SLI and 16 TD children ages 8/4 to 11 years participated in the study. The children were presented with the SCAN-C and tests measuring verbal working memory.

Results: Initial comparisons revealed that the SLI group obtained significantly lower scores than the TD group on the SCAN-C. However, after controlling for verbal working memory, significant differences between the 2 groups were no longer observed. Correlational analyses revealed that the composite score from the SCAN-C was related to all tests assessing verbal working memory.

Conclusions: Performance on the SCAN-C may be related to working memory functioning. As a consequence, it is unclear whether difficulty on this task should be viewed as a problem with auditory processing or a problem with verbal working memory.

Improving outcomes of preschool language delay in the community : protocol for the Language for Learning randomised controlled trial

Background

Early language delay is a high-prevalence condition of concern to parents and professionals. It may result in lifelong deficits not only in language function, but also in social, emotional/behavioural, academic and economic well-being. Such delays can lead to considerable costs to the individual, the family and to society more widely. The Language for Learning trial tests a population-based intervention in 4 year olds with measured language delay, to determine (1) if it improves language and associated outcomes at ages 5 and 6 years and (2) its cost-effectiveness for families and the health care system.

Methods/Design

A large-scale randomised trial of a year-long intervention targeting preschoolers with language delay, nested within a well-documented, prospective, population-based cohort of 1464 children in Melbourne, Australia. All children received a 1.25-1.5 hour formal language assessment at their 4th birthday. The 200 children with expressive and/or receptive language scores more than 1.25 standard deviations below the mean were randomised into intervention or ‘usual care’ control arms. The 20-session intervention program comprises 18 one-hour home-based therapeutic sessions in three 6-week blocks, an outcome assessment, and a final feed-back/forward planning session. The therapy utilises a ‘step up-step down’ therapeutic approach depending on the child’s language profile, severity and progress, with standardised, manualised activities covering the four language development domains of: vocabulary and grammar; narrative skills; comprehension monitoring; and phonological awareness/pre-literacy skills. Blinded follow-up assessments at ages 5 and 6 years measure the primary outcome of receptive and expressive language, and secondary outcomes of vocabulary, narrative, and phonological skills.

Discussion

A key strength of this robust study is the implementation of a therapeutic framework that provides a standardised yet tailored approach for each child, with a focus on specific language domains known to be associated with later language and literacy. The trial responds to identified evidence gaps, has outcomes of direct relevance to families and the community, includes a well-developed economic analysis, and has the potential to improve long-term consequences of early language delay within a public health framework.

Assessing health literacy : a new domain for collaboration between language testers and health professionals

Health literacy, defined as an individual's capacity to process health information in order to make appropriate health decisions, is the focus of increasing attention in medical fields due to growing awareness that suboptimal health literacy is associated with poorer health outcomes. To explore this issue, a number of instruments, reported to have high internal consistency and strong correlations with general literacy tests, have been developed. However, their validity as measures of the target construct is seldom explored using multiple sources of evidence. The current study, involving collaboration between health professionals and language specialists, set out to assess the validity of the Rapid Estimate of Adult Literacy in Medicine (REALM), which describes itself as a “reading recognition” test that measures ability to pronounce common medical and lay terms. Drawing on a sample of 310 respondents, including both native and non-native speakers of English, investigations were undertaken to probe the REALM's validity as a measure of understanding the selected terms and to consider associations between scores on this widely used test and those derived from other recognized health literacy tests. Results suggest that the REALM is underrepresenting the health literacy construct and that the test may also be biased against non-native speakers of English. The study points to an expanded role for language testers, working in collaboration with experts from medical disciplines, in developing and evaluating health literacy tools.

Cultural adaptation and validation of the Health Literacy Questionnaire (HLQ): robust nine-dimension Danish language confirmatory factor model

Health literacy is an important construct in population health and healthcare requiring rigorous measurement. The Health Literacy Questionnaire (HLQ), with nine scales, measures a broad perception of health literacy. This study aimed to adapt the HLQ to the Danish setting, and to examine the factor structure, homogeneity, reliability and discriminant validity. The HLQ was adapted using forward-backward translation, consensus conference and cognitive interviews (n = 15). Psychometric properties were examined based on data collected by face-to-face interview (n = 481). Tests included difficulty level, composite scale reliability and confirmatory factor analysis (CFA). Cognitive testing revealed that only minor re-wording was required. The easiest scale to respond to positively was 'Social support for health', and the hardest were 'Navigating the healthcare system' and 'Appraisal of health information'. CFA of the individual scales showed acceptably high loadings (range 0.49-0.93). CFA fit statistics after including correlated residuals were good for seven scales, acceptable for one. Composite reliability and Cronbach's α were >0.8 for all but one scale. A nine-factor CFA model was fitted to items with no cross-loadings or correlated residuals allowed. Given this restricted model, the fit was satisfactory. The HLQ appears robust for its intended application of assessing health literacy in a range of settings. Further work is required to demonstrate sensitivity to measure changes.