LANGUAGE AND LITERACY DISORDERS

TOPIC: Informal assessment of different domains- Tasks and stimuli specific languages for
phonological awareness, orthographic skills, phonological processing, oral language skills etc.

Presented by: SIVASWETHA R(I M.Sc.Speech Language Pathology)

Informal assessments are those spontaneous forms of assessment that can easily be incorporated
in the day-to-day activities and that measure the persons performance and progress. Informal
assessments are content and performance driven.

Examples:

 checklist
 observation
 portfolio
 rating scale
 time sampling
 event sampling
 anecdotal record

Informal assessment cannot completely replace the formal assessment. Need of both, as one

complements the other, in depicting accurate pictures of patients.  We can use either type
(depending on the intended purpose) to improve teaching and learning. The type of assessment
we should use should match the intended purpose of the assessment. For example, if we want to
assess the students’ academic achievement and compare it with other students, then we can use
the formal assessment. If we want to use assessment to monitor students’ progress and help them
maximize their own learning, or use assessment to improve instruction, then we can use the
informal assessment.

Informal assessments are not data driven but rather content and performance driven. For example,
running records are informal assessments because they indicate how well a student is reading a specific
book. Scores such as 10 correct out of 15, percent of words read correctly, and most rubric scores are
given from this type of assessment.
Research from multiple languages has given us insights into the components of literacy and
associated cognitive domains that need to be assessed to gain insights into a child’s literacy
learning difficulties. Literacy and language tests are useful only if they assess skills and
knowledge that are known to be specifically associated with particular writing systems and
languages. Moreover, tests are valuable only if they have been locally standardized.
A framework is described in the box below that draws upon a multi-factorial view of literacy
development, a dimensional view of learning difficulties and the acknowledgement that the cut-
off for diagnosis is externally negotiated based on the local context.
Apart from these theoretical underpinnings, it is also important to recall two trends in diagnosis: the
use of discrepancy criteria is increasingly falling out of favour and the use of a response to intervention
approach is particularly relevant when children have had low opportunity for quality instruction.

A comprehensive assessment of literacy needs to document attainments in component skills such

as:
• Letter knowledge
• Reading accuracy
• Reading speed
• Reading comprehension
• Spelling accuracy
• Rate of writing, and
• Quality of written expression
JESSLINE:
Ideas for assessment of general cognitive and perceptual skills:
General abilities
Culture fair tests are difficult to find. The test with the most widespread use currently is the
Raven’s Progressive Matrices which is a nonverbal test typically used to measure general human
intelligence and abstract reasoning and is regarded as a non-verbal estimate of intelligence from
5 years through elderly.

Speed of processing
This can be done with a collection of tests that time children’s performance, such as visual
search or coding from the Wechsler tests. More specific tests linked to literacy performance
include the rapid automatized naming task and timed tasks of phonological manipulation.

Visual processing
The use of visual processing tasks in literacy assessment is gaining interest for languages with
extensive, visuo-spatially complex symbol sets. There are several ways in which visual
processing has been assessed. One set of tasks targets visual short-term memory, where children
have to recall just shown visuals of different orientations and degree of detail. Another set of
tests assesses visual sequential memory where strings of visuals are shown and children have to
recall the target string from a set of distracter sequences.

Attention
Many children with ADHD read well, though some experience problems of reading
comprehension owing to its working memory and executive demands. However, there is a strong
tendency for dyslexia to co-occur with symptoms of inattention and recent genetic data suggest a
common genetic basis. It follows that it is important to make an assessment of a child’s ability to
control and sustain attention. Ideally, information should be sought from parents and teachers
and in this regard rating scales are popular. The Strengths and Difficulties Questionnaire (SDQ,
Goodman, 1997) includes 5 questions pertaining to attention and can provide a screen for
“hyperactivity” and poor attention. It is also useful to supplement these data with behavioural
observation in the classroom.

Motor coordination
 Developmental coordination disorder (also called dyspraxia) is one of the most common co-
morbid conditions of childhood. In terms of behavioural assessment for a suspected co-morbidity
with specific learning difficulties, it is important to make an assessment of pencil control, quality
of writing and copying skills.
For the older child, producing complex diagrams (e.g., in science) and using scissors and other
tools (e.g., for project work in middle school, in vocational courses that are oriented to fine
motor skills such as carpentry and in design & technology courses) may pose a problem.

Number skills
DSM-5 proposes that dyscalculia be defined as difficulties in production or comprehension of
quantities, numerical symbols, or basic arithmetic operations that are not consistent with the
person's chronological age, educational opportunities, or intellectual abilities. When numeracy is
an issue for a child, it is important to know if their difficulties are associated with number facts
and their manipulation(arithmetic) or with more abstract mathematical thinking. Many children
with dyslexia struggle to learn number facts, especially multiplication tables, but may be good
mathematicians. In contrast, the poor comprehended profile has been reported to be associated
with poor mathematics in the face of well-developed arithmetic skills. It follows that both
aspects of numeracy should be assessed. DSM-5 advocates that multiple sources of information
be used to assess numerical, arithmetic, and arithmetic-related abilities. Where standardized tests
are not available, it is possible to devise short age-appropriate tasks to tap basic arithmetic facts,
simple addition and subtraction and verbally posed mathematical problems for solution.

Anxiety and coping

Many children with specific learning difficulties experience anxiety in the classroom and, for
some, this may contribute to a more general anxiety disorder. Similarly, self-esteem is lowered
as a consequence of literacy problems since these can affect performance in most areas of the
curriculum. The SDQ (Goodman, 1997) is a useful tool for understanding children’s emotional
and behavioural difficulties. This is a 25-item questionnaire covering emotional behavioural
problems, conduct problems, hyperactivity/inattention, issues with relationships especially with
peers and the strength of positive social behaviours. There are translations of this questionnaire
in several languages, and importantly, SDQ is an open access tool.

SRIRAM & AISHWARYA:

PHONOLOGICAL AWARENESS:
Phonological Awareness is an individuals awareness of the phonological structure ,or sound structure
of words. Phonological Awareness includes rhyming recognition ,rhyming production ,word awareness,
syllable awareness, initial sound identification, medial sound identification ,final sound identification ,sound
segmentation ,sound blending. Phonological skills, which involve hearing and manipulating sounds in spoken
language (e.g. phonemes, syllables) are necessary for developing strong word reading skills. Phonological
skills help children understand how letters and letter patterns work to represent language in print. Problems in
developing phonological awareness can contribute to difficulties with fluent word reading, and, in turn, often
cause problems with comprehension.
 Difficulty with phonological skills might become evident in classroom observations or
assessments, even before the start of formal schooling. Children might display difficulty with:

 noticing rhymes, alliteration, or repetition of sounds

 remembering how to pronounce new words or names; distinguishing difference(s) in
similar sounding words
 clapping out syllables or separating a compound word
 identifying the first sound in a word or separating a word into its individual sounds
 adding, subtracting, or substituting single sounds within a word (Understood.org; Ehri et
al., 2001)
 recognizing and producing the correct sound for phonics/spelling patterns, even after
practicing with them
 decoding new words
 after sounding out a word correctly, blending those sounds back together to read the word
 remembering and automatically recognizing words, even after repeated opportunities to
practice reading them (Kilpatrick, 2015)

Tasks for phonological awareness:

Sound Comparison

Sound comparison tasks use a number of different formats that all require children to make
comparisons between the sounds in different words. For example, a child might be asked to
indicate which word (of several) begins or ends with the same sound as a target word (e.g.,
“Which word begins with the same first sound as cat— boy, cake, or fan?”).

Additionally, tasks that require children to generate words that have the same first or last sound
as a target word would fall in this category. Sound comparison tasks are particularly appropriate
for kindergarten-age children, as they do not require as fully explicit knowledge of phonemes as
tasks that require children to pronounce or manipulate individual phonemes.

Phoneme Segmentation

Phoneme segmentation tasks require a relatively explicit level of awareness of phonemes

because they involve counting, pronouncing, deleting, adding, or reversing the individual
phonemes in words. Common examples of this type of task require pronouncing the individual
phonemes in words (“Say the sounds in cat one at a time.”), deleting sounds from words (“Say
card without saying the /d/ sound.”), or counting sounds (“Put one marker on the line for each
sound you hear in the word fast.”).

Phoneme Blending
Phoneme blending skill has only been measured by one kind of task. This is the sound blending
task in which the tester pronounces a series of phonemes in isolation and asks the child to blend
them together to form a word (e.g., “What word do these sounds make /f/ - /a/ - /t/?”). Easier
variants of the sound-blending task can be produced by allowing the child to choose from two or
three pictures the word that is represented by a series of phonemes.

An important point about these different kinds of tasks is that they all appear to be measuring
essentially the same construct, or ability. Although some research (Yopp, 1988) has indicated that the
tasks may vary in the complexity of their overall intellectual requirements, and there may be some
differences between segmentation and blending tasks at certain ages (Wagner, Torgesen, & Rashotte,
1994), for the most part, they all seem to be measuring different levels of growth in the same general
ability (Hoien, et al., 1995; Stanovich, Cunningham, & Cramer, 1984). Sound comparison measures are
easier and are sensitive to emergent levels of phonological awareness, while segmentation and blending
measures are sensitive to differences among children during later stages of development involving
refinements in explicit levels of awareness. Measures of sensitivity to rhyme (which word rhymes with
cat—leg or mat?) are not included among measures of phonemic awareness because they appear to be
measuring something a little different, and less predictive of reading disabilities, than those measures
that ask children to attend to individual phonemes. For the same reason, measures of syllable awareness
are not included in this group.

Segmentation of Phonemes

Sample item: “I’m going to say a word, and then I’ll say each sound in the word. Listen
carefully. Cat. (Say the individual sounds, pausing slightly between each one./c - a - t/.)

“Tell me each sound in off.”

The child receives credit if all sounds are given in the proper order. There are ten items.
Isolation Blending

Sample item: “I’m going to say a word, and I want you to tell me the beginning or first sound in
the word. What’s the beginning sound in the word cat?” /k/

Deletion

Sample item: “I’m going to ask you to say a word and then to say it again without one of its
sounds. Say cat.” (Student says cat.) “Now say it again, but don’t say /k/.” (at)

Substitution

Sample item: The first part of this subtest requires the use of colored blocks to show the different
sounds in words. The examiner says, “I’m going to show you how to make the word fun with
these blocks. Each block is one sound of the word.” The examiner illustrates the relationship
between blocks and sounds by teaching each block while saying /f/ - /u/ - /n/.
The examiner then says, “Now, watch how I change fun to run.” This change is illustrated by
replacing the first block with a different colored block. “Now it says run.” There are ten test
items that require children to show which sounds have changed on examples like map to mop, or
tip to tick.

The examiner asks the child to change a given sound, /p/, in a word like paint, to another sound, /f/, to
produce another word (faint). Another example would be, “Say cow, now change /k/ to /h/.” (How).
Blending:

Sample item: “I’ll say the sounds of a word. You guess what the word is. What word is this?”
Then the phonemes /p/ - /o/ - /p/ is pronounced at one per second. The child must pronounce the
word correctly in order to receive credit.

KAVYA & PRANAV:

PHONOLOGY PROCESSING:
Phonological Processing
Phonological processing is the use of the sounds of one's language (i.e., phonemes) to process
spoken and written language (Wagner & Torgesen, 1987).The broad category of phonological
processing includes phonological awareness, phonological working memory, and phonological
retrieval.
All three components of phonological processing are important for speech production as well as
the development of spoken and written language skills. Therefore, it is important and necessary
to monitor the spoken and written language development of children with phonological
processing difficulties.

Phonological Awareness:
Phonological awareness is the awareness of the sound structure of a language and the ability to
consciously analyze and manipulate this structure via a range of tasks, such as speech sound
segmentation and blending at the word, onset-rime, syllable, and phonemic levels. Phonological
awareness is the umbrella term; phonemic awareness applies when the units being manipulated
are phonemes, rather than words, onset-rime segments, or syllables.

Phonological Working Memory:

Phonological working memory involves storing phoneme information in a temporary, short-term
memory store (Wagner & Torgesen, 1987). This phonemic information is then readily available
for manipulation during phonological awareness tasks. Nonword repetition (e.g., repeat /pæg/) is
one example of a phonological working memory task.
Phonological working memory' is responsible for mentally holding and manipulating acoustic
and speech-based information. Phonological working memory is assessed using 'digit span', 'digit
span-running', and 'nonword repetition' tasks. The 'digit span' task requires children to repeat lists
that vary in length from 2-8 digits. This task is presented to children in the context of playing a
copycat game with a robot. The child repeats what the robot says, trying to remember as many
digits in the sequence as possible. The 'digit span-running' task is presented in the context of
playing a copycat game with sea monsters who read lists of numbers 7-10 digits in length;
however, children do not know how many digits will be presented in a list. When the list is
completed, the child is prompted to recall as many digits as possible, in forward order, from the
end of the list. In the 'nonword repetition' task, children repeat novel words (e.g., 'genfad' and
'yitvodgoom'), which help the pirate build a candy bridge over a river.

Phonological Retrieval:
Phonological retrieval is the ability to recall the phonemes associated with specific graphemes,
which can be assessed by rapid naming tasks (e.g., rapid naming of letters and numbers). This
ability to recall the speech sounds in one's language is also integral to phonological awareness.

Most students with LLD do not make a large number of phonological errors. Some distort a few
sounds or retain one or two phonological simplification processes. When this is the case,
procedures discussed for the developing language stage can be used to assess these problems. If
obvious phonological errors are not evident, though, we may want to know how phonologically
“robust” the child’s system is. Researchers such as Catts (1986); Dollaghan and Campbell
(1998); and Graf Estes, Evans, and Else-Quest (2007) have shown that children with LLD often
have trouble with phonologically demanding tasks, such as producing complex, unfamiliar words
and phrases, even when their conversational speech is not full of errors. Such vulnerability may
indicate problems with phonological awareness as well, as Webster and Plante (1992) suggested.
Phonological awareness, as we’ve seen, is important for literacy acquisition. So, part of the oral
language assessment of a child with or at risk for LLD, particularly a child in the primary grades
or one who is reading on a primary-grade level, should include some index of these higher-level
phonological skills that serve as the foundation for learning to read.

There are several ways to approach this assessment:

FIRST:
The first is to look at production skills in phonologically demanding contexts. Hodson’s (1986)
Multisyllabic Screening Protocol section of the Assessment of Phonological Processes—Revised
can be used to measure this aspect of phonological skill. Many standardized tests of phonological
awareness also contain subtests that use non-word repetition tasks, since these have been shown
to be markers of language impairment (Dollaghan & Campbell, 1998; Graf-Estes et al., 2007),
and provide standardized scores. The Comprehensive Test of Phonological Processing (Wagner,
Torgeson, & Rashotte, 2000) and the Children’s Test of Nonword Repetition (Gathercole
& Baddeley, 1996) are two examples.

SECOND:
A second way to look at higher level phonological skills in students with LLD is to examine
phonological awareness directly.

THIRD:
A third approach to assessing higher-level phonological impairments was suggested by the work
of Catts, Fey, Zhang, and Tomblin (2002); Powell, Stainthorp, Stuart, Garwood, and Quinlan,
(2007); and Swank (1994), who advocate assessment of rapid automatized naming (RAN).
Bowers and Grieg (2003), Brizzolara et al. (2006), and Wolf et al. (2002) have reviewed
evidence showing that RAN, like phonological awareness, is also highly correlated with reading
ability.
In RAN tasks students are asked to name common objects presented in a series as rapidly as they
can. Children also can be asked to produce overlearned series such as days of the week or
months of the year.
Performance on tasks such as these has been shown to discriminate between good and poor
readers. Some standardized tests, such as the Clinical Evaluation of Language Fundamentals—4
(Semel, Wiig, & Secord, 2003), contain sub-tests that tap this ability.

For older students already known to have reading deficits, phonological assessment is less
important, and evaluation of other areas of oral language needed to support reading should be
focussed.

Once basic phoneme segmentation, sound blending, and letter-sound correspondence have been
mastered, we should move on to building other aspects of oral language skill to support reading
development, such as vocabulary, fluency, text comprehension, and literate language production,
rather than continuing to teach more and more advanced phonological awareness skills.

SRINIDHI & AKSHAYA:

Informal Observations to assess Orthographic Knowledge

Observe students reading:

Orthographic reading skills refer to the ability to identify patterns of specific lettera as words
,eventually leading to word recognition .With the development of these skills ,reading becomes
an automatic process.

Students’ reading and spelling are related (Ehri, 1997; Henderson, 1990), but are not mirror
images because the processes differ slightly. In reading, words can be recognized with many
types of textual supports, so the ability to read words correctly lies a little ahead of students’
spelling accuracy (Bear & Templeton, 2000).
For example, within word pattern spellers, who are also transitional readers, may read many two-
syllable words like shopping and cattle correctly, but might spell those same words as shoping
and catel. Spelling is a conservative measure of what students know about words in general. If
students can spell a word, then we know they can read the word. It seldom works the other way
around except in the very early stages, when students might generate spellings they don’t know
how to read (Rayner, Foorman, Perfetti, Pesetsky, & Seidenburg, 2001). When students consult
reference materials such as a spell checker or dictionary, the spelling task becomes a reading
task; we all know the phenomenon of being able to recognize the correct spelling if
we just see it.

Observe students writing

Teachers have daily opportunities to observe students as they write for a variety of purposes.
These observations help to reveal what students understand about words.
The following example demonstrates what you might learn about a kindergartner’s
literacy development. Sarah called this her “first restaurant review.” Although it
appears to be a menu, she posted it on the wall the way she had seen reviews posted
in restaurants.

What Sarah Wrote How She Read What She Wrote

1. CRS KAM SAS First course, clam sauce
2. CRS FESH Second course, fish
3. CRS SAGATE Third course, spaghetti
4. CRS POSH POPS Fourth course, Push Pops

This writing tells a lot about Sarah: She sees a practical use for writing and she enjoys
displaying her work. She has a good grasp of how to compose a list and she is even
beginning to understand menu planning! When we look for what Sarah knows about spelling, we
see that she represents many consonant sounds and some digraphs (the sh in fish and push), but
blends are incomplete (as in kam for clam). She has placed a vowel in all but one syllable;
however, she is using but confusing short vowels. In spelling fish as fesh, Sarah uses a vowel, but
she confuses e and i. In the word course, spelled as crs, the letter r represents the /r/ and the
vowel sound.

VASUDHARANY & NACHAMMAI:

Assessment guidelines for Oral language skills:

Teachers will listen to each child in the classroom during informal interactions to determine
which children are using oral language flexibly and readily to understand and express conceptual
meanings with others in the classroom.
Children not exhibiting strong oral language skills should be assessed individually. The
assessment area should be quiet and free from major distraction. Generally, a small table where
the teacher can sit beside the child is sufficient.

Procedure
1. Show all the picture cards to the child and allow her or him to select one. Do not discuss the
pictures during this preview.
2. Place the chosen picture on the table in front of the child and say, Tell me a story about the
picture. Transcribe the child’s entire response. You may prompt the child by saying, Tell me
more, or What else can you say? Do not ask leading questions.
3. Score the completed transcription using the rubric. For the syntax rubric, you may use the
child’s typical speech to assess use of regular and irregular verbs and regular and irregular
plurals, if necessary. Write the scores on the paper with the script. Add the child’s name and
date of assessment to the scored script, and place it in the child’s portfolio. Enter each of the
three scores on the student record sheet.
4. Repeat the assessment during kindergarten and first grade as appropriate until the child obtains
a score of three, indicating typical performance, on each element of the rubric.
 Additional Oral Language Sample
If an additional language sample is indicated when a student’s performance lacks consistency
with observed classroom behaviours, consider taping an oral language sample without a specific
picture prompt. Choose a topic the child has expressed interest in, and provide an open-ended
prompt; i.e., “Sintenesha, tell me about your birthday party.” Using the rubric supplied, score the
child’s recorded response.

Tasks for oral language skills:

Syntax awareness: The primary task will be assessing the child’s vocabulary, grammar, memory,
reading ability.
Grammatical correction:
This comprises of tasks such as
i) Subject - speech verb agreement eg; The baby are sick
ii) Subject – verb agreement eg; The girls climbs the tree
iii) Tense – agreement eg; Yesterday, John learn his spellings
Word order correction:
i) With semantically reversible sentences eg; the donkeys the horse race
ii) Semantically unstrained sentences eg; the girl the kitten bushes
Derivational Morphology
Fix It and Fill It In
Instructions: Change the word to fill in the blank and make grammatically correct sentences.
The ________ was very talented. (Paint)
That is a ______ orange. (Juicy)
He has a college ______. (Educate)
The ________ sketched a picture. (Art)

Derivational Morphology Activity 2:

Morph It
Instructions: Given a base word, “morph” the word into as many word forms as possible using
previously taught prefixes and suffixes. Label each word according to its part of speech.

Wor Noun: Verb: Adjective: Adverb:

d
Heat Heater Preheat Heated Heatedly
Reheat
Appl
y

Derivational Morphology Activity 3:

All in the Family Word Sort (Adapted from Wasowicz, Apel, Masterson & Whitney, (2012).
SPELL-links to reading and writing: A word study curriculum (2nd ed.). Evanston, IL: Learning
By Design.
Instructions: Just like family members, words can look alike or different and be related or
unrelated. Sort these words according to their “relationships.”

Words Can Look or Sound Alike and Be Related (family members):

swim – swimming
slip – slipped

Words Can Look or Sound Different and Be Related (family members):

divide – division
explode –explosion

Words Can Look or Sound Alike but NOT Be Related (friends)

car-carrot
luck-cluck

Word-Building:
Compound Creation
Instructions: Use the parts of the following compound words to create your own unique words
(e.g., a “cowsuit” would allow you to dress up like a cow).
side walk
fire fighter
lawn mower
space suit
cow boy

Build a Word
Instructions: Create your own word using Greek and Latin roots and affixes. Take a prefix, base
word and suffix from the following lists and put them together to make a new word. Explain
what your word means (e.g., “antimotology” might be the study of why people don’t move or
run).
(text in bold) (text in italics) (underlined text)

anti-(against) -ped (to walk) -ology (study of)

un- (not) -act- (to do) -ion (state of being)

re- (repeat) -mot- (to move) -ness (state of being)

SNOWFY & KAVYASHREE:
Auditory processing and the development of language and literacy
A study done by Peter J Bailey and Margaret J Snowling concludes that

• Advances in the understanding of the role of auditory processing in the genesis of language
difficulties have been hampered theoretically by a lack of agreement about the relationship
between basic auditory skills, speech perception and phonological processing abilities, and also
methodologically by frequent uncontrolled group differences in experimental studies.

• It should be clear from this review that by no means all children with language learning
impairments demonstrate non-verbal auditory processing problems. It has been suggested that,
where present, auditory processing deficits may be a ‘synergistic risk factor’ for language
impairment, that exerts a moderating influence when children are already at genetic risk of
language disorder, but they are neither necessary nor sufficient to explain language difficulties.

• Children with oral language impairments require comprehensive assessment of their cognitive
strengths and difficulties to specify more accurately the nature of their difficulties. It is
premature given the present state of knowledge to advocate training in auditory skills for these
children. While this might bring about some benefit for their auditory attention and listening
skills, the large-scale adoption of such training programmes is counter-indicated until the causal
relationships among auditory, phonological and language impairments are clarified.

• Children with oral language impairments beyond the pre-school years require intensive
programmes of speech and language therapy and there is good evidence of the benefits of
phonological awareness training for dyslexia.

Another study by Melanie A. Ferguson titled Communication, Listening, Cognitive and

Speech Perception Skills in Children with Auditory Processing Disorder (APD) or Specific
Language Impairment (SLI) was done to identify whether there were differences between
these characteristics in children with SLI or APD resulted that there was generally no difference
between the performance of the children with SLI and the children with APD on the
questionnaire and test measures, and both groups consistently and significantly underperformed
compared with the children in the MS group. Speech intelligibility in both noise and quiet was
unimpaired in the SLI and APD groups.

REFERENCES:

 Nag, S., & Snowling, M. J. (2012). School underachievement and specific learning
difficulties. IACAPAP e-textbook of child and adolescent mental health. Geneva:
International Association for Child and Adolescent Psychiatry and Allied Professions.
 Chapter 11 &13: Paul, R. & Norbury, C. (2012). Language disorders from infancy
through adolescence: Listening, speaking, reading, writing, and communicating (4th
Ed.). St. Louis, MO: Elsevier.
 Phonological Awareness Informal Assessment for school-aged children Designed by:
Care & Learning Service – Speech and Language Therapy: January 2016
 Oral Language- MLPP Second Edition/2000
 Getting Started- Assessment of Orthographic Development
 Peter J Bailey, Margaret J Snowling, Auditory processing and the development of
language and literacy, British Medical Bulletin, Volume 63, Issue 1, October 2002, Pages
135–146, https://doi.org/10.1093/bmb/63.1.135
 Ferguson, Melanie & Hall, Rebecca & Riley, Alison & Moore, David. (2011).
Communication, Listening, Cognitive and Speech Perception Skills in Children with
Auditory Processing Disorder (APD) or Specific Language Impairment (SLI). Journal of
speech, language, and hearing research: JSLHR. 54. 211-27. 10.1044/1092-
4388(2010/09-0167).