Using the Spanish Battelle Developmental Inventory-2: A case for clinical judgement

This presentation describes the limitations of the Spanish Edition of the BDI-2, as well as the appropriate use of test norms. It identifies how language differences affect test results and describes how cultural differences can influence test results. Methods for supplemental or alternative assessments are also addressed.

1. TSHA Convention
March 7, 2013
Dallas, Texas
Ellen Kester, Ph.D., CCC-SLP
Keith R. Lebel, M.A., CCC-SLP

2. Disclosure Statement
Relevant financial relationship(s), no relevant
nonfinancial relationship(s)
•I have thefollowing relevant financial
relationship(s) in the products or services described,
reviewed, evaluated or compared in this
presentation. SMILE for Young Children is
mentioned as a resource. The authors are
employees of Bilinguistics. Bilinguistics receives
royalties on sales of SMILE.
•I have no relevant nonfinancial relationship(s)to
disclose.

3. Texas ECI Demographics
Percent
Hispanic/Latino
White
Black/African American
Asian/Pacific Islander
American
Indian/Alaskan

4. Learner Objectives
•Describe the limitations of the Spanish Edition
of the BDI-2
•Describe the appropriate use of test norms
•Identify how language differences affect test
results
•Describe how cultural differences can influence
test results
•Describe methods for supplemental or
alternative assessments

5. What is the BDI-2?
•Comprehensive measurement of all
developmental areas (5 domains, 13
subdomains)
•Variety of administration options: structured,
observation, interview
•Multiple point scoring-helps identify emerging
skills
•Based on developmental milestones
•Used by all ECI programs in Texas since Sept
2011

6. BDI-2 Domains
•Personal-Social
•Adaptive
•Motor
•Communication
•Cognitive

7. Standardization Sample
•Nationally representative norm sample
-n= 2500
-ages birth to 7 years, 11 months
•Sample closely matches the percentages for variables
identified in the US Census Bureau 2001 publications
-age
-sex
-race/ethnicity
-geographic region
-socioeconomic level

8. Spanish Translation
•Provides an adaptation/translation of all spoken
text
•Item books, instructions, and some stimulus
materials available on CD (for printing by
examiner)
•Provides Spanish Record Forms (Full, Screening,
Electronic)
•Requires English test kit materials and manual
•Allows an estimate of abilities combining English
and Spanish (only if using software option)

9. The Spanish version of the BDI-2 is
not normed.
•Keen clinical judgment is necessary
•While many motor skills and daily living skills
are not influenced by language, communication
skills are obviously strongly affected.
•Norms do not transfer from one language to the
other.
•Understanding the building blocks for speech
and language that are similar across languages is
essential.

10. Basal and Ceiling Rules across two
test versions
•In order for basal and ceiling rules to work,
items have to be ordered by level of difficulty
from easiest to hardest.
•When a test is translated, item difficulty levels
are not the same.
•When using a translated version of a test, test
below the basal and above the ceiling.

11. Understanding Linguistic and
Cultural Differences

12. Informed Clinical Opinion
•Per DARS ECI, “Teams must use Informed Clinical
Opinion when a child qualifies under developmental
delay.”
•This can apply to:
▫an individual test item
▫interpretation of test scores
▫determining the adequacy of testing tool (i.e., the BDI-2)
▫when reviewing results
▫when making a qualitative determination of
developmental delay

13. Linguistic Differences–
Communication Domain
•RC 14
▫English: Responds to the prepositions “out”and
“on.”
▫Spanish: Responde a las palabras “fuera”y
“sobre.”
•These prepositions are similar in meaning,
though they do not have a one-to-one
correspondence across languages and therefore
likely differ in their level of difficulty.

14. Linguistic Differences–
Communication Domain
•RC 17
▫English: Understands the possessive form ’s.
Baby’s mommy. Daddy’s boy.
▫Spanish: Entiendelasformasdel posesivo.
El bebéde la mamá. El hijodel papá.
•In English this deals with morphology and in
Spanish it deals with syntax. It cannot be
assumed that these will follow the same
developmental sequence.

15. Linguistic Differences–
Communication Domain
•RC 28
▫English: Understands irregular plural forms.
▫Spanish: Usa el plural.
•There are no irregular plurals in Spanish. This is
a much more challenging item in English than it
is in Spanish but the use of basal and ceiling
rules that are based on English assumes the
same level of difficulty.

16. Linguistic Differences–
Communication Domain
•EC 17
▫English: Uses three-word phrases meaningfully.
▫Spanish: Usa frases coerentes de 3 palabras.
•Children can express something that is at the
same level of complexity with fewer words in
Spanish than in English.
▫“I want cookie.”= “Quiero galleta.”
▫“Pick me up.”= “Recójame”
▫“Give to me.”= “Dame”

17. Linguistic Differences–
Communication Domain
•EC 19
▫English: Uses the pronouns I, you, and me.
▫Spanish: Usalos pronombres, yo, me, mi, tú, te, ti
•The requirement is that each of them is used on
a daily basis. The Spanish pronouns “me”and
“te”are more complex pronouns that those
tested in English. Additionally, pronouns are
used with less frequency in Spanish than in
English. Thus, this item would be more difficult
for Spanish speakers.

18. Linguistic Differences–
Communication Domain
•EC 25
▫English: Uses the articles theand a.
▫Spanish: Usa los artículos el, la, un, and una.
•In Spanish the article system is more complex
because it includes gender, which does not exist
with the same complexity in English. Instead of
two articles, Spanish has six (un, el, los, una, la,
las). The Spanish translation focuses on the four
singular articles.

19. Linguistic Differences–
Communication Domain
•EC 27
▫English: Uses plural forms ending in /s/ and /z/.
▫Spanish: Usa las terminaciones plurales.
•In English this tests two plural forms ending
with /s/ and two endings with /z/. In Spanish
this difference would be /s/ and /es/. The
Spanish item tests three /s/ and one /es/. In
English the number of syllables in the word
remains the same, while in Spanish the number
of syllables increases when /es/ is required.

20. Linguistic Differences–
Communication Domain
•EC 29
▫English: Repeats familiar words with clear
articulation.
▫Spanish: Repite palabras conocidas articulando
claramente.
•The sound inventories of the languages are not
equally represented. There are no final
consonants evaluated in Spanish but there are 6
in English. There are fewer final consonants in
Spanish than in English but they do exist.

21. Linguistic Differences–
Communication Domain
•EC 29
▫English: Repeats familiar words with clear
articulation.
▫Spanish: Repite palabras conocidas articulando
claramente.
•The sound inventories of the languages are not
equally represented. There are no final
consonants evaluated in Spanish but there are 6
in English. There are fewer final consonants in
Spanish than in English but they do exist.

22. Considering Culture
•Culture can influence performance on test items
•Understand how culture can affect responses
•Incorporate cultural variation into your
Informed Clinical Opinion

23. Cultural Considerations
Receptive Communication 32
▫Recalls events from a story presented orally.
En la mesa habíahuevos, pan tostado y jugode
naranja.

24. Cultural Considerations
Expressive Communication 30
▫Follows conventional rules of conversation.

25. Cultural Considerations
•Self Care 13, 15 & 16
▫Child uses a spoon or other utensil to feed himself.
▫Child feeds himself with a utensil without
assistance.
▫Child drinks from a cup (not sippycup) without
assistance.

26. Cultural Considerations
•Self Care 22 & 25
▫Child asks for food at the table.
▫Child obtains a drink from a tap without
assistance.

27. Cultural Considerations
Adult Interaction 5, 15, 17
▫Child explores adult facial features
▫Child helps with simple household tasks.
▫Child greets familiar adults spontaneously

28. Cultural Considerations
Reasoning and Academic Skills 4, 9 & 10
▫Child shows interest in books
▫Child names the colors red, green and blue
▫Child identifies to sources of common actions
What barks?/Quiénladra?

29. Determine Percent Delay
▫Adaptive
▫Personal-Social
▫Communication
▫Gross motor
▫Fine Motor
▫Cognitive
If the child is from a bilingual environment consider
the items carefully and use your informed clinical
opinion on each item. If you calculate a percent delay
based on test results, know that they might provide a
guideline but could misrepresent the child’s abilities.

30. Requirement
•If the child is from a bilingual environment and
communication is the only area of concern,
additional information is necessary.

31. Four Possibilities after BDI-2
Administration
BDI ✗
C. J. ✔
BDI ✗
C. J. ✗
BDI ✔
C. J. ✔
BDI ✔
C. J. ✗
Eligible
Not
Eligible
C. J. =
Clinical Judgment

32. Language samples in all languages
Inside HELP
PLS-4-Spanish or PLS-5-Spanish and English
Use intelligibility guidelines
Other resources about bilingualism

33. Language Samples
•Conversational
•Story telling
•Story retelling
•Interactive book reading

34. Analyzing Language Samples
•Transcribe online or record
•Identify errors
•Classify the errors

35. Differencevs. Disorder
TYPICAL
DEVELOPMENTAL
ERRORS
SECOND-
LANGUAGE
INFLUENCE
ATYPICAL
ERRORS

36. Inside HELP
•Identifying and Interpreting Needs for
Intervention
▫Poor oral motor skills
▫Auditory processing difficulties
▫Oral motor planning difficulties
▫Hearing impairment
▫Other causes of differences not indicative of
disabilities
Cultural/dialectal differences
Different speech models

37. Highlights from Inside HELP
•Speech production
▫Consider vowel productions –frequent vowel
distortions are not typical
▫Omission of word-initial sounds is not typical
▫35+ months: 80% intelligible

38. PLS-4-Spanish
•Norm-referenced
•Normed on Spanish-speaking children in in the
U.S.
•Separate versions for Spanish and English

39. PLS-5-Spanish and English
•Norm-referenced
•Normed on children from Spanish-speaking
homes in the United States
•Uses conceptual scoring
▫Items are administered in Spanish
▫If missed, items are administered in English
▫Allows for different knowledge/vocabulary in two
languages

40. •For parents: (Lynch, Brookshire & Fox, 1980)
▫18 months -~25% intelligible
▫2 year olds -50-75% intelligible
▫3 year olds -75%-100% intelligible
•For unfamiliar: (Flipsen, 2006)
▫18 months -~25% intelligible
▫2 year olds -~50% intelligible
▫3 year olds -~75% intelligible
▫4 year olds -100% intelligible

41. Additional Resources
•http://speechpathologyceus.net/cld-resource-
library/
Link to Live Site

42. •Difficulty learning both languages,
even with adult assistance
•Difficulty producing sounds in both languages
•Family history of language/learning disabilities
•Slower development than siblings
•Difficulty interacting with peers
•Inappropriate pragmatic/social language skills (i.e., turn-
taking, topic maintenance, considering listener needs,
non-verbal communication)
•Difficulty with language in many routines
•Idiosyncratic error patterns
•Speech and language performance unlike others with
similar cultural/linguistic experiences

43. More Resources on Bilingualism
•The International Guide to Speech Acquisition
▫McLeod, S. (2007). Thomson Delmar Learning.
•Developmental Milestones in the back of SMILE
for Young Children (2012).
www.bilinguistics.com

44. Case Study
•Child –Juan Diego
•Age 2 years, 6 months
•Language background
▫Father speaks mostly Spanish, some English
▫Mother is fluent in both English and Spanish
▫Two older siblings are fluent in both
▫In the home Spanish is the primary language.
▫Juan Diego stays home with his mother who
speaks Spanish 90% of the time with him.

45. Juan Diego Case Study Continued
•BDI is administered in Spanish
•Per publisher directions, English norms are
referenced
•You (savvy ECI person), know the norms are not
a good representation of Juan Diego because:
▫The test you administered was not normed.
▫You did not use basal and ceiling rules.
•The child did well in all areas except
communication and you are on the fence about
whether his communication skills are delayed.

46. Juan Diego-Additional Information
•Speech sample during play
▫Utterance English Translation
▫Atos (zapatos) shoes
▫a-eta (galleta) cookie
▫o-o-a (pelota) ball
▫Un o-ito (un osito) a bear
▫Ete niña (este niña)this girl
▫Iya oto (mira oso) mira, bear
•Intelligibility rating
▫Mom understands approximately 50%
▫Unfamiliar people understand roughly 25%

47. Juan Diego-Additional Information
•Language sample using wordless picture book
▫Utterance English Translation
▫Guau guau dog
▫Dis this (?)
▫Una ana (rana) a frog
▫X [unintelligible]
▫Una ana (rana) a frog
▫Ete (este), mio this, mine
▫Una on a X
▫Iño (niño) boy
▫Ayó (cayó) fell down
▫Ete, oyos. This, X
▫I (si) Yes

48. Assessment
•Language
▫PLS-4-Spanish score was 85 (low average)
▫Language sample indicated below average
•Speech
▫Inside HELP indicates that initial consonants are
not typically omitted
▫Intelligibility is lower than it should be.
▫Child omits 2+ consonants in 3-syllable words
▫Child gets frustrated when not understood
•Eligibility: Delayed speech development
▫Enroll and re-evaluate in 6 months

49. References
Determining Eligibility. (n.d.). Retrieved August 9, 2012 from
http://www.dars.state.tx.us/ecis/eligibility.shtml#eligibility
Battelle Developmental Inventory, Second Edition (BDI-2). (2005). Riverside Publishing: Illinois.
Goldstein, B. (2011, ed.), Bilingual language developmentand disorders in Spanish-English speakers
(2nd ed.). Baltimore, MD: Brookes Publishing.
Hofstede, Geert (2001). Culture consequences (2nd ed.). London: Sage.
Iglesias, A. (2002). Latino Culture. In D. Battle (Ed.), Communication disorders in multicultural
populations (p. 179-202). Boston: Butterworth-Heinemann.
Langdon, H.W.. (2008) Assessment and intervention for communication disorders in culturally and
linguistically diverse populations . Book. Clifton, NY: Cengage, (2008).
Kester, E. S. & Peña, E. D. (2002). Language ability assessment of Spanish-English bilinguals: Future
directions. Practical Assessment, Research, and Evaluation, 8, 4.

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