Unlock the Power of Rating Scales in Your SLP Evaluations: Part 1 - Value and Use

They can offer invaluable perspectives from parents, teachers, and even the students themselves, giving you a much richer and more comprehensive understanding of their communication skills across different environments. Let's dive into why these tools are so powerful and how you can effectively use them!

Why Rating Scales are Your Secret Weapon

Rating Scales bridge this gap, providing insights into real-world communication in various contexts. They're especially golden for those communication skills (or deficits) that might not always shine through during formal testing - and you get it without overwhelming the student with lengthy testing. This is where your experience as an SLP moves beyond giving a rote test.

Questionnaires/Rating Scales can be used to:

• Guide an evaluation or demonstrate the need for an evaluation
• Generate a discussion about speech/language skills
• Develop child-centered, functional goals
• Track progress over time
• Identify areas of most need
• Provide insight on communication in different environments

Important Note: Rating Scales should NOT be used as the sole diagnostic tool for speech or language disorders. However, they can easily demonstrate the need for related services.

Choosing Wisely (or Creating Your Own Magic!)

Selecting the right questionnaire is key, and of course, age-appropriateness is the name of the game. While finding that perfect age-specific tool can sometimes feel like searching for a unicorn, don't despair! Even broader questionnaires can be helpful in painting a picture of the "end goal" and where our students currently stand in relation to it.  "Questionnaire" is an umbrella term that usually signifies open-ended questions, but rating scales are super useful because the response forms are limited, and therefore easier to compare.

For example, with stuttering, a student's feelings about their speech can be the crucial factor that differentiates a mild presentation from one perceived as moderate or even severe. It can also highlight students who, despite ongoing stuttering, feel they've gained the necessary tools from therapy versus those whose negative attitudes indicate a need for more intensive intervention. 

I even have specific versions for articulation and fluency to tap into these nuanced self-perceptions in different areas of communication. This self-awareness piece is so vital and can significantly inform your clinical decision-making.  I've also thrown in a short, 10 question check-in scale for both articulation and fluency, for more frequent use.

And don't underestimate the power of adapting existing rating scales, or turning a questionnaire with open-ended questions into a rating scale! Take something like Orion's Pragmatic Language Skills Questionnaire – a simple tweak of adding "as compared to peers" to the questions can make it even more relevant and help raters focus on those crucial peer comparisons.

• Look at existing questionnaires, developmental milestones, or curriculum standards to get a feel for the skills and areas typically covered.
• Keep your rating scales concise – no more than four levels is usually best.
• Frame your rating scale in terms of 'level of concern' (rather than 'always/never') to encourage direct peer comparison.
• Ensure your top ratings reflect typical peer performance, not perfection.
• Maintain consistency in your chosen scale (e.g., 0 = no concern, 4 = high concern).
• Ensure all questions are easily understood by parents and teachers.

Finally, a quick but crucial note on published questionnaires: always double-check if they are free to reproduce, or make sure you purchase the rights to use them. We want to be ethical SLPs!

Handling the "Not Applicable" Headscratcher

We've all been there – a question on a questionnaire that just doesn't fit the context. If you allow for a "Not Applicable" response (which I highly recommend!), here's my simple approach: if a respondent marks a question as not applicable, I simply adjust the total number of rated items. For example, if there are ten questions and one is marked "N/A," I calculate the overall score based on the remaining nine. Easy peasy!

Keeping It Peer-Focused

Finally, when you're asking respondents to rate a child's skills, it's so important to emphasize the "compared to peers" perspective. Make sure your instructions clearly state that they should be thinking about how the child's communication skills stack up against those of their same-age peers. This helps to provide a more meaningful and relevant comparison.

Stay tuned for Part Two, where we'll dive into how to effectively present and interpret the valuable data you gather from questionnaires in your reports!

To get you started, here are a few links to freely available questionnaires and rating scales that you might find useful in your evaluations:

1. Orion's Pragmatic Language Skills Questionnaire (PDF): This is a widely shared questionnaire for screening pragmatic language abilities. I've made it into a fillable form for free on my TeachersPayTeachers store.

2. Early Childhood Speech and Language Assessment - Speech and Language Assessment Scale (PhenX Toolkit): Find it at https://www.phenxtoolkit.org/protocols/view/200302. The PhenX Toolkit offers various measurement protocols, including this one for early language.

3. Intelligibility in Context Scale (ICS) (PDF): Accessible via https://cdn.csu.edu.au/__data/assets/pdf_file/0010/399970/ICS-English.pdf. This parent-report scale helps understand a child's speech clarity in different situations.

4. Speech Assessment and Analysis in Conversation (SPAAC): Located at https://www.csu.edu.au/research/multilingual-speech/speech-assessments/spaa-c. This tool focuses on analyzing speech within conversational contexts.

5. NESC Resources - SLP Tools: Visit https://nesc.k12.sd.us/resources.html#slp for a broader list. Be sure to check out the sections dedicated to Autism and Social Skills for more relevant questionnaires.