Download here: The Critical Questions Handout

NEW! Download here: The Critical Questions in Spanish 

Dr. Catherine Crowley developed these questions over the course of her clinical practice. She has found them to be the most effective and valid pieces of information needed by the evaluator in order to distinguish language difference from disorder, especially in culturally and linguistically diverse populations. There are two sets of questions included in this document, one for parents and one for teachers. In addition, this set of questions includes questions supported by research as being the one of the most accurate measures of language disorder (Restrepo, 1998).

WITHOUT THE ANSWERS TO THESE QUESTIONS WE CANNOT DISTINGUISH DISORDER FROM “SOMETHING ELSE.”

Evaluator must personally interview parent to allow for reframing of questions, follow-up and clarification to collect the essential data. Parent interview best done before evaluator sees student so can know about language acquisitional history and what to expect re dialect/language/vocabulary/prior experiences/etc.

  1. Language/dialect acquisitional history?
    1. Includes exposure over time to languages and dialects
    2. Often includes immigration patterns and acculturation
    3. If sequential bilingual important question is how was development of L1 (or D1) before introduction of L2 (or D2)
    4. Percent of day in the different languages
    5. Check whether the family speaks an indigenous language
  2. Parent’s highest education level?
    1. For both parents and biological parent if applicable and known
    2. Strong indicator of likely academic achievement and standardized test performance
    3. Education and SES strongly linked which gives some indication of quality of education, exposure to books and vocabulary, etc.
  3. Family history of speech-language problems? Family history of academic problems?
    1. Many disorders have a genetic predisposition
    2. Careful: We have many false positive identifications of disability in NYC
  4. Significant changes in the family structure?
    1. Difficult to focus or do well in school when family structure is in flux
    2. Divorce, remarriage, living in shelters, death or serious illness, etc.
  5. How do student’s communication skills compare to peers or siblings at same age?
    1. According to the research, the most critical “Critical Question”
    2. Spend time on this question. Make sure comparisons are with typical peers/siblings and not precocious ones
  6. Were child’s language skills in the evaluation representative or typical for him?
    1. Does student speak more at home or in school
    2. Confirm with parent and teacher your findings to raise authenticity of your results
  7. Is child clumsy?
    1. Dr. Lisa Goffman’s research on SLI is finding these students are also clumsy, i.e., low average motor skills
  8. 10 examples of best communications and where it breaks down.
    1. When making the appointment, ask the caregiver to write down 10 instances of the student’s best communications from when you make the appointment and when you see the student.
    2. Parents provide examples in various settings, over time, and in authentic settings.
    3. Often these examples are the best data I have for my differential diagnosis.

Resources: 

Critical Questions for the Parent Interview Part 1 

Critical Questions for the Parent Interview Part 2

Critical Questions 1-4

Critical Questions 5 & 6

Critical Questions 7-9

Difference Disorder or Gap: A School Age Disability Evaluation 

Critical Questions Spanish

References: 

Restrepo, M. A. (1998). Identifiers of predominantly Spanish-speaking children with language impairment. Journal of Speech, Language, and Hearing Research, 41, 1398-1411.