The subtle cognitive-communication challenges experienced by students with traumatic brain injury (TBI) are often missed, leaving these students with unmet needs in the school environment and increasing the likelihood for negative social, academic, and vocational outcomes. For children and adolescents with TBI, nonstandardized assessment offers several advantages over standardized assessment procedures, and may improve speech-language pathologists' ability to identify students who might benefit from intervention services. This article discusses curriculum-based assessment and discourse analysis specifically and uses case studies to demonstrate how these procedures can be used within the school environment. Nonstandardized assessment procedures are a valuable tool to measure a student's cognitive-communication abilities and the effects of intervention in real-world contexts.
Purpose
The purpose of this study is to describe and synthesize existing research on nonstandardized assessment of cognitive-communication abilities in children with traumatic brain injury (TBI) in order to improve the detection, diagnosis, and tracking of injury sequelae and guide appropriate service provision.
Materials and Method
A search of peer-reviewed journal databases revealed 504 unique articles published between January 2000 and August 2019. For full inclusion, articles had to report on empirical studies examining variables related to the nonstandardized assessment of cognitive-communication skills following TBI in children. Review articles, expert opinion pieces, and non–English language articles were excluded. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guided this process.
Results
Results were tabulated for each of the 14 articles that met full inclusion criteria. Included studies presented five different types of nonstandardized assessment: discourse analysis (
n
= 3), systematic observation of child's performance during an instrumental activity of daily living (
n
= 4), virtual reality tasks (
n
= 3), structured cognitive tasks (
n
= 2), and functional rating scales (
n
= 2). The majority of included studies compared the outcomes of nonstandardized assessment against subtest scores and checklists drawn from a variety of existing standardized and criterion-referenced assessments. Targeted cognitive-communication skills included attention, working memory, self-regulation, planning, multitasking, social problem-solving, inferencing, and macrolevel discourse.
Conclusions
Preliminary research suggests that a well-designed and systematically implemented nonstandardized assessment can yield essential information about children's cognitive-communication abilities in real-world contexts. Further research is needed to validate these assessments and to determine in which settings and situations they may prove most effective.
Supplemental Material
https://doi.org/10.23641/asha.15079026
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