MENTAL RETARDATION AND DEVELOPMENTAL DISABILITIES RESEARCH REVIEWS 11: 247252 (2005)

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SOCIAL COMMUNICATION SKILLS IN PRESCHOOLERS

Rebecca J. Landa*

Center for Autism and Related Disorders, Kennedy Krieger Institute, Johns Hopkins School of Medicine, Baltimore, Maryland

This paper orients the reader to social communication assessment and reviews methods for assessing social communication behavior in children from toddlerhood through the preschool years. Most standardized, normed tests of language in this age range focus on morpho-syntactic and semantic comprehension and production abilities. While social communication is perhaps one of the most important skills for peer acceptance, these skills are often overlooked in language evaluation with children. However, there are a number of caregiver questionnaires, interviews, or direct socialcommunication sampling methods that are available to assist clinicians or researchers in documenting social-communication skills or behaviors. Since assessment of social communication is essential in clinical work with children with an autism spectrum disorder, some of the tools described below are outgrowths of autism research or provide autism-related scores. While many children receiving social communication assessments do not have autism, the need to assess social communication skills in children with language impairment is highlighted by the growing literature documenting social and pragmatic difculties in this population (Bishop [2000] Causes, Characteristics, Intervention, and Outcome. Hove, UK: Psychology press). Regardless of whether the measures presented herein were initially designed for children with autism or not, they will provide insights into the social communicative behaviors or tendencies in young children.

2005 Wiley-Liss, Inc.

MRDD Research Reviews 2005;11:247252.

Key Words: social; communication; assessment; preschoolers

INTRODUCTION ommunication is a multifaceted phenomenon that is conceptualized here as having three intersecting domains: form, content, and use. Communication always occurs through the vehicle of some form, such as speech, gesture, sign language, written form, cartoons, facial expression, vocal tone, and so forth. The content of communication is the meaning that is conveyed. In linguistic communication, the meaning, or conceptual system, includes vocabulary and relational meaning as in the types of meaning relationships that are expressed (action object, agent action, possessive, location, etc.) as well as nonliteral language relationships as in gurative language, humor, and metaphor. The last major domain, the way that communication is used to accomplish something, involves the pragmatic system. Pragmatics can be divided into three main domains: (1) communicative intentions (e.g., requesting, calling, commenting, teasing, informing) that are expressed directly (Open the window) or indirectly (It is very hot in here); (2) presupposition, involving the ability to make assumptions about a partners informational needs (so the appropriate amount of background information may be given), information processing abilities (so that the words and grammar used are appropriate),

and social status (so that the appropriate degree of politeness is used); and (3) discourse management skills, involving the ability to use appropriate topic initiation, maintenance, and termination strategies. Depending on the purpose of the communication evaluation and the questions to be answered, the examiner will decide to assess one or more of the domains described earlier. In the selection of assessment tools and strategies, bear in mind that each of the domains above has both receptive and expressive components, and that assessing one domain without tapping into another domain (as well as other cognitive and social cognitive systems) is quite difcult. One caution is made here about selection of tools for measuring communication. Tests that are designed to measure intellectual functioning (intelligence quotient (IQ)) were not designed to assess communication. There is a high correlation between Verbal IQ (which makes heavy demands on language comprehension and expression skills) and vocabulary development, but a child may score within normal limits on a verbal IQ test and/or a vocabulary measure and still have a communication delay or disorder. Hence, if there is an interest in understanding a childs communication functioning, an IQ test cannot be the only measure administered. This volume has an article that focuses heavily on the assessment of morpho-syntactic and semantic comprehension and expression via the Preschool Language Scale. Therefore, the present article will focus on the assessment of the following aspects of social communication: joint attention, communicative intents, communicative initiation and responsiveness, integration of affect and gesture with communication, and so forth. These aspects of communication tend to be overlooked in assessment of children, and they are the least easily measured from a standardized perspective. Nevertheless, these features of communication greatly impact a childs social success in the community, especially with peers [Hemphill and Siperstein, 1990]. Therefore, social communication has important implications for the childs social acceptance, and behavioral and psychosocial well-being. Severe social communication impairment
Contract grant sponsor: NIMH; Contract grant numbers: 1-RO1-MH59630 01A3, 154MH066417 01A2. *Correspondence to: Rebecca J. Landa, Ph.D., CCC-SLP, Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD. E-mail: landa@kennedykrieger.org Received 11 July 2005; Accepted 26 July 2005 Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/mrdd.20079

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may indicate the presence of autism or Asperger syndrome, in which linguistic skills may be minimally affected or unimpaired. Such children may fail to qualify for, but sorely need, language intervention services. Assessment of social communication should involve some examination of a childs comprehension of the social signals sent to him/her by others. This is because language is learned and used within a social context. If a child does not understand the social cues given by others, he/she is likely to violate basic pragmatic rules as well as encounter challenges to language learning. According to Bruner [1975, 1983], a child learns conventional word use by participating in interactions (meaningful and already understood shared experiences) that he/she rst understood nonlinguistically. COMMUNICATIVE INTENTION An important aspect of communication is the childs intended goal of communicating. Generally, these intended goals are categorized as either declarative (social in nature) or regulatory (requesting something or somehow regulating an interaction for a purpose that is not mostly social in nature). One of the most important types of communication for children to understand and initiate is that of joint attention. Joint attention refers to the ability to coordinate attention with a social partner around an event or object. The emergence of joint attention has its roots in early to mid infancy [Scaife and Bruner, 1975], but by 9 to 12 months of age, children understand that certain adult behaviors (such as pointing gestures and head turns paired with a shift in eye gaze direction) signal something about the adults intention and attention [Carpenter et al., 1998]. At around 12 months of age [Liszkowski et al., 2004], children point to show objects/events of interest to others. Later, during the preschool years, pointing gestures may be partially replaced by linguistic means of sharing information and ideas [Tomasello, 1995]. Joint attention is perhaps the most discussed and researched aspect of social-communicative intentionality and comprehension because it is believed to be a pivotal aspect of the development of intersubjectivity and a precursor to the development of theory of mind. Furthermore, researchers have demonstrated that this skill predicts future language development [Mundy et al., 1990; Morales et al., 1998]. In addition, the absence of joint attention skills appears to be an early marker for signs of developmental disabilities, such as autism [Charman, 2003]. 248

Examiners must note not only whether children initiate joint attention, but the form, content, and quality of such initiations. Some young children with more advanced communication skills may be able to initiate joint attention very robustly, coordinating a pointing gesture with eye gaze that shifts from the object of attention to the communicative partner and back to the object, and verbal expression such as Do you see the airplane? However, a more subtle and less mature expression of joint attention, such as sustained gaze at the caregiver with a brief vocalization, may also be considered a bid for attention. In addition to joint attention, other social communicative intents expressed by children during the preschool period include greeting, calling, negotiating, teasing, commenting, and so forth. By 14 months, social intents such as greetings, politeness (e.g., thank you), and notice indicators (e.g., uh-oh) are common but intents involving announcement of the childs own intended purpose for communicating (e.g., Im asking you. . . ) or providing afrmative answers to questions does not emerge until 20 months of age, and requests for clarication are still emerging at 32 months of age [Snow et al., Unpublished]. Noting the types of meaning that a child expresses during social communication is also useful because a restricted range of communicative intents may indicate that a child has pragmatic difculties and may also have difculties in peer interaction. Research on preschool-aged children with specic language impairment (SLI) has indicated that, while these children initiate communication as often as their non-SLI peers, they more often communicate these initiations via nonverbal means [van Balkom and Verhoeven, 2004]. Their nonverbal initiations primarily carried the communicative intent of initiating or restarting play activities; both non-SLI and SLI groups infrequently directed these communicative intentions to their partners and thus, did not contribute to the ow of conversation. Furthermore, the two groups did not differ in the variety of communicative intents exhibited. PRESUPPOSITION Gathering information about a childs presuppositional skills often involves observing his/her ability to produce the quantity and quality of information that is contextually appropriate. Context refers to many things simultaneously, such as the relationship that the conversational partner has with the child (e.g., family member, authority gure

such as the teacher, peer, or stranger), background knowledge that the partner has about the topic, setting, and so forth. Presuppositional competence requires that a child be able to make inferences about the type of language, type of topic, amount of detail to be given (based on inferences about shared knowledge, for example), and specic linguistic forms to be used, and be able to consider multiple aspects of the context, draw from their prior knowledge and experience from similar situations, and use the linguistic exibility available to them to phrase their communication in a situationally appropriate way. Presuppositional skills are emerging in preschoolers, as is evident in their ability to make linguistic form and content adjustments based on characteristics of their listeners (particularly age) [Ricard and Snow, 1990; Sachs et al., 1990; De Temple et al., 1991]. However, this aspect of pragmatic ability unfolds with time, as childrens metacognitive, social cognitive (e.g., theory of mind), working memory, and linguistic skills increase in sophistication. DISCOURSE MANAGEMENT Discourse management for a young child mostly centers around reporting on events and carrying on a conversation. Skills to observe in an assessment would include conversational turntaking, maintaining someones topic by contributing topic-relevant information, indicating when ones turn is complete or not (indicating that a turn is not over by saying things like and then), being able to keep the ball rolling in a conversation by inviting responses from the conversational partner (including making small talk), repairing communication breakdowns, initiating new topics, using techniques for transitioning to a new topic, and so on. Managing conversation is challenging for children because of the many skills utilized simultaneously, including planning the linguistic forms and content, monitoring the comprehension of the partner and of oneself, as well as adhering to all of the social rules for the interaction within the specic context. For example, children learn that the rules for conversation in a classroom are different than on the playground. Conversational turn-taking begins to be sustained with parents rst and then with peers by the age of 3 years [Keenan and Klein, 1975; Ervin-Tripp, 1979], and the use of techniques to hold the conversational oor is present by the age of 4 years [Jisa, 1984/1985; Peterson and McCabe, 1988].
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Social communication is a difcult domain of development to assess, largely because it varies with context. Hence, there are rather few social communication measures available; a sampling of useful screening and assessment measures with acceptable reliability and validity are described below. Only one of the tools reviewed is appropriate for the direct assessment of children ranging in developmental age from 24 months through the end of the preschool period: the Autism Diagnostic Observation Schedule [ADOS; Lord et al., 2001] (reviewed later). Many of the available measures were developed for the assessment of autism spectrum disorders (ASDs), but the ones listed here are acceptable for use with children who are not suspected of having an ASD so that a screening/sampling of social communication behavior may be obtained. These tests do not provide data on sensitivity and specicity. These measures do not break out pragmatics as a distinct skill to be measured, but may have specic items pertaining to certain pragmatic behaviors (e.g., response to joint attention, pointing, initiating interaction with others). Hence these tests are not organized in ways that would align with the overview of pragmatics presented earlier. A pragmatic analysis using descriptive checklists or frequency counts could be used if such information is needed, but these analyses are often time-consuming. Most of the pragmatic checklists were designed for older children or adults, and may be of limited use in preschoolers. MEASURES Ages and Stages Questionnaires: SocialEmotional [ASQ:SE; Squires et al., 2002] Area of Assessment: Developmental delays with a focus on social emotional skills Type of Measure: Parent/Caregiver Questionnaire (Screening tool) (may also be used by professionals to grossly monitor development) Age Range: 3 months to 5 years Time to administer and score: 10 to 30 min for administration; 1 to 3 min for scoring Training required to administer: None Cost: $135 Reliability: Moderate test-retest reliability; Moderate inter-observer reliability; High internal consistency (94%) Validity: Moderate validity (75 89%)
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Description The ASQ is an easy-to-use series of screening questionnaires for caregivers or professionals; questionnaires are available in 6-month intervals. Competence and problem behaviors are sampled. Domains covered by the ASQ:SE include self-regulation, compliance, communication, adaptive functioning, autonomy, affect, and interacting with people. The ASQ:SE was designed to accompany the Ages and Stages Questionnaire, which focuses on more general aspects of development. Advantages The ASQ provides an in-depth screening for social and emotional, and communicative abilities in young children. This measure is solely intended to be used as a screen for potential developmental disorders. If a child fails, it is important that further and a more thorough developmental assessment be performed. This tool is available in English and Spanish. Disadvantages This tool emphasizes social emotional development, with little focus on actual social communication. It is included here because it is one of the few well-normed screening measures tapping social development. Autism Diagnostic Interview-Revised [ADI-R; Rutter et al., 2003] Areas of Assessment: Communication, social interactions, and restricted/repetitive stereotyped behaviors; ASD specic Type of Measure: Structured Caregiver Interview (93 items) Age Range: 24 months-adulthood Time to administer: 1.53 h Training required to administer: Intensive Cost: $175.00 Reliability: Moderate inter-rater reliability (0.52 0.97 in different studies); Test-retest reliability (Chronbachs 0.93 0.97; 0.82 0.91) Validity: Moderate discriminant validity Description The interview focuses on developmental history and current day-to-day behavior involving language/communication, reciprocal social interactions, and restricted/repetitive/stereotyped behaviors and interests. These are the three diagnostic domains specied for autism in the ICD-10 [WHO, 1993] and the DSM-IV [ APA, 1994]. For each item, there are specic probes provided for the
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examiner so that information is elicited in a standardized fashion across interviewers and interviews. Caregivers responses are generally coded on a 4-point scale (0 to 3) based on the frequency, range, and/or severity of the behavior in question. An algorithm, consisting of selected ADI-R items, provides a means of determining whether the individual meets diagnostic criteria for autism. The child is not present during the interview. Advantages This is a comprehensive interview that permits historical and current accounts of social and communicative development and functioning. The nature of the queries provides the interviewer with clear interviewing guidelines, as well as a method for obtaining specic information about how a child is using different social and communication skills. These skills may be difcult to assess in a brief interaction with the child, and so if detailed information is needed on such behaviors, or a historical account of development is desired, this is the most comprehensive instrument available for obtaining such information. Disadvantages This instrument is lengthy, and may have limitations in capturing the subtle abnormalities of high-functioning socially impaired preschoolers, but it is perhaps the most thorough standardized instrument available for obtaining a careful and comprehensive history of a childs social and communicative development and current functioning. GhumanFolstein Screen for Social Interaction [SSI; Ghuman et al., 1998] Area of Assessment: Social interaction (capacity, quality, and competence) Type of Measure: Caregiver Questionnaire Age Range: 6 months to 5 years Time to administer: Varies Training required to administer: Minimal Cost: Not specied Reliability: High internal consistency (Chronbachs 0.756); Moderate test-retest reliability (r 0.51 0.91); Moderate inter-rater reliability (r 0.51 0.67) Validity: Not specied Description The authors state that the instrument measures the capacity for social interaction (social initiations and re

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sponses), quality of social interaction (positive or negative, appropriate or inappropriate), and competence with which social interaction is used. Behaviors are rated along a 4-point frequency continuum. The SSI score was negatively correlated with the Autism Diagnostic Interview-Revised [Rutter et al., 2003] (reviewed below), which is a parent report measure of social, communicative, and behavioral patterns associated with autism, where a higher score indicates more abnormality. This provides some preliminary support for the validity of the SSI. Advantages This is a quick and efcient way to sample parents perceptions of their childs social behaviors and provides information about the childs social communicative interactions in ecologically valid situations. Questions focus on eye contact, shared positive affect, how the child indicates need to the caregiver, greeting (and how this is executed by the child), playful behavior of the child, how the child shows interest in other children, and how social exchanges are initiated and continued. This scale is not diagnostic, but it does provide a threshold that can be used to ag children whose social and communication skills require further assessment. Disadvantages There are no norms for this measure, which eliminates comparison with what is typical for same-aged peers. Social Responsiveness Scale [SRS; Constantino, 2005] Area of Assessment: Severity of autism symptoms Type of Measure: Caregiver-report rating scale (65-item scale) Age Range: 4 18 years Time to administer: 1520 min Training Required to Administer: Minimal Cost: $82.50 Reliability: High internal consistency (Chronbachs 0.756); Moderate test-retest reliability (r 0.51 0.91); Moderate inter-rater reliability (r 0.51 0.67) Validity: Not measured Description The type of social and communicative behaviors that are sampled through the SRS are those that are commonly impaired in autism, and that contribute to an autism diagnosis, including social 250

awareness, social information processing, capacity for reciprocal social responses, and social use of language. These, along with items focusing on repetitive and stereotyped behaviors, are rated on a 0 (never true) to 3 (almost always true) point scale. A singular scale score provides an index of severity of autism social decits. It distinguishes ASD from other psychiatric disorders [Constantino et al., 2000]. Scores on the SRS are highly heritable, generally unrelated to IQ and continuously distributed in the general population [Constantino and Todd, 2000; Constantino and Todd, 2003; Constantino et al., 2003]. Siblings of children with Pervasive Developmental Disorder (PDD) had much higher scores than siblings of children with non-PDD psychiatric disorders [Constantino et al., 2004]. Substantial agreement between SRS scores, the Vineland Adaptive Behavior Composite, and scores for social impairment on the Autism Diagnostic Interview Revised has been identied (Pine et al., in press). Advantages This instrument is useful for the late preschool period through the teen years. It addresses a variety of social and communicative behaviors and permits the examiner to glean the parents perspective of their childs social and communicative functioning and severity of difculty. Recent evidence suggests that this scale may be useful in detecting social impairment in children as young as 3 years of age (Pine et al., in press). There is preliminary evidence that the SRS may be sensitive to change (though probably not subtle changes) (Pine et al., in press). Disadvantages The provision of the autism score may not be relevant to the nonautism population. However, this tool should still be considered when the desire is to obtain an efcient and rapid insight into a childs social and communicative behavior outside the clinical setting, at least as viewed by the caregiver. Autism Diagnostic Observation Schedule [ADOS; Lord et al., 2001]. Area of Measurment: Social and communication behaviors related to Autism Spectrum Disorders Type of Measure: Standardized assessment Age Range: 14 months-adult Time to administer: 30 45 min Training required to administer: Intensive Cost: $1345.00

Reliability: High inter-rater reliability; High internal consistency; High test-retest reliability Validity: High discriminant validity Description The ADOS is an assessment of communication, social interaction, and play or imaginative use of objects. It was primarily developed as a structured means of using standard activities and materials for assessing individuals referred for a possible diagnosis of autism or other pervasive developmental disorders. The ADOS consists of four modules, with each higher module presenting progressively more complex tasks, materials for a more mature individual, and designed for an individual with more complex language skills. This hierarchy of modules permits the ADOS to be appropriate for use with children and adults with receptive and expressive language skills ranging from absent to verbally uent adult levels. Based on the individuals age and an estimate of expressive language ability, a module will be selected for use. If it becomes clear that the selected module is too difcult or easy, a different module may be used. As the ADOS is administered, notes are made in the scoring booklet. Based on a 3-point rating scale, overall ratings (rather than scores for specic tasks, except in a few instances such as Response to Name and Response to Joint Attention tasks) are made immediately after the administration. An algorithm is provided in which key items are included. The Algorithm is broken into four sections: Communication, Reciprocal Social Interaction, Play or Imagination/Creativity, and Stereotyped Behaviors and Restricted Interests. Diagnostic criteria for autism or ASD are given based on the communication and social domains. For clinical use, examiners must attend a two-day clinical training. The ADOS was validated using children with and without autism (mostly from Psychiatry clinics, but with a small number of typically developing children) and the process for validating the algorithm (how cut-offs for autism and ASD were established) are described in the manual. DSM-IV [APA, 1994] and ICD-10 [WHO, 1993] classications were used in the development of the algorithm. The ADOS cannot be used alone to make a diagnosis of autism or ASD for multiple reasons, but it is presented here because it is one of the few standardized measures (though it provides no normative data) for eliciting social and communicative behaviors in children across a wide age range and range of language functioning. Thus, it is useful when there
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are concerns about social communication, even when there is no question about autism per se. Advantages This is the only measure described in this article that involves direct child assessment using standardized sampling probes and an operationally dened scoring system for social and communicative behavior across such a wide developmental range. Substantial research data have been collected on children with and without autism. Training programs and DVD/videotapes are available for administration and scoring of the ADOS. This training has the added benet of honing the clinicians eye to detect abnormalities in social and communication behavior. Disadvantages This test does not provide norms for social and communicative development, but it does provide an algorithm that enables the examiner to see whether the child is functioning in an expected way for his/her general developmental level. Some of the items in the higher modules are not easy for language impaired children (e.g., telling a story from a wordless book), but speech-language pathologists may be able to obtain more information than the instrument intended from such items. Tape recording responses to these standardized probes for narration may provide data that could be coded using separate scoring/coding schema and add to the information yielded just from the ADOS. Global ratings are provided, which are useful for documenting strengths and needs, but frequency counts are not provided (which would be useful if a more detailed analysis of social communication behavior were desired, as in the CSBS-DP). CSBS-Developmental Prole [CSBS-DP; Wetherby and Prizant, 2003] Area of Assessment: Language and communication Type of Measure: Standardized Instrument; Subsets include: Infant-Toddler Checklist, Caregiver Questionnaire, and a Behavior Sample Age Range: Normed for ages 6 to 24 months, but may be used up to 6 years of age if developmental level is at or below the 24 month level Time to administer and score: InfantToddler Checklist: 510 min, Caregiver Questionnaire: 1520 minutes, Behavior sample: 30 min Training required to administer:
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Moderate. The tool should be administered by a certied speech-language pathologist, early interventionist, psychologist, pediatrician, or other professional trained to assess the development of young children. Cost: $399.00 Reliability: High degree of internal consistency (Chronbachs 0.86 0.93); High test-retest reliability; High inter-rater reliability Validity: High validity Description The CSBS-DP measures seven language predictors in young children: emotion and eye gaze, communication, gestures, sounds, words, understanding, and object use. Each area is measured by the three main components of the CSBS-DP (all of which are normed, with norms being presented at 1- to 4-month intervals): a one-page Infant-Toddler Checklist (may be downloaded from the internet for free); a four-page follow-up Caregiver Questionnaire; and a Behavior Sample, administered by an examiner with the parent present. The Infant-Toddler Checklist is a rst-step screening to determine whether a developmental evaluation is needed. The Behavior Sample employs action-based toys to entice spontaneous communication, book sharing, symbolic play using materials that encourage pretending with objects, blocks (to observe constructive play), and vocabulary comprehension probes (peoples names, objects, body parts). Cluster scores are available for the following skill domains: Communicative Function, Gestural Communicative Means, Verbal Communicative Means, Reciprocity, Social-Affective Signaling, and Symbolic Behavior. There are also two probes for comprehension of joint attention cues in which the examiner says Look as he/ she points to something to the childs side and, in a separate probe, to an object behind the child. Most of the activities are enticing to children of the targeted developmental level and keep the child engaged. It can be scored as the test is being administered (though this is more difcult in children who are communicating often and using words and/or word combinations frequently). The following behaviors are scored: three point gaze shifts and shared positive affect (present or absent across the ve communication temptations and the play sample), looking toward the target in the joint attention comprehension probes (pass/fail for each of the items), initiation of joint attention, social communication and behavior regulatory bids (counting
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up to four per communicative temptation and in the play sample), gesture, consonants, words and word combinations used communicatively (meaning that the child directs their communicative intent to another individual in specic ways), number of words comprehended, action schema used in play, combinations of action schema, action schema directed toward others, and number of blocks stacked. Information on the concurrent validity, testretest stability, and predictive validity of the three components of the CSBS-DP are presented in Wetherby et al. [2002]. Advantages The CSBS-DP is a fast, comprehensive, and child-enticing way to sample important early social and communication skills. It may be used for screening or evaluation, and also to document change over time. The Infant-Toddler Checklist is free and can be downloaded from the internet. The training videotapes are very useful and help the clinician develop thresholds for accepting a behavior as communicative as well as to interpret toddlers communicative behavior as social or regulatory. Disadvantages This assessment has an early cut off age and the scoring requires training and practice. The skills assessed by the CSBS-DP overlap with those assessed in the Autism Diagnostic Observation Schedule (ADOS). So for older preschoolers, the examiner may switch over to the ADOS, which does not have developmental norms like the CSBS-DP. However, the scoring system of the ADOS does not sample the types of communicative intention nor provide frequency counts of different types of social communicative or social cognitive behaviors. If such information was desired from an ADOS, one could develop a coding system and use the ADOS behavior sample as the basis from which to code a variety of social communicative behaviors. Sequenced Inventory of Communication Development [SICD; Hedrick et al., 1995] Area of Assessment: Communication ability Type of Measure: Diagnostic test Age Range: 4 48 months Time to administer: 30 75 min for children 24 months and older, less time for younger children Training required to administer:

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Moderate Cost: $399.00 Reliability: Moderate reliability Validity: Moderate validity Description This assessment is a screening tool of communication, covering a broad spectrum of behaviors and resulting in a summary of areas in need of further in-depth assessment. From a clinical perspective, the developmental proles provided by the SICD reveal patterns of strength and need that can be translated into long-term intervention goals. Processing proles are presented, in which test items have been classied according to semantic-cognitive, syntactic, and pragmatic aspects of communication. The Expressive Processing Prole also presents phonological information, while the Receptive Processing Prole allows for classication of perceptual items. The test materials are child-friendly; there are many miniature toys that are engaging for young children. Scoring is based on observation and parent report (even if the skill cannot be elicited during the evaluation session). There is a Spanish translation of the SICD. Advantages This measure spans a wider age range than most tools that permit the sampling of social communication. It measures social as well as linguistic aspects of communication. Norms are provided, and the examiner is able to take into account parent report. This is an advantage because sampling skills in a clinical setting does not always represent the full range of ability a child may exhibit outside such a setting. Disadvantage This measure does not sample a broad range of social communication. SUMMARY This review of social communication measures was intended to provide the reader with useful information about the importance of assessing this aspect of language, the context in which to do so, and a review of some available measures. The majority of tools are parent-report, enabling the evaluator to capture the parents perspective and input, which is lost in direct sampling measures. This information is extremely valuable for assessing all communicative functioning. However, it is recommended that an observational tool be

used in combination with a parent report measure to gain a more complete picture of the childs social communicative abilities. Whichever tool is chosen to assess these skills, it is important that the evaluator is cognizant of whether the tool is a screening tool (and thus further testing may be required) or the one in which the results will provide sufcient information regarding social communication. f ACKNOWLEDGMENTS Much appreciation is expressed to Mary Blair and Julie Rusyniak for their assistance as this manuscript was prepared. REFERENCES
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