TESTS TO EVALUATE GENERAL CONDITION

Aspect to evaluate Instruments

Degree of development
Portage Guide, McCarthy Developmental Scale

Intelligence WISC-R, Dominoes Test, Raven, K-BIT

Interview with parents, neuroimaging

neurological problems
examination, neuropsychological battery

Social interaction level Interview with parents

TESTS TO EVALUATE AUTISTIC CHARACTERISTICS

Aspect to evaluate Instruments

Screening tests CHAT

SCQ
ADI-R

Evaluation tests CARS ADOS

extensive ACACIA

IDEA

LANGUAGE TESTS

Aspect to evaluate Instruments

Language development
MacArthur Scale (CDI) Portage Guide

Phonology Bosch phonological test

Acosta phonological test
Peabody
Vocabulary Boston Test

Language batteries

BLOC BLOC-S ITPA AREL PLON-R TSA Sadek-

Khalil

Literacy TALE-2000
1. EVALUATION OF THE DEGREE OF DEVELOPMENT

Portage Guide

The Portage Guide is an evaluation test that allows us to determine the general abilities of children, and
among them are linguistic abilities. It consists of a series of objective lists that summarize the most
relevant behaviors that frequently occur between birth and six years, organized in a way that is in
accordance with the typical order of succession. These objectives cover the following areas:

a) How to stimulate the baby . This area focuses on providing stimuli to the baby from his
environment, before a response is expected from him. This area has been designed for children
between 0 and 4 months old or for children with similar functional behavior.
b) Socialization . It includes learning socialization skills, appropriate behaviors in home
environments, and behaviors to interact with people around you through imitation,
participation, and communication.
c) Language . Language learning begins with what the child captures through listening to his
environment, prompting him to emit sounds, babbling, echolalia and finally words and
holophrases, to gradually begin to combine his vocabulary. in intelligible phrases and sentences.
This area, in addition to being an excellent means of evaluation, constitutes a rich language
program.
d) Self Help . This area evaluates the skills that the child masters in the field of personal autonomy
(feeding, dressing/undressing, bathing...).
e) Cognition . This area evaluates cognition, or the act of thinking, such as the ability to remember,
see or hear similarities and differences, and establish relationships between ideas and things.
f) Motor development . It assesses the ability to control coordinated movements of large muscles
(gross motor skills) and small muscles of the body (fine motor skills).

Its use is appropriate for children from 0 to 6-8 years, although in the case of subjects with
developmental delay it can be used up to 14 years. For each of the previous areas, a series of objectives
are included that children must master in their normal development, using a check-list format. In this
way, the objective lists allow us to know (a) the behaviors that the child currently executes in the
different areas, (b) the behaviors that the child is learning, and (c) the behaviors that the child has not
mastered.

McCarthy Developmental Scale (MSCA)

It is an individual test, designed for children between 2 and 8 and a half years old. Its application is
individual, taking about 45 minutes, and measures the child's cognitive and psychomotor development.
The test is made up of 18 tests that give rise to 6 subscales:

■ Verbal: maturity of verbal concepts and expressive aptitude

■ Perceptive-Manipulative: reasoning capacity in playful-manipulative tasks
■ Quantitative: ease of handling and understanding of numerical concepts and symbols
■ Memory: visual, acoustic, verbal and numerical
■ Motor skills: motor aptitude (coordination of large movements and fine motor skills) ■ General
Cognitive: includes Verbal, Quantitative and Perceptual-Manipulative subscales

Through the application of the MSCA, the child's degree of development can be determined, as well as
the comparison with the expected development for the age level.
2. INTELLIGENCE EVALUATION

Wechsler Intelligence Scale for Children (WISC-R)

The WISC-R scale (Wechsler Intelligence Scale for Children-Revised) is certainly the most well-known and
used intelligence test for children. In addition, it is often used as a reference when establishing the
degree of mental retardation, for example in cases of Down syndrome, autism or general developmental
delay. Its application is individual, takes between one and two hours, and is appropriate for children
between 6 and 17 years old.

It is composed of a series of ten tests, distributed in two scales: the verbal scale (with five subtests), and
the manipulative scale (with another five subtests). Below are the different tests that make up each of
the scales:

1. Verbal scale:
• Information: 28 questions in which the amount of information that a subject with
average intelligence has been able to acquire from the environment is evaluated. For
example, how many legs a table has, or what color milk is.
• Comprehension: 18 elements that evaluate the ability to analyze questions, and the
ability to adequately verbalize the answers. For example, what is charity, or what is
Greece.
• Arithmetic: 14 elementary arithmetic problems, to assess problem solving and
resistance to distraction. For example, if three pieces of gum cost 5 pesetas, how much
will 24 pieces of gum cost?
• Similarities: 19 elements that evaluate the similarities and differences between objects,
facts or ideas presented, and the person's classification ability. For example, you
wonder what a wheel and a ball, or a meter and a kilo, have in common.
• Vocabulary: 33 words written as knife or clock are presented, and the subject must
indicate their meaning, thus measuring comprehension and the ability to verbally
express themselves.

2. Manipulative scale:
• Incomplete Figures: 25 cards with objects that are missing something, and the person
must say which part is missing.
• Cubes: the person must build 14 drawings using several cubes whose faces are red,
white, or both colors. Measures the ability to analyze and abstract, and solve
problems.
• Comics: 11 elements in which subjects must organize a “comic” type story so that they
make sense.
• Matrices: measures abstract reasoning. It consists of completion, classification,
analogical reasoning and serial reasoning of arrays of elements.
• Symbol Search: 60 items in which the subject must decide whether an item belonging
to one group is in a different set of items. Evaluate perception and speed.

The scores for each of the tests are obtained individually, and the scores for the verbal part and the
manipulative part are subsequently added. Thus, a triple measure of IQ is obtained:

a) Verbal intelligence quotient (VIC): sum of the scores on the verbal scale, which indicate linguistic
intelligence.
b) Manipulative coefficient (MIC): sum of the scores on the manipulative scale, which indicates
intelligence in manipulative tasks.
 c) Total intelligence quotient (CIT): total sum of the scores, which would indicate the child's
intelligence.

To assess the IQ obtained (both verbal, manipulative and total), it is compared with the classification of
degrees of delay established by the AAMR (American Association on Mental Retardation).

Raven's Progressive Matrices Test

It is a general intelligence test, although it uses non-verbal responses (specifically, choosing one
option among several). Because it does not use written materials, it is intended to provide a measure of
intellectual functioning independent of the cultural environment. There are several versions of the test,
although the most common is the General Scale, aimed at subjects aged 12 to 65, and whose application
time is around 40 minutes.

In the Raven matrix test, series of progressive difficulty are presented, where the complexity
increases each time, and the person must indicate among several options which element is missing in
each series. For example:

From the responses of the subjects to the different series, a measurement of the person's
intelligence is obtained, as well as a comparison with the intelligence of the general population.

For younger children, there is a special test that uses a wooden shape board, and there is also a
more modern version called Progressive Color Matrices.

D-48 and D-70 (Domino Tests)

The D-48 and D-70 are different versions of the same test, which measures general intelligence
and abstraction capacity through logical series built with dominoes. It is used with subjects 12 years of
age and older, and the application is generally individual. It is a fairly quick test, around 25 minutes.

In dominoes tests, series of dominoes are presented that maintain some type of relationship
between them (mathematical, logical or physical), and the person must indicate which element is missing
in each series, although without giving any response option as in Raven's matrix test. For example:
 From the responses of the subjects to the different series, a measurement of the person's
intelligence is obtained, as well as a comparison with the intelligence of the general population.

Kanufman Rapid Intelligence Test (K-BIT)

This intelligence test was developed by professors Alan and Naudeen Kaufman, based on a previous
instrument called K-ABC. It is aimed at people between 4 and 90 years old, and its fundamental objective
is to have a screening test that is easy to apply and correct, which would allow quick decisions to be
made about the cognitive repertoire of the subjects. In fact, its application only takes 15-30 minutes.

The K-BIT consists of separate scales:

■ The verbal scale contains two subtests (verbal knowledge and guessing) that evaluate crystallized
abilities such as knowledge of words and their meanings. Receptive and expressive vocabulary is
covered, without it being necessary for the person to know how to read.
■ The nonverbal scale includes a matrix subtest that assesses fluid thinking and the ability to solve new
problems through relationships and analogies. The stimuli do not consist of words but of images and
abstract designs, so it can be applied to people with poor linguistic skills.

In each of these scales, materials designed to be attractive to children and facilitate their application are
used. From the evaluation, scores are calculated on the verbal and non-verbal scales, as well as a
composite IQ (with a mean of 100 and a standard deviation of 15). There are scales adapted to the
Spanish population.

The K-BIT has been shown to be a test that correlates well with the WISC-III and has good psychometric
properties. Among its advantages we can highlight that it allows a quick evaluation of intelligence, that it
detects children with problems well and that it is applicable even in children with very reduced verbal
repertoires.

3. RAPID ASSESSMENT OF AUTISM

Checklist for Autism in Toddlers (CHAT)

It is an early detection test for autism spectrum problems, and as such is aimed at establishing the
existence of psychological indicators of autism risk in 18-month-old children. It was originally designed to
be applied by pediatric doctors, and in fact there are countries where it is part of routine health check-
ups for children. Its application is very quick (between 20 and 30 minutes) and it is a test that is not
marketed, but rather was offered in a manual in English.

It consists of two different sections, with a total of 14 items:

■ In the first, parents are asked questions such as whether their child is interested in other children, if
they use gestures to point, or if they interact with them appropriately.
■ In the second section, the doctor himself (or another evaluator) presents several situations to the
child related to language and imaginative play, to check his reactions.

Depending on the number of items that are not passed correctly, a degree of risk for autism is
established. Therefore, it is a screening test that warns of potential problems, which must be confirmed
with the administration of other more complete tests and with follow-up over time.

Social Communication Questionnaire (SCQ)

It is another screening instrument designed to quickly evaluate the communication and social
relationship abilities of children who may suffer from autism spectrum disorders (ASD). It allows the
symptoms observed by the parents or caregivers of the children to be collected in order to properly
decide whether it is appropriate to refer them for a more in-depth evaluation.

This test is related to the ADI-R, which allows a more in-depth analysis of the symptoms relevant to the
diagnosis of autism disorders in relation to other possible disorders such as those related to language.

4. EXTENSIVE AUTISM EVALUATION

Autism Diagnostic Interview (ADI-R)

The Autism Diagnostic Interview is a semi-structured interview that allows a detailed evaluation of those
children and adults who show a possible autism disorder (or an autism spectrum disorder). It is a very
useful instrument for the formal diagnosis of children from 2 years old, and its application takes about
two hours.

It is composed of 93 items, which focus on three main aspects or domains: language and communication,
reciprocal social interactions, and stereotyped and repetitive behaviors. In this way, a total of eight
content areas related to autism are covered, specifically:

■ History of the subject.

■ early development.
■ Language acquisition and language loss.
■ Current functioning in linguistic and communicative aspects.
■ Social and game development.
■ Interests and behavior.
■ Clinically relevant behaviors (aggressions, etc.).

The results of the ADI-R can be used to diagnose autistic disorders in high-risk populations (for example,
children with severe developmental problems or medical disorders), and studies indicate that it is quite
effective in distinguishing between problems of autism and other similar conditions, as well as between
classic autism problems and other autism spectrum disorders.

Childhood Autism Rating Scale (CARS)

The CARS is one of the most used and reliable scales to identify children with autism and to distinguish
them from children with developmental difficulties who do not have autism.

It is a brief instrument aimed at children aged 2 years and older and composed of 15 items, each of
which focuses on a typical characteristic or behavior of autism. Each of these items uses a seven-point
scale, so that the evaluator indicates the degree (a lot/little) to which the evaluated child deviates for
each specific characteristic from what would be expected of a normal child, using the data collected in an
interview or observation.

Once all the items have been applied, a total score is obtained, so that children whose score falls above a
cut-off point (which depends on age) can be considered autistic. In that case, the scores allow a
distinction to be made between the severity of the symptoms of the autistic disorder.

Autism Diagnostic Observation Schedule (ADOS)

It is a semi-structured observational scale that can be used to evaluate possible cases of autism in
patients of all ages and linguistic abilities. To do this, the ADOS proposes various activities that generate a
controlled context that allows the evaluator to observe social and communicative behaviors related to
autism.

It is made up of four modules of activities, so that each person evaluated only goes through one of them
depending on their age and linguistic abilities:

■ Module 1: designed for children who have not mastered the first phrases stage.
■ Module 2: designed for children who have already mastered the first sentences, but who do not yet
have fully developed verbal fluency.
■ Module 3: designed for children who have completely acquired the language.
■ Module 4: designed for adolescents and adults.

Among the activities proposed within these modules to serve as contexts for observation, there are free
play, construction tasks with blocks, responding to names, imitating a task after seeing a model,
describing images, telling written stories, games with emotions. , etc.

The ADOS scale includes very precise instructions for passing and scoring the different activities. A global
score is then obtained and compared with cut-off scores so that children whose score falls on a cut-off
point (which depends on age) can be considered autistic. In addition, cut-off scores are offered to
establish a diagnosis of autism according to a classical view, or of a general autism spectrum disorder.
ACACIA Diagnostic Test

This test, designed by Spanish researchers, evaluates autism problems in children from 2 years old. It
proposes as one of its main objectives the presentation of situations that elicit basic social strategies,
such as instrumental or anticipatory strategies, that allow the observation of relevant categories in social
interaction. It is aimed at boys and girls with very little or no functional expressive language skills, and
with a mental age of less than 36 months.

It starts from a structured interaction situation, in which the evaluator acts according to a previously
established script. Ten situations are proposed that are recorded on video, and which take about 15
minutes. Some of the situations that this test consists of are: toy sample, food sample, interactive games
or passive attitude without objects.

Subsequently, the recordings are interpreted with a guide that focuses on aspects such as the child's
smile, the functional use of objects, the communicative level, the social interaction shown or the type of
game.

Autism Spectrum Inventory (IDEA)

Designed by Angel Riviere's group, this inventory aims to assess the severity and depth of the autistic
traits that a person presents, both in cases of autism spectrum disorders and Asperger's. It is aimed at
children from 5-6 years old.

It evaluates twelve characteristic dimensions of people with autism spectrum and/or pervasive
developmental disorders:

1. Social relationship.
2. Joint attention.
3. Affective and inferential capacity of mental states.
4. Communicative functions.
5. Expressive language.
6. Receptive language.
7. Anticipation competition.
8. Mental flexibility.
9. Sense of one's own activity.
10. Imagination.
11. Imitation.
12. Ability to create signifiers.

5. EVALUATION OF LINGUISTIC DEVELOPMENT

Macarthur Scale of Communicative Development (cdi)

It is a well-known instrument that allows assessing the initial development of children's language. It
applies to children between 8 and 30 months, and covers the normal process of language acquisition:
prelinguistic vocalizations, initial vocabulary, first sentences, grammar, etc.

The CDI consists of two different tests: vocalizations, first words and gestures (8-16 months), and
vocalizations, words and grammar (16-30 months). Both are designed to be completed by parents, and
allow knowing the development of different language components, as well as knowing the degree of
general language development in comparison with the level expected by age.
Portage Guide

The Portage Guide is an evaluation test that allows us to determine the general abilities of children, and
among them are linguistic abilities. It consists of a series of objective lists that summarize the most
relevant behaviors that frequently occur between birth and six years, organized in a way that is in
accordance with the typical order of succession.

6. PHONOLOGY TESTS

Acosta phonological test

It is a test suitable for children from 3 years of age, and is made up of a list of words that covers the basic
phonological spectrum of Spanish, presenting the different phonemes in various positions, diphthongs,
etc. The list of words, divided into different categories, appears at the end of this document.

Generally, the presentation is done by showing each word on a cardboard card, which the child must
read. If they do it correctly, they move on to the next card, while if they make a mistake, the evaluator
says the word for the child to imitate. The development of the test is usually recorded, to later analyze
the speech difficulties and the specific sounds in which they occur.

Bosch phonological test

It is similar to the Acosta test that appears below, and allows us to observe how the production of the
different phonemes in Spanish develops. It is especially intended for children between 3 and 7 years of
age.

The test consists of a phonological analysis of 32 words, which include all the phonemes of Spanish. The
application of the test consists of two moments. First, drawings are shown showing images and actions
that include the target words. And secondly, all the words are presented and the child must repeat them
by imitation. In both cases, the number of errors made and the problematic phonemes are counted.

7. VOCABULARY TESTS

Peabody Vocabulary Test

Measures children's vocabulary, especially in its comprehensive aspects. It is designed for children and
adults ages 2 and a half and up; The application is individual, and takes between 10 and 20 minutes.

The Peabody contains 192 plates with four drawings each in which the subject must indicate which
illustration best represents the meaning of a word given by the examiner (that is, the response requested
is to point, never to name). From the subjects' responses to the different pictures, a measurement of the
person's comprehensive vocabulary is obtained, as well as a comparison with that of the general
population.

Boston Vocabulary Test

It is a test designed to measure vocabulary, although unlike the Peabody, it focuses on verbal aspects. It
is appropriate for children and adults from 5 years old, the application is individual, and its duration
depends on the age of the person.

The Boston test consists of 60 images, ordered from least to greatest difficulty, that the tested subjects
must name (that is, the response requested is to name verbally). From the responses of the subjects to
the different series, a measurement of the person's productive vocabulary is obtained, as well as a
comparison with that of the general population.

8. LANGUAGE BATTERIES
Objective and Criteria Language Battery (BLOC)

It is a test designed to determine the child's linguistic skills and abilities, as well as whether he or she has
language disorders. A very important characteristic of the BLOC is that it is specifically built in Spanish, so
that in its design special attention was paid to its properties, acquisition and use. It is intended for
children between 5 and 14 years of age.

The BLOC explores four major aspects of language: morphology, syntax, semantics and pragmatics, both
at the comprehensive and expressive levels. It allows obtaining a score between 0 and 100 (centiles) that
would indicate the child's language level for each of the four aspects evaluated.

Illinois Test of Psycholinguistic Abilities (ITPA)

It is a well-known test that is used to determine the general linguistic abilities of children, as well as to
establish their level of language acquisition. The ITPA is appropriate for children from 5 to 10 years old,
and the application is individual, taking between 45 and 60 minutes.

The instrument includes two scales, one for spoken language and another for written language. The tests
that comprise them are the following:

a) Spoken language scale:

• Analogies: The evaluator tells a four-element analogy, in which the last part is missing.
The child must say that part that is missing. For example, in response to “Birds fly and
fish…” you should say “swim.”
• Vocabulary: the evaluator verbalizes a word that is an attribute of some name. For
example, you can say “I'm thinking about something that has a roof” and the child
should point to “a house.”
• Morphological closure: the examiner presents a sentence in which the last part is
missing. For example, you could say “Big, bigger…” and the child should complete the
sentence with “The biggest.”
• Syntactic Sentences: The examiner verbalizes a sentence that is syntantically correct
but does not make semantic sense, such as “Red flowers are smart.” The child must
repeat it.
• Sound Deletion: The evaluator asks the child to delete syllables and phonemes from
words. For example, you can instruct him to say the word “bumper” without the
syllable “cho.”

Rhythmic sequences: the evaluator presents a series of elements that rhyme with each
other, and that increase in length, such as "ma", "mommy", "my mom" and "my mom
pampers me". The child must repeat it.

b) Written language scale:

• Sentence Sequencing: The child reads a series of sentences and arranges them in an
appropriate sequence. For example, if the sentences were A. I'm going to school, B. I
get up and C. I get dressed, the sequence would be B, C and A.
 • Written Vocabulary: A written adjective is presented (for example, “Unbroken”) and
the child writes a matching noun (such as “mirror” or “car”).
• Sign decoding: the child pronounces a written list of words that contain irregular parts.
• Decoding sounds: the child reads aloud the names of imaginary creatures (for example
Flant and Yang).
• Sign Spelling: The evaluator reads a list of words, and presents the child with a sheet on
which the beginnings and endings of those words are printed. The child must write the
missing phonemes. For example, the evaluator says “shirt", presents "c a" and the child
must add "amis".
• Spelling sounds: The evaluator reads aloud made-up but phonetically correct words,
and the child must write them down.

Once the different tests have been passed, scores are obtained for each of them which are subsequently
converted into percentiles. In this way, a global score is obtained for each scale, and a global score is
then converted into an approximate age of development according to standardized criteria.

Language Delay Analysis Questionnaire (Arel)

It is an instrument aimed at children between 3 and 6 years old, for individual application, and designed
specifically in Spanish and Catalan for the evaluation of language delays and SLI. It consists of a set of
three protocols for language evaluation in a spontaneous context:

• Protocol for the evaluation of language delay: to perform a rapid evaluation in the general
population.
• Complementary assessment protocol: to evaluate concomitant factors.
• Language profiling protocol: allows the results obtained from the application of the instrument
to be represented to establish the objectives of the intervention.

Once the instrument is applied, it is possible to determine the child's level in communication, language
comprehension and language production (phonetics and phonology, lexicon, morphology and syntax).

Navarra Oral Language Test (Plon-R)

It is a test that is used for rapid evaluation (screening) of oral language development, since it only takes
between 10-15 minutes. Its application is individual and is indicated for children 4 to 6 years old.

Through different tests, the PLON-R evaluates the content, form and use of language, using materials
adapted to each age group. For example, in one of the tests the child must name various objects
presented in a booklet of images, in another he is asked to repeat phrases pronounced by the evaluator,
and in another a series of drawing sheets are presented, so that in On some occasions the child must
point to the object that the evaluator says, and on other occasions he must name the one that is pointed
out to him.

Development of Morphosyntax in the child (TSA)

It is a test aimed at children aged 3-7 years that measures the understanding and expression of aspects
of the morphosyntactic level of language. Its application is very convenient, since a book with plates is
used that contains all the necessary materials.
Sadek-Khalil test

Although it was originally designed for the English language, there is a translation adapted to Spanish. Its
use is suitable for children from 6-7 years old with minimal reading ability, and is complemented by an
adult evaluator. The test is made up of twelve different tests, each of which explores a particular aspect
of language use:

Test I: noun and verbs. Test VII: verb tenses.

Test II: articles and pronouns. Test VIII: chronological order and statements.
Test III: opposites.
Test IV: arithmetic operations.
Test V: drawing and expression. Test IX: meaning and use of prepositions.
Test VI: question and words Test X: conjunctions, restrictions and
indefinite. Names.
Test XI: use of pronouns.
Test XII: direct and indirect speech.

Within each of these tests, children must put all their linguistic skills into play simultaneously:
comprehension, production, syntax, morphology, etc. Therefore, this is not an instrument that measures
the development of each of the language levels separately, but rather it measures the global
development of this capacity.

Because the tests evaluate language in a broad way, it must subsequently be examined in which aspects
of language the greatest difficulties are found and, in addition, those skills that the child masters without
problems. This type of open evaluation can be more complicated than that used in traditional tests, in
which errors are counted numerically to obtain a final objective value that would reflect the subject's
level of competence. But in exchange, it offers much more significant and rich results since they explicitly
show the linguistic aspects that the child masters and those that he or she does not, therefore facilitating
the evaluation of the language (and possible intervention on it).

9. LITERACY TESTS

Literacy Analysis Test (Tale-2000)

This instrument consists of a series of tests that measure different reading and writing skills, so that its
use is appropriate for any child at a given moment in the process of acquiring such behaviors, although in
general it is applied between 5 and 14 years of age. years.

The TALE is divided into two fundamental tests: reading and writing. However, within each of them
several subtests are distinguished: reading letters, syllables, words and texts, and copying, dictation and
spontaneous writing. In each subtest, a series of pictures is presented to the child, who must read or
write these materials following the instructions provided.

Once the application of the TALE is completed, the total number of errors made for each subtest is
determined, which is subsequently compared with the number of errors expected per age group in order
to determine what level of reading and writing the child presents.