Case Two

A 10-year-old shows strong sound-word level skills on phonemic awareness and all the nonword tasks (repetition, reading and spelling), but scores significantly below age level on story retelling (immediate and delayed), as well as on subtests of listening and reading comprehension, vocabulary awareness, social communication, and written expression. A focus on phonics and phonological word structure would not be the best use of treatment time for this student. A better use of treatment time would be to focus on vocabulary, syntax, and discourse skills that could improve comprehension and expression across spoken and written communication modalities, preferably using the student’s actual curricular materials.

Q. What are the next steps a school should take after a TILLS assessment? Does TILLS include guidance on what to do next?

TILLS results also may be used to support more specific diagnoses. Consider the following examples:

A. The results of the TILLS assessment can be used by Multidisciplinary Evaluation Teams in schools as a critical piece of valid and reliable evidence in deciding whether a student meets eligibility criteria as having a language impairment or learning disability.

• A diagnosis of dyslexia would be consistent with a pattern of low TILLS scores in sound and word structure knowledge, reading fluency, and reading comprehension, but higher TILLS scores in listening comprehension and story retelling. This is the upper left-hand corner of the quadrant model.
• A diagnosis of specific deficit in the area of comprehension would be consistent with a pattern of relatively better TILLS scores in sound and word structure knowledge.
• If students’ scores fall in an area of marginal concern, school teams might decide to recommend further instruction in a response to intervention (RTI) model that does not include special education placement. TILLS could be readministered 6 months to a year later to add to other evidence regarding the student’s need for special education.
• A diagnosis of general spoken-written language impairment, which may also be called language-learning disability, would be consistent with a pattern of low skills across both language levels and all four modalities, although perhaps still with some areas of relative strength. This is the lower left-hand corner of the quadrant model.

References

Bishop, D. V. M., & Snowling, M. J. (2004). Developmental dyslexia and specific language impairment: Same or different? Psychological Bulletin, 130, 858-886.

A companion tool, the TILLS Student Rating Scale, can be used to document parent, teacher, and student perceptions and priorities related to the student’s strengths and needs. Use of both tools is consistent with the requirements of IDEA that multiple methods and sources of input must be used to determine eligibility for services in schools. By considering the pattern of specific strengths and weaknesses for a given student, along with information on the TILLS Student Rating Scale, the team can prioritize intervention targets and know which areas of strength to draw on.

Q. When will I be able to get TILLS?

Nickola Wolf Nelson, Ph.D., CCC-SLP, is the Director of the PhD program in Interdisciplinary Health Sciences at Western Michigan University, Kalamazoo, Michigan. Elena Plante, Ph.D., CCC-SLP, is a Professor, Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson. Nancy Helm-Estabrooks, Sc.D., CCC-SLP, is the Brewer Smith Professor Emerita, Western Carolina University, Cullowhee, North Carolina. Gillian Hotz, Ph.D., CCC-SLP, is the Director of the KiDZ Neuroscience Center, Research Professor, Department of Neurosurgery, University of Miami Miller School of Medicine in Miami, Florida.

About the Developers

A. TILLS will publish in the summer of 2015.

To provide information about patterns of language and literacy strengths and areas of concern that will guide next steps in assessment and intervention.

A. The major goal of the TILLS assessment is to identify oral and written language disorders and learning disabilities in school-age students (ages 6;0-18;11 years). TILLS is unique in assessing both oral AND written language in a manner that allows comparisons of a student’s sound-word and sentence-discourse level abilities across the four modalities of listening, speaking, reading, and writing. In addition, TILLS includes some subtests aimed directly at measuring aspects of memory that are relevant to classroom performance and performance on the other subtests. TILLS addresses three major assessment goals:

With a little practice, TILLS is easy to give, score, and interpret. The Examiner’s Manual and Record Form include key information needed to administer each subtest. Using the TILLS, clinicians can conduct a comprehensive assessment of students’ oral and written language skills and construct a complete profile that is meaningful to parents, teachers, and others involved in making educational decisions for students.