# Q&A from the webinar "How to Get the Most Out of TILLS"
with presenter Dr. Nickola Nelson

**Original Broadcast: December 10, 2015**

## Q. If Story Retell can be given without the follow-up of Delayed Story Retell, then why would we only give the one versus both?

**A.** An examiner might give Story Retelling alone if there were not enough time to give Delayed Story Retelling 20-30 minutes later in the same session. If that were to happen, the Story Retelling standard score still could provide valuable information about the student’s ability to understand, remember, recall, and retell narrative discourse immediately after hearing a story. I believe the point being made in the Webinar was that the examiner cannot administer Delayed Story Retelling in a session in which Story Retelling was not administered previously (20-30 min earlier). Whenever possible, we recommend administering all 15 TILLS subtests to get the most complete information about the student, although many tests can be given alone. In the case of Story Retelling, it is better to have both scores so you can compare immediate story retelling with story retelling after a short delay but in the same session; however, if you can only manage one, it must be the original Story Retelling score.

Information about the TILLS performance for students with autism spectrum disorder who participated in the TILLS standardization research can be found on pp. 15-18 of the Technical Manual. Students with ASD are known for their individual differences. When evaluated with 79 students with ASD at a variety of ages, the TILLS was sensitive to social communication and language comprehension difficulties associated with ASD, as well as semantic difficulties (based on Vocabulary Awareness).

## Q. What advice do you have for practitioners using the TILLS when evaluating concerns of ASD? What would you expect to see in their profile?

As summarized in the TILLS Technical Manual, group means for ASD students were lowest for Social Communication (Mean Standard Score [SS] 4.08; SD 4.10); Reading Comprehension (Mean SS 4.11; SD 4.27); Listening Comprehension (Mean SS 5.23; SD 4.45); and Vocabulary Awareness (Mean SS 5.42; SD 4.44). Remember that 10, by definition, is the mean SS for students with typical language development. The highest mean scores were for Written Expression, both sentence and word scores, perhaps because students can see the print stimuli while rewriting the facts. An interesting observation for a few of the higher functioning students with ASD was that they were unusually good at embedding kernel sentences using a sort of “house that Jack built” strategy, which yielded extra-long T-units and high sentence combining scores. There is also a case study in the Examiner’s Manual (pp. 140-146) for a 6 year 6 month old student, “Randy,” with ASD that may be helpful in illustrating how to get the most out of TILLS with this population and how to relate TILLS results to the common core standards.

## Q. How do you get teenage boys to be the "actor" on the Social Communication subtest? Only one of my students has been willing.

**A.** This question requires a two-part answer. First, set up the task to be minimally threatening. Different students respond to different forms of encouragement. Younger children, in particular, may respond to the practice item if you demonstrate your willingness to be a little bit silly in acting out the whiny voice, but this may not work with the teenager. Try saying, “I know that some kids your age find this a bit embarrassing; you just have to act well enough so that I can tell you know what the words mean; you don't have to be overly dramatic; it’s just you and me here.” Try to sound a little conspiratorial, wait expectantly, and express confidence that the student can do this. You might add, “Just give it a try.” Praise the first solid attempt at acting (without giving feedback about the correctness of the item). Second, the instructions for this subtest allow you to use your judgment so as not to penalize shyness in scoring the items (see tips on pp. 83-84 of the Examiner’s Manual). You do need to see evidence that the student understood the key word and could represent its communicative intent both linguistically and pragmatically (i.e., with nonverbal or intonation features). Remember that you must be able to credit both aspects to give the student a point for that item.

## Q. Do you ever use the teacher/parent questionnaire as a screening to determine if the TILLS is indicated?

**A.** A primary reason we developed the TILLS Student Language Scale (SLS) was to screen for students who are at risk for a language/literacy disorder. If a student is rated on the SLS by his or her teacher lower than 5 on two or more of the items 1-8, that is a strong indication of a language/literacy disorder, which is an indicator that the student should be tested with TILLS.

## Q. I've administered the Social Communication subtest to a number of students. I tested with documented social communication impairments secondary to psychiatric diagnoses. I was quite surprised when several of these students scored within the average range yet based on their performance on other social pragmatic retesting still continued to present with significant social pragmatic impairments. What do you think accounts for this discrepancy?

**A.** The Social Communication subtest is sensitive to difficulty in formulating socially appropriate language to fit social contexts, but it is not a stand-alone assessment of social communication disorder. My guess would be that the students you describe have learned to respond in somewhat rote fashion because they have developed a surface understanding of the key terms that describe communicative intent on this subtest. It could be possible to earn credit for the items on this subtest and still have difficulty with social communication. I would look for signs of difficulty on other subtests for students like those you describe, such as for inferring meaning on the Listening and Reading Comprehension subtests, with semantic flexibility on the Vocabulary Awareness subtest, and with Story Retelling. I would view it as a positive prognostic factor if I found the results you are describing, with implications that social stories might provide a useful intervention context for students who are working on their social skills.

## Q. Where can I find the TILLS Easy-Score (electronic Scoring)?

**A.** This tool is still under development and should be available soon.

## Q. Can the test be given to English learners?

**A.** The TILLS can be given to English learners who use English as their primary school language, but not to identify disorder. For example, it might be useful for identifying patterns of strength and weakness in curriculum-relevant oral and written language and for tracking change over 6 month periods or longer; however, it should NOT be used to diagnose disorder for students who have not been learning English since birth. It was not standardized for that purpose.

## Q. What is the distinction between the role of Reading Specialist and that of the Speech-Language Pathologist given that many of the components of this assessment focus on assessments typically given by a reading specialist in the Core Curriculum?

**A.** Role division, role sharing, and inter-professional collaboration are extremely important, but roles cannot be assigned in the abstract. Decisions about roles in serving individual students must be made by teams based on local circumstances. What I can say in response to this question is that the TILLS is designed to be administered by Reading Specialists, SLPs, and other professionals, such as psychologists, who have been trained to administer standardized tests to individuals. Any one of these professionals could administer the TILLS and then the members of the team could consider the results collaboratively from multi-disciplinary perspectives. That would be a good way to get the most out of TILLS.