Bridging the gap by GAPS: a spoken language measure for young deaf children
When it comes to identifying spoken language difficulties in young deaf children, we have been missing a crucial tool. Unlike hearing children who have a plethora of appropriate tools available, identifying language issues in deaf children is like searching for a needle in a haystack. This is partly because deaf children may have more variations in their early language development than hearing children, which makes it harder to develop a standardised language test that accurately captures their language abilities. However, we’ve uncovered a test that can quickly identify language difficulties in young deaf children!
And here’s the best part: this test was originally developed for hearing children but surprisingly works even better for deaf children. The icing on the cake is – no special training is required to administer the test, making it a valuable tool for parents and teachers, not just speech therapists. With the new effectiveness of this test now revealed, the possibilities for its widespread use in both clinical and non-clinical settings are immense. By improving early communication of deaf children, this test has the potential to make a profound impact on children’s later language proficiency, academic achievement, socialization, and psychological well-being (Humphries et al., 2022).
Unveiling the language test – GAPS 💭
The test we mentioned previously is the Grammar and Phonology Screening (GAPS), designed by Van der Lely and colleagues in 2006. GAPS begins with an introduction to BIK, a friendly alien who wants to hear a story, making it a fun and exciting experience for children during the assessment. BIK can only understand children’s speech, so the children are invited to repeat the sentences spoken by the examiner and repeat the words spoken by BIK (acted out by the examiner). This interactive approach helps to fully engage children in completing the two main tasks of GAPS: sentence and nonword repetitions. These respectively examine grammatical (ability to use the rules and structures of a language) and phonological (ability to recognize and use the sounds of a language) skills. And in contrast to the typical hour-long standardised clinical evaluations, the whole test only takes 15 minutes.
Excitingly, despite GAPS’ short length, previous studies suggested that GAPS could accurately measure the grammatical and phonological skills of 3-6-year-old hearing children. And by 
assessing the grammatical and phonological performance, GAPS is able to identify whether a hearing child has language difficulties that may persist into language disorders. We wanted to take it a step further and validate GAPS as an effective tool for deaf children.
Insights from Our Research📄
We recruited 86 hearing children and 84 deaf children aged 3-4 years from nurseries around London and examine the efficacy of GAPS in both groups. To understand how we validated GAPS, let’s start with an analogy. 💭Imagine you’re building a house and need a ruler to measure the walls 📏📐. Different rulers may have varying precision, but ultimately, the results of length remain the same. In our case, when measuring children’s grammar and language skills, we want to know if GAPS is a reliable tool. To examine its accuracy, we
compared GAPS to other well-established language tests such as the CELF and the ERB, which are known for their ability to measure grammar and phonology effectively.
The good news is that the results of the GAPS, ERB and GAPS were highly correlated, showing that GAPS is a trustworthy way to measure kids’ those two language abilities. Surprisingly, the correlations between GAPS grammatical and phonological subtests and the corresponding CELF/ERB subtests were stronger among deaf children (table 1) than among hearing children (table 2). This suggests that GAPS, originally designed for hearing children, might be more effective in identifying language difficulties in deaf children.
Now let’s dive deeper 🤿: can GAPS accurately identify children with and without language difficulties? Think of it like a doctor using a thermometer to take a patient’s temperature🌡️. Just like how a fever can be a sign of an underlying illness🤒, grammatical and phonological are important signs of a language disorder. Importantly, we found that GAPS is more effective at identifying deaf children with language difficulties (70% accuracy) than hearing children (30% accuracy). Not only that, GAPS also has an impressive 96% accuracy at identifying deaf children without language difficulties, compared to 91% accuracy for hearing children.
Next Steps: Implications and Future Directions
- Our findings challenged the bias that it’s difficult to have tests that can accurately measure early spoken language skills and language difficulties in deaf children. It’s high time we develop more assessment tools for deaf children! Moreover, GAPS’ short and user-friendly administration can be widely applied in both clinical and non-clinical settings, making it a promising tool to improve language development in deaf children.
- Second, we found that GAPS can effectively identify children without language difficulties. This helps to prevent unnecessary referrals for further assessment or intervention. However, GAPS falls short when it comes to identifying children with language difficulties. This may lead to children missing out on necessary support and intervention in language development. These results echoed previous findings by Nash et.al., (2011).
- Last, it’s important to acknowledge that language tests generally aim for 90% accuracy. Our results showed that GAPS only achieved 70% accuracy in identifying language difficulties in deaf children and 30% accuracy in hearing children. These results suggest that further validation is needed for GAPS.
Reference
Gardner, H., Froud, K., McClelland, A., & van der Lely, H. K. (2006). Development of the Grammar and Phonology Screening (GAPS) test to assess key markers of specific language and literacy difficulties in young children. International Journal of Language & Communication Disorders, 41(5), 513-540.
Humphries, T., Mathur, G., Napoli, D. J., Padden, C., & Rathmann, C. (2022). Deaf Children Need Rich Language Input from the Start: Support in Advising Parents. Children, 9(11), 1609.
Johnson, E. S., Jenkins, J. R., Petscher, Y., & Catts, H. W. (2009). How can we improve the accuracy of screening instruments?. Learning Disabilities Research & Practice, 24(4), 174-185.
Nash, H., Leavett, R., & Childs, H. (2011). Evaluating the GAPS test as a screener for language impairment in young children. International journal of language & communication disorders, 46(6), 675-685.