Assessing language comprehension in motor impaired children needing AAC: validity and reliability of the Norwegian version of the receptive language test C-BiLLT

Abstract

Children with severe motor impairments who need augmentative and alternative communication (AAC) comprise a heterogeneous group with wide variability in cognitive functioning. Assessment of language comprehension will help find the best possible communication solution for each child, but there is a lack of appropriate instruments. This study investigates the reliability and validity of the Norwegian version of the spoken language comprehension test C-BiLLT (computer-based instrument for low motor language testing) – the C-BiLLT-Nor – and whether response modality influences test results. The participants were 238 children with typical development aged 1;2 to 7;10 (years/months) who were assessed with the C-BiLLT-Nor and tests of language comprehension and non-verbal reasoning. There was excellent internal consistency and good test–retest reliability. Tests of language comprehension and non-verbal reasoning correlated significantly with the C-BiLLT-Nor, indicating good construct validity. Factor analysis yielded a two-factor solution, suggesting it as a measure of receptive vocabulary, grammar, and overall language comprehension. No difference in results could be related to response mode, implying that gaze pointing is a viable option for children who cannot point with a finger. The C-BiLLT-Nor, with norms from 1;6–7;6 is a reliable measure of language comprehension.

Keywords:

• Assessment
• augmentative and alternative communication
• C-BiLLT
• cerebral palsy
• cognition
• language comprehension

Acknowledgments

The authors would like to thank the participating children and their parents.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This project was funded by the Extrastiftelsen of Norway, as a part of the intervention study “Better life with Bliss”.