Test Review:  
Preschool Language Scales- Fifth Edition (PLS-5)  
 
 

Version: 5th edition  

Copyright date: 2011  
Grade or Age Range: Birth-7;11  
Authors: Irla Lee Zimmerman, Ph.D., Violette G. Steiner, B.S., & Roberta Evatt Pond, M.A.  
Publisher: Pearson  
 
 

Section Page Number

1. Purpose pg. 2
2. Description pg. 2
3. Standardization Sample pg. 3
4. Validity pg. 3
a. Content pg. 4
b. Construct pg. 4
1. Reference Standard pg. 5
2. Sensitivity and Specificity pg. 6
3. Likelihood Ratio pg. 7
c. Concurrent pg. 8
5. Reliability pg. 9
a. Test-Retest Reliability pg. 9
b. Inter-examiner Reliability pg .9
c. Inter-item Consistency pg. 10
6. Standard Error of Measurement pg. 11
7. Bias pg. 11
a. Linguistic Bias pg. 11
1. English as a Second Language pg. 11
2. Dialectal Variations pg. 12
b. Socioeconomic Status Bias pg. 13
c. Prior Knowledge/Experience pg. 13
d. Cultural Bias pg. 15
e. Attention and Memory pg.15
f. Motor/Sensory Impairments pg. 17
8. Special Alerts/Comments pg.17
9. References pg. 18

 
  
 

 
1. PURPOSE  
 
The PLS-5 is designed for use with children aged birth through 7;11 to assess language
development and identify children who have a language delay or disorder. The test aims to
identify receptive and expressive language skills in the areas of attention, gesture, play, vocal
development, social communication, vocabulary, concepts, language structure, integrative
language, and emergent literacy (Examiner’s Manual, pg. 3). The PLS-5 aids the clinician in
determining strengths and weaknesses in these areas in order to determine the presence and
type of language disorder (e.g. receptive, expressive, and mixed), eligibility for services and
to design interventions based on norm-referenced and criterion referenced scores. Although it
is not intended to determine if a child is gifted, it may provide appropriate supplemental
information regarding their language development.  
 
2. DESCRIPTION  
 
The PLS-5 consists of two standardized scales: Auditory Comprehension (AC), to "evaluate
the scope of a child's comprehension of language," and Expressive Communication (EC), to
"determine how well a child communicates with others"(Examiner’s Manual, pg. 4).
Administration time varies based on the child’s age and can range between 25-35 minutes for
children aged birth through 11 months to 45-60 minutes for children over one year. Specific
AC tasks assessed include comprehension of basic vocabulary, concepts, morphology, syntax,
comparisons and inferences, and emergent literacy. Specific EC skills include naming,
describing, expressing quantity, using specific prepositions, grammatical markers, sentence
structures, and emergent literacy skills. Three optional supplemental measures are also
included (Language Sample Checklist, Articulation Screener, and Home Communication
Questionnaire). Scores are provided at three month intervals from birth through 11 months,
and at 6 months intervals from 1 year through 7;11. The PLS-5 yields norm-referenced
scores including standard scores, percentile ranks and age equivalents for the AC and EC
scales as well as for Total Language (TL). However, the manual warns against the use of age
equivalent scores as this type of score does not provide the sufficient information to
determine the presence of a language disorder, can be easily misinterpreted and have a
number of psychometric limitations (Examiner’s Manual pg. 17) The test recommends that
examiners calculate norm-referenced scores to identify speech and language disorders.
However the test does comment that evaluation of a child can also include portfolio
assessment, dynamic assessment and parent/caregiver interview (Examiner’s Manual, pg. 9).
Caregiver's responses to the Home Communication Questionnaire may support items on the
AC and EC scales from birth through 2;11. According to the test manual, the PLS-5 may
only be administered by trained professionals including speech-language pathologists, early
childhood specialists, psychologists and other professionals who have training and
experience in diagnostic assessment of children of this age.  

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3. STANDARIZATION SAMPLE  
 
The standardization sample for the PLS-5 included 1400 children aged birth through 7;11.
The standardization sample was matched to the 2008 United States census and was stratified
by demographic factors including age, sex, geographic region, race/ethnicity, and primary-
care giver’s highest education level. Inclusion into the standardization sample required
completion of the test without modifications. English was required to be the primary
language for all subjects for both comprehension and expression. For preverbal children,
English was the primary language of the caregivers in the home. Approximately 3% of the
sample population was from homes that spoke a language other than English. No note was
made in the Examiner’s Manual to match the standardization sample to U.S. census data
regarding children who spoke languages other than English in the home. The standardization
sample consisted mainly of children who spoke SAE (78.9%). The sample also included
4.2% of children who spoke African American English (AAE), 5.8% who spoke Spanish
influenced English, 4.4% who spoke Southern English, and less than 3% who spoke other
dialects. Scoring rules were adapted for children who spoke AAE, Spanish-influenced
English, Chinese-influenced English, Appalachian English and Southern English so that
children would not be penalized on test items that assess dialect specific linguistic skills.
However these modified rules only accounted for a portion of the other dialects in the sample.
No information is included in the manual explaining how participants were selected. The
manual does not discuss whether participants with disabilities were included in the
standardization sample. This is relevant because inclusion of participants with disabilities in
the standardization sample lowers the mean score of the test and negatively impacts the test’s
ability to distinguish between typically developing children and children with disorders (Pena,
Spaulding & Plant, 2006).
 
4. VALIDITY  
 
Content - Content Validity refers to how representative the test items are of the content that
is being assessed (Paul, 2007). Content validity was analyzed using literature reviews,
clinician feedback, expert review and response processes. New items on the PLS-5 were
refined from the PLS-4 to reflect current research on language development and were
determined via literature review and clinician feedback. Children’s response processes and
clinician feedback during the pilot and tryout phases of the PLS-5 development was used to
ensure the appropriateness and breadth of test items. Tryout testing to evaluate the
appropriateness and breadth of the PLS-5 took place between February and July 2009. Two
samples were collected: a nonclinical sample of 455 children aged 0-7;11 who had not been
previously diagnosed with a language disorder and a clinical sample of 169 children aged 2-
7;11 diagnosed with a receptive or expressive language disorder based on a score of 1.5 SD
below the mean on an unspecified standardized language test. Since we are unable to

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evaluate the accuracy and validity of the language tests used to classify the clinical sample,
the standardization process merely determined if the PLS-5 scores of the children matched
their scores on other unspecified language tests. It did not determine the presence of a
disability and the clinical sample’s true diagnostic status is unknown. As well, according to
Spaulding, Plante and Farinella (2006), the practice of using an arbitrary cut-off score to
determine disability is unsupported by the evidence and increases the chances of
misdiagnosis. Currently, no commercially available test is considered acceptably accurate in
identifying a disorder based on a score alone and research demonstrates that standardized
language tests do not consistently diagnose children correctly (Dollaghan and Horner, 2011).

Items were revised or deleted if they did not sufficiently differentiate between the clinical
and nonclinical samples or if the items were considered unfair or too difficult to score. PLS-
5 content was assessed for bias during pilot and tryout testing via a review of a panel of
experts with experience in assessment issues related to cultural and linguistic diversity. The
panel included speech-language pathologists and one psychologist who are professors at
various universities in the United States. Specific information regarding the background and
training of the “panel of experts” was not provided. As a result, the expert review panel may
have been limited in its ability to accurately assess the test content for bias. According to
ASHA (2004), clinicians working with culturally and linguistically diverse clients must
demonstrate native or near-native proficiency in the language(s) being used as well as
knowledge of dialect differences and their impact on speech and language. It is unknown if
this panel of experts was highly proficient in the variety of dialects and complexity of
linguistic differences for which they were evaluating content. Therefore we cannot be certain
that test items are free from cultural and linguistic biases. Due to lack of information
regarding method of selection of sample populations and diagnosis of the clinical population
as well as the training and background of “the expert” panel, content validity of the PLS-5
cannot be considered sufficient.  
 
Construct – Construct validity assesses how well the test measures what it purports to
measure (Paul, 2007). It was measured by comparing the performance of special groups of
children with language disorders or delays to typically developing children. The TD children
were defined as children who had not been previously diagnosed as having a language
disorder and who were not receiving speech and language services at the time. The children
with a language disorder or delay were defined based on a score of 1.5 SD below the mean
on an unspecified language test. The diagnosis of each group of children was compared with
their status to determine the diagnostic accuracy of the PLS-5. Once again, the lack of
information regarding what measure was used to determine diagnostic status immediately
calls into question the construct validity of the PLS-5. Also, as mentioned previously, the use
of an arbitrary cut score has been demonstrated not to be an effective or accurate way to
determine disability (Spaulding, Plante and Farinella, 2006). Clinical samples identified

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through the use of arbitrary cut off scores should not provide evidence for construct validity
and diagnostic accuracy.  

Reference Standard  
In considering the diagnostic accuracy of an index measure such as the PLS-5, it is
important to compare the child’s diagnostic status (affected or unaffected) with their
status as determined by another measure. This additional measure, which is used to
determine the child’s ‘true’ diagnostic status, is often referred to as the “gold standard.”
However, as Dollaghan & Horner (2011) note, it is rare to have a perfect diagnostic
indicator, because diagnostic categories are constantly being refined. Thus, a reference
standard is used. This is a measure that is widely considered to have a high degree of
accuracy in classifying individuals as being affected or unaffected by a particular disorder,
even accounting for the imperfections inherent in diagnostic measures (Dollaghan &
Horner, 2011).  

The reference standard used to identify children for the sensitivity group was a score
below 1.5 SD on an unspecified standardized test of language skills. The reference
standard was applied to two groups of children to determine the sensitivity measure. One
group was classified as language disordered (LD) and consisted of 229 children at least
three years of age who scored at least 1.5 SD below the mean on an unspecified language
test and were enrolled in a language therapy program at the time of test administration.
The second group was classified with developmental language delays (DLD) and
consisted of 23 children between one year and 3;11 who scored at least 1.5 SD below the
mean on an unspecified standardized test of language skills and were enrolled in a
language stimulation program. The test manual does not specify the language tests used
to classify the groups of affected children. As well, the test manual does not explain why,
other than age range, a distinction was made between the two clinical groups since they
only differentiating factor is age. Therefore, the validity of these tests is unknown and we
are unable to determine the accuracy of these tests in identifying children with language
disorders or delays.

It should be noted that children included in the DLD or LD groups were classified with
moderate to severe language delays. Children with mild language delays were not
included in the study (Examiner’s Manual pg. 93). In fact, to better distinguish between
children with a developmental language delay and typically developing children the
distinguishing score was shifted from 1 SD (cut score of 85) to 1.5 SD (cut score of 77).
The authors noted that the initial inclusion criteria were amended because at scores of 1
SD below the mean it was difficult to distinguish children with mild language delays
from those children that were typically developing (pg. 93). This inflates the diagnostic
accuracy of the test because it does not reflect the test’s ability to distinguish between TD
and children with mild DLD. Therefore, the diagnostic accuracy reported by the PLS-5
demonstrates a spectrum bias, which occurs when “diagnostic accuracy is calculated from

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a sample of participants who do not represent the full spectrum of characteristics”

(Dollaghan & Horner, 2011).

Many issues result in insufficient construct validity for the PLS-5. The reference standard
was not identified and therefore could not be evaluated. Additionally, the reference
standard used was not applied to the children classified as typically developing therefore
we cannot be sure they are free from the disorder (Dollaghan, 2007). This affects the base
rate, sensitivity and specificity measures and likelihood ratios. Construct validity is
reduced because test designers excluded children with mild language disorders in order to
inflate the diagnostic accuracy reported in the test manual.  

Sensitivity and Specificity  

Sensitivity measures the proportion of students who have a language disorder that will be
accurately identified as such on the assessment (Dollaghan, 2007). For example,
sensitivity means an eight-year-old boy previously diagnosed with a language disorder,
will achieve a score indicative of having a language disorder on this assessment. For the
group of children identified as LD (ages 3;11-7;11), the PLS-5 reports the sensitivity to
be .83 at a cut score of 1 SD or more below the mean. According to Plante & Vance
(1994), validity measures above .9 are good, measures between .8 and .89 are fair, and
measures below .8 are unacceptable. Therefore, the sensitivity of this measure would be
considered “fair.” It is important to consider the implication of this measure; a sensitivity
of .83 means that 17/100 children with a language disability will be identified as typically
developing and will not receive appropriate services. For the group of children identified
as DLD (ages 0-3;11), the PLS-5 reports the sensitivity to be .91 at a cut score of 1 SD
below the mean. This measure would be considered “good” according to the standards in
the field (Plante & Vance, 1994). However, the reported measures are invalid due to
spectrum bias noted in the typically developing and language delayed/disordered group.
Additionally, because the reference standard was previously determined to be invalid or
unknown, it is also unknown whether the sensitivity measures actually reflect the test’s
diagnostic accuracy.  

Specificity measures the proportion of typically developing students who will be

accurately identified as such on the assessment (Dollaghan, 2007). For example,
specificity means that an eight-year-old boy with no history of a language disorder will
score within normal limits on the assessment. In the clinical study with the group of TD
children, the PLS-5 reports specificity measures to be 0.8 at a cut score of 1 SD below the
mean, which would be considered a “fair” measure according to the standards in the field
(Plante & Vance, 1994). It is important to consider the implications. A specificity of .8
means that 20/100 typically developing children will be identified as having a language
disorder and may be inaccurately referred for support services. In the clinical study with
the group of DLD children, the PLS-5 reports specificity measures to be .78, an
unacceptable measure according the standards in the field (Plante & Vance, 1994).

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Additionally, because the reference standard was previously determined to be invalid or

unknown, the specificity measures do not reflect the test’s diagnostic accuracy.

The same reference standard was not applied to both the specificity and sensitivity groups.
This decreases the validity of the test due to spectrum bias which occurs when the sample
population does not represent the full spectrum of the clinical population (Dollaghan &
Horner, 2011). Due to lack of information about the reference standard, the diagnostic
status of the specificity group is unknown so we cannot be sure about the accuracy of the
specificity measure. Sensitivity and specificity were also determined to be unacceptable,
despite reported measures considered to be “fair” or “good” (.80 or above), due to lack of
information regarding the reference standard as well as spectrum bias caused by different
reference standards being used for different clinical populations.  

Likelihood Ratio  
According to Dollaghan (2007), likelihood ratios are used to examine how accurate an
assessment is at distinguishing individuals who have a disorder from those who do not. A
positive likelihood ratio (LR+) represents the likelihood that an individual who is given a
positive (disordered) score on an assessment actually has a disorder. The higher the LR+
(e.g. >10), the greater confidence the test user can have that the person who obtained the
score has the target disorder. Similarly, a negative likelihood ratio (LR-) represents the
likelihood that an individual who is given a negative (non-disordered) score actually does
not have a disorder. The lower the LR- (e.g. < .10), the greater confidence the test user
can have that the person who obtained a score within normal range is, in fact, unaffected.  
 
Likelihood ratios for the reference standard are not reported as the reference standard was
not applied to the typically developing group. While the reference standard was applied
to the language disordered group and the language delayed group, the PLS-5 does not
report how many children in each group scored below a score of 77 (the cut-off score).
Thus, the sensitivity value does not truly reflect the test’s diagnostic accuracy and
consequently likelihood ratios cannot be calculated.  

Overall, construct validity, including the reference standard, sensitivity and specificity, and
likelihood ratios of the PLS-5 was determined to be insufficient. An unspecified reference
standard invalidates the diagnostic accuracy of the test because we cannot be sure children
identified as having a disability by the reference standards were accurately diagnosed. As well,
because no reference standard was applied to the non-clinical group for the specificity measure
we cannot be sure these children are free from a disorder. Inflated diagnostic accuracy reported
in the test manual contributes to concern regarding the validity of the PLS-5 in detecting the
presence of language disorder. In addition, the authors changed the diagnostic criteria for
distinguishing between LD and TD individuals to below 1.5 SD when they realized that scores
below 1 SD did not distinguish between the two groups. This produces spectrum bias because it
excludes those individuals who have a mild disorder. As a result, the population used to

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determine the validity of the PLS-5 does not represent the clinical population encountered by
speech language pathologists, which is likely to include children with mild language delay or
disorder. This makes the PLS-5 inappropriate for real-world applications and intentionally leads
an evaluator who has not carefully read the manual to believe the PLS-5 has a level of accuracy
which it does not possess when applied to real clinical populations. The test manual does not
state that it is only intended to identify children as moderately or severely delayed. In addition, in
determining concurrent validity, the reference standards used (below 1.5 SD on the PLS-4 or
CELF-P2) were themselves invalid measures for determining the presence of a language delay or
disorder and these comparison populations did not cover the entire age range for which the PLS-
5 was designed. Therefore, the diagnostic accuracy of the PLS-5 is insufficient and the PLS-5
cannot be considered a valid diagnostic tool.

Concurrent - Concurrent validity is the extent to which a test agrees with other valid tests of
the same measure (Paul, 2007). According to McCauley & Swisher (1984), concurrent
validity can be assessed using indirect estimates involving comparisons amongst another test
designed to measure similar behaviors. If both test batteries result in similar scores, the tests
“are assumed to be measuring the same thing” (McCauley & Swisher, 1984, p. 35).
Concurrent validity was measured by comparing performance of a clinical sample on the
PLS-5 to two other child language assessments: the CELF-P2 and the PLS-4. The study
conducted to compare the PLS-5 to the PLS-4 consisted of a sample of 134 children aged 0-
6;11 as this is the age range for the PLS-4. Correlation coefficients for the study were .80 for
the AC and EC scales and .85 for TL. The study conducted to compare the PLS-5 with the
CELF-P2 consisted of a sample of 97 children aged 3-6;11 as this is the age range for the
CELF-P2. Correlation coefficients for the study ranged between .70-.82. According to Salvia
and Ysseldyke (as cited in McCauley and Swisher, 1984), a correlation coefficient of .90 or
better is needed to provide sufficient evidence. It is important to note that the entire age
range for which the PLS-5 is intended was not standardized. According to the test manual,
the PLS-5 is intended to diagnose language delay/disorder in children from birth to 7:11,
however concurrent validity was not determined for ages 6;11- 7;11. Further, concurrent
validity “requires that the comparison test be a measure that is itself valid for a particular
purpose” (APA, 1985, as cited in Plante & Vance, 1994). The PLS-4 has a specificity
measure of .90 but a sensitivity measure below .50 which is unacceptable according to the
standards in the field and should not be used to determine the concurrent validity of the PLS-
5. The CELF-P2 had a sensitivity of .85 and specificity of .82 on the core language score
indicating fair diagnostic accuracy. However, since it only compares children between 3-6;11
it does not account for children in the range for which the PLS-5 is intended (0-7;11) it
should not be used as a comparison measure. Due to comparison measures which do not meet
acceptable levels of validity and/or measures which do not cover the entire age range for
which the PLS-5 is intended, concurrent validity was found to be insufficient.

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5. RELIABILITY  

According to Paul (2007, p. 41), an instrument is reliable if “its measurements are consistent
and accurate or near the ‘true’ value”. Reliability may be assessed using different methods,
which are discussed below. It is important to note, however, a high degree of reliability alone
does not ensure validity. For example, consider a standard scale in the produce section of a
grocery store. Say a consumer put on three oranges and they weighed one pound. If she
weighed the same three oranges multiple times, and each time they weighed one pound, the
scale would have good test-retest reliability. If other consumers in the store put the same 3
oranges on the scale and they still weighed 1 pound, the scale would have good inter-
examiner reliability. Now say an official were to put a one-pound calibrated weight on the
scale and it weighed two pounds. The scale is not measuring what it purports to measure—it
is not valid. Therefore, even if the reliability appears to be sufficient as compared to the
standards in the field, if it is not valid it is still not appropriate to use in assessment and
diagnosis of language disorder.  
 
Test-Retest Reliability – Test-retest reliability is a measure used to represent how stable a
test score is over time (McCauley & Swisher, 1984). This means that despite the test being
administered several times, the results are similar for the same individual. Test-retest
reliability was calculated by administering the test twice to 195 children from the normative
sample ranging in age from birth to 7;11. The administration was conducted by the same
examiner, and the testing interval ranged from 3-28 days. Correlation coefficients were
calculated for Auditory Comprehension, Expressive Communication, and Total Language for
three age brackets: 0;0-2;11, 3;0-4;11, and 5;0-7;11, yielding nine correlation coefficients.
The reliability coefficients ranged from .86 to .95. According to Salvia, Ysseldyke, & Bolt
(2010, as cited in Betz, Eickhoff, & Sullivan, 2013), many of these reliability coefficients are
insufficient. They recommend a minimum standard of .90 for test reliability when using the
test to make educational placement decisions, such as speech and language services. As well,
the small sample size of children in each age band limits the reliability measure. Thus, the
test-retest reliability for the PLS-5 is considered insufficient due to a small sample sizes and
because three out of nine correlation coefficients were less than the accepted minimum
standard.  
 
Inter-examiner Reliability– Inter-examiner reliability is used to measure the influence of
different test scores or different test administrators on test results (McCauley & Swisher,
1984). It should be noted that the inter-examiner reliability for index measures is often
calculated using specially trained examiners. When used in the field, however, the average
clinician will likely not have specific training in test administration for that specific test and
thus the inter-examiner reliability may be lower in reality. Inter-examiner reliability was
assessed in a study where two examiners assessed 54 children in two age brackets: birth -
3;11 and 4;0 - 7;11. Inter-examiner reliability coefficients ranged from .96 - .99 across

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subtests for both age groups, indicating acceptable inter-examiner reliability (Salvia,
Ysseldyke, & Bolt, 2010, as cited in Betz, Eickhoff, & Sullivan, 2013).

Test developers additionally conducted a second study, referenced as the interscorer study, to
evaluate the consistency of scoring rules for test items that are judged subjectively or where
there is room for interpretation. For example, item 38 on the EC scale requires the child to
answer questions logically. To be considered correct a specific answer is not required. Rather,
the examiner judges the item to be correct based on their interpretation of the child’s answer.
To examine inter-scorer reliability, scores were compared between trained scorers and the
examiner to determine if scoring rules were clear and objective. Trained scorers consisted of
five individuals who had been trained in applying scoring rules to the subjective items. Two
hundred test protocols were randomly selected for use in this study. Interscorer agreement
ranged from 91.9 to 100%, indicating acceptable reliability (Salvia, Ysseldyke, & Bolt, 2010,
as cited in Betz, Eickhoff, & Sullivan, 2013). This implies that most clinicians will arrive at
the same score decision for items that have subjective scoring and that interscorer reliability
meets acceptable standards.  
 
Inter-item Consistency – Inter-item consistency assesses whether “parts of the test are
measuring something similar to what is measured by the whole” (Paul, 2007). Inter-item
consistency was calculated using a split half coefficient for three populations: the normative
sample, children with language disorders and children with language delays. Correlation
coefficients ranged between .91 and .98 for all three groups. Please see the chart below for
correlation coefficients.  
 
Population   AC Coefficient   EC Coefficient   TL Coefficient  
Normative Sample   .91   .93   .95  
Children with Language Disorders   .97   .97   .98  
Children with Language Delays   .96   .93   .97  
 
Based on these numbers, inter-item consistency is considered acceptable (Salvia, Ysseldyke,
& Bolt, 2010, as cited in Betz, Eickhoff, & Sullivan, 2013).

Overall, most types of reliability for the PLS-5, including inter-item consistency and inter-
examiner reliability, meet standards established as acceptable for the field. Test-retest
reliability was compromised, however, due to unacceptable coefficients and issues regarding
sample size and short latency time between test-retest administrations that could lead to a
practice effect. Regardless, “a high degree of reliability alone does not ensure validity”
(McCauley & Swisher, 1985, pg. 35). As noted in previous paragraphs, the PLS-5 was not
found to be a valid instrument for identifying the presence of language disorder or delay.

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6. STANDARD ERROR OF MEASUREMENT

 
According to Betz, Eickhoff, and Sullivan (2013, p. 135), the Standard Error of Measurement
(SEM) and the related Confidence Intervals (CI), “indicate the degree of confidence that the
child’s true score on a test is represented by the actual score the child received.” They yield a
range of scores around the child’s standard score, which suggests the range in which their
“true” score falls. Children’s performance on standardized assessments may vary based on
their mood, health, and motivation. For example, a child may be tested one day and receive a
standard score of 90. Say he was tested a second time and he was promised a reward for
performing well; he may receive a score of 96. If he were to be tested a third time, he may
not be feeling well on that day, and thus receive a score of 84. As children are not able to be
assessed multiple times to acquire their “true” score, the SEM and CIs are calculated to
account for variability that is inherent in individuals. Current assessment guidelines in New
York City require that scores be presented within CIs whose size is determined by the
reliability of the test. This is done to better describe the student’s abilities and to
acknowledge the limitations of standardized test scores (NYCDOE CSE SOPM 2008, p. 52).
 
The clinician chooses a confidence level (usually 90% or 95%) at which to calculate the
confidence interval. Although a larger range of scores is yielded with a higher confidence
interval, the clinician can be more confident that the child’s ‘true’ score falls within that
range. A lower level of confidence will produce a smaller range of scores but the clinician
will be less confident that the child’s true score falls within that range. The wide range of
scores necessary to achieve a high level of confidence, often covering two or more standard
deviations, demonstrates what little information is gained by administration of a standardized
test.  

The PLS-5 provides CIs at the 90% and 95% confidence levels for AC, EC, and TL. For
example, consider a child aged 2;0-2;5 who received a raw score of 22 on the EC subtest,
that raw score converts to a standard score of 77. As this score falls 1.5 SD from the mean,
this child would likely be classified as having a mild expressive language disorder. However,
according to the manual, at a 90% confidence level, the child’s true score falls between 72
and 87. The lower bound of this interval would suggest a moderate to severe expressive
language impairment while the upper bound would classify the child as typically developing.
We cannot determine eligibility for special education services and provide a disability label
based on a measure with this much variability (even if the test were a valid measure).  

7. BIAS:  

Linguistic Bias

English as a Second Language

 

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Paradis (2005) found that children learning English as a Second Language (ESL) may
show similar characteristics to children with Specific Language Impairments (SLI) when
assessed by language tests that are not valid, reliable, and free of bias. Thus, typically
developing students with limited English proficiency (LEP) may be diagnosed as having
a language disorder when, in reality, they are showing signs of typical second language
acquisition. According to ASHA, clinicians working with diverse and bilingual
backgrounds must be familiar with how elements of language differences and second
language acquisition differ from a true disorder (ASHA, 2004).  

According to Paradis (2005), grammatical morphology has been noted as an area of

difficulty for children with LEP. In the AC subtest, children are presented with a
grammatically incorrect sentence such as, “Her can eat cookies” (pg. 52). Children are
required to make grammaticality judgments and provide the correct response. A child
with LEP, who has difficulty with pronouns, may respond with “Her ate cookies” which
would be considered incorrect. The answer however may reflect the child’s lack of
exposure to English pronouns rather than a disorder since an acceptable response to this
sentence could be “she ate cookies”. As well, many items in the EC subtest are judged
correct based on the grammaticality of the child’s response. For example, a child is
required to correctly describe pictures using present progressive tense or formulate
grammatically correct questions in response to picture stimuli. All of these items could be
challenging for a child with LEP and they could be misdiagnosed as having a language
disability. Despite research demonstrating the similarity in expressive language of LEP
children and LD children, the manual makes no mention of this fact to alert clinicians to
the potential inappropriateness of the test.

Dialectal Variations  

A child’s performance on the PLS-5 may also be affected by the dialect of English that is
spoken in his or her home and community. It is important to consider the dialect issues
caused by the test being administered in Standard American English (SAE). For example,
imagine being asked to repeat the following sentence, written in Early Modern English:
“Whether 'tis nobler in the mind to suffer the slings and arrows of outrageous fortune or
to take arms against a sea of troubles and by opposing end them” (Shakespeare, 2007).
Although the content of the sentence consists of words in English, because of the
unfamiliar structure and semantic meaning, it would be difficult for a speaker of SAE to
repeat this sentence.  

Speakers of dialects other than SAE (e.g. African American English (AAE), Patois) face
a similar challenge when asked to complete tasks such as sentence repetition e.g. “When
he came home from school, Joey ate a snack”, EC #57), story retelling (AC #53-57, EC
#58-60) and sentence formulating (EC #61). Consider how taking a test in your non-
native language or dialect will be more taxing - it will take longer and more energy for a

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dialect speaker to process test items in a dialect that they are not familiar/conformable
with. As a result, the child’s performance will necessarily be affected and is not
comparable to a normative sample consisting almost entirely of SAE speakers. The PLS-
5 takes into consideration dialectal variations in scoring but does not account for the
variety of dialects spoken in the United States. As well, if the examiner does not speak
the same dialect it may place an extra burden on the child or they may be uncomfortable
using their dialect and attempt to switch to SAE despite being less proficient. The test
designers fail to recognize this inherent bias and do not suggest accommodations that
examiners can make or even acknowledge this bias in the manual.  

Socioeconomic Status Bias  

Hart & Risley (1995) found that a child’s vocabulary correlates with his/her family’s Socio-
economic Status (SES); parents with low SES (working class, welfare) used fewer words per
hour when speaking to their children than parents with professional skills and higher SES.
Thus, children from families with a higher SES will likely have larger vocabularies and thus
will likely show a higher performance on standardized child language tests. A child from a
lower SES background may be falsely identified as having a language disorder if they are
unable to correctly label items or answer questions that rely on vocabulary exposure such as
the understanding analogies items in the AC subtest.  Children from low SES often perform
more poorly than age-matched peers from middle SES on standardized language tests. In
contrast, there is often no difference in the abilities of these two groups to learn novel words,
demonstrating the bias of standardized tests against children from low SES as these tests are
highly correlated to SES (Horton-Ikard & Weismer, 2007).    According to Peña and Quinn
(1997), children from a low SES have less exposure to labeling and may be at a disadvantage
in tasks that require labeling such as picture identification on the AC scale [e.g. television
(#31), rollerblades (# 46)] or picture naming in the EC scale [e.g. balloon (#26)]. A child
from a lower SES may not have had exposure to certain items such as a rollerblades, which
would impair their ability to correctly answer these questions. According to Hart and Risley
(1995), students from low SES on average have significantly less exposure to vocabulary and
less familiarity with books. They would be especially challenged on the story retelling and
would be less able to demonstrate emergent literacy through book handling and print
awareness on the AC scale (#63).

Prior Knowledge/Experience  

A child’s performance on the PLS-5 may also be affected by their prior knowledge and
experiences. For example, a child from a city may not know what a frog (AC #51) or motor
boats (AC #58) are because they have not been exposed to these things previously.

It is also important to consider that the format of the test may affect a child’s performance if
they do not have prior experiences with the specific type of testing. According to Peña, &

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Quinn (1997), children from culturally and linguistically diverse backgrounds do not perform
as well on assessments that contain tasks such as labeling and known information questions,
as they are not exposed to these tasks in their culture. The PLS-5 contains a number of tasks
that are dependent on prior knowledge and experience. Many items on the EC scale are based
entirely on labeling. A child who has not been exposed to this type of testing may not
perform well on these tasks. For example, EC item 30 requires the child to label items as the
examiner points to various pictures [e.g. cookie, scissors, banana]). A child may label
scissors as “used for cutting” as they have been exposed to function-type description tasks in
their culture rather than labeling the object itself. According to Pena and Quinn (1997),
children from different cultures tend to use functional descriptions to label objects based on
culturally dependent maternal teaching strategies and different cultural expectations. As a
result, he or she may be falsely identified as having a language disorder due to poor
performance on similarly culturally dependent tasks such as this one.

Further, many tasks on the PLS-5 require the child to respond to a “known question,” where
the clinician obviously knows the answer. The child and the clinician attend to a single image
and the child is required to provide information. For example, on the “understands negatives
in sentences” portion of the AC subtest, the clinician provides a probe and the child responds
by pointing, (e.g. “Look at all the babies. Show me the baby who is not crying”). If the child
has not been exposed to this type of question, they may answer incorrectly because they are
unfamiliar with what is expected of them and their performance will not reflect their true
skills.  

Further, a child’s performance on the test may have been affected by their prior exposure to
books and toys. According to Peña and Quinn (1997), some infants are not exposed to books,
print, take-apart toys, or puzzles. The PLS-5 requires the child to interact appropriately with
different toys including blocks, a teddy bear, and various kitchen items. If the child has no
prior experience with these toys or this type of play, their performance may not reflect their
true skills. The PLS-5 demands the child attends to the test book for the length of the
assessment, something he or she may be unaccustomed to doing. He or she must also realize
that pictures and symbols have meaning and have familiarity with how to attend to them.
This is referred to as print awareness, which is a learned skill. Lack of prior exposure to
books and print materials may result in a lack of familiarity with letters and sounds. This can
appear to be a delay in pre-literacy skills including phonological awareness and letter
knowledge when compared to a normative sample largely made up of children with adequate
and mainstream exposure to print and books. This may negatively affect the child’s
performance on the AC scale when they are required to identify word initial sounds (#51) or
rhyme words on the EC scale (#53).

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Cultural Bias  

According to Peña & Quinn (1997), tasks of language assessments often do not take into
account variations in socialization practices. For example, the child’s response to the type of
questions that are asked (e.g. known questions, labeling), the manner in which they are asked,
and how the child is required to interact with the examiner during testing, may be affected by
the child’s cultural experiences and practices. For example, during test administration,
children are expected to interact with strangers. In middle class mainstream American culture,
young children are expected to converse with unfamiliar adults as well as to ask questions. In
other cultures, however, it may be customary for a child to not speak until spoken to. When
he does speak, the child often will speak as little as possible or only to do what he is told. If a
child does not respond to the clinician’s questions because of cultural traditions, they may be
falsely identified as having a language disorder. Also, a child’s level of comfort making eye
contact with the examiner or speaking to an adult may affect their performance on items in
the EC subtest that require the child to elaborate on or retell a story or formulate sentences.  

Attention and Memory  

Significant attention is required during administration of standardized tests. If the child is not
motivated by the test’s content, or they exhibit a lack of attention or disinterest, they will not
perform at their true capacity on the assessment. Further, fatigue may affect performance on
later items in the test’s administration. Even a child without an attention deficit may not be
used to sitting in a chair looking at a picture book for an hour. A child that has never been in
preschool and has spent most of his days in an unstructured environment and playing with
peers and siblings may find it very challenging to sit in front of a book for extended periods
of time.  
PLS-5 administration time varies depending on the child’s age, ability, attention span and
willingness to participate during the test. Administration time for young (birth – 11mo)
children ranges between 25-35 minutes and increases up to an hour for children 3 years to 7
years 11 months. This can be taxing for children, particularly if they are struggling with the
test or are uncomfortable with the testing situation. The test manual does permit break time
for children to rest, have a snack or go to the bathroom in order to optimize their attention
and focus. However, even with these concessions, many children (even those from
mainstream, middle class backgrounds) will still be highly resistant to finishing the test or
performing to their best ability due to lack of interest and/or motivation in the testing
materials.  

Short-term memory could also falsely indicate a speech and/or language disorder. Many of
the test items require the child to hold several items in short term memory at once, then
compare/analyze them and come up with a right answer. A child with limited short-term
memory may perform poorly on standardized assessments due to the demands of the tasks.
However, he may not need speech and language therapy but rather techniques and strategies

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to compensate for short-term or auditory memory deficits. Further, as the sample population
did not include children with attention and/or memory deficits, results of this assessment are
invalid for children with attention deficits.  

Motor/Sensory Impairments  
In order for a child to participate in administration of this assessment, they must have a
degree of fine motor and sensory (e.g. visual, auditory) abilities. If a child has deficits in any
of these domains, their performance will be compromised. For example, for a child with
vision deficits, if they are not using proper accommodations, they may not be able to fully
see the test stimuli, and thus their performance may not reflect their true abilities. A child
with motor deficits, such as a child with typical language development but living with
cerebral palsy (CP), may find it much more frustrating and tiring to be pointing to/attending
to pictures for an extended period of time than a typically developing non-disabled child. The
child with CP may not perform at his highest capacity due to his motor impairments and
would produce a lower score than he or she is actually capable of achieving. Further, as the
sample population did not include children with motor/sensory impairments, results of this
assessment are invalid for children with motor and sensory impairments.  
8. SPECIAL ALERTS/COMMENTS  

The PLS-5 was designed to assess receptive and expressive language abilities in children
aged 0-7;11 in order to determine the presence of a language delay or disorder. The test
consists of an auditory comprehension scale and expressive communication scale to
evaluate specific areas of strength and weakness. However, results obtained from
administration of the PLS-5 are not valid due to an insufficient reference standard and
insufficient discriminant accuracy to properly identify children with a language delay or
disorder. Furthermore, there are other issues of concern that call into question the validity
of the PLS-5 as a diagnostic measure of speech and language ability. The PLS-5 manual
states that it is a valid test with sensitivity values that appear to be fair or acceptable
according to the standards in the field. However, it is critical to note that these numbers are
misleading as the clinical populations chosen for the sensitivity measure were chosen
through an unspecified measure. Specificity measures reported as fair were invalid since no
reference standard was applied to the non-clinical sample for the specificity measure.
Additionally, the clinical sample used to determine sensitivity and specificity was subject to
spectrum bias. Only those individuals who were clearly language disordered/delayed were
included in the sensitivity sample and only those who were not receiving speech and
language services were included in the specificity sample. Mildly delayed children and
children who were borderline typically developing were excluded from diagnostic accuracy
measures reported. Diagnostic accuracy measures are irrelevant as they were not based on
a population representative a real world clinical population.

    16  
  
 

In addition to unacceptable measures of validity, accuracy and reliability in determining the

presence of language disorder or delay, the PLS-5 contains significant cultural and
linguistic biases which preclude it from being appropriate for children from diverse
backgrounds. This is noted in federal legislation which requires testing materials to be
“valid, reliable and free of significant bias”(IDEA, 2004). As many parts of this test are
largely vocabulary based, it will likely falsely identify children as language delayed or
disordered from non-mainstream cultural and linguistic backgrounds or who come from
lower socioeconomic status.

Labeling children as disabled and placing them in special education when they do not need
to be there has many long lasting and detrimental consequences. These consequences
include a limited and less rigorous curriculum (Harry & Klingner, 2006), lowered
expectations which can lead to diminished academic and post-secondary opportunities
(National Research Council. 20002; Harry & Klinker, 2006) and higher dropout rates
(Hehir,2005) Due to cultural and linguistic biases such as vocabulary and labeling tasks as
well as assumptions about prior knowledge and experiences (Hart & Risley, 1995; Peña and
Quinn, 1997), this test should only be used to probe for information and not to identify a
disorder or disability. Even for children from mainstream, SAE speaking backgrounds, the
test has not demonstrated adequate validity and diagnostic accuracy. Therefore, scores
should not be calculated to determine classification or referral to special education services.
A speech and language evaluation should be based on clinical observations, consideration
of the child’s prior experiences and development history, as well as the parental report.
Performance should be described in order to gain the most accurate conclusions about the
nature and extent of language skills and to develop appropriate treatment recommendations
(McCauley & Swisher, 1984).

   

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