Interpretation of Working Memory Assessments

Leder, V. (2019, February 27). How To Improve Child’s Working Memory? STEM Little Explorers. https://www.stemlittleexplorers.com/en/improve-childs-working-memory/#google_vignette

1. Choose the most appropriate tests for the individual client.

   When choosing tests, consider ecological validity. Standardized tests may not be related to activities and behavioural in the class environment (Ward & Jacobsen, 2014). Furthermore, norms may not include all clinical populations including Developmental Language Disorder (DLD), or account for cultural/linguistic diversity. Scores should be used as a guide with further evidence to support the individual's profile.

2. Look for patterns across multiple tasks- not single scores.

   SLPs should consider performance across tasks of assessment to highlight areas of relative strength and weakness for children with DLD (e.g., comparing working memory [WM] and language deficits).

   
   

   - e.g., Normal digit recall, but poor nonword repetition may be due the impact of linguistic constraints from limited linguistic or phonological knowledge (Archibald, 2018).

   - e.g., Poor performance across the board would indicate a limitation in WM regardless of the nature of the stimuli (Archibald, 2018).

3. Compare performance within subtypes of WM.

   There are usually more deficits reported on verbal WM compared to visuospatial WM in children with DLD (Archibald, 2018), therefore this is what we may expect. If there are relative strengths in visuospatial WM, SLPs can leverage these abilities to compensate for verbal WM deficits. Another example of comparison is between forward and backward digit spans since forward assesses short-term memory and backward assesses working memory due to added manipulation of the input (Diamond, 2020).

4. Analyze the child's strategies and behaviours during testing.

   Scores never tell the whole story, so it's important to observe:

   - Rehearsal

   - Giving up quickly after errors

   - Confusing order vs. content

   - More errors with longer sequences

   - Asking for repetitions or support

   - Losing focus as linguistic loads increase

5. Consider Error Patterns & Therefore Relative Strengths

   Although SLPs should be cautioned for over-interpreting individual or subtest responses such as forgetting half of a sentences or non-responses (Archibald, 2018), consistent patterns should be noted.

   1. Phonological errors: nonword substitutions, omissions, and/or additions may suggest weak phonological encoding or rehearsal.

   2. Chunking Errors: failing to group information into chunks may indicate struggles organizing information in the WM.

   3. Intrusions/Preservations: can indicate poor inhibitory control.

   4. Slower recall: could indicate processing speed limitations rather than pure storage issues.

   5. Strategy errors: skipping or repeating items could indicate poor self-monitoring, sequencing, or attention allocation.

   6. Dual-interference: if performance drops when a secondary task is added, this could indicate central executive resources rather than storage alone.

5. Interpret Results in Relation to Classroom Demands

   1. Difficulty with complex span tasks: may struggle with instructions from educators.

   2. Weak phonological WM: may struggle with new vocabulary, phonics, spelling.

   3. Weak visuospatial WM: may impact reading, math, organization.

References

Archibald, L. M. D. (2018). The reciprocal influences of working memory and linguistic knowledge on language performance: Considerations for the assessment of Children with Developmental Language Disorder. Language Speech and Hearing Services in Schools, 49(3), 424–433. https://doi.org/10.1044/2018_lshss-17-0094

Diamond, A. (2020). Executive functions. In Handbook of clinical neurology (pp. 225–240). https://doi.org/10.1016/b978-0-444-64150-2.00020-4

Ward, S., & Jacobsen, K. (2014b). Executive Function Situational Awareness Observation tool. Perspectives on School-Based Issues, 15(4), 164–173. https://doi.org/10.1044/sbi15.4.164