Rossetti test

The Rossetti test, Rossetti Infant-Toddler Language Scale

The Rossetti test or the Rossetti Infant-Toddler Language Scale is a comprehensive assessment of verbal and preverbal communication skills in children from 0 to 36 months. Speech and language skills are critical, and contribute to a child’s daily functioning, communication, social interaction, and academic performance. However, some children do not acquire these skills as expected. An estimated 16% of children experience delays in the initial phases of learning language.

An estimated 16% of children experience delays in the initial phases of learning language.

Fortunately, speech therapy can help. The field of speech-language pathology (also referred to as speech therapy) is a specialization focused on the evaluation and treatment of communication disorders.

For infants and toddlers, early communication skills are important for developing cognitive skills, sharing ideas and emotions with others, and learning age-appropriate concepts. Early identification of a speech delay can lead to timely intervention, which has been shown to improve the child’s outcomes.

One of the most effective and commonly used tools by speech-language pathologists  assessing speech and language delays in infants and toddlers is the Rossetti Infant-Toddler Language Scale or the Rossetti test.

Let’s explore the Rossetti test and how speech-language pathologists can incorporate it into their practice.



Understanding the Rossetti test

The Rossetti test is a criterion-referenced assessment of communication skills in children up to 36 months old. The test was developed in 2006, and uses a combination of observation, direct assessment of the child’s skills, and caregiver report to assess a child’s skills.

The purpose of the Rossetti test is to identify language delays in young children. This can assist the speech-language pathologists with making a diagnosis of an Expressive Language Delay (ICD-10 CM F80.1) or a Mixed Receptive-Expressive Language Disorder (ICD-10 CM F80.2).

Key components and subtests of the Rossetti test
The Rossetti test consists of the following 6 subtests:
  • Interaction Attachment: Assesses the qualities of the interaction and relationship between the caregiver and the child.

  • Pragmatics: This subtest assesses the child’s use of language within social situations.

  • Gesture: Examines how the child uses gestures to communicate with others.

  • Play. Assesses the child’s use of symbolism and representational thought.

  • Language Comprehension: This subtest examines the child’s understanding of language.

  • Language Expression: Assesses the child’s use of language to communicate.

The Rossetti test includes test forms and an examiner’s manual. A list of additional items (such as balls and picture stimuli) that are required to administer the test items can be found in the Appendix within the Examiner’s Manual.

To administer the Rossetti, the examiner follows the guide on the test form to determine a starting point for the child according to their age. Speech therapists can complete each subtest included in the Rossetti or choose to administer only specific subtests.

Once the starting point for the subtest is determined, the therapist addresses each test item in order. Mastery of each skill can be reported by clinical observation, parent report, or as elicited by the therapist.

The Rossetti test does not yield a standard score or age equivalency. Instead, results reflect mastery of all skills in the area assessed at a 3-month interval. Severity rating guidelines are available to help the clinician interpret the results.

These results can be used to accurately determine the severity of a child’s delay in a specific domain. Therefore, the Rossetti test is invaluable as a tool for early identification of language delays and disorders in infants and toddlers.

Benefits and advantages of using the Rossetti test in speech therapy

There are several advantages of utilizing the Rossetti test in speech therapy. The results of the assessment can be used to identify language delays and disorders at an early age. By assisting therapists with identifying an appropriate diagnosis, using the Rossetti can also lead to timely intervention.

Early intervention through speech therapy can result in the best outcomes for the child. A child’s first few years are a critical time for learning, as 1 million new neural connections are formed each second.

“In the first few years of life, more than 1 million new neural connections are formed every second.”

Another benefit of using the Rossetti test as an assessment tool in speech therapy is that it provides a comprehensive assessment of various communication skills in the areas of both receptive and expressive language. This provides detailed information on a child’s specific areas of strength and difficulty.

Examining these areas of strengths and weaknesses can serve as a guide for therapists when creating an individualized treatment plan for a child. Strengths can be considered when selecting treatment materials and strategies. Difficulties can be targeted as goals in therapy.

The results of the Rossetti test can also be communicated with parents and caregivers, which can empower them with insights into their child’s communication abilities. This increased caregiver involvement in the therapy process is helpful in improving home carryover and accelerating a child’s progress.

Challenges and considerations in the Rossetti assessment

As with all assessment tools, SLPs should keep a few important considerations in mind when utilizing the Rossetti test in speech therapy.

Because the assessment is designed to be used with very young children (ages 0-3), certain challenges can arise. For example, the child may show a reduced attention span and decreased cooperation. An advantage of using the Rossetti test is that if test items cannot be successfully observed or elicited during the assessment, the caregiver can report on the child’s skill to complete a test item.



Tips for speech-language pathologists utilizing the Rossetti test
Keeping a few important points in mind can help speech therapists efficiently utilize the Rossetti in assessments.
  • First, the therapist should have received proper training and observation of the test. They should also familiarize himself with the test items within the age range for the client they are working with.

  • Building a supportive and trusting relationship with parents and caregivers can help the therapist complete an accurate, comprehensive interview when completing the Rossetti. This allows caregivers to feel more comfortable answering questions and asking for clarification.
  • Speech therapists can use the results of the Rossetti to customize therapy approaches by taking a holistic view of the child’s strengths and areas of difficulty into consideration. For example, if a child’s play skills are delayed in addition to expressive language skills, the therapist may consider targeting improvement of the child’s play skills and imitation as pre-language skills.

  • Observing family dynamics during administration of the Rossetti provides the therapist with insight into ways to involve the family in the therapy process. Caregiver involvement is particularly important when working with infants and toddlers. It allows for continuous practice and reinforcement of communication skills in functional, daily situations.

  • Speech therapists can directly involve caregivers in therapy sessions. It’s also helpful to provide resources and guidance to parents for fostering language development at home. For example, the therapist might recommend that the parent present choices throughout the day as a strategy for improving a child’s expressive vocabulary (i.e., “do you want juice or milk?).

The Rossetti Infant-Toddler Language Scale is a valuable assessment tool that provides speech language pathologists with an objective measurement of a child’s communication skills during the early years (birth through 3 years-old).

Early intervention is key for achieving the best outcomes in children with speech and language delays. The Rossetti test helps with this by assisting therapists in identifying communication delays, which can lead to timely intervention. Intervention can effectively improve communication skills and overall quality of life for infants and toddlers.


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Resources

Therapists can use TheraPlatform, an all-in-one EHR, practice management and teletherapy solution, to seamlessly integrate language assessments into their practice. Consider starting with a free trial of TheraPlatform today.

References

Al-Shamsi, A., Badawieh, M. (2023). The factors that impact the speech delay in the first three years of a child’s life. Journal of Language and Linguistic Studies, 19(1). DOI: https://www.jlls.org/index.php/jlls/article/view/5203

Heidi M. Feldman; How Young Children Learn Language and Speech. Pediatr Rev August 2019; 40 (8): 398–411. https://doi.org/10.1542/pir.2017-0325

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