The Test of Integrated Language and Literacy Skills, TILLS

The Test of Integrated Language and Literacy Skills (TILLS) is a comprehensive assessment tool that is commonly used to evaluate and diagnose language and literacy disorders in children.

Integrated language and literacy skills are crucial for participating in academic tasks and daily, real-life situations. It’s essential that individuals are able to comprehend and express wants, needs, and thoughts, through verbal and written language.

Speech therapy can play a critical role in supporting a child’s communication abilities. This includes developing both language and literacy skills, which allows individuals to communicate in academic and social environments.

In the field of speech therapy, a thorough and reliable assessment is the basis for effective treatment.  Here, we’ll take a close look at the TILLS, including the purpose of the assessment, associated benefits and challenges, real-life applications, and tips for administration. 

Understanding the Test of Integrated Language and Literacy Skills (TILLS)

The Test of Integrated Language and Literacy Skills (TILLS) is a comprehensive, norm-referenced assessment that examines oral and written language skills in children between the ages of 6-18 years.

The TILLS was published in 2016 by a team of experts in the field of speech-language pathology and literacy. This standardized test has three purposes:
  1. To identify language and literacy disorders
  2. To profile the child’s pattern of strengths and weaknesses. Examiners can compare the child’s skills at the sound-word level and the sentence discourse level for oral language (input and output) and written language (reading and writing).
  3. To monitor/track changes in language and literacy skills over time. The TILLS can be administered as often as once every 6 months. The examiner can compare the scores. The TILLS provides a True Change Interval, which allows examiners to know whether the child’s change in scores is statistically significant.

The TILLS consists of 15 subtests which assess key areas including:
  • Phonological awareness
  • Reading
  • Writing
  • Speech production
  • Listening skills (speech perception, comprehension)
  • Story recall

Benefits and advantages of using the TILLS 

There are several advantages to using the TILLS assessment with children and adolescents in speech therapy.

First, the assessment allows the speech-language pathologist to identify strengths and weaknesses in specific areas of language and literacy proficiency, by examining the results of individual subtests. The areas that a child scores below age-level expectations would be considered weaknesses, and can be targeted through goals in speech therapy. 

Strengths identified through areas on the test that a child scores at or above age-level can be incorporated into tasks and strategies used in speech therapy. Through this, SLPs are able to tailor therapy interventions based on the TILLS results to improve overall communication and literacy abilities.

Early intervention is key for effectively addressing improving language and literacy disorders in speech therapy. The TILLS is a valuable tool that allows SLPs to identify disorders in these areas early on, which can lead to timely targeted interventions.

Challenges and considerations for the TILLS Assessment

When administering the TILLS assessment, speech therapists should be aware of the diverse learning styles and linguistic backgrounds of their clients. Therapists can adapt the testing process (in accordance to the assessment manual) to account for these diversities, which can lead to a more accurate representation of a client’s true abilities.

It’s also recommended that therapists collaborate with educators and other professionals working with the client to complete a truly holistic evaluation. This collaborative approach can ensure a deeper, more comprehensive understanding of the client’s language and literacy skills across contexts.

Ensuring a supportive environment for individuals during the assessment process can ease anxiety or stress the client may have. By creating a comfortable and supportive testing environment, more accurate test results can be obtained.

Therapists should keep in mind that children with special needs or those with communication impairments may require adapted assessment methods. It’s important to review a client’s history and be prepared with ways to adapt or modify the TILLS to cater to an individual’s unique needs.

Case studies and real-life applications
  • Examining case studies in which the TILS assessment was utilized show how the test can be instrumental in speech therapy.
Here is a case study presented on the TILLS assessment website:

Case study: Dawn

  • 6-year-old Kindergarten student

  • Previous diagnosis of oral language difficulties

  • TILLS assessment revealed ongoing difficulties in vocabulary awareness, phonemic awareness, and nonword repetition.

  • Dawn received ongoing intervention, which included tasks specifically designed to target her areas of difficulty on the TILLS. Strengths in written language were incorporated into therapy techniques and activities such as:
    • Writing compound words (while identifying beginning and ending sounds) related to a community professions unit in the classroom (learning about jobs such as firefighters and doctors). 

  • Strategies such as allowing Dawn to sit at the front of the class during daily story reading were incorporated.

TILLS-guided speech therapy interventions such as the one described in the case study above can lead to positive outcomes for clients and more comprehensive intervention plans from speech therapists.

Tips for speech therapists utilizing TILLS

Before administering the TILLS, there are a few helpful tips that therapists should be aware of.

First, it’s important to receive proper training in the administration of the TILLS. ASHA certified speech-language pathologists can familiarize themselves with the test items and review the TILLS examiner’s manual. This helps the examiner become knowledgeable and comfortable with testing procedures prior to administering the assessment.

The examiner should be sure to have all of the materials included in the TILLS assessment present, including:
  • Examiner’s kit
  • Examiner’s manual
  • Record forms
  • Student response forms
  • Audio downloads
  • Examiner’s practice workbook

Building trust and rapport with children and adolescents is an essential component of a successful assessment and therapy process. Establishing this type of positive relationship can encourage more accurate evaluations and effective interventions.

Each child who takes the assessment has a unique TILLS profile. Therefore, the therapy approach used must be customized based on the child’s specific strengths, weaknesses, and learning styles identified on the assessment. 

Collaborating with parents and teachers is essential for reinforcing therapy goals in educational settings. By actively involving others involved in the child’s care, therapists can ensure a holistic approach to language and literacy development.

The Test of Integrated Language and Literacy Skills (TILLS) is a valuable tool for assessing oral and written language and literacy skills in children and adolescents. Speech therapists can use the results of the TILLS to develop a unique treatment plan and measure the outcomes of therapy.

Proficient language and literacy skills are essential for an individual’s success in  academic and social environments. Starting therapy with a comprehensive assessment such as the TILLS helps therapists pinpoint a child’s areas of difficulties to target in therapy.

The TILLS can also be administered via telepractice (Tele-TILLS). Research shows that Tele-TILLS results can be equivalent to traditional TILLS, making it a convenient and effective assessment option for speech therapists.


Nelson, N., Plante, E., Anderson, M., Applegate, E. (2022). The Dimensionality of Language and Literacy in the School-Age Years. Journal of Speech, Language, and Hearing Research, 65(7). DOI: https://doi.org/10.1044/2022_JSLHR-21-00534

Nelson, N., Plante, E. (2022). Evaluating the Equivalence of Telepractice and Traditional Administration of the Test of Integrated Language and Literacy Skills. Language, Speech, and Hearing Services in Schools, 53(2). DOI: https://doi.org/10.1044/2022_LSHSS-21-00056


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