Interview With Dr. Lisa Fitton of University of South Carolina

Lisa Fitton is an assistant professor in the Communication Sciences and Disorders department at the University of South Carolina. Her clinical and research work focuses on improving educational opportunities for children from culturally and linguistically diverse backgrounds. To make progress toward this overall goal, her research emphasizes valid assessment practice, emergent literacy development, and rigorous statistics and methodology.

Note: You should consult with your doctor or speech pathologist for recommendations on treatment. The views and opinions expressed in this article are those of Dr. Fitton and do not necessarily reflect the official policy or position of

How did you become interested in researching speech pathology assessment?

Assessment forms the foundation of our practice as speech-language pathologists. Valid and reliable assessment results allow us to tailor our intervention plans to maximize our clients’ opportunities to make gains. Creating appropriate and informative assessment tools is not an easy task, however. It requires ongoing consideration of educational practice, cultural shifts, and changing experiences among highly diverse groups of people. This creates a lot of space and opportunity for research! There will always be need for more information about assessments and how they work differently for different people.

How are current assessments lacking in the way they evaluate children of linguistically and culturally diverse backgrounds?

Many of assessment tools used in educational settings have a number of limitations in their appropriateness for children from diverse backgrounds. Not only do the normative samples (and therefore scores) fail to capture their “typical development” adequately, but often test items are culturally or linguistically biased against children who are not monolingual speakers of Mainstream American English. This is a substantial issue to overcome – test developers have made some strides in recent years to create tools that are more appropriate for more children, but it is always essential for practitioners to take scores with a grain of salt. No child perfectly fits the mold – this is why developers often have a large number of items and provide confidence intervals for children’s normative scores.  

How does this impact children who are not properly assessed?

Inappropriate assessment can have a number of negative consequences. It can lead to both over- and under-identification of children as having communication disorders. Over-identification is a problem because it can place unnecessary stress on the child and family and take valuable time and resources away from other children. Under-identification is similarly problematic because it results in a child being deprived of needed services. Both over- and under-identification is a significant issue among children from culturally and linguistically diverse backgrounds. We see the consequences of misidentification every day.

What can we do to improve these assessments?

There are some great resources available to practitioners interested in building their assessment “toolboxes.” To make an informed decision about eligibility for services, it is essential to rely on multiple sources of information. These may include interviews with caregivers, observation of daily communication interactions, language sampling, dynamic assessment, norm-referenced assessment, etc. The key is to always consider the individual’s background experiences and environments. Every person comes from a different cultural and linguistic background. Therefore, it is essential to have several pieces of converging evidence anytime we make a decision – one assessment or datapoint cannot give us enough information to capture those background experiences adequately.

What are the challenges to getting speech-language pathologists (SLPs) and schools to adopt more inclusive assessments as they become available?

Two major challenges are time and money. Practitioners are under increasing pressure to maximize their time while limiting their expenditures. My work focuses on maximizing information gained from each assessment administered – I hope to be able to help SLPs glean as much valid information as possible from the tests they give. Ideally, this will help us reduce assessment time and increase efficiency in individualizing intervention for each person. Whenever I make recommendations or engage in research, I try to keep the practical side of assessment in mind. There are a lot of real-life issues that many SLPs face daily. I hope to do what I can to address some of those limitations and help SLPs do their best work while considering those challenges.

How do you choose new research projects to take on?

Because I just started my job at the University of South Carolina this fall, it is important for me to make sure that whatever work I do is clearly within my primary focus: improving educational opportunities for children from all backgrounds. Because so much work can fit into that focus, I try to make sure that projects also tie back to at least one of my expertise areas: high-quality research methodology and statistics, literacy development, educational assessment, and cultural and linguistic diversity. If a project overlaps with two or more of those areas, I typically find it too interesting to turn down! On a broader scale, I think that it is essential to work with people who are great collaborators. I have several collaborators/friends who I deliberately try to work with as often as possible – research is always better when it is the product of a great collaboration.

What aspect of your research are you most proud of?

I’m most excited about the work that directly translates to practice, though sometimes it’s difficult to know up front which projects will provide the most useful results for practitioners and the children they serve. I also am proud of the projects that take a deeper look at how research methodology influences findings – sometimes research findings get over-extended (in research and in practice) and it’s important to take a second look to see if those interpretations are valid. I enjoy that line of work because of the real connection to practice.

What is your advice to those considering a career in speech pathology?

I would encourage any potential speech-language pathologist to learn how to read, evaluate, and synthesize information from research as efficiently as possible. Developing those skills takes time, but it is essential for us to be able to consume and apply research to our practice because our field is so young. There are an increasing number of resources available supporting implementation science and evidence-based practice in speech pathology, but when you have a specific question about a specific case, being able to read and apply research on your own is invaluable.

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