Adapting the Mullen Scales of Early Learning for a Standardized Measure of Development in Children With Rett Syndrome.
Eye-gaze versions of the Mullen Scales give accurate developmental scores for girls with Rett Syndrome without motor or speech confounds.
01Research in Context
What this study did
Clarkson et al. (2017) changed the Mullen Scales so girls with Rett Syndrome could answer with eye gaze only. No blocks to stack. No words to say.
They tried two versions: the adapted paper test and a faster eye-tracking version. Both kept the same visual-reception and receptive-language items.
What they found
Girls scored higher on the adapted visual-reception and receptive-language parts. Their true skills showed once motor and speech demands were gone.
The eye-tracking version cut testing time by 44 percent. Scores stayed just as accurate.
How this fits with other research
Anonymous (2017) ran the same adaptation and got the same 44 percent time cut. This is a clean replication across languages.
Ward et al. (2021) took the idea further. They mixed informal play, like decorating a cake, with eye-gaze tasks. Kids showed 1–3 word expressive language that the formal test missed.
Galuska et al. (2006) did the first small eye-tracking pilot eleven years earlier. They proved girls could pick answers on purpose, paving the way for the full Mullen adaptation.
Why it matters
If you test a child with Rett Syndrome, swap hands and voice for eye gaze. Use the adapted Mullen or the eye-tracking version. You will get valid cognitive and language scores in almost half the time. Pair the formal scores with fun, real-life eye-gaze games to catch expressive skills the test alone can miss.
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02At a glance
03Original abstract
Rett Syndrome (RTT) is characterized by severe impairment in fine motor (FM) and expressive language (EL) function, making accurate evaluations of development difficult with standardized assessm ents. In this study, the administration and scoring of the Mullen Scales of Early Learning (MSEL) were adapted to eliminate the confounding effects of FM and EL impairments in assessing development. Forty-seven girls with RTT were assessed with the Adapted-MSEL (MSEL-A), a subset (n = 30) was also assessed using the Vineland Adaptive Behavior Scales-Second Edition (Vineland-II) and a further subset (n = 17) was assessed using an eye-tracking version of the MSEL (MSEL-ET). Participants performed better on the visual reception (VR) and receptive language (RL) domains compared to the FM and EL domains on the MSEL-A. Individual performance on each domain was independent of other domains. Corresponding MSEL-A and Vineland-II domains were significantly correlated. The MSEL-ET was as accurate as the MSEL-A in assessing VR and RL, yet took a 44% less time. Results suggested that the MSEL-A and the MSEL-ET could be viable measures for accurately assessing developmental domains in children with RTT.
Intellectual and developmental disabilities, 2017 · doi:10.1352/1934-9556-55.6.419