Uptake and Evaluation of a Crosslinguistic Nonword Repetition Test in Clinical and Research Contexts

Abstract

Introduction

The Crosslinguistic Nonword Repetition Test (CL-NWR) was designed to accommodate the phonological diversity of human languages, providing a tool that may support the identification of Developmental Language Disorder (DLD) across different linguistic backgrounds. The test materials, including a PowerPoint game with recorded stimuli, administration guidelines, and scoring instructions, were available upon request. This study examines the uptake and application of the CL-NWR in clinical and research settings through a survey of individuals who have accessed the materials. The survey covered three main areas: (i) participant demographics; (ii) experience of using the CL-NWR task; and (iii) views on administration and scoring of the CL-NWR task.

Methods

We explored views of CL-NWR users through an online survey delivered through the Qualtrics platform and distributed to 156 individuals who had requested CL-NWR materials up to November 2024. Follow-up reminders were sent at one- and two-week intervals to maximise response rates. Response formats included yes/no, multiple choice, Likert scales and open-ended text responses. Survey data were analysed through descriptive statistics and content analysis of open-ended questions.

Results

A total of 109 respondents from 36 countries completed the survey, yielding a response rate of 70%. The test was most commonly used with multilingual children and those with suspected DLD. Notably, 92% of respondents indicated that the CL-NWR made a valuable contribution to their assessments. Qualitative responses highlighted its practical benefits as well as areas for refinement.

Conclusion

The high response rate and overwhelmingly positive feedback suggest a high level of engagement and interest in the CL-NWR, particularly in multilingual populations. These findings will inform future developments of the CL-NWR test, ensuring its continued relevance and effectiveness in both clinical and research applications. The study also underscores the value of crosslinguistic tools in supporting equitable language assessment worldwide.

WHAT THIS PAPER ADDS

What is already known on this subject

• Nonword repetition tasks are widely used to support the identification of Developmental Language Disorder across languages. The Crosslinguistic Nonword Repetition Test (CL-NWR) was developed as a language-neutral tool for multilingual populations, and a growing body of research has reported findings from diverse samples using the task. However, its uptake, usability, and application in clinical and research settings have not yet been systematically evaluated.

What this study adds to existing knowledge

• This study provides the first large-scale evidence of global uptake and application of the CL-NWR across clinical and research contexts. Findings show high levels of use, particularly with multilingual children, and strong perceived value in assessment. The results highlight both the practical utility of the tool and areas for further development.

What are the clinical implications of this study?

• The CL-NWR is a feasible and valuable tool for supporting language assessment, particularly in linguistically diverse populations. The identified need for clearer guidance on administration, scoring, and developmental norms has informed the provision of additional materials and access instructions, supporting more consistent and informed use in clinical and research practice.