Problem Solving and Verbal Reasoning | Smart Speech Therapy

Posted on June 26, 2015January 5, 2022 by Tatyana Elleseff — 12 Comments

Special Education Disputes and Comprehensive Language Testing: What Parents, Attorneys, and Advocates Need to Know

Image result for evaluation Several years after I started my private speech pathology practice, I began performing comprehensive independent speech and language evaluations (IEEs).

For those of you who may be hearing the term IEE for the first time, an Independent Educational Evaluation is “an evaluation conducted by a qualified examiner who is not employed by the public agency responsible for the education of the child in question.” 34 C.F.R. 300.503. IEE’s can evaluate a broad range of functioning outside of cognitive or academic performance and may include neurological, occupational, speech language, or any other type of evaluations as long as they bear direct impact on the child’s educational performance.

Independent evaluations can be performed for a wide variety of reasons, including but not limited to:

To determine the student’s present level of functioning
To determine whether the student presents with hidden, previously undiscovered deficits (e.g., executive function, social communication, etc.)
To determine whether the student’s educational classification requires a change
To determine if the student requires additional, previously not provided, related services (e.g., language therapy, etc.) or an increase in related services
To determine whether a student might benefit from an application of a particular therapy technique or program (e.g, Orton-Gillingham)
To determine whether a student with a severe impairment (e.g., severe emotional and behavioral disturbances, genetic syndrome, significant intellectual disability, etc.) is a good candidate for an out of district specialized school

Why can’t similar assessments be performed in school settings?

There are several reasons for that.

“The school district may lack the personnel or expertise to conduct a particular type of evaluation” (Source: Wrightslaw)
Due to a variety of job-related constraints the school-based personnel may lack adequate time needed to perform the assessment or lack of access to appropriate testing materials needed to assess a particular student.
Finally, “a school district may seek an IEE to assuage parental concerns about the fairness or accuracy of an evaluation”. (Source: Wrightslaw)

Why are IEE’s Needed?

The answer to that is simple: “To strengthen the role of parents in the educational decision-making process.” According to one Disability Rights site: “Many disagreements between parents and school staff concerning IEP services and placement involve, at some stage, the interpretation of evaluation findings and recommendations. When disagreements occur, the Independent Educational Evaluation (IEE) is one option lawmakers make available to parents, to help answer questions about appropriate special education services and placement“.

Indeed, many of the clients who retain my services also retain the services of educational advocates as well as special education lawyers. Many of them work on determining appropriate level of services as well as an out of district placement for the children with a variety of special education needs. However, one interesting reoccurring phenomenon I’ve noted over the years is that only a small percentage of special education lawyers, educational advocates, and even parents believed that children with autism spectrum disorders, genetic syndromes, social pragmatic deficits, emotional disturbances, or reading disabilities required a comprehensive language evaluation/reevaluation prior to determining an appropriate out of district placement or an in-district change of service provision.

So today I would like to make a case, in favor of comprehensive independent language evaluations being a routine component of every special education dispute involving a child with impaired academic performance. I will do so through the illustration of past case scenarios that clearly show that comprehensive independent language evaluations do matter, even when it doesn’t look like they may be needed.

Case A: “He is just a weak student”.

Several years ago I was contacted by a parent of a 12 year old boy, who was concerned with his son’s continuously failing academic performance. The child had not qualified for an IEP but was receiving 504 plan in school setting and was reported to significantly struggle due to continuous increase of academic demands with each passing school year. An in-district language evaluation had been preformed several years prior. It showed that the student’s general language abilities were in the low average range of functioning due to which he did not qualify for speech language services in school setting. However, based on the review of available records it very quickly became apparent that many of the academic areas in which the student struggled (e.g., reading comprehension, social pragmatic ability, critical thinking skills, etc) were simply not assessed by the general language testing. I had suggested to the parent a comprehensive language evaluation and explained to him on what grounds I was recommending this course of action. That comprehensive 4 hour assessment broken into several testing sessions revealed that the student presented with severe receptive, expressive, problem solving and social pragmatic language deficits, as well as moderate executive function deficits, which required therapeutic intervention.

Prior to that assessment the parent, reinforced by the feedback from his child’s educational staff believed his son to be an unmotivated student who failed to apply himself in school setting. However, after the completion of that assessment, the parent clearly understood that it wasn’t his child’s lack of motivation which was impeding his academic performance but rather a true learning disability was making it very difficult for his son to learn without the necessary related services and support. Several months after the appropriate related services were made available to the child in school setting on the basis of the performed IEE, the parent reported significant progress in his child academic performance.

Case B: “She’s just not learning because of her behavior, so there’s nothing we can do”.

This case involved a six year old girl who presented with a severe speech – language disorder and behavioral deficits in school setting secondary to an intellectual disability of an unspecified origin.

In contrast to Case A scenario, this child had received a variety of assessments and therapies since a very early age; however, her parents were becoming significantly concerned regarding her regression of academic functioning in school setting and felt that a more specialized out of district program with a focus on multiple disabilities would be better suitable to her needs. Unfortunately the school disagreed with them and believed that she could be successfully educated in an in-district setting (despite evidence to the contrary). Interestingly, an in-depth comprehensive speech language assessment had never been performed on this child because her functioning was considered to be “too low” for such an assessment.

Comprehensive assessment of this little girl’s abilities revealed that via an application of a variety of behavioral management techniques (of non-ABA origin), and highly structured language input, she was indeed capable of significantly better performance then she had exhibited in school setting. It stood to reason that if she were placed in a specialized school setting composed of educational professionals who were trained in dealing with her complex behavioral and communication needs, her performance would continue to steadily improve. Indeed, six months following a transfer in schools her parents reported a “drastic” change pertaining to a significant reduction in challenging behavioral manifestations as well as significant increase in her linguistic output.

Case C: “Your child can only learn so much because of his genetic syndrome”.

This case scenario does not technically involve just one child but rather three different male students between 9 and 11 years of age with several ‘common’ genetic syndromes: Down, Fragile X, and Klinefelter. All three were different ages, came from completely different school districts, and were seen by me in different calendar years.

However, all three boys had one thing in common, because of their genetic syndromes, which were marked by varying degrees of intellectual disability as well as speech language weaknesses, their parents were collectively told that there could be very little done for them with regards to expanding their expressive language as well as literacy development.

Similarly to the above scenarios, none of the children had undergone comprehensive language testing to determine their strengths, weaknesses, and learning styles. Comprehensive assessment of each student revealed that each had the potential to improve their expressive abilities to speak in compound and complex sentences. Dynamic assessment of literacy also revealed that it was possible to teach each of them how to read.

Following the respective assessments, some of these students had became my private clients, while others’s parents have periodically written to me, detailing their children’s successes over the years. Each parent had conveyed to me how “life-changing”a comprehensive IEE was to their child.

Case D: “Their behavior is just out of control”

The final case scenario I would like to discuss today involves several students with an educational classification of “Emotionally Disturbed” (pg 71). Those of you who are familiar with my blog and my work know that my main area of specialty is working with school age students with psychiatric impairments and emotional behavioral disturbances. There are a number of reasons why I work with this challenging pediatric population. One very important reason is that these students continue to be grossly underserved in school setting. Over the years I have written a variety of articles and blog posts citing a number of research studies, which found that a significant number of students with psychiatric impairments and emotional behavioral disturbances present with undiagnosed linguistic impairments (especially in the area of social communication), which adversely impact their school-based performance.

Here, we are not talking about two or three students rather we’re talking about the numbers in the double digits of students with psychiatric impairments and emotional disturbances, who did not receive appropriate therapies in their respective school settings.

The majority of these students were divided into two distinct categories. In the first category, students began to manifest moderate-to-severe speech language deficits from a very early age. They were classified in preschool and began receiving speech language therapy. However by early elementary age their general language abilities were found to be within the average range of functioning and their language therapies were discontinued. Unfortunately since general language testing does not assess all categories of linguistic functioning such as critical thinking, executive functions, social communication etc., these students continued to present with hidden linguistic impairments, which continued to adversely impact their behavior.

Students in the second category also began displaying emotional and behavioral challenges from a very early age. However, in contrast to the students in the first category the initial language testing found their general language abilities to be within the average range of functioning. As a result these students never received any language-based therapies and similar to the students in the first category, their hidden linguistic impairments continued to adversely impact their behavior.

Students in both categories ended up following a very similar pattern of behavior. Their behavioral challenges in the school continued to escalate. These were followed by a series of suspensions, out of district placements, myriad of psychiatric and neuropsychological evaluations, until many were placed on home instruction. The one vital element missing from all of these students’ case records were comprehensive language evaluations with an emphasis on assessing their critical thinking, executive functions and social communication abilities. Their worsening patterns of functioning were viewed as “severe misbehaving” without anyone suspecting that their hidden language deficits were a huge contributing factor to their maladaptive behaviors in school setting.

Conclusion:

So there you have it! As promised, I’ve used four vastly different scenarios that show you the importance of comprehensive language evaluations in situations where it was not so readily apparent that they were needed. I hope that parents and professionals alike will find this post helpful in reconsidering the need for comprehensive independent evaluations for students presenting with impaired academic performance.

Posted on June 7, 2015January 5, 2022 by Tatyana Elleseff — Leave a comment

Friend or Friendly: What Does Age Have To Do with It?

In my social pragmatic language groups I target a wide variety of social communication goals for children with varying levels and degrees of impairment with a focus on improving their social pragmatic language competence. In the past I have written blog posts on a variety of social pragmatic language therapy topics, including strategies for improving students’ emotional intelligence as well as on how to teach students to develop insight into own strengths and weaknesses. Today I wanted to discuss the importance of teaching students with social communication impairments, age recognition for friendship and safety purposes.

Now it is important to note that the focus of my sessions is a bit different from the focus of “teaching protective behaviors”, “circles of intimacy and relationships” or “teaching kids to deal with tricky people“. Rather the goal is to teach the students to recognize who it is okay “to hang out” or be friends with, and who is considered to be too old/too young to be a friend.

Why is it important to teach age recognition?

There are actually quite a few reasons.

Firstly, it is a fairly well-known fact that in the absence of age-level peers with similar weaknesses, students with social communication deficits will seek out either much younger or much older children as playmates/friends as these individuals are far less likely to judge them for their perceived social deficits. While this may be a short-term solution to the “friendship problem” it also comes with its own host of challenges. By maintaining relationships with peers outside of their age group, it is difficult for children with social communication impairments to understand and relate to peers of their age group in school setting. This creates a wider chasm in the classroom and increases the risk of peer isolation and bullying.

Secondly, the difficulty presented by friendships significantly outside of one’s peer group, is the risk of, for lack of better words, ‘getting into trouble’. This may include but is not limited to exploring own sexuality (which is perfectly normal) with a significantly younger child (which can be problematic) or be instigated by an older child/adolescent in doing something inappropriate (e.g, shoplifting, drinking, smoking, exposing self to peers, etc.).

Thirdly, this difficulty (gauging people’s age) further exacerbates the students’ social communication deficits as it prevents them from effectively understanding such pragmatic parameters such as audience (e.g., with whom its appropriate to use certain language in a certain tone and with whom it is not) and topic (with whom it is appropriate to discuss certain subjects and with whom it is not).

So due to the above reasons I began working on age recognition with the students (6+ years of age) on my caseload diagnosed with social communication and language impairments. I mention language impairments because it is very important to understand that more and more research is coming out connecting language impairments with social communication deficits. Therefore it’s not just students on the autism spectrum or students with social pragmatic deficits (an official DSM-5 diagnosis) who have difficulties in the area of social communication. Students with language impairments could also benefit from services focused on improving their social communication skills.

I begin my therapy sessions on age recognition by presenting the students with photos of people of different ages and asking them to attempt to explain how old do they think the people in the pictures are and what visual clues and/or prior knowledge assisted them in the formulation of their responses. I typically select the pictures from some of the social pragmatic therapy materials packets that I had created over the years (e.g., Gauging Moods, Are You Being Social?, Multiple Interpretations, etc.).

I make sure to carefully choose my pictures based on the student’s age and experience to ensure that the student has at least some degree of success making guesses. So for a six-year-old I would select pictures of either toddlers or children his/her age to begin teaching them recognition of concepts: “same” and “younger” (e.g., Social Pragmatic Photo Bundle for Early Elementary Aged Children).

For older children, I vary the photos of different aged individuals significantly. I also introduce relevant vocabulary words as related to a particular age demographic, such as:

Infant (0-1 years of age)
Toddler (2-3 years of age)
Preschooler (3-5 years of age)
Teenager (individual between 13-19 years of age)
Early, mid and late 20s, 30s, 40s
Middle-aged (individuals around 50 years of age)
Senior/senior citizen (individuals ~65+ years of age)

I explain to the students that people of different ages look differently and teach them how to identify relevant visual clues to assist them with making educated guesses about people’s ages. I also use photos of my own family or ask the students to bring in their own family photos to use for age determination of people in the presented pictures. When students learn the ages of their own family members, they have an easier time determining the age ranges of strangers.

My next step is to explain to students the importance of understanding people’s ages. I present to the students a picture of an individual significantly younger or older than them and ask them whether it’s appropriate to be that person’s friend. Here students with better developed insight will state that it is not appropriate to be that person’s friend because they have nothing in common with them and do not share their interests. In contrast, students with limited insight will state that it’s perfectly okay to be that person’s friend.

This is the perfect teachable moment for explaining the difference between “friend” and “friendly”. Here I again reiterate that people of different ages have significantly different interests as well as have significant differences in what they are allowed to do (e.g., a 16-year-old is allowed to have a driver’s permit in many US states as well as has a later curfew while an 11-year-old clearly doesn’t). I also explain that it’s perfectly okay to be friendly and polite with older or younger people in social situations (e.g., say hello all, talk, answer questions, etc.) but that does not constitute true friendship.

I also ask students to compile a list of qualities of what they look for in a “friend” as well as have them engage in some perspective taking (e.g, have them imagine that they showed up at a toddler’s house and asked to play with him/her, or that a teenager came into their house, and what their parents reaction would be?).

Finally, I discuss with students the importance of paying attention to who wants to hang out/be friends with them as well as vice versa (individuals they want to hang out with) in order to better develop their insight into the appropriateness of relationships. I instruct them to think critically when an older individual (e.g, young adult) wants to get particularly close to them. I use examples from an excellent post written by a colleague and good friend, Maria Del Duca of Communication Station Blog re: dealing with tricky people, in order to teach them to recognize signs of individuals crossing the boundary of being friendly, and what to do about it.

So there you have it. These are some of the reasons why I teach age recognition to clients with social communication weaknesses. Do you teach age recognition to your clients? If so, comment under this post, how do you do it and what materials do you use?

Helpful Smart Speech Resources Related to Assessment and Treatment of Social Pragmatic Disorders

Posted on May 28, 2015January 5, 2022 by Tatyana Elleseff — 3 Comments

Improving Emotional Intelligence of Children with Social Communication Disorders

Our ability to recognize our own and other people’s emotions, distinguish between and correctly identify different feelings, as well as use that information to guide our thinking and behavior is called Emotional Intelligence (EI) (Salovey, et al, 2008).

EI encompasses dual areas of: emotion understanding, which is an awareness and comprehension of one’s and others emotions (Harris, 2008) and emotion regulation, which are internal and external strategies people use to regulate emotions (Thompson, 1994).

Many students with social communication challenges experience problems with all aspects of EI, including the perception, comprehension, and regulation of emotions (Brinton & Fujiki, 2012).

A number of recent studies have found that children with language impairments also present with impaired emotional intelligence including impaired perception of facial expressions (Spackman, Fujiki, Brinton, Nelson, & Allen, 2005), prosodic emotions (Fujiki, Spackman, Brinton, & Illig, 2008) as well as abstract emotion comprehension (Ford & Milosky, 2003).

Children with impaired emotional intelligence will experience numerous difficulties during social interactions due to their difficulty interpreting emotional cues of others (Cloward, 2012). These may include but not be limited to active participation in cooperative activities, as well as full/competent interactions during group tasks (Brinton, Fujiki, & Powell, 1997)

Many students with social pragmatic deficits and language impairments are taught to recognize emotional states as part of their therapy goals. However, the provided experience frequently does not go beyond the recognition of the requisite “happy”, “mad”, “sad” emotions. At times, I even see written blurbs from others therapists, which state that “the student has mastered the goals of emotion recognition”. However, when probed further it appears that the student had merely mastered the basic spectrum of simple emotional states, which places the student at a distinct disadvantage as compared to typically developing peers who are capable of recognition and awareness of a myriad of complex emotional states.

That is why I developed a product to target abstract emotional states comprehension in children with language impairments and social communication disorders. “Gauging Moods and Interpreting Abstract Emotional States: A Perspective Taking Activity Packet” is a social pragmatic photo/question set, intended for children 7+ years of age, who present with difficulty recognizing abstract emotional states of others (beyond the “happy, mad, sad” option) as well as appropriately gauging their moods.

Many sets contain additional short stories with questions that focus on making inferencing, critical thinking as well as interpersonal negotiation skills. Select sets require the students to create their own stories with a focus on the reasons why the person in the photograph might be feeling what s/he are feeling.

There are on average 12-15 questions per each photo. Each page contains a photograph of a person feeling a particular emotion. After the student is presented with the photograph, they are asked a number of questions pertaining to the recognition of the person’s emotions, mood, the reason behind the emotion they are experiencing as well as what they could be potentially thinking at the moment. Students are also asked to act out the depicted emotion they use of mirror.

Activities also include naming or finding (in a thesaurus or online) the synonyms and antonyms of a particular word in order to increase students’ vocabulary knowledge. A comprehensive two page “emotions word bank” is included in the last two pages of the packet to assist the students with the synonym/antonym selection, in the absence of a thesaurus or online access.

Students are also asked to use a target word in a complex sentence containing an adverbial (pre-chosen for them) as well as to identify a particular word or phrase associated with the photo or the described story situation.

Since many students with social pragmatic language deficits present with difficulty determining a person’s age (and prefer to relate to either younger or older individuals who are perceived to be “less judgmental of their difficulties”), this concept is also explicitly targeted in the packet.

This activity is suitable for both individual therapy sessions as well as group work. In addition to its social pragmatic component is also intended to increase vocabulary knowledge and use as well as sentence length of children with language impairments.

Intended Audiences:

Clients with Language Impairments
Clients with Social Pragmatic Language Difficulties
Clients with Executive Function Difficulties
Clients with Psychiatric Impairments
- ODD, ADHD, MD, Anxiety, Depression, etc.
Clients with Autism Spectrum Disorders
Clients with Nonverbal Learning Disability
Clients with Fetal Alcohol Spectrum Disorders
Adult and pediatric post-Traumatic Brain Injury (TBI) clients
Clients with right-side CVA Damage

Areas covered in this packet:

Gauging Age (based on visual support and pre-existing knowledge)
Gauging Moods (based on visual clues and context)
Explaining Facial Expressions
Making Social Predictions and Inferences (re: people’s emotions)
Assuming First Person Perspectives
Understanding Sympathy
Vocabulary Knowledge and Use (pertaining to the concept of Emotional Intelligence)
Semantic Flexibility (production of synonyms and antonyms)
Complex Sentence Production
Expression of Emotional Reactions
Problem Solving Social Situations
Friendship Management and Peer Relatedness

Helpful Smart Speech Resources:

References:

Brinton, B., Fujiki, M., & Powell, J. M. (1997). The ability of children with language impairment to manipulate topic in a structured task. Language, Speech and Hearing Services in Schools, 28, 3-11.
Brinton B., & Fujiki, M. (2012). Social and affective factors in children with language impairment. Implications for literacy learning. In C. A. Stone, E. R. Silliman, B. J. Ehren, & K. Apel (Eds.), Handbook of language and literacy: Development and disorders (2nd Ed.). New York, NY: Guilford.
Cloward, R. (2012). The milk jug project: Expression of emotion in children with language impairment and autism spectrum disorder (Unpublished honor’s thesis). Brigham Young University, Provo, Utah.
Ford, J., & Milosky, L. (2003). Inferring emotional reactions in social situations: Differences in children with language impairment. Journal of Speech, Language, and Hearing Research, 46(1), 21-30.
Fujiki, M., Spackman, M. P., Brinton, B., & Illig, T. (2008). Ability of children with language impairment to understand emotion conveyed by prosody in a narrative passage. International Journal of Language & Communication Disorders, 43(3), 330-345
Harris, P. L. (2008). Children’s understanding of emotion. In M. Lewis, J. M. Haviland-Jones, & L. Feldman Barrett, (Eds.), Handbook of emotions (3rd ed., pp. 320–331). New York, NY: Guilford Press.
Salovey, P., Detweiler-Bedell, B. T., Detweiler-Bedell, J. B., & Mayer, J. D. (2008). Emotional intelligence. In M. Lewis, J. M. Haviland-Jones, & L. Feldman Barrett (Eds.), Handbook of Emotions (3rd ed., pp. 533-547). New York, NY: Guilford Press.
Spackman, M. P., Fujiki, M., Brinton, B., Nelson, D., & Allen, J. (2005). The ability of children with language impairment to recognize emotion conveyed by facial expression and music. Communication Disorders Quarterly, 26(3), 131-143.
Thompson, R. (1994). Emotion regulation: A theme in search of definition. Monographs of the Society for Research in Child Development, 59(2-3), 25-52

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Posted on April 28, 2015January 5, 2022 by Tatyana Elleseff — Leave a comment

SLP Efficiency Bundles™ for Graduating Speech Language Pathologists

Graduation time is rapidly approaching and many graduate speech language pathology students are getting ready to begin their first days in the workforce. When it comes to juggling caseloads and managing schedules, time is money and efficiency is the key to success. Consequently, a few years ago I created SLP Efficiency Bundles™, which are materials highly useful for Graduate SLPs working with pediatric clients. These materials are organized by areas of focus for efficient and effective screening, assessment, and treatment of speech and language disorders. Continue reading SLP Efficiency Bundles™ for Graduating Speech Language Pathologists

Posted on May 30, 2014January 5, 2022 by Tatyana Elleseff — 2 Comments

Why Do I Have to Tell You What’s Wrong with My Child? Or On the Importance of Targeted Assessments

A few days ago I received a phone call from a parent who was seeking a language evaluation for her child. As it is my policy with all assessments, I asked her to fill out an intake and a checklist to identify her child’s specific areas of difficulty in order to compile a comprehensive and targeted testing battery. Her response to me was: “I’ve never heard of this before? Why do I have to tell you what’s wrong with my child? Why can’t you figure it out?” Similarly, last week, another parent has questioned: “So you can’t do the assessment without this form?” Given the above questions, and especially because May is a Better Hearing and Speech Month #BHSM, during which it is important to raise awareness about communication disorders, I want to take this time to explain to parents why performing targeted speech language assessments is SO CRUCIAL.

To begin with it is very important to understand that speech and language can be analyzed in many different ways beyond looking at pronunciation, vocabulary or listening and speaking skills.

Targeted areas within the scope of practice of pediatric school based speech language pathologists include the assessment of:

SPEECH
- The child may have difficulties with pronunciation of sounds in words, stutter, clutter, have a lisp or have difficulties in the areas of voice, prosody, or resonance. For the majority of the above difficulties completely different tests and testing procedures may be needed in order to appropriately assess the child.

LANGUAGE
- Receptive Language
  - Ability to follow directions, answer questions, recall sentences, understand verbal messages, as well as comprehend orally presented text
- Memory and Attention
  - Also see executive function skills
- Expressive Language
  - Vocabulary knowledge and use, formulation of words and sentences as well as production of narratives or stories
- Problem Solving
  - Verbal reasoning and critical thinking skills are very important for successful independent decision making as well as for interpretation of academically based texts and complete assignments
- Pragmatic Language
  - Successful use of language for a variety of communicative purposes
    - Initiate and maintain topics, maintain conversational exchanges, request help, etc
- Social Emotional Competence
  - Effective interpersonal negotiation skills, compromise and negotiation abilities, as well as perspective taking are integral to academic and social success. These abilities are often compromised in children with language disorders and require a thorough assessment
- Executive Functions (EFs)
  - These are higher level cognitive processes involved in inhibition of thought, action and emotion, which are located in the prefrontal cortex of the frontal lobe of the brain.
  - Major EF components include working memory, inhibitory control, planning, and set-shifting. EFs contribute to child’s ability to sustain attention, ignore distractions, and succeed in academic settings.
READING DISABILITIES AND DYSLEXIA
- Phonological Awareness
- Reading Ability
- Writing
- Spelling

One General Language Test Does Not Fit All!

Children with speech and language disorders do not necessarily display weaknesses in all affected areas but may only display difficulties in selected few.

To illustrate, high functioning students on the autistic spectrum may have very strong academic skills related to comprehension and expression of language but may display significant social pragmatic language weaknesses, which will not be apparent on general language testing (e.g., administration of Clinical Evaluation of Language Fundamentals -5). Thus, the administration of a general language test will be contraindicated for these students as it will only show typical performance on these tests and will not qualify them for targeted language based services that they need. However, by administering to them a testing battery composed of tests sensitive to social pragmatic language competence will highlight their areas of difficulty and result in a creation of a targeted intervention plan to improve their abilities in the affected areas.

Similarly, children at risk for reading disabilities will not benefit from the administration of general language testing either, since their deficits may lie in the areas of sound discrimination, isolation, or blending as well as as impaired decoding ability. So the administration of tests sensitive to phonological awareness and emergent reading ability would be much more relevant.

This is exactly why taking an extra step and filling out a simple form will result in a much more targeted and beneficial speech language assessment for the child. The goal of any competent professional assessment is to eliminate the administration of unnecessary and irrelevant tests and focus only on the administration of instruments directly targeting the areas of difficulty that the child presents with. Given the fact that assessment of language covers so many broad areas, it makes perfect sense to ask parents to fill out relevant checklists/intakes as a routine part of a pre-assessment procedure. Otherwise, even after observations in school setting, I would still just be blindly ‘fishing’ for deficits without really knowing whether I will ‘accidentally stumble upon them’ using a general test at hand.

Of course, even checklists need to be targeted by age and areas of functioning. Here’s how I use mine. When performing comprehensive fist time assessments I ask the parent to fill out the comprehensive checklists based on the child’s age. These are broken down as follows:

However, oftentimes when I perform reassessments or second opinion evaluations, I may ask the parent to fill out checklists pertaining to specific, known, areas of difficulty. These currently include:

After the parent fills the checklist out, the child’s areas of difficulty literally jump out from the pages. Now, all I need to do is to choose the appropriate testing instruments, which will BEST help me determine the exact nature and cause of the child’s deficits and I am all set. I administer the testing, interpret the results and write a comprehensive report detailing which therapy goals will be targeted. And this is why pre-assessment checklist administration is so important.

Helpful Resources:

Posted on February 25, 2014January 5, 2022 by Tatyana Elleseff — 4 Comments

Winter Non-Fiction Leveled Reading Passages and Questions Product Swap and Giveaway

Today I am doing a product swap and giveaway with Sharon Schackmann, the author of the Speech with Sharon blog, who’s created a product entitled: Winter Non-Fiction Leveled Reading Passages and Questions with a focus on teaching non-fiction text to older students: elementary through -high school ages.

This mega sized 44 page packet includes 7 passages on a variety of winter related topics including: Continue reading Winter Non-Fiction Leveled Reading Passages and Questions Product Swap and Giveaway

Posted on January 8, 2014January 5, 2022 by Tatyana Elleseff — 1 Comment

Tips Corner: Creating Opportunities for Spontaneous and Functional Communication

In today’s guest post, Natalie Romanchukevich advises readers on how to create opportunities to expand children’s spontaneous communication skills.

Helping young children build speech- language skills is an exciting job that both caregivers and educators try to do every second of the day. We spend so much time giving our children directions to follow, asking them a ton of questions, and modeling words and phrases to shape them into eloquent communicators.

What I find we do NOT do enough, sometimes, is hold back on our never ending “models” of what or how to say things, questions, and directions, instead of allowing our children initiate and engage with us. Greenspan refers to these initiations as opening circles of communication (Weirder & Greenspan “Engaging Autism”, 2006).

Speech- language development can be thought of as having three interacting and equally important domains- Form ,Content, and Use (Lahey, 1988).

Form refers to the grammatical correctness of our words and sentences (eat vs. eat+ ing).

Content is what the we are essentially communicating- the meaning of our words and sentences.

Use (also known as pragmatics) refers to the function of our words or for what purpose we are using them.

The communicative functions that slowly emerge and characterize communication over the course of language acquisition in vary in typically developing young children. Children communicate to greet others, comment on objects/actions, request desired objects, request assistance, protest, deny (a statement), ask questions, regulate others (e.g. “blow!”, “open!”), entertain, and narrate events.

In order for children to be able to express these functions, aside from the intent to communicate, there must also be opportunities to express ideas, wants, needs. For example, why would Timmy request for an object (nonverbally or verbally) if the caregiver hands everything to the child at the slightest sign of a tantrum. Why ask a “where?” question if every toy or beloved object is comfortably in sight? Why ask for help if the caregiver readily assists the child with all activities. The educators describe it as assuming the child’s needs.

Of course we do it out of love and care for the child, and, let’s be honest, sometimes, to save time. However, it is important with both typical and delayed children to be mindful of what (form, content, use) we model, when (timing is crucial in teaching) we model it, how (facial expression, tone of voice, etc) we model it, and why (is it developmentally important to teach it now?) we model it at this very moment.

Just as it is important for kids to comprehend concepts, follow directions, and understand the different wh- questions, it is also paramount that your child is able to initiate communication. After all, communication is the ability to express ideas, thoughts, and wants, not just understand those expressed by others. Answering questions and following commands is not initiating. Language that is elicited by us- is not spontaneous.

To use language spontaneously, effortlessly and creatively, children need opportunities to practice the skill, to experience taking the lead. In order for our children to get there, we must first offer models of how to initiate communication and do so appropriately. We can then create opportunities for the child to speak up.

The most basic strategies you can use to encourage spontaneous initiations (whether nonverbal or verbal) may seem seem initially as counterintuitive. I mean what is the point to introducing attractive new toys or displaying a yummy snack and then putting it away? Yet it is exactly that action which may very much encourage your child to run after you with gestures or words. Even then, you may still choose to play “dumb” and be “unsure” as to what it is your child wants. Does s/he want that bag with new toy or snack “opened?” and “out?”

If the child is nonverbal, his use of gestures to regulate your actions to get the desired item out and open may be the child’s initial step toward sound imitation. If you are working on getting the child to request help (not just objects), here is your opportunity to model “help” if the child can’t open the item independently. On a side note, I often hear educators model “help me please!” when the child is clearly at a single word level. This is not a developmental way of teaching. Yes, it is nice to hear a full sentence but your child may not be ready for it.

While playing with your child and actively commenting on your joint play, you may find it productive to suddenly become quiet and cease all attempts to ask questions. This often works beautifully in my therapy sessions; usually, after I have engaged the child into some sort of cooperative and enjoyable play! But it takes a conscious effort and self-control on the part of the adult, since we are so used to engaging in this adult- directed (telling the child what to do as opposed to letting him/her lead and you follow) approach to teaching.

However, once you are able to contain your speech and actions (I promise you it is possible), you may be surprised to hear some immediate or delayed imitations of words/ phrases as well as spontaneous meaningful language. The language produced, to me, is an indication that the child wants more of the experience- more language enriched play. Use this opportunity to expand on what s/he is already saying.

Here, timing is really important as you want to imitate back everything your child is doing. This is another way to communicate with your child. Build on your child’s language to further describe the objects or people in play without using long sentences. So, allowing nothing to happen for a few minutes at a time may just be the push to help your child come out with some form of communication.

In addition, stopping a novel activity or toy exploration at the very height of your child’s excitement also works well with many children. You don’t have to be confrontational about it, “if you don’t imitate my word/ phrase I just won’t give it back to you”. make sure to create these “obstructions”, as Greenspan refers to them, in a friendly, playful and positive manner. Obstructions or fabricated “problems” are also a big part of social-cognitive and constructivist theories of language learning.

The idea behind these “obstructions” is that the children are forced to problem solve and use resources (language being one of them!) so they can get what they want. Allowing your child to problem solve is critical to overall cognitive development that affects and shapes speech and language. Presenting your child with developmentally appropriate activities that involve thinking and figuring out of how to get X is an invaluable strategy that I always use with all of my children.

In sum, stop access to items that are already loved, tape up containers, close boxes and jars with favorite snack and toys, give your child all but ONE important item that is needed to complete an activity (glue, scissors), give your child the “wrong” item, or offer the “wrong” solution to the problem. All of these “problems” will push the kid to think and figure out what to do next. This, in turn, facilitates spontaneous language use.

Letting go of control and just allowing for things to spill, break, or simply not follow the predictable comfortable routine, too, elicits a ton of speech- language and fun communication. These are the most teachable moments as our children experience all the new words and concepts first hand. Perhaps, this is why many children learn “dirty” or “wet” attributes before they learn their colors. These concepts are more easily learned because they are experiential and bring about relevant words to describe these personally relevant and emotional experiences. Cleaning up and taking turns arranging things back in place is super educational too as our children need to learn responsibility and helping others.

Moreover, exposing children to objects that are completely novel and foreign (but safe!) may help elicit an attempt to ask a question “what this?” because the child wants to know. The motivation is there. Now s/he needs language to get the answer from you. Some children may use a word with a rising intonation, which too is a question form, just not grammatically mature one. For example, “Hat?” is as much of a question as “Is that a hat?!”. If all your child is capable of verbalizing is “wow”, then you can go ahead and model “what IS that?” question a few times. Of course, you want to pair it up with an exaggerated expression of surprise and excitement in your voice.

To sum up, do not be afraid to experiment, get “messy”, stay silent, entice, intrigue and just wait for a few minutes to see what your child will do. Yes, we want to teach our children to attend, sit down for a structured activity, and identify objects, shapes, colors, and actions; but these adult- directed activities do not allow for self- expression or spontaneous language use. You also want to follow your child’s natural interests and inclinations as this is frequently a way into their world. If you show interest in your friend’s ideas and you let him/her speak, will they not want to bond with you even more? Will they not want to communicate with you?

Creative and talented teachers are those who can use unconventional materials presented in unexpected ways while targeting all the skills that must be learned! Learning to manipulate the environment to get the most out of your child’s skills can be difficult but indescribably rewarding.

References:

Lahey, M. (1988). Language disorders and Language Development.
Greenspan, S. & Weider, S. (2006). Engaging Autism: Using the Floortime approach to help children related, communicate, and think.
Wetherby, A. & Prizant, B. (1990). Communication and Symbolic Behavior Scales. ChicagoIL: Applied Symblix.

Natalie Romanchukevich has a MS in Communication Sciences and Disorders from Long Island University (LIU) as well as Bilingual (Russian/English) Certification, which allows her to practice speech- language pathology in both Russian and English. Following graduation, Natalie has been working with both monolingual and bilingual 0- 5 population in New York City, and has been an active advocate for preschoolers with disabilities in her present setting. Natalie’s clinical interests and experience have been focused on early childhood speech- language delays and disorders including speech disorders (e.g., Articulation, Childhood Apraxia of Speech (CAS), Pervasive Developmental Disorders, Autistic Spectrum Disorders, Auditory Processing Disorders, Specific Language Impairment (SLI), as well as Feeding Disorders. Presently she is working on developing her private practice in Brooklyn, NY.

Posted on October 27, 2013January 5, 2022 by Tatyana Elleseff — 4 Comments

Birthday Extravaganza Day Twenty Seven: Elementary My Dear, Analogies

It’s DAY 27 of my Birthday Month Giveaways and I am raffling off a giveaway by Straight Up Speech, which is Elementary, My Dear Analogies.

This adorable 12-page critical thinking packet targets early analogies and uses child-friendly graphics to engage students in filling-in-the missing answers.

Packet Contents: Continue reading Birthday Extravaganza Day Twenty Seven: Elementary My Dear, Analogies

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Birthday Extravaganza Day Twenty Seven: Elementary My Dear, Analogies

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