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SALT report - advice please(10 Posts)
Just received the report which says ds(7) has a moderate delay in expressive language and a severe delay (1%) in understanding. He is not following the 'normal' path of language development.
Ds has dx's of ASD, Gdd, Mod Learning disability and is under investigation for epilepsy (scary time at the moment).
Ds never stops talking but doesn't really interact appropriately in conversations, follows his own agenda and is pretty good at manipulating a conversation. SALT is quite impressed with this ability!
Ds doesn't understand any time concepts, such as now, next, later and gets very agitated when these words are used. I guess because he doesn't understand them.
Quite often he gives very strange descriptions when he can't remember a word. Recently, when trying to complain about the noise of the washing machine, he described it as that thingy that goes round. Croquet potatoes were described as that soft, square food - this actually led to a meltdown followed by a trip to shop!
He also drags us around the house rather than talk.
Also says things that seem completely irrelevant and out of the blue but if you know him well it makes sense and you can see a link to what is happening but he gets so frustrated!
Anyway I would appreciate some advice on how best to help him. SALT has introduced a personal visual timetable at school as well as happy and sad faces. I don't mind these too much but don't want to rely on visuals all the time, although we use them to teach specific things at home.
Also asks questions in strange ways such as that milk was nice instead of saying please can I have some milk. I have been modeling the question for him but have to be careful as he gets very upset.
Any way if you have got this far thanks for reading and any advice at all will be welcome.
What advice would you like, blue? I'm not 100% sure?
Visuals are going to be important with that degree of comprehension impairment. Unfortunately, there is limited evidence that severe comprehension deficits can be "fixed", so visuals are likely to be important in the long-term (though the aim would be for him to take control of them as he grows older). He needs to learn how to use context as best he can, and visual cues will be a large part of that.
There are a lot of separate issues here. He has multiple diagnoses already and may have epilepsy? Some of the features you describe seem related to the ASD diagnosis (e.g. may reflect how he views the world as well as specific difficulties with language/learning difficulties).
What would you most like to work on right now?
yes, DS had (?has) a language delay, and a lot of what you describe rings bells, some of it being an issue now, others past issues.
In terms of the time words - people have found visuals useful for those - you can get boards with now/next/later from ebay. I remember the very first way I dealt with sequences with DS was with very simple stripped back language "playground then McDonalds, OK?". Then I moved on to using little jigsaw puzzles/2 picture sets to use sequencing language - at first it was "the dog barked AND THEN .... AND THEN", and after that we moved onto concepts like next/later/last etc.
DS also does that talking around/describing thing when he can't remember the word, it's pretty common with language problems, think you just have to accept it as a strategy for getting round the word retrieval problem.
Re:questions - like the milk example - would he consistently be able to say "I want milk", sort of as a staging post towards asking more "politely"
Sorry I didn't get back last night - world war 3 broke out!
I guess the real problem is that I don't know where to start and so sad as I thought delay meant he would catch up but the gap is just getting bigger.
Sequencing seems to be a good place as I'm hoping that this could eventually lead to ds using visuals independently. At the moment ds can't sequence 2 pictures and we have been working on this forever.
Word retrieval(thanks another brickinthewall as I couldn't phrase it well) is a huge problem but I can't work out where to start with this and it can lead to huge meltdowns.
We just get so frustrated and worried for the future and don't seem to be making much progress and it is so hard knowing how to break things down into the smallest chunks possible. Ds responds so well when he has tiny, tiny steps to accomplish.
Right I'll stop waffling and thanks for replying.
Has the SaLT put in a programme to help you get started.It is important to get a really good programme in place with a therapist who will give games for you to work on each day. It's too much to expect you to know how to do all this on your own.
What I find work best with my DD are memory games as they help with word retrieval and recall. Her memory is still really bad but I dread to think what it would be like without all the work we have done. One of the easiest to go that I remember from this age is very simple. Just get four coloured pens, say draw triangle in top corner. Then add extra insturction blue, square in middle. Just keep adding instructions till you can get to draw girl, with hat and red flower in centre of page.
I do feel for you as my dd is now nearly 11 and still having SaLT but greatly improved. IT's a long hard slog and there is no easy answer. Just get that programme and keep working at it.
With regard to the timing we can't even use playground then macdonalds as he only hears the last thing you say ie macdonalds.
His hearing is fine btw just can't explain it any other way.
I have made a now and next board for him but we are seriously struggling with it. Salt gave us a MONTHLY board. Not sure why as way above his level. New salt though, have had previous one for 4 years.
Oh I don't know, just can't seem to find a way forward that works!
We have sequencing games and memory games but ds can't seem to retain the information.
I love the drawing idea but ds is probably not ready for that as he can hardly hold a pencil and is just managing to sort of form a circle. He has very delayed fine motor skills.
I can go bak a level. using sweets at the other end of the room ask them to retrieve yellow jelly bean, or pink smarty. And don't think because they start remembering it that they will retain the information. You have to go over it daily.
Do you use pictures with the now and next board. Is visual learning better. Repeat very short games regularly in a certain order or at certain times so they get used to the expectations you have.
Don't worry about pushing as it will come eventually, just much older than their peers. But it will come.
Ask SaLT for homework to do everyday, games, books etc. Push for this as they won't offer it.
How often do you see SaLT. If fine motore skills are delayed ask for referal to OT for exercises to build up strength and skills.
It's just a matter of bashing away over the years.
Bashing away I am!
Visual learning is better and we have pictures for now and next but, a big but, they have to be very exact photo's not generic pictures.
I'll try the sweet game with skittles, ds favorite - and purple ones are kept for very special occassions!
We see salt every half term and school work on a 1:1 with ds daily (or are supposed too)
Ds has just been rereferred to OT otherwise we will be going private as they seem to have an unusual policy for taking children on around here.
Have you tried going to a private OT. We did and it was probably the best money we ever spent, she is not being funded by the LEA to see DD twice a half term. Same thing as you the LAs do something everyday with her. But it is down to the quality of the SaLT and we had a excellent one. Saw LEA SaLT and she was rubbish.
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