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A question about a SALT dx?

(9 Posts)
Piffleoffagus Sun 07-Nov-04 21:20:07

What a week for Piff and DD..
In the middle of the ten day vomiting bug we had a long awaited SALT assessment dd's first ever (she is just 2 last month)
She was ok that day, very tired and below herself but not puking so we took her, the waiting having taken 3 months blah blah
Anyway it came out as DD having mild delay and single word understanding?
Now she talks in a few 2 word sentences, more nana, more milk, more water, go home, go bed, etc plus if I say to her where is your medicine (she is teething) and she goes to my top drawers where the calpol is, collects her medicine and spoon and brings it to me.
Loads of other less obv examples of further understanding, am a little bit chocked at single word understanding being put down, ok she was quiet that day and it was during her normal nap time, should I asks for a retest and am I the onle one that thinks the Derbyshire Rapid Screeenign should be done in own home?
Am a bit peeved, but if someone could offer me a little more info I'd be grateful, maybe I am missing something...

Jimjams Sun 07-Nov-04 21:39:02

That's one keyword. 2 keyword would be go and get your HAT and COAT. Or Bring me the RED HAT. iyswim. She may be able to do that- but may not have done it consistently on the day.

TBH I wouldn't worry too much - ds1 can understand 2 keywords at times but it isn't consitent or easy enough for him to count yet. For example he could follow "Get your COAT from the FRONT ROOM" especially if I reminded him en route- but he would often mistakenly look on his peg iyswim. They do like it to be consitent before they count it. It's important really for pitching the therapy at the correct level.

Jimjams Sun 07-Nov-04 21:39:48

Hope she's feeling better anyway....

mizmiz Mon 29-Nov-04 16:02:17

Piffleoffagus, I have only just seen this (am a salt) or Iwould have answered earlier. Anyway, thread seemds to have died so I hope you are happy with Jimjam's answer (yes she is right!) but I will just add a bit!

Yes obviously kids 'perform' much better in their homes. We all accept that, but for reasons of time and economy, an SALT can get through a lot more appointments if the children come to him/her. We all know it is not ideal. (I do home visits but most of my service users have PMLD and are going to be seen for a long time so this makes sense.)

The Derbyshire RST is just that. RAPID and a SCREEN
In other words, it gives a vague idea very quickly. Again,far from ideal but this is the way it is.Salts tend to err on the side of caution. better to get a modest baseline and then be pleasantly surprised (which happens all the time-it's lovely!) than to decide on a rather ambitious one which will then be proved false. Very very demoralising for families who are already having a tough time.

Has the idea of ICWs (information carrying words) been explained to ytou properly? Jimjams is obviously familiar with it.
In a nutshell, even in long sentence, there are usually only certain words you need to truly understand to get the jist of the sentence. To use your medicine example, you could say
'Are you a bit poorly darling? Go and get the Calpol It's in the drawer.'
15 words there (16 actualy!)but to be honest, the child only needs to understand 'Calpol' especially if you usually keep it in the same place and she knows it.
Think of how abroad you can get by with understanding a few words-hear a sentence and just let them stand out and make sense of it.
Also context helps. If a waiter is standing there with a cold drink in his hand and saying something in a questioning tone, you could be anywhere from Ulaan Bator to Timbuktoo and have a pretty good idea what he is saying!!

I am NOT saying that this is necessarily the case with your child, but it is something we all do to a greater or lesser extent.

Also all salts bear it in mind if a child is not feeling her best. Iam sure it is in the file notes. Ask to see them!! (You have every right to do so!) If it isn't there ask for them to write it in if it makes you feel better.

Finally, she sounds as if she is coming on pretty well. Don't know how long you had to wait for an appointment, but it is pretty good that you have been seen so soon.

Oh! One more thing! For various boring statistical reasons, most assessments can't be redone within 6 months so I don't think it is worth asking for another one.

Things sound like they are going well. Please don't worry!!

Jimjams Tue 30-Nov-04 09:34:40

Thanks mizmiz- that's really helpful! I've never had it explained to me- just had to kind of pick it up. We had a really shocking SALT assessment at BIBIC. It was the first time anyone had sat him down and done any sort of standard assessment with him- he was 3 rising 4 I think. And my god! Up until that moment we had NO idea that he was only understanding nouns and absolutely nothing else- but the test showed it really very clearly. I came away feeling quite stupid but the therapists reassured me that he hid his lack of understanding well (I guess he's very good at tuning into key words and also using the environment as a cue).

mizmiz Wed 01-Dec-04 14:32:05

Glad to be of service Jimjams!
I wonder what you mean by a 'shocking' assessment.
Was it so because of what it revealed about your child?
I think a lot of parents are dismayed by what (to them) often seems to be a very low score on a lang. assessment.As you point out, children with comm. difficulties are very very clever at hiding/masking their lack of understanding! In fact I am never able to get over how resourceful they are at using other clues!

How is your child getting on now?

Piffleoffagus Mon 20-Dec-04 12:52:33

thanks for the great reply mizmiz
DD has come on leaps and bounds and says over 100 words now whereas 2 mths ago she had only 5-10 ones that we could really understand
Now she has bra and beer
We are being put fwd for a portage assessment as we have a slight physical delay as well.
Although we attend an opportunity playgroup which is run by SALts and physios and they have seen dd at her chatty best and now have reasured me that she is bang in the middle of where her development speechwise would be expected to be.
I am sure we will end up going through this again as dd peaks and troughs pretty regularly...
But thanks again, have been a rubbish posted cos of no internet and because I've been very poorly after ectopic preg, but no sympathy wanted as am absolutely fine now

mizmiz Sun 16-Jan-05 22:30:49

Hi Piffle
Yes, I had learnt of your sad news on other threads.So sorry to hear this, but glad you're recovering.
Excellent news about your dd. That is a hell of a lot of progress in a short space of time!
LOL about bra and beer! (latter quite difficult to say actually for various phonological reasons that would bore you to death so I won't go into them!)
Take it easy.

onlyjoking9329 Mon 17-Jan-05 10:01:58

sorry to hear about your ectopic, i had one my first pregnancy too, six weeks later i was pregnant with twins, good luck with everything.

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