conflicting assessments: SLT v everyone else

[kissingfrogs]

Dds latest SLT assessment today shows only minor language difficulties (vocab, auditory memory, word retrieval). Emphasis on minor.

We're awaiting another EP assessment. The last one a year ago showed significant gap beyween cognative and language abilty (eg verbal comprehension 5th percentile, non verbal reasoning 97th).

These new reports are going to make the difference between intervention and non intervention.

Other professionals (TOD, SENCO,SENCO co-ordinator, teachers) have all recognised that dd has a language difficulty which is not apparent until you get to know her as she is very clever at concealing it (being bright, using diversion tactics etc).

The SLT might think alls well because dd can answer basic questions like how old she is, her teacher's name, but dd can not grasp concepts (abstracts esp) because you can't verbally explain them without loosing her and u can't tell how much she understood because she can't hold a conversation. Minor? Dd isn't a toddler, she's in YR1. It's not flaming minor when your child says she doesnt like school because "I'm different, I talk different."

So, my question is: am i right in thinking that these SLT assessment procedures focus on grammar, vocab & phonology but do NOT recognise that though a child may be reasonably competent in these they still may have a language difficulty (semantics, pragmatics, conversational disability)?

If so, what assessments can they do to test this (on a 5.5yr old)?

working there's a multidisciplinary meeting being set up on teachers request. This is likely to be before the new EP and next specialist SLT assessments, so the only new report on the table will be this SLTs. The only people around the table will be me, teacher, TOD and senco. Therefore I think that there will still be that vagueness, that wooliness, because there is an overriding element of not understanding quite what dd presents. There are so many paradoxes that I myself find it baffling.
I need to clarify what strategies are being used in class and get this addressed. I'll discuss the issues you mentioned as you have made some very relevant points.

This is so frustrating! I have just written a response and lost it!

Basically, I was directing you to links at the University of Strathclyde where there is a Language Support Model for teachers and a Language Therapy Manual for indirect therapy.

I can't get the Language Support Model up, now buthere is the Language Therapy Manual.

It would need to have targets set by an SLT but it may be of interest as it was used as the basis of a randomised controlled clinical trial on indirect intervention for language impairment and the research participants were included if they had a subtest scaled score of 6 somewhere on the CELF.

The RCT was on children with primary language impairment (HI excluded) so I present it with some caveats underlining again the need for targets to be set with an appropriately qualified professional.

However, I suppose what I would do in your position is approach the SLT ahead of the meeting with some thoughts about what you would like in terms of outcome e.g. you are aware that your daughter has identified deficits in sentence structure/recalling sentences and you would like to have targets identified to support these both for indirect intervention and classroom strategies. You could mention this manual as a research-based intervention that has proved suitable for language difficulties of this type and ask her to "take a look at it" and advise.

The reason I suggest this is that it may improve the outcome of a meeting/allow for something more specific now ahead of a diagnosis etc. I think that if you all head into a meeting feeling irritated with the SLT, wanting to tear her findings apart (however justifiably ) what will happen is that there is lots of finger wagging and justification and the SLT will dig her heels in. End result - nothing useful for your dd NOW.

Give her some rope. She can choose to climb out of the whole or hang herself with it. You have nothing to lose: you are going to change input anyway. It just might give more direction NOW.

Diagnosis is important but in complex cases it is arguably more important to get on and try to do something in the absence of a definitive answer.

Hi kissingfrogs

I do know where you are coming from, I help run the APDUK helpline, as well has having three sons who now all have clinical diagnosis of APD, as do I and my partner.
You can download the Medical Research Councils (MRC) APD pamphlet, and it is the MRC that define medical issues in the UK, which all GPs should abide by.

APD issues are live long problems and so the earlier your dd becomes aware of the her information processing deficits, the sooner she will become aware of or compensating strengths, which she has already begun to develop.

If APD is the cause of the problem then seh will not be able to process or sue phonics based instruction well if at all, Those who have APD have problems processing the gaps between sounds which make up words, and tend only to be able to identify and reproduce the whole sound of a word, and as a reseult can only match the whole sound of word to the shape of the graphic symbols (letters in our writing system) used to represent the visual notation of speech, or the written word.

working brilliant. That manual will be so helpful, and I've only read up to strategies-to-recall-appropriate-word so far but had to stop and post. I would say that this manual applies to equally to HI as to primary language impairment - both being communication difficulties. The communication-friendly-classroom is also the criteria for the HI friendly classroom.
Having read on, comprehension monitoring is a must for dd as the strategies she has herself developed (eg distraction)need changing as this is such an important area.

I did speed read the research project and was suprised at the findings. I understand better now the fundamental importance of support within the main environment - the classroom. Rather than seeing SLT therapy sessions as THE holy grail, it is apparent that the environment has to adapt, particularly with regard to optimising receptive language. Must go back and reread in depth.

I'm going to give copies of the manual to teacher and TOD (and to SLT) so that it can serve as a guide for discussing plans and targets during the next meeting. Great stuff

dolfrog Dds TOD has mentioned APD as she suspects an auditory processing problem. I haven't read much yet about the diagnostic process though suspect that testing someone who has a HI would present a certain difficulty (differentiating between HI v APD) when validating the results. I may be wrong?

"I did speed read the research project and was suprised at the findings. I understand better now the fundamental importance of support within the main environment - the classroom. Rather than seeing SLT therapy sessions as THE holy grail, it is apparent that the environment has to adapt, particularly with regard to optimising receptive language. Must go back and reread in depth."

I'll be honest with you, at the moment this is my holy grail.

I observed a secondary lesson last week in which there were 38 advanced/specialist words in 5 minutes of teacher talk. There was a particularly excruciating teaching sequence where the teacher tried to explain a particular concept (characteristics), asking "what is a characteristic?" 15 times but never giving any hints or information while the class just slipped away/zoned out.
The kids just couldn't cope with the language content. They were unable to generate any responses to his questions (all highly inferential). There were no opportunities for them to use or repeat the words themselves. Most of them couldn't even pronounce the words (and these are not technically SEN kids). There was no structure - objectives for the lesson were introduced but not followed in order so I couldn't work out what we were doing at several points.

SLT therapy individually has its place but in and of itself, it won't necessarily have sufficient impact.

We call it "magic wand therapy" e.g. X school called to complain because we aren't giving Y "magic wand therapy" e.g. taking them out of class and "fixing" them.

There was a follow up study to the RCT on a group whose staff implemented the programme with less SLT support which didn't have as good outcomes.

The ideal programme IMO is a mix of professionally directed language therapy within the context of an appropriately adapted environment. For this to work, you really need to have the school on board and this is not always that easy to achieve. I have worked in schools in which I have had quite a lot of commitment to individual therapy but NONE to staff implementation e.g. where I have had to battle for months to get 15 minutes of training in a staff meeting. 15 minutes. Sigh. On the other hand, in a school which "gets it" and embraces collaboration, changes to the environment and integrated targets can work much better than stand-alone language therapy.

It's all about time. As a language learning disabled child, the more time you spend engaged in meaningful language activities at a level that is right for you and the more opportunities you have to use your language in meaningful ways across the day, the greater the potential benefit.

Unfortunately, there is limited commitment to this type of intensity in many places.. as this board is a sadly a testament to.

There is very much a view of individual SL therapy being the Only Way and SLTs as the Fixer. I had this view as a parent new to language difficulties. I knew about adapting the environment for HI but did not apply it to language impaired. Why? I was ignorant not well-informed, and somehow SLT has the same it'll-fix-it assumption about it as going to the doctors for your prescription.

HI professionals appear to be there in a overall management context. For example, dds last school supplied with teacher packs (eg NDCS publications) plus input from the TOD such as sitting dd near the front, topic vocab etc. There is much more environmental awareness in the area of HI and it gets promoted.

Both HI and SLI are Communication Difficulties, both require providing appropriate environments, yet both are viewed very differently. It may be because these disabilities are perceived as fixable/non-fixable longterm/shortterm, but it may also be (IMO) because there is a lack of knowledge of the importance of the environment for language impaired children because it is not well promoted.