Receptive language

[bochead]

meeting @ school soon to discuss and I'd like to be able to ask intelligent questions.

Can I pick your brains re receptive language & what I should be looking for from a programme to address this. DS scores very lowly here, even though he was an early talker and very articulate. It's at the root of a lot of his issues as people think cos he is articulate and bright he understands instructions etc, when in reality he has perfected the art of smiling, nodding his head and not having a clue lol! His auditory processing is also poor if that helps.

His statement gives him weekly 30 mins monitored/measured programme adminstered by TA but set by SALT. He's never had any SALT apart from statement assessment, so all I know is what I've picked u from here (thanks Moondog!).

One of the most crucial skills for any child with receptive language is to get beyond that natural inclination to smile, nod their heads and mask their difficulties.

Getting any child to say "I don't understand", "say it again" or "what does that mean?" (and every imaginable variant of these) has to be a first point of therapy. There is a programme called Active Listening by Maggie Johnson which we have used with many of our students that goes through the phrases etc (we adapt to specific needsm obviously) which can help teach the basics, but ultimately you need this to be pushed across the school day in a systematic, targeted way for it to work/generalise. It's also really important that this is practised in social situations also... stopping conversations to clarify as well as just listening for information... it's probably even more critical but rarely targeted.

It's really hard to get kids to do this and to maintain it (nightmare at secondary) but because auditory processing/receptive language tends to be an ongoing problem, it's crucial. I would also say that it's really important that information is linked whenever possible and wherever possible.... think mindmaps here, but it's not the mindmap strategy itself that is most important, just making explicit the links between ideas and concepts because these won't always be naturally made.

After that, it's really a matter of working out what bits are most problematic and working on these.

bochead

Those who have an auditory processing disorder, like me, try to make sense of what is being said, by subconsciously trying to fill in the information processing gaps automatically using their existing alternative compensating cognitive skills, and abilities. And because we are trying to make sense of what is going on all the time, we are not aware when we have miss understood something or completely miss understood something, because from our point of view we have made some sort of sense of it. It can be many hours , days, months, or even years later that we find out that we may have miss interpreted something. We spend our lives either consciously or subconsciously filling in the information processing gaps.
The problem is that most think that this is all part of some conscious methodology, and that some type of program may help. Wrong. Most of the time we are not aware we have miss understood something or not processed the information at all. So we we continuous support and understanding from all around us, including teachers, family, and speech and language therapists, etc that we may not process information on a random basis, and we will need life long support from those around us to help through our lives. So all who we come into regular contact with need to understand the full nature of our auditory communication disability or disabilities, so that we are best able to achieve our maximum potential, and not keep on being blamed for the nature of our communication disability by others.

you could have a look at my own web site Living with and Invisible Disability

"The problem is that most think that this is all part of some conscious methodology, and that some type of program may help. Wrong."

You say a programme won't help, then contradict yourself by referring to support from SALT?

"So we we continuous support and understanding from all around us, including teachers, family, and speech and language therapists, etc that we may not process information on a random basis"

What is the nature of that support? What should it look like? What form should it take?

I'm a proponent of the neurodiversity model, in that I believe everyone can learn if we play to their strengths, and I'm not gonna be defeatist here. His receptive abiliity may never hit 50th centile but if with help he can go from 5th - 10th. He's never had SALT and he's 7. I wanna take advantage of the value a salt can add - to do that I need to know what to ask for.

working9' - sounds like aba stylee to start with to get him to ask to clarify auditory information in the classroom as a 1st step?

What dolfrog is saying is similar to what my students say. I think the idea is that the nature of tjese difficulties doesn't change over time. Understanding of words and sentences and concepts will improve, but when, say, the person is in a new environment, encountering new information, tired or sick, understanding will still be challenging. There currently isn't much evidence that this is something that can be changed longterm. I think good teaching of clarifying info would help, but I would favour basing a programme on one which has examples of and activities for clarifying in a range of ways, as just going on what can be observed might not yield best results. I would personally avoid 'uh uh, that's not it, you need to listen' feedback that doesn't highlight the exact nature of the gap in understanding. So a full programme, generalised in meaningful and motivating ways, yes.. The pack above might give ideas. Text is also helpful for readers and visuals to help identify breakdown and support learning.. Later on, taking down notes and crossreferencing these with teachers/lecturers and even at work is functional for many..

Am in a similarish position - my DS had whopping receptive and expressive delays at 3, has mostly "caught up" - well signed off SALT for a few years now, but there are still some residual issues.

I think I can see where Dolfrog is coming from - that as well as specific work with your child, the staff working with your child need to remain aware, and pay attention the way we do as parents, that just because our kid says "yes" doesn't meant they understand, but that they are taking the path of least resistance, and be alert to seeming non-compliance or rudeness not being naughtiness. also that staff need to be look at whether the appropriate response to your child saying he' doesn't understand is to simplify language, or allow more processing time. I have found that as my DS is a very visual learner, literacy has helped massively with learning/understanding language. DS had a good teacher last year, who would also try and get him to repeat back instructions, to check he understood.

In terms of things to work on - I guess a starting point would be for someone - ideally SALT to assess if he is missing any of the concepts you would expect a child his age to have, and possibly to try some "barrier" games - [http://www.playingwithwords365.com/2011/11/barrier-games-great-for-language-enrichment/]

btw dolfrog - I had a look at your new site, was v interested in the article about the gifted visual spatial learner by that NZ author, some of it rang a lot of bells about my DS.

I do see where Dollfrog is coming from, in that my sons basic wiring isn't gonna change, and people in his life will always need to be aware of that. Sign language, TEACH lite, & a good understanding school are all helping him no end right now.The school has a deaf unit, so all staff are experienced in presenting info in a non-auditory way on a daily basis.

I get the feeling that generally all the focus tends to be on children's expressive language in the early years with not enough emphasis put on whether the poor blighters understand much at all sometimes. My son's issues are weren't picked up cos he was early talker and he really suffered for that on starting at his original school.

Deffo gonna have a look at the resources recc'd above - thank you all so much for your suggestions!

SALT is something that was damn hard won and likely to be swiped away at the next annual review (only won via Tribunal, and LEA not great) so I really want to DS to get as much benefit as he can from it while he has the chance.

TheLightPassenger

It used to be easier describing APD when i first started out on this journey, as it was not as complicated as it is now lol. the author you mentiond Lesley Sword is from Australia, but the best link to that particular article is on that New Zealand based web site. Her mento, Linda Silverman and her colleagues have been writing about Visual-Spatial learners and Visual Spatial learning for a couple of decades now. If yopu have a look at Learing Style Section of the APDUK web site (top menu, squares on the bottom rows) we have included waht we think are the most relevent articles, which took ages to format as they are on the web site,as a demonstrationof how those like me prefer text o be presented. However the articles are all listed on Learning Styles Section Summary

this is interesting.

I have a 5.5yo with huge receptive problems. After two years of ABA his expressive language is now in the normal range but receptve still very delayed/disordered (he's in a range between 2nd & 14th centiles, improved from 0.1 across the board a year ago). I'm not sure how much of the improvement is actual & how much due to good compliance - he does that classic thing of talking to mask his lack of understanding.

SALT suggested barrier games (which he hates) but not much else. He's not making progress. I'm concentrating on his reading in the hope that will help.

Hi Bochead, to prepare, I would recommed Liz Baldwin's "Receptive Language Difficulties". Probably another moondog recommendation.

TheLightPassenger, have you namechanged from TC?

Dolfrog, I think your posts are great but sometimes they don't convey all the different variations that there can be between individuals - I say this respectfully, I appreciate that you are campaigning for change and that can make it necessary to be quite forthright.

Some of the regulars on here used to say things like "that's my autism, the autism I understand, but I know I don't understand your autism". I think it can be a bit like that with receptive language difficulties too.

Anyway, highjacking the thread somewhat: I do agree that the problem doesn't go away and that you need lifelong support from people who love you. My dad has had a normal life despite his language processing problems. But now in old age his quirky answers to questions are being misunderstood as short-term memory loss. It's really painful for me - now, all of a sudden, he genuinely would benefit from a label, as he is about to be given the wrong label (Alzheimers).

Example:
Doctor "how old were you when you left school"
Dad - under pressure to answer quickly "12"
Doctor - oh, you must have been very clever to leave school at 12!
Dad - silent but realising that the doctor hadn't in fact wanted him to explain that at 12 he was taken out of the local school and forced to go to boarding school which he hated.

Next question:
doctor: "how many brothers and sisters have you got"
dad: there's three.
mum: no, two, two sisters.
Doctor
Dad - silent again, realising that explaining that he was one of three siblings wasn't the right thing to do.

Of course, the stress of this meant that dad seized up completely and couldn't answer loads more questions. Yet out of all my relatives it is he who remembers to follow up on things the children have just done and find out how they got on .

^ that's EXACTLY the kind of conversation my son has with people lingle!^

Constantly misinterpreting context of questions so "getting it wrong". He does have lots of other ASD traits from dysraxia to obsessions but the receptive language dfficulties are I think a KEY barrier now we've "dealt" with the sensory goings on at school.

Oh bochead it's hard seeing it isn't it?

What are his strengths? Sometimes I think all we can do is build up their weak points to a level where they can still harness their strengths.

Dad prob. had a bit of dyslexia too but "found" himself as a young adult with (i) jazz (he has been in continuous demand since the 1950s and is still playing in a band) and (ii) engineering - classic visual thinker. So he has shone in situations where he didn't have to respond to speech - no problem giving a speech at my wedding, for instance.

Whereas I found my forte in the written word - reading gives you more thinking time.

And DS....... not sure yet!

Dad's sisters (4&5 years younger) remember him being a joker as a young boy. It must have been his strategy - but probably one he could only use in the context of home.....

of course, because they remember him being jokey, they can't understand why I raise ASD as an issue - but I'm sure he was happier with younger children - fewer social demands.

lingle

this goes back years, one of the first decisions we had to make was whether to focus solely on APD or whether to focus on all of the various auditory issues which can cause an auditory processing disorder. Back in 1998 - 2002 it was thought it would be best to focus on just APD as the various separate contributing factors would be too complicated a message to put across. Now is probably the time to switch from the single issue to the multiple issues that can cause an auditory processing disorder.
Campaigning wise I am well past my sell by date, and was dragged out of semi retirement a couple of years ago when those who were then running APDUK had various illnesses and family issues which required their undivided attention. I was enjoying my role of lurking in the background while researching my own pet areas of interest, and editing Wikipedia articles.

From what you have described above your dad and I could have quite a bit in common, just that i never found a career option that did not require understanding speech. There is an adult APD forum the OldAPDs (old meaning anyone above school age lol) which has been running for over 11 years now, and has over 600 members, and has some online links and files (many of which can be downloaded) and a clinical diagnosis is not compulsory, as many are self diagnosed. There are even some downloadable APD cartoons.

Lingle, I can really relate to your earlier post with the scenario of your father at the doctors. That's my dd2. When asked if she has a sister she'll reply 2. She's 1 of 2 and she's a sister too. It's a quirky logic. She's 6 now and seemingly copes very well, having learnt to be very adept at masking her difficulty. Reading helped hugely in increasing her vocab. She now reads well above her age level. But conversation is a tricky one.
I find it very hard to tell what she does or doesn't understand because she doesn't like talking about it. She says she's Different. While her receptive/expressive has improved, I feel that a great deal of it is due to her improving her masking techniques.

interesting to hear about your DD2 kissingfrogs. I found reading a great help as a child though to be honest I retreated into it a lot.

Does it run in the family for you too or not?

What help is your dd2 getting? What are her strengths? I think that dolfrog's point that outsiders assume there is some intent behind our quirky responses is a critical one.

I was thinking that for my DS2 I should figure out the common traits between me and dad. Both of us are (or were in his case) hugely strong on specific types of pattern recognition- musical for both of us, visual for him, patterns in text for me. Both of us struggle with situations where a fast response is required to certain kinds of communication.

But I think it's not speed of incoming communication that's the issue. As a jazz musician who has often played as a "session" musician with people he didn't know, dad has had to excel at reacting and communicating instantly - literally, he is a professional improviser. But crucially, a jazz musician only has to respond to one kind of communication at a time. An engineer can look at drawings without having to talk. A lawyer can argue a case without wondering if she looks pretty, is smiling enough or is sending out good body language (with clients I'm much better on the phone).

So it's something to do with needing communication to be specialised, an inability to multi-task.

I am doing my MSc on this issue of "multimodalities", lingle.. specifically I am looking at gesture and language. My results so far (and those of others) seem to indicate that where gesture reinforces language e.g. it is more "sign like" and very specifically conveys a message, it seems to reinforce language understanding, but where it conveys something slightly different or supplementary e.g. you say "I'm going outside for a bit" while gesturing that you will smoke, it significantly slows down processing for everyone including people with typical language development. The effect is disproportionate for people with language and communication impairment, but it's not particularly clear cut..

Speech processing seems to be a major factor, unsurprisingly. The students who have performed most poorly (slowest reactions/most errors) in the simple, structured tasks we have been doing are those with speech disordered profiles, which surprised me. Many of the students with poor understanding responded faster to meaning conveyed across "two channels" than they did to speech only... the students with poor speech had far slower reaction times when they needed to listen for information in speech and also pay attention to gesture.

It is all very complex, really and there is so much to learn... we know so little really. Often difficulties are described as being about "social communication" or "pragmatics" when really they reflect difficulties with processing, understanding and using language form. In the same way, difficulties processing social information can be mistaken for difficulties with understanding or structuring language form. When you read transcripts of conversations with adults after stroke, you can often see this in action: the meaning is distorted. Yet in context with a supportive conversation partner, it's obvious that social understanding is there, but subtleties of the message have been misunderstood or the means to convey the social understanding isn't there. Yet socially and functionally, these students seem to "manage" this information better in everyday conversations than their peers with understanding difficulties....?

One of the reasons that some this stuff is so poorly targeted often is because of these subtleties. Simple sentences are easily broken down and "taught", and some basic complex sentences too (because.. when.. etc). However, the speed and flexibility of ongoing speech, combined with the multiple cues from context and nonverbal communication etc, is hard to break down into teachable targets. There is a desperate desire for "programmes" for "social skills" but teaching outward behaviours e.g. eye contact/volume/proximity etc just doesn't really match the level of demand when there are difficulties with language and/or social information processing.

I have had the most success with "supported conversation" type techniques... coaching students through their communication breakdowns in real, naturalistic situations... over time, I see real changes with this approach. In contrast, I have seen very little success comparatively with structured social interventions either in ABA or speech therapy.

^the above is really interesting and helps explain why sign language (which he's learnt FAST!) seems to have really helped my DS's auditory understanding of things like simple instructions^

Just a couple of my own thoughts on my experience with DS so far that perhaps might help others, given the low cost implications. This is something for us that came about totally accidently, as a side product of my search for a school where teaching staff were used to habitually using visual methods in their everyday teaching. (How he ended up at a school with a deaf unit and not an asd unit).

We did a lot of "sing and sign" stuff when he was a baby and now I credit this with having helped him to be an early talker. At the time I had no idea he was sen - I just had a couple of the DVD's and it was a fun thing to do for 15 mins every morning before I had to drop him @ the childminders and go to work. As he was an early talker it wasn't used at all past 18 months.

Sign language is used in assemblies etc as the school has a deaf unit so it's used WITH speech, DS says it helps him "be quick enough" to understand the instructions given. (It's important it's not instead of speach for him to get value).

DS has always had incredible visual observation skills, but is very behind with literacy at present. However I don't think he'd be getting the benefits to such an extent if I hadn't first spent a year teaching him aba style to make eye contact, so if this is an issue I'd focus on that as a first step.

Lingle: my father has aspergers, he is very articulate, pedantic in speech, but admits he can not do "small talk" and therefore finds conversation v stressful. He's a recluse who will avoid talking on the phone, prefering writing in a rather grandiose fashion. Myself, I love language and it's only when I'm talking about I'm passionate about that I can't find the words. I have terrible visual spatial skills, I fit the dyslexic personality (if you can call it that) to a tee.

I work with a young man who has quite severe aspergers. He explained that he can't talk and maintain eye contact because he can only concentrate on one or either, never both at the same time - it's simply too much.

Dd2 gets 1 session per week at school with the senco using black sheep semantics material, currently working on who, what, when. "when" is a problem as time is an abstract concept that dd finds most difficult.
Dd2s difficulty with language is complicated by being mild-mod deaf (as was my father). She has v clear speech but language probs more in line with a severe-profoundly deaf person. Her tod thinks apd.

Her strengths are visual processing skills, particularly strong in pattern recognition. Her other strength is the sheer determination to be the first, the winner, the best!

Working: supported conversation - this sounds like something that dd needs as it is conversation that dd struggles so much with. Dd relies on her ever increasing pre-learnt repoitoire of simple-complex sentences but, just as you have said, there is so much more to maintaining a conversation.

Bochead: dont mean not to address you in these posts. I'm too tired to write anymore at the mo. Just want to say that my dd now does her language sessions in a small group of 3 and she likes this - probably because the others can help fill thevgaps when she doesn't understand or doesn't know what to say, the upside being it's more comfortable for her and the less anxiety she feels the better she can learn.

fascinating working9while5, really interesting. hope to re-read and engage later.

Bochead, wow your son really really sounds like my dad only of course dad didn't get help. Instead he got (i) bombed (ii) evacuated to the country (iii) moved to a horrible boarding school - three things we can be cautiously optimistic won't happen to little bochead. I wonder if bochead junior will become interested in engineering. His reading is ok isn't it?

Of course, the modern age, filled with not-so-instant instant communication on the internet is massively on the side of our children.

"time is an abstract concept that dd finds most difficult."

kissing, have you used the timetimer, the calendar, perhaps even my doctored clock? Apologies if we have a grandmother egg-sucking situation here.

Isn't it interesting that, as the traits pass down through the generations, the over-specialised pattern-recognition skills are always there and yet the type of pattern-recognition varies widely. Dad has excellent visual-spatial, mine is appalling. Dad has awful text-reading skills, mine are very good.

Here's a question for working9while5 to ponder: if overspecialisation is the problem, are we tending to work on the wrong thing? I recognise myself as talking too much in semi-informal places like PTA meetings. So I tend to focus on thinking "don't talk, don't talk" (and fail because you can't sit muttering that to yourself for an hour solid). But if the problem is an unbalanced brain, maybe I ought instead to by sitting with a piece of paper doing "real" drawing using just visual processing (not analytical tricks like using perspective etc).

Sadly a rigid adherence to phonics flashcards and Ruth Miskin did a lot of damage at his last school that we haven't yet overcome literacy wise so he's very behind. He also has issues with writing by hand and is probably "dyslexic". Text therefore isn't an option to help him "yet". However I'm confident that given another year or so we'll get there on the reading front now home and school are working together consistently in a way that suits his learning style.

At home a combi of Ladybird "Peter & Jane" (lots of sightwords based on keywords & how I learnt to read as exclusive phonics isn't the whole answer for everyone!)& "clicknread" (a nice cheap predicitable internet phonics scheme idea for asd need for consistency) seems to be working really well. Schools "system" is very complimentary to this and the "clicknread" report gives valuable data for areas of specific difficulty. I was cheeky enough to submit the clicknread report in my application for a statement and to Tribunal.

I've also found "storynory.com" very helpful. It's a free audio story library with printed text. The narrating style is very consistent and there's section called "catch phrase" that explains common catch phrases for literal thinkers extremely well. We listen, read and have lots of conversations together to clarify the meanings in the stories.

DS can listen to a story and we can talk about it while I'm prepping dinner. As it's free I really rec' other people test it out as you have nothing to lose. (So much in the world of SEN costs serious cash!).

On moondog's rec we are evaluating "headsprout", hopefully to start using at home/school later in the year as we want to use the 2nd level from scratch.

working9while5, I am finding your post heartening. I have a meeting set up with DS2's teacher after half term to talk about the way forward in the social skills group. I had been feeling a bit down because in the old days when I worked on language I usually knew what to work on next because it and he were simpler.

But if actually there is no real understanding, then the best thing is simply to encourage them to engage with him in a way that they find works and have them enjoy his company and vice versa.

Thinking about kissingfrogs' "young man who has quite severe aspergers. He explained that he can't talk and maintain eye contact because he can only concentrate on one or either, never both at the same time - it's simply too much." This is very much like what I experience in my violin lessons (where I am pretty neurotypical, just a bit rubbish). Teacher shows me a right-hand thing, a left-hand thing and a musicianship thing. Then she seems baffled that I can't combine them and I whimper "I can't do both at once". Of course, one solution is to take the right-hand thing and practice it on its own until you get the famous "automatic execution", then add the others back in. But consider the fact that training pupils this way is notorious for producing many "wooden" and unspontaneous players as we see in parody (google muppet show piginini) ..... like someone with Aspergers who has learnt through endless repetition to combine eye contact and speech.... but you take no pleasure in listening to them because there is something forced....

"Text therefore isn't an option to help him "yet"."

As you say though, there are so many different paths to reading.

Ruth Miskin suited my lad (late talker) but I can imagine it would feel daft to an early talker.

He's a sight-reader so there he departs from my dad. Sounds like he may go on to have a very rich relationship with text with your help. Dad's main reads were "choosing a large dog", "choosing a small dog" and "choosing a medium size dog". It took him so bloody long to read them in the end I had to go out and buy him a dog.