Low understanding percentile

[firawla]

If a child scores low on understanding of language, as well as expressive language, does that mean they have a learning disability and is it linked to cognitive ability, or is it a totally separate thing because it just affects language?

My ds2 (4 next month) had a formal assessment of his speech and language today and he's come out low for both of them. I thought there was a bigger gap between his understanding and expressive language but he was low across the board so just wondering?

He has a dx of asd and a speech disorder, before his asd dx he was referred to as having gdd but although he functions overall like a much younger child I never thought he had cognitive problems and it's not been mentioned. Would I need to have this assessed or not, and who would do it? He still hasn't seen an educational psychologist which we need for statement, is this the kind of thing they would be looking at?

After his assessment, SLT mentioned that maybe he would be better in an Autism unit than in mainstream (previously we were thinking about language unit but he wont get in). When he was diagnosed, his paediatrican said he should be fine for mainstream and he was one of the better prognosis that she had seen that day but another doctor he's seen wrote on his report that he is severe.

I know he is very bright in his own way, he has problem solving skills and the things that he knows he is very quick with! If he has an adult 1 to 1 he does really try, and he can learn quite well. He can count now up to 4, and learned most of the colours, some shapes etc..

I'm reapplying for statement after being turned down last time, just so anxious in case they turn him down again when he so clearly needs support, and so confused about everything. Just when I think I know what I'm doing with it all something new comes up!!

I'm not sure about this firalwa but I have wondered the same thing, my dd(4) has ASD and a speech disorder and her understanding and receptive language is very poor and I'd expect her to score quite low on this but recently on a form used for SA request the school described her ( as well as ASD and speech and comm difficulties) as having significant learning difficulties and I'm not sure I agree with this. She definitely has difficulties with language and her sensory issues effect her concentration but she definitely can learn most other things, and some things she picks up easily, like you said, your DS is 'bright in his own way' dd is a whizz on the iPad, she picked it up straight away when we first had it, and she is good at puzzles and jigsaws and anything where visual clues are given so i guess what im trying to say is I don't think of her having overall learning difficulties but just difficulties in learning language.
I think this is what an educational psychologist would look at, overall ability, not just speech and language skills

I'm surprised they turned down the statement request as he has ASD and a speech disorder, I definitely think you should push for ed psyc if he's never seen one. Hope you get more luck this time

No it doesn't necessarily mean low IQ

Ds below 1st percentile for speech on understanding and expressive. His IQ (tested for tribunal) came out within normal range. He's now in mainstream with ABA support and his reading age is a year ahead and his speech 3 years behind.

Learning 'difficulties' and learning 'disability' are different
the autism and speech difficulties will interfere with learning, thats not the same as saying he has impaired cognitive function / a learning disability.

Learning disability usually used for when IQ below 70

Most IQ tests are language based so children with autism tend to score below their true IQ - so ds scores well on non verbal iq eg spotting patterns etc and poorly on verbal iq

school have to say high needs or wont get funding so i wouldn't take that as a diagnosis.

trust your instincts. At diagnosis meeting we were told they couldn't rule out LD / low IQ and I just 'knew' he didn't have LD because he was so sly and clever at getting what he wanted.

An EP can do tests but depends how compliant child is and as I say not very accurate. Usually rate of learning once they get good intervention is a better indicator

Ds was on 2nd percentile for receptive understanding. After 3 months doing ABA he was on 34th percentile, after 9 months on the 92nd percentile.

These scores were tested in a 1:1 ABA situation.

Recently 3 years later he's been tested again non-ABA and came out on 47th percentile.

My point is that he can achieve higher score when the assessor understands the principles of ABA, BUT having had ABA he can now score significantly higher in a non-ABA test.

His expressive language tells a similar story but he has been (almost) Dx with severe language disorder on top of his ASD and his expressive is what he struggles with most.

Thanks for all the responses, especially agnes that's helped me understand a little bit more how these things are defined.

oso he was turned down because I was given the wrong info about how to apply and hadn't sent enough of the reports and evidence in, but i'm always worried that I will miss something again and he will end up being turned down again! Because he is so sociable and friendly to anyone it also makes him appear more high functioning than he is (even though its actually because he has no social boundaries and danger awareness, so hes happy to go up to anyone, which makes him quite vulnerable.....) but i always worry that on first meeting maybe people wouldn't see pastthat?? like educational physcologists etc - i suppose they would though as they must know what they are looking for, testing for etc??

Also interesting about the ABA... in my borough ive found it has a bad name with most people, doesn't seem to be popular - but it does give really good results and maybe I need to look into it further. my ds is actually already very compliant though, it's in his nature - unless you ask him to do anything he really hates but generally he would just go along with anyone and follow the instructions for any tests etc. that's what does worry me a bit with his understanding scores, he really did comply and sat there and tried his best to take part but he has still scored low.

ABA isn't about compliance. It is about speeding up the rate of learning by ensuring the child is alert, engaged, unstressed and motivated.

Compliance for the sake of it is dangerous and can leave an already vulnerable child open to abuse.

ABA is hated by those that are scared of what they don't know and the threat it poses to their preferred way of doing things which meets their needs rather than the child's, often.

firawla the language test probably is accurate then - but that just means can't process language (yet) and will need lots of intensive intervention to learn language.

It doesn't mean his IQ is not normal - that would require different non verbal tests.

Like I say DS language scores are through the floor but its very obvious he is quite clever. He just doesn't 'get' language. But he can do IT, maths, learnt to read (although he can't understand what he reads, he relies on visual clues). He can learn patterns and learn things when demonstrated visually quite quickly.

Its taken 4 years to get DS understanding from 1 keyword in a sentence to 3-4 key words. But he is making progress.

You will not get intensive language teaching in most mainstream schools. Its a specialist skill and mainstream teachers have no real experience. The model is 30 children in the class, one teacher at the front talking a lot and expecting the children to follow along. So its really hard for a child with speech disorder to learn in that way.

Its worth looking at the unit from the perspective of whether they are good at teaching language, have specialist SLT input etc. Lots of children do gain language and it improves but in my experience most with low percentile scores need very intensive input to get there. Often children can move into mainstream later. Or we have ABA in mainstream so his ABA 1:1 breaks down the teacher's task using simpler language etc for DS. ABA staff also teach new language via systematic programmes (he only goes to school part-time and we do lots of language work in 1:1 at home)

Donna Williams is an autistic writer and says she didn't understand language until she was 9, it was just a swirling confused babbling in the background.

Is he getting good / regular SLT? Cerebra charity offer £500 voucher for private SLT if a child is not getting direct SLT.

ABA staff generally know how to teach language but a SLT with autism expertise is another option.

NAS and IPSEA advice lines have caseworkers who can check over paperwork for you.

He is getting good slt, possibly not as much as he could have but he has nhs weekly sessions (with breaks inbetween though, he is on break at the moment) and private slt too.

Thanks all of you.