SaLT assessment says no processing difficulties but literally everyone working with DS disagrees.... Where to go from here?

[MeteorShower]

DS (8) is awaiting the results of ASD and ADHD assessments. He's in mainstream but has an EHCP with full time 1-1. He's incredibly verbal and chatty but I have been convinced for years that there is something not right with his processing.

We've had a SaLT assessment (which I sat in on and was happy with how it was carried out) which has concluded that DS has above average processing speed and can follow 4 step instructions. TBF, in the assessment that is what he demonstrated .

In the actual real world, however, everyone working with DS (4 different TAs with experience in working with kids with SN, the SENCO, the advisory teachers and me!) know that this isn't accurate. At school and at home, we can't get him to follow more than 2 step instructions and that's rare, mostly we have to revert to 1 step. His processing speed for verbal information is absolutely not above average in the real world! Everyone knows to wait at least 3 times as long as you'd expect for an answer to a question for example.

So... Where do we go from here? Can we request another assessment? Is there any point? I don't think there were issues with how it was carried out, I agree that in that room on that day the findings were accurate but it's completely not reflective of his issues or abilities in the real world

SALT would only look at language processing - so understanding of language. To get a true idea of processing speed you need an Educational Psychologist or specialist SPLD teacher to assess.

Also, and I may be wrong, there is a difference between sitting in a room with two adults and being in a classroom with all the additional noise/activities going on.
Educational Psychologist is the way to go.

Wouldn't want to put you off getting an ed psych assessment which is useful for getting a more specific idea of weaknesses and strengths. But this also happened with DS. The ed psych said he had average processing speed, but the teachers at his special school talk a lot about him having a slow processing speed and I agree with the teachers. I think this is a wider issue with ed psychs and other child/education experts that because they take such care to tease out the strengths as well as weaknesses, the resultant 'spiky profile' is heartening to parents. All the experts who assessed DS said he could do really well at a mainstream school with the right support but I really shudder at the thought of him going to a mainstream secondary! (He won't be, he'll be staying at special school much to my relief).

Maybe problems with executive function skills? Language development and executive function are symbiotically linked.

www.understood.org/en/learning-attention-issues/child-learning-disabilities/executive-functioning-issues/understanding-executive-functioning-issues

We've had 3 EP assessments so far (by 2 different local authority EPs) and none of them have even mentioned processing or cognitive ability. I can request another for the EHCP review that's coming up but not sure they're looking at the right things? Do I maybe need to look at a private EP? I'm wary of the expense, especially after having our private OT report basically ignored because what it recommended was expensive and nobody wanted to find it

hello, I am currently doing research into what forms of support are available to children with speech and language issues in a primary school. I myself am severely dyslexic and while in primary school, received no support at all, i am interested to see if, now, more support is available. If you are a parent of a child who has speech issues, I would be very grateful if you could fill out my questionnaire in as much detail as you can. If you have any questions please feel free to email me on [email protected]. Thank you in advance for your participation :)
Here is the link to my questionnaire, Thank you!
www.surveymonkey.co.uk/r/BSCQXZH

Thanks but my child doesn't have speech issues which you'd know if you'd read my post rather than just spamming to get your questionnaire filled in

My son has no ‘difficulties’ in SALT formal assessments. However, this does not reflect functional abilities.

Did SALT observe in the classroom too? Talk to staff? Talk to you? Ask your son what he finds difficult?

Our recent SALT (private) recommended APD investigation, based on her observations, ds’s views, staff views, my views etc.

He also needed additional processing time in the timed SALT assessments. We’re any the assessments you observed timed? Many are not, so the child isn’t required to respond as quickly.

What assessments did the SALT carry out?

My son scored very highly in both CELF 4 and 5 formal assessments. But his language processing was very slow, for both making sense of what he heard and for putting his thoughts into words.

Both school and I were given questionnaires to complete, examples.....regarding listening, things such as ask people to repeat what they have said. Speaking, difficulties answering questions as quickly as other students. Reading, trouble identifying the main idea. Conversation skills, which included eye contact, sense of humour, responding to greetings etc. Asking for help, gaining attention etc. Non verbal communication, body language, cues etc.

SALT observed ds in class. She observed things such as my ds was keen to answer questions, but then took a very long time to answer. Appeared confused by complex explanations at times etc.

All of which was written in her report.

He responded really fast to everything the SaLT asked... I can't remember what the assessments she did were called but I can check the report. There was one with pictures and he had to point to them in a specific order (ie, "can you point to the big house before you point to the blue ball then the little house", right up to 4 step instructions). He did that fast and reliably got it right. But in the real world he can't follow more than one step at a time - so "go upstairs and get your jacket and shoes" would just result in him going upstairs and forgetting why he was there.

She picked up on plenty of social communication issues (with cards showing emotions mainly) and thought he was masking at some points. She didn't go into school because she didn't feel he had any underlying speech or language issues though.

I’m not a SALT...obviously however showing a child a picture of x,y,z and asking them to point, is visual cues.

Can you go upstairs and get x,y, x is different! Purely auditory! Memory etc.

I would suggest an independent SALT assessment, with observation in school too.

Oh bugger, not sure if I can afford it tbh

But yes you're quite right and it's very frustrating that we have a report saying he can follow multiple step instructions when he can do no such bloody thing! Not worth the paper it's written on.

How did the SALT establish he can follow multiple steps instructions, is what I’m getting at? Based on what assessment? Pointing at pictures or anything with a visual prompt, is not the same at processing auditory information without.

Without observing him in school, without questionnaires for school, home. Not a very good assessment, given his history and evidenced difficulties.

If you gave your ds pictures, in sequence of what he was suppose to get from upstairs, he probably could!?

Unfortunately LA and NHS assessment are not very detailed, past diagnosis.

It’s seems very in depth to justify a diagnosis, after very vague, when it comes to actually providing provision!

Ah ok, with you now.

She established he could follow multiple steps (in her opinion) by showing him pictures and giving him fairly complex instructions to follow on pointing to them in a certain order.

So yes, if I write down a list or draw him a picture he could go upstairs and fetch two things if he doesn't encounter the cat in the stairs in which case all bets are off but if I just tell him then no chance!

As yet we have no diagnosis - awaiting the results of neurodevelopmental assessments for ASD and ADHD. So far every assessment we've had appears to be geared towards finding as little 'wrong' as possible

It’s the pictures, so it’s not purely auditory! She has not tested his auditory processing. And as you say, add to that distractions in a real life situation, is not the same on a 1:1 basis. It doesn’t describe functional accurately.

My son is exactly the same, go upstairs, brush your teeth, your hair and get your shoes on.....is forgotten by the fourth step!

I make adjustments, as you probably do, without even realising! Hair brush is downstairs, as are shoes now. So instruction is go upstairs and brush your teeth!

Ah, I should have mentioned that he has also seen a hearing specialist who established that his auditory processing (in isolation) was fine!

But whilst every expert we see claims there is no specific issue that they can identify within their specialism, in the real world DS can't function as most 8 year olds can by a very very long way. Who puts all this together and takes an overview?

Where was your son assessed for APD? I ask as my son is being referred to GOSH to the APD Clinic. I recently discovered there are very few places that can actually test for it! GOSH for example being the only one in London.

A paed usually pulls it all together ie refers off to different professionals, who assess and reports go back to paed.