Progress and diagnosis, etc.

[Guest guest]

We got Benny's six-month evaluation of his progress from his SLP. When

he started last November, they couldn't do the Preschool Language Scale

because he wasn't interested in cooperating, but they did some Birth to

3 checklist of learning and language behavior and thought that

understanding was at approx. the 27 month age level, and expressive

skills at the 23-24 month age level. He was 32 months at the time, now

he is 38 months.

Now, after six months of twice a week speech therapy and twice a week

OT, they gave him the Preschool Language Scale-3, and his receptive

language came out at 1 yr, 9 mos (68) and expressive language was 2

yrs, 5 months. He is speaking much much better, but it looks to me like

he has just started to progress normally (for expressive speech), not

catch up in any way.

Moreover the SLP said, " Results of testing revealed numerous

phonological and articulation errors including: syllable deletion,

final consonant deletion, intermittent initial consonant deletion,

devoicing, stopping, deaffrication, and cluster reduction. Ben seemed

to have the most errors with words in which he was not familiar; this

observation would be in keeping with previous evaluation which revealed

difficulty with novel words and tasks. "

I have an intuitive suspicion that he has auditory processing

difficulties--which would also account for these observations--but

since he is only 38 months old, it is difficult to tell. The SLP

recommended 4 times a week speech and 4 times a week language therapy

and twice a week therapy for oral/feeding difficulties.

She still says in the evaluation that he shows no overt signs of a

motor speech disorder (apraxia) which she seems to equate solely with

the presence of " groping/delayed motor movements for word productions, "

which were not noted. But the fact that he can't " demonstrate bucchal

expansion and tongue elevation, " makes me wonder about that. I've been

wondering about that all along because his speech is not consistent,

his ability to pronounce words varies.

He certainly is a lot better off than he was six months ago, but is

this much progress sufficient, if he is not really catching up? I think

that is why she has recommended more frequent therapy than before. Or

is this good progress and I am expecting too much?

And what about the apparent *drop* in estimated receptive speech? She

didn't think it was real, she said, " ..it is felt that there were many

tasks on the PLS-3 that Ben could complete, but did not do during this

evaluation. " But I am worried that we might be brushing off a real

problem saying he wasn't trying. I suggested to his dad that a

pediatric neurologist consult might be in order, and got told I was

overanxious.

Any comments from those of you who are knowledgeable?

Peace,

Kathy E.

Kathleen_E@...

Benny's grandma

[Guest guest]

Kathy I'll email you privately.

I think the intensive and consistent therapy is an excellent thing.....

talk tomorrow,,,,

`karyn

[ ] Progress and diagnosis, etc.

We got Benny's six-month evaluation of his progress from his SLP. When

he started last November, they couldn't do the Preschool Language Scale

because he wasn't interested in cooperating, but they did some Birth to

3 checklist of learning and language behavior and thought that

understanding was at approx. the 27 month age level, and expressive

skills at the 23-24 month age level. He was 32 months at the time, now

he is 38 months.

Now, after six months of twice a week speech therapy and twice a week

OT, they gave him the Preschool Language Scale-3, and his receptive

language came out at 1 yr, 9 mos (68) and expressive language was 2

yrs, 5 months. He is speaking much much better, but it looks to me like

he has just started to progress normally (for expressive speech), not

catch up in any way.

Moreover the SLP said, " Results of testing revealed numerous

phonological and articulation errors including: syllable deletion,

final consonant deletion, intermittent initial consonant deletion,

devoicing, stopping, deaffrication, and cluster reduction. Ben seemed

to have the most errors with words in which he was not familiar; this

observation would be in keeping with previous evaluation which revealed

difficulty with novel words and tasks. "

I have an intuitive suspicion that he has auditory processing

difficulties--which would also account for these observations--but

since he is only 38 months old, it is difficult to tell. The SLP

recommended 4 times a week speech and 4 times a week language therapy

and twice a week therapy for oral/feeding difficulties.

She still says in the evaluation that he shows no overt signs of a

motor speech disorder (apraxia) which she seems to equate solely with

the presence of " groping/delayed motor movements for word productions, "

which were not noted. But the fact that he can't " demonstrate bucchal

expansion and tongue elevation, " makes me wonder about that. I've been

wondering about that all along because his speech is not consistent,

his ability to pronounce words varies.

He certainly is a lot better off than he was six months ago, but is

this much progress sufficient, if he is not really catching up? I think

that is why she has recommended more frequent therapy than before. Or

is this good progress and I am expecting too much?

And what about the apparent *drop* in estimated receptive speech? She

didn't think it was real, she said, " ..it is felt that there were many

tasks on the PLS-3 that Ben could complete, but did not do during this

evaluation. " But I am worried that we might be brushing off a real

problem saying he wasn't trying. I suggested to his dad that a

pediatric neurologist consult might be in order, and got told I was

overanxious.

Any comments from those of you who are knowledgeable?

Peace,

Kathy E.

Kathleen_E@...

Benny's grandma

[Guest guest]

Hi,

My two cents as a parent of a very similar child. The test results should

not be brushed aside. The tests were performed for a reason. I would

definitely seek out further testing. Has he been tested by a professional

team yet? A psychologist, slp and ot working together? Has he been seen by a

developmental pediatrician yet? Either would be good. I would seek further

testing in any case to explore the drop in expressive language skill. Is he

in a special education program? He would probably benefit from it, in

addition to receiving speech services.

Rather than obsess on diagnoses, focus on what his apparent issues are and

deal with them through the appropriate therapies. It sounds like he will be

receiving a tremendous amount of therapy at school. Follow-through can occur

at home and his family can just as easily chart his progress in terms of

what he is able to pronounce and understand. we keep a notebook of what our

son can now pronounce, how many words he is putting together, etc. That way

we have proof of how he is progressing.

I myself worry constantly, does he have apraxia, does he have a processing

disorder, am I doing enough? But my son is also 38 months and too young to

be diagnosed. I can only work with the information I have.

I hope this helps. It is only my opinion and I am not a professional. Just a

mom who has done a lot of reading and homework.

D.