ADP: Language Assessment and Treatment

ADP: Language Assessment
and Treatment
Sara S. Plager, M.Ed., CCC
Chief and Senior Clinical Lecturer
Speech-Language Pathology
Department of Communicative Disorders
Definitions
Hearing Acuity:
• The clearness/sharpness of hearing ability.
• Involves the reception of sound.
Definitions
Central/Auditory Processing
• How the brain interprets the sounds
• Involves the perception of sound
• Difficulties in discrimination, identifying
and/or retaining sounds after the ear has
heard them
Central/Auditory Processing, con’t
Typically there will be problems in:
• Listening in the presence of background
noise
• Localizing sounds
• Following directions
Central/Auditory Processing, con’t
And problems with:
• Attending
• Daydreaming
• Distractibility
• Fatigue towards the end of class
• Disruptive behaviors
Definitions
Language Processing
• How the brain attaches meaning to the
sound groups that form words, sentences,
stories, etc.
• Also occurs in reading
Language Processing, con’t
Typically the deficits/problems include:
• Delayed responses
• The need to rehearse statements
• The need for frequent review of newly
learned material
Language Processing con’t
There tend to be difficulties understanding:
• Language concepts
• Abstract ideas
• Idioms
• Colloquial expressions
• Humor
• Words with multiple meanings
• Inferences
Language Processing con’t
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Figurative language
Logic
Defining
Comparing
Contrasting
General listening
Note taking
Inconsistent performance in academic work and
behaviors
Language Processing, con’t
Can co-exist with:
• Learning Disabilities (LD)
• Attention Deficit/Hyperactivity Disorder
(ADHD)
• Other pragmatic/social deficits
Assessment
Language Battery
• Vocabulary (receptive and expressive)
• Grammar (morphology and syntax)
• Language Concepts (defining, comparing,
contrasting)
• Phonological awareness
• Auditory memory
• Non-verbal intelligence
Assessment, con’t
Receptive Vocabulary
• Receptive One-Word Picture Vocabulary Test-2000
(ROWPVT-2000)
-ages 2 thru 18-11
• Peabody Picture Vocabulary Test-III (PPVT-III)
-ages 2-6 thru 90
• Picture Vocabulary subtest of the Test Of Language
Development-P:3 (TOLD-P:3)
-ages 4 thru 8-11
• Vocabulary Subtest of the Test for Auditory
Comprehensions of Language-3 (TACL-3)
-ages 3 thru 9-11
Assessment, con’t
Expressive Vocabulary
• Expressive One-Word Picture Vocabulary Test2000 (EOWPVT-2000)
-ages 2 thru 18-11
• Expressive Vocabulary Test (EVT)
-ages 2-6 thru 90
• Relational Vocabulary Subtest of the TOLD-P:3
-ages 4 thru 8-11
• Oral Vocabulary Subtest of the TOLD-P:3
-ages 4 thru 8-11
Assessment, con’t
Grammar (morphology and syntax)
• Grammatical Morphemes Subtest
(receptive) of the TACL-3
• Elaborated Phrases and Sentences
Subtest (receptive) of the TACL-3
• Grammatic Understanding subtest
(receptive) of the TOLD-P:3
• Grammatic Completion Subtest
(expressive) of the TOLD-P:3
Assessment, con’t
Auditory Memory
• Token Test for Children-Revised
-ages 3 thru 12-6
• Concepts and Directions Subtest of the Clinical
Evaluation of Language Fundamentals-3 (CELF3)
-ages 6 thru 21)
• Auditory Number Memory subtests of the Test of
Auditory-Perceptual Skills-Revised (TAPS-R)
-ages 4 thru 12-11
Auditory Memory, con’t
• Auditory Sentence Memory Subtest of the
TAPS-R
-ages 4 thru 12-11
• Auditory Word Memory Subtest of the
TAPS-R
-ages 4 thru 12-11
• Auditory Interpretation of Directions
Subtest of the TAPS-R
-ages 4 thru 12-11
Assessment, con’t
General Language, Language Processing,
Thinking, Reasoning, and Pragmatics
• Language Processing Test-Revised (LPT-R)
-ages 5 thru 11-11
• Listening Test
-ages 6 thru 11
• Auditory Processing Subtest of the TAPS-R
-ages 4 thru 12-11
Assessment, con’t
• Test of Oral and Written Language Scales
(OWLS)
-ages 3 thru 21
• Test of Pragmatic Language (TOPL)
-ages 5 thru 13-11
• TOLD-P:3
-ages 4 thru 8-11
• CELF-4
-ages 6 thru 21
Assessment, con’t
Nonverbal Intelligence
• Test of Nonverbal Intelligence-3
-ages 6 thru adult
Assessment, con’t
Phonological Awareness
• Lindamood Auditory Conceptualization TestRevised (LAC)
-grades K thru adult
• Comprehensive Test of Phonological Processing
(CTOPP)
-ages 5 thru 24-11
• Test of Phonological Awareness (TOPA)
-ages 5 thru 8-11
Assessment, con’t
Plager’s typical battery
• Age 6 thru 12-6
-EOWPVT-2000
-TOLD-P:3*
-Token Test for Children (1st or 2nd ed)
-TONI-3
-LAC
*Will add in the TACL-3 if the Grammatic
Understanding subtest of the TOLD-P:3 was low
Assessment, con’t
Plager’s typical battery
• Age 12-7 thru 21
-ROWPVT-2000
-EOWPVT-2000
-OWLS
-Concepts and Directions subtest of the CELF-3
-TONI-3
-LAC
Assessment, con’t
• Tricks of the trade:
-If I “know” something isn’t right and none
of these test scores reflect deficiencies,
then I will do the LPT-R and/or a TOPL.
Interpretation and Considerations
• Compare the TONI-3 SS to the Total SS
• Compare receptive SS to expressive SS
• Compare the various language realms/subtests to each
other
• Note behavioral observations
• Note response “rise time”
• Note auditory discrimination errors
• Note L/R orientation
• Note handwriting/fine motor skills/strength
• Note impulsivity, attending, focus to detail
• Note general “attitude”
Impressions
• The pattern of language difficulties
appears c/w a language processing deficit.
• Test profile appears c/w a language
learning disability.
• Significant difficulty with perception and
conceptualization of speech/sound units,
indicative of a dysfunction that disrupts the
spelling/reading process and interferes
with the acquisition of spelling/reading.
Impressions, con’t
• Significant difficulty following longer (greater
than ___ critical elements) and syntactically
more complex directions, indicative of auditory
memory and/or language processing and/or
depressed attending skills.
• Based on the language profile (exp scores
higher than rec scores), it would be easy to
assume, based on verbal output, that child
understand more/all/most of what is said to him,
however, this is not the case. Child tends to be
more of a “social butterfly”.
Recommendations
• School records and IEP request for review
• Based on profile obtained (verbal/non-verbal
gap, increased response/”rise-time”, gaps
among various language realms, rec/exp gap,
word discrimination errors, difficulty focusing
during external auditory stimuli, declining scores,
etc), testing for Auditory Processing Disorders
(APD) and/or psychoeducational testing should
be completed.
Recommendations, con’t
• Language therapy
• Further testing for dyslexia/reading disorders.
• Implementation of the Earobics home computer
program (phonological awareness).
• Keep directions short and syntactically simple
-Given in a logical, time-ordered sequence
-Use cueing words (“first”, “next”, “last”)
-Verify direction prior to implementation
-Completion of one direction prior to giving
next direction
Recommendations, con’t
-Encourage child to ask for further
clarification.
-Avoid embedded clauses and wording
in the negative
• Monitor impulsivity and attending skills in
the classroom
• Use “readying cues” (“Listen”, “Get ready”,
“Here’s the next one”, etc)
Recommendations, con’t
• Intervention for teaching memory strategies
-chunking
-intonation
-list-making (pictures and words)
-over-practice
• Multi-modal approach to teaching
-visual/written
-gestural
-verbal/auditory
Recommendations, con’t
• Encourage use of a school agenda
• Use chore charts and/or lists at home and
at school
• Avoid timed tests
• Allow additional time between the time a
question is asked and that a response is
expected
• Alternative classroom placement may
want to be considered
Recommendations, con’t
• Continued monitoring of ADHD symptoms
at home and at school (defer to school
personnel for monitoring and to physician
for recs re: changes to medications and/or
doseages.
• Implementation of strategies to
encourage/reinforce slowing down and not
rushing thru school work/homework

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