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Help! Need SLP/CELF experts

Submitted by an LD OnLine user on

We just starting seeing an SLP for our 9yr old 3grder dd. Mainly for articulation, but I also wanted her to evaluate her expressive/receptive language. She administered a couple subtests from the CELF just to get us started (I didn’t want to do a full language eval yet).

Formulated Sentences - 50% (down from 63% 3 yrs ago)
Recalling Sentences - 25% (down from 50% 3yrs ago)
Sentence Structure (I’m guessing from memory, can’t remember exact name? - it’s the one where you have to use visual ques) - 99% (wasn’t administered last time)

I really don’t think my dd was having an off day on the 1st 2 and that scores are pretty accurate. DD was feeling pretty good, rested, top of her game that day.

I’m concerned about the recalling sentences. I had an SLP tell me couple years ago that it was an important subtest of the CELF. Can anyone tell me what kind of tasks you have to be good at to score well on this test? What is this telling me where her weakness is lying? What is good remediation (i.e. would Fastforword address this?). Is a full language evaluation in-line based on the split between couple of scores?

Auditorily she appears to be falling apart with the language? I’m feeling really down right now. I thought we were making more progess in this area, but apparantly we have digressed this past year.

Submitted by Anonymous on Wed, 04/09/2003 - 7:36 PM

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one of these days I will get off this computer…

Formulated sentences…The child is shown a picture and they have to make a sentence about the picture using the prompt word given. For instance if they are shown a picture of a book and the examiner says I’ll give you a word to use in a sentence, You must use the word in a sentence with the words in the same order I tell you. . This tests their abiltiy to use nouns, verbs, adjectives, adverbs, conjucatinos, and phrases. she is in the middle of the road here..

Recalling sentences she is given a setnence and she is to repeat it exactly as she hears it. NO VISUAL CUES i.e., My sister is in the fifth grade. Does Mrs. Marx teach math? It tests their auditory memory and their abitliy to use Active and passive sentences, some are declarative with conjuntions, some are questions, some have several clause put together. If the child gives bits and pieces they are either not attending or they may have a hearing or processing problem.. Lower quartile…but shows she is having trouble with her auditory memory.

Sentence Struture she is shown a picture and she has to point to the one that corresponds to what she heard. She did well on that..

Fast Forword would help with some of her auditory processing issues…but if she has undiagnosed ADD it might not.. If I remember right…have you done a lot of intervention with her up to this point?

Submitted by Anonymous on Thu, 04/10/2003 - 12:20 AM

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I suspected auditory memory might be the problem. I had asked the SLP and she did not state auditory memory, but more comments like ‘doesn’t understand the proper use of language’ or something like that.

Yes, we have done LOTS of remediation and specifically in the auditory memory. I felt she had made lots of progress. She even got to like an age 10 level on PACE auditory memory? Attention - yes that could be a factor - she has some ADD inattentive symptoms.

My husband informed me that he was listening in the other room when the tests were given to her. He feels like maybe she didn’t understand that she was suppose to repeat the sentence back EXACTLY as it was told to her. She had just done formulated sentences and SLP told her it DOES NOT have to be EXACTLY. My husband said he was confused and would have done same thing. So…. may be accurate score, may not be??

Submitted by Anonymous on Thu, 04/10/2003 - 2:37 AM

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DEA,

If you want another check on auditory memory, the Test of Auditory Perceptual Skills-Revised has a few subtests that have to do with memory. That is my child’s weakest area.

Janis

Submitted by Anonymous on Thu, 04/10/2003 - 4:40 AM

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Well it doesn’t have to be verbatim but she needs to have the gestalt of the sentence…If she didn’t undertsand the directions there is a problem that was created by the SLP because she didn’t clarify the directions.

I use the TAPS-R all the time. I like it as it’s inexpensive and you can get some good information from it. On my last assessment I gave the auditory discrimination portion of the TAPS-R to a kid who seemed to understand the directions and passed the pre test items but as I got into the test he bombed the first 10 items. There is no ceiling on that subtest so I stopped the test and turned around and had to teach him about same and different and I also faced him. Which totally blows the norming out the window but I had to see what he could do when he understood the directions. Once I had him trained I turned around and he started missing some items again. He needed to see my face, incidently I went back over the first 10 he had missed and he got them right…I can’t use the normative data but I know what I had to do to modify the test for him told me more than just having him bomb the whole test without modifying it…. This kid was defintely ADD, it was evident as I went through the assessment.

Knowing everything you have done…I really wonder if the missing piece is ADD, because kids with ADD tend to be good expressively, they love to talk but where it really shows is receptively and in the content of what they are talking about. Meaning she is close, she talks around things or describes things but she doesn’t use the proper words…

How is she in regards to telling you a story…is she all over the map? Is there a definite sequence to them? A beginning, middle and an end?

Submitted by Anonymous on Thu, 04/10/2003 - 12:17 PM

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Patti,

What do you see low TAPS-R memory subtest scores typically effecting? Would it carry over to phonological memory? problems with comprehension? I am seeing this with my child and also a couple of my HI students. Any suggestions about how to help this?

Janis

Submitted by Anonymous on Thu, 04/10/2003 - 7:27 PM

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I think it is all inter related and memory has a lot to do with the ability to hear, hold the information use it or store it…and this is all related to executive functioning issues. I try to strenghten the auditory system through music and rhymes. What about using Read Naturally?

Submitted by Anonymous on Thu, 04/10/2003 - 8:24 PM

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Thanks, Patti. Shay may be coming down here in June to do a PG training and I asked her to bring all her materials so I can look at them! She will bring Read Naturally so I’ll be able to take a look at it.

Janis

Submitted by Anonymous on Thu, 04/10/2003 - 9:19 PM

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10 yeard old, 4th grade, dd.

1) The inability to repeat a story, in sequence, or describe a movie, in sequence (first middle last) what is the area that is weak when this happens?

2) We go over vocabulary words for Social Studies. I read the definition (which she prefers). She’ll say, “Okay, wait, I know this… Uggh! I can’t think of the word (word retrieval?). So I go through the list and the 2nd time through I say the word instead of the definition and she’ll tell me the gist of it - doesn’t have it word for word.

Does best on “word bank” tests and/or multiple choice. Does well in following directions at school.

Any comments/suggestions?

Submitted by Anonymous on Thu, 04/10/2003 - 10:52 PM

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yes ADD could be part of what is going on. She does have a diagnosed CAPD (she does not ‘hear’ words properly in a noisy environment).

I’m going to ask SLP to redo the recalling sentences one more time. I’m also going to test her with the PACE auditory memory test to see how she does now. I’m just surprised she dropped so much in this area.

She is not good expressively. She has a very hard time describing stories, events etc. But not because of sequencing issues (I don’t think) - she does understand beginning, middle, end. But there is an organization of thought issue going on, as well as word finding. She will get real frustrated and then just clam up.

As I’m writing this, I’m becoming more and more curious about what kind of effect a dose of ‘medication’ would have on her?

Do you see thought organization/expressive language improvements with stimulant medication?

Submitted by Anonymous on Thu, 04/10/2003 - 11:50 PM

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Dea,

I am not surprised because the same thing happened to my daughter…It took me 4 years to finally get to the bottom…remember?? My kiddo has a memory and mind like a steel trap, once it gets in there it stays but because she was “tuned” out for so many years due to the CAPD and ADD we have holes all over the place in her langauge.. Kids pick up vocabulary by eavesdropping from their peers and if your daughter has trouble processing speech in background noise then she is not picking up vocabulary and syntax efficiently.

You are talking about executive functioning issues in other words (ADD) which are impacting her speech and language and they are intertwined…I even have problems with this..and from my own experience medication does help one organize expressive language..

She may understand the sequencing receptively but she has trouble using it expressively. When my daughter first tried meds she said..:”Mom is this what it feels like to focus? Things are making sense now.”

My son who had been off meds for about 2 months (his choice) and he was just drowning, overwhelmed, unmotivated, frustrated, he tried but he just couldn’t pull it together, he procrastinated…and my husband had to reteach AP physics, and Math analysis at home because He couldn’t focus in class, After 2 months of frustration for the whole family…Our son finally realized, after talking with the Dr. that he needed to go back on meds. What a difference it has made in one week. He told me last night. “I hate the fact that I have to take meds to focus but I am doing a lot better than I was” and I told him “they aren’t making you smarter they are just making it easier for you to process what is coming in so you can learn.”

Submitted by Anonymous on Fri, 04/11/2003 - 12:00 AM

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What you are asking is also related to memory…and executive functioning. Kids with problems in this area are great at circumlocution…I am the queen of it…i had a job interview today and I couldn’t remember the name of the Neuropsyche who refers kids to me..LOL Talk about embarrasing an educational therapist with word retrieval issues…but that little glitch was related to my ADD and being on the spot and not my auditory processing..

On tests I suppose she can recognize the words if you ask her to come up with the word she starts spinning her wheels..Does that sound a bit familiar? Happens to me all the time..

It is the SPECIFITY and picking out DETAILS and organizing them in a LOGICAL and ORDERLY manner that are problematic for kids with ADD Writing can be a bear or another way….They can write about absolutely everything and it is like a conversation, the thoughts are all jumbled up or they can have trouble with organizing their writing and getting started. They have trouble with formulating the sentences..

Submitted by Anonymous on Sat, 04/12/2003 - 12:22 AM

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Yeah, we have the exec functioning and memory problems too -ADD -.

I’m getting it as I get older :0)

Thanks for your response

Submitted by Anonymous on Sat, 04/12/2003 - 8:44 PM

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Just a note of caution here- be careful of interpreting just a few scores. Complete the evaluation of receptive language, expressive language, and auditory memory/processing and then see what you have. The 25% score is actually still within the average range. I understand the concern of the drop in scores, but the drops quoted are not statistically significant- meaning they could have happened by chance…

Submitted by Anonymous on Sun, 04/13/2003 - 11:00 PM

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“Do you see thought organization/expressive language improvements with stimulant medication?”

We sure do. My son also shows improved gross motor skills and handwriting.

Andrea

Submitted by Anonymous on Sun, 04/13/2003 - 11:34 PM

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Hi. You just described the problem my 11 year old ADD/dyslexic son has with writing. He’s on medication, Concerta, which has helped tremendously. However, he can not write a 5 paragraph essay. His ideas are all over the place. This is frustrating to him.

Are there any programs that can help with this?

LMB clinic has recommended V/V and believes this will help. Any thoughts?

Submitted by Anonymous on Mon, 04/14/2003 - 12:41 AM

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It is Called Strengthening a Students Writing Through focus by William Spivey. It really helped my daughter with her writing. You can find it on the web through the name Writing Express. I am trained in VV and most LMB programs. however, they don’t teach writing the way that this program does.

Submitted by Anonymous on Mon, 04/14/2003 - 12:45 AM

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My daughter recalls multiplication facts better on meds than off. Also, handwriting improves dramatically.

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