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ADP: Language Assessment and TreatmentSara S. Plager, M.Ed., CCC
Chief and Senior Clinical LecturerSpeech-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
• 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 Test-
2000 (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 (CELF-3)
-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 Test-
Revised (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