Any suggestions for helping language disability?

[imagine.more]

So Ana (age 15, mild ID, hearing impaired, dyslexia, ADHD) seems to not be progressing in language skills STILL. We've had her 4 years now and our home is VERY language-rich. We make sure to speak where she can read our lips, try to ask questions to check that she heard us, watch the TV with the subtitles on 100% of the time, and enforce her wearing her hearing aids all the time. Our birth kids have unusually high vocabularies and complex sentence structure from an early age, even our dyslexic 6 year old who isn't even able to get the added benefit of reading real books independently yet. 

 

We assumed Ana's language issues were from her other disabilities (primarily deafness) but I was reading "Overcoming Dyslexia" and realized that the description of a Language Learning Disability is spot on for Ana. She does not retain new vocabulary, does not ever learn vocabulary in context (it must be explained to her). Even when paired with actions she doesn't understand or remember words long-term. It took explicit teaching to teach her what aluminum foil is. Her vocabulary and sentence structure is still at roughly age 6-7. It's been that for YEARS. She attends speech therapy 2x a week now with a lovely therapist who has direct experience with deaf children. Also, it's not just an issue at the word level. She still constantly mixes up Subject-Verb agreement. Constantly. And plural vs singular words too. She'll say "Both cat are on the table." and be all "Oh yeah, well, I meant cats" when we correct her. She gets it right sometimes but not consistently. Her sentence structure is all wrong a lot of the time and she gets by and passes as okay in everyday conversation by using simplistic speech and responses.  It's a pervasive problem across the board. And I feel bad because in math she's making progress, passed the California Achievement Test at a 7th grade level (woot!!) in calculations. But you add in word problems and she scored at like a 2nd grade level. Even her speech therapist seems perplexed by her lack of progress so I'm getting the sense this is not just a HOH thing. And again, if it was just HOH then the fact that she has hearing aids and speech therapy and that we are actively working to help her vocabulary and language skills should be resulting in some gains. 

 

Has anyone dealt with this? It sounds similar to what some autistic kids deal with in having aberrant language patterns when they're young but they seem to improve generally, at least anecdotally. Ana, however, doesn't. And the typical advice of "just read good books to her, explain things, let her learn it in context" hasn't been working because we've been doing that for 4 years. It's hard to explain but if you met her you'd get the idea after trying to work with her that she's capable of more mentally than she's doing verbally. Like I know she'll always be behind but I don't think her IQ even accounts for the language issues we're seeing and the just lack of progress. 

[PeterPan]

The Grammar Processing Program | Product Info This is not the *only* thing you could use, but it's an example of what you could use. Super Duper has more things like The Processing Program - Level 1 | REVISED 2nd Edition | Product Info  

 

Is the SLP working on this? What is she working on? Sometimes SLPs use cheap things because better things cost $$$$. Not that good things HAVE to cost money, but unfortunately if what you need is a totally incremental language program, you aren't going to get it for $4.99 on TPT. And yes SLPs are going to TPT for stuff. That's fine too, if TPT has what they need. 

 

So if the SLP is working on this and she's not making progress, that's even more of an issue. Yes, that would certainly be a question, whether a diagnosis got missed or needs to be added. Sometimes on girls it takes a little longer to be obvious. In fact, before you do any serious language intervention, I would see if you can get coverage for some really good evals. Will medicaid or something cover it for her? Fresh evals for additional diagnoses right now might open some doors for her for coverage, transition services, etc. They might be more valuable even than the actual information. 

[Crimson Wife]

No, that isn't just a hearing loss thing. Missing -s for plurals and 3rd person singular verbs is common in hard-of-hearing kids because it's such a quiet, high frequency sound. But the other things you mentioned are not typical. LBLD can absolutely co-occur with hearing loss.

 

IIRC you're in PA, yes? I would call up the DREAM Clinic at Johns Hopkins Kennedy Krieger and get on the waiting list for a neuropsych eval there. Dr. Jennifer Reesman is awesome.

[imagine.more]

Crimson Wife, actually we're in Virginia now (long story, but we moved here for DH's work basically :) ) Still close to PA though, we're 2.5 hours from our old town. Do you think insurance would cover another neuropsych eval if we have one that is ~3 years old? And out of state? They might since she hasn't had any neuropsych evaluations here in VA. I'm not sure. 

 

Her SLP is working on vocabulary, but not in a systematic way. We talked today and coming up with a set goal based on the Most Frequently Used English Words dictionary, which is often recommended for ELL. Because we've been at a loss on where to start exactly, besides just starting with some 2nd grade lists since age 6-7 is where Ana is at. She's been working on word lists based off of our homeschool studies since fall, in addition to working on subject-verb agreement and extending sentences to be more descriptive. 

[PeterPan]

Believe it or not, a neuropsych isn't necessarily the best way to get autism diagnosed. You might be better off at a developmental clinic at a hospital. Or find a clinic that actually specializes in autism. It's really a separate, very involved question. The np approach to it is pretty cursory, frankly. 

 

If you get the referral, by the time you get in it probably will have been almost 4 years. I would think you would need new evidence of ASD if that's the specific eval/discussion you're trying to have. 

 

It sounds like your SLP isn't accomplishing very much for you. What kind of progress do you feel she has gotten in the last year? It doesn't sound like these issues are really her specialty, when you're both winging it. You might want to look for someone who works with a lot of kids with developmental delays and see how they are handling vocabulary and language. The materials I've used are concerned about things like lexicon (how the words organize in the brain), retrieval (which is improved by working in an organized way), etc. So to work on a high frequency list is sort of disorganized, seems to me. Not an expert, just saying I would be wondering about fresh SLP evals, fresh eyes on the situation. You may have maxed out what this person can do.

 

DeGaetano's stuff is FABULOUS and has been spot-on for my ds. Here's her list of materials for vocabulary. The site will have other topics too. 

Search Results

 

Vocabulary: GROWTH This book, in particular, seems very organized. My concern with a random approach is you're not exploring how the brain organizes to retrieve those words. With dyslexia, etc., you're likely to have word retrieval issues. If she had a previous np eval, they may have done word retrieval testing. My dd had that testing. Now my ds, who also had a np eval, did not. So it's not like it's standard and always. Just saying they *can* test and quantify these things, and it can give you data to affect how you work with them. 

 

Facilitating Word Recall Could she do exercises like the ones in this book easily? Even if she knows the word in isolation, sometimes you'll find that when she has to retrieve it in context, it's not there to be useful, that it got stored in a file folder somewhere else in the brain. So a lot of your language work needs to be organized so they can actually retrieve it and use it.

[Guest]

I've been working my way through "Teach Me Language" (Freeman and Dake). It self-describes as "A language manual for children with autism, Asperger's syndrome and related developmental disorders."

 

I have no idea if this is something that would help or not, but I thought I'd mention it as something you could investigate. It is written for parents' usage and uses laymen terminology, so it is user-friendly.

Edited January 19, 2017 by Kinsa

[PeterPan]

That starting point is pretty low with that vocabulary, but I agree TML could be good. You'd just go through it with post-it notes and find starting points in each section where you're like ok this can work. Some of the activities would work really well. It's not a very fleshed out thing, but I'll bet your creativity would run with it. 

 

Fwiw, you can also find online the language skills of ABLLS and use those lists/activities to guide you. There's a lot available on actual, structured, sequential developmental of language once you get over to the autism community. The problem is being with a regular SLP who doesn't specialize in it.

 

Tracking Sheets This is a site like what I'm talking about.

 

Personally, I would work both directions. The Grammar Processing Program from Super Duper would hit these issues like verb conjugation, pronouns, prepositions, etc. It would be complementary with the TML/ABLLS stuff, and GPP is super, super easy to implement. It's spiral/incremental, so everything gets held and used.

Edited January 19, 2017 by OhElizabeth

[PeterPan]

And if you're needing to do this kind of work, you want fresh evals for language (ABLLS, CELF, CASL, something) to give baseline data. Not only does it help you target your intervention, but it may be the difference between qualifying and not qualifying for services, depending on your state definition of autism. The state does NOT necessarily use the DSM definition of autism, so their services will depend on meeting their definition. If language is still in there, you want that baseline.

[Crimson Wife]

Believe it or not, a neuropsych isn't necessarily the best way to get autism diagnosed. You might be better off at a developmental clinic at a hospital. Or find a clinic that actually specializes in autism. It's really a separate, very involved question. The np approach to it is pretty cursory, frankly.

 

I would agree with this for a child with suspected autism and typical hearing. But there are only a handful of clinics in the country that are capable of correctly evaluating LD's and DD's in children with hearing loss. The typical evaluator is not going to have enough experience with deaf & hard-of-hearing kids to tease apart the impact of the physical disability from the impact of the LD's and DD's. It's been my experience that clinicians used to working with hearing kids see the "deaf" label and then chalk  everything up to "the kid can't hear me properly". DREAM at Kennedy Krieger, Boys Town in Omaha, and the Clarke School in western MA are the 3 clinics that I've found and I really looked since all of those are far from me.

 

I'm doing a hybrid online/in-person training program this semester at UNC-Chapel Hill and my mentor SLP was saying how she is part of UNC's interdisciplinary eval team. She was asking ME questions about autism that showed a very basic level of understanding about the disorder, yet here she is getting paid to evaluate kids as part of the interdisciplinary team. Don't get me wrong, she is very knowledgeable about hearing loss and its impact on language development. But I don't think that she would be the best person to judge what else is going on with a "deaf plus" child.

 

My DD was seen by Dr. Reesman at Kennedy Krieger in 2015 and we're considering taking her for a comprehensive eval at Clarke this summer. She's such a complex case that I think it would be worth doing the more comprehensive multi-day testing that Clarke offers. Plus their clinic is likely to have a different selection of assessments available.

[Crimson Wife]

In terms of the vocabulary, I really like Landmark School's Thinking About Language. I went through the book and found lists that I had my DD's BCBA incorporate into the language portion of her ABA program. 

 

Landmark also has a new book out on LBLD's. I haven't read it yet but it's on my list of things I want to read.

[Terabith]

I wonder if part of it is that she missed the language input when she was in the sensitive period for language as a young child?

[kbutton]

I would want to know if her expressive and receptive language skills are progressing together or apart. Wouldn't it be something if her receptive is actually better than expressive? Sounds crazy, but it could be true, and you don't know until you have testing data on that.  

 

Then, I think I would want to know where she is really at for expressive/receptive skills. Something concrete and shown as part of a progression developmentally--I really like the looks of the book that Crimson Wife posted. 

 

Then, I think I would use the book Crimson Wife posted to order resources that OhElizabeth is referencing, as applicable, taking into account any other disabilities that come to light.

 

It's my understanding that language disorders may be clumped together and cause similar symptoms, but they don't always respond to the same treatments. I would think that knowing whether she has a mixed receptive/expressive disorder vs. dyslexia vs. both would be helpful for knowing what remediation would look like, how it should progress or be evaluated to see if it's effective, etc. 

 

I would want to know if the glitches are related to something like autism or not, and I think I would want someone who gets deaf kids to have a say in that. You might need to insert this as  "find out about this" someplace in that list--maybe right after figuring out where the expressive and receptive language skills are in an absolute sense (and she may be all over the map). Still, there could be a pattern that emerges that shouts dyslexia or autism or something when an experience tester looks at it.

 

I have one with ASD, and I have one with language-based learning disorders, but technically LD-NOS because nothing really fits. That kiddo also has CAPD. I have friends with kids who are similar in IQ. So basically, I am trying to put all of that together to imagine your child when I read this, but I am not sure that what I would be concerned about is totally prioritized correctly. 

 

If finances are an issue, is she eligible for any services from your state/local board of developmental disabilities? If you don't have her on waiting lists for waivers and things like that, and she's eligible, you might be missing services, and/or have to wait a lot longer for her to get services as an adult, should she need them. Also, around here, if your child qualifies to be put on a waiver list, the child also is eligible for whatever things the county can afford to do in the interim, and those things can be a range of services. Perhaps you could use the county for something specific you are already doing another way, and then save that money for evaluations. Just a thought.

[imagine.more]

I don't think she is on the autism spectrum, it doesn't fit with her issues generally. I suppose it's possible but I'd be very surprised for her. 

 

I did some digging through her old medical records. We were given a huge stack of these papers at adoption, most of which were copies of stuff we already had but there are a few details I missed originally in looking it over. 

 

She's had several SLP evaluations starting at age 8 when she was first diagnosed as hearing impaired and just before she received her hearing aids for the first time. Then again every 1-2 years since then, but of course with different assessments because why be consistent....that would be too sensible!  :001_rolleyes:

 

At 11 years old her SLP did diagnose her as having a Mixed Expressive-Receptive Language Disorder. Before that they had chalked it up to deafness but then realized her lack of progress went beyond that because she consistently showed that with aids and proper lipreading she was able to correctly hear and repeat language adequately. That term was again used by her SLP from a year ago. Her pragmatics have always been noted as being very normal. Which is part of why I don't actually suspect autism for her. She doesn't bear any resemblance in symptoms to teens I know on the autism spectrum, including one in my co-op class alongside her. In fact, her struggles are almost opposite, like a lot of dyslexics but way more extreme because of course most dyslexics do not struggle with oral language and higher order thinking, those are usually strengths. 

 

As for whether there is a difference between her expressive and receptive scores: Her expressive and receptive language is progressing (very very slowly) closely together. Receptive is slightly higher than Expressive usually.

 

2015 CELF-4:

Receptive - Standard Score (SS) 76

Expressive - SS 64 

 

2013 Picture Vocabulary:

Receptive - SS 74  (age equivalency of 7)

Expressive - SS 75 (age equivalency of 6)

 

kbutton, We are waiting on a call from the social worker to get her on the ID Waiver list. That's something her neuropsych here recommended getting started now so you're totally right. 

 

Anyway, so, I guess a Mixed Expressive-Receptive Language Disorder is where I should start looking? Crimson Wife, I was just looking at Landmark's website separately actually. I agree, their resources look like they could be a good fit. I'm going to research those a bit more for sure. I'm going to check out the Grammar Processing Program too. I've been looking for something to supplement our Barton work. I've noticed real gains in her ability to make a sensible sentence since starting Barton but she needs more help in grammar for sure to improve any more. 

 

 

[kbutton]

I think the grammar processing program is going to assess her ability to take in specific grammatical syntax and then work on it (receptive). I don't believe it's used for expressive language. I have a similar product at home to try to work on auditory processing skills. You would want something for expressive language too.

 

I am glad you're taking steps to get her on the waiver list! That's a big deal. You might want a case manager or whatever they call them as soon as she "qualifies" whether or not she immediately gets services. In our state, you can have that right away, but you have to ask. Once they get the waiver, they get some kind of case manager automatically. It might be different there, but it gives you questions to ask.

[PeterPan]

You can use GPP to work on expressive too. It's all in how you use it. What I did was to do it receptively (I read, you point), and then to turn the book and have *him* make up some for *me* to touch following the same pattern. This was very, VERY hard for him! We only did 3 of those for a page. If it was too, too hard, we would come back and repeat that page or even go back and start with the previous page the next session. I then decided whether to call it a day and repeat or push on. I would not hesitate to repeat lessons. GPP is set up where lessons duplicate and are only slightly harder. So I liked to be in a situation where I was repeating the lesson that was the repetition/expansion of the new concept (essentially starting with something that was, at that point familiar or easier) and then do the next page with the new concept. Then next session you could do the new concept page and the following repeat/expansion page.

 

It won't say that, but you'll see it. And if a concept is crunchy or you just want to work on expressive more, look at MagneTalk Match-up Adventures Kit | Language-Based Magnetic Barrier Games and Activities | Product Info If they don't fit her, that's fine too. I'm just saying it's a way. You could just as easily do it with Dixit (just a normal game you can buy at ToysRUs) or playmobil or felt puppets or comic cells or whatever interests her or whatever you have lying around. 

 

So yes, you'll need to take the concept and carry it over to expressive. I totally agree it's not enough to do it only receptively. We kinda want our kids to be able to get stuff out, lol. 

 

For my ds, working on language helped reading and speech. Like I think it will improve more than you imagine. I don't know MERLD and I'm not an SLP. I just know with my ds, with his language issues, some effort, imperfect effort, made a SIGNIFICANT difference. I think you can go with your gut on looking at materials. If something looks like it will be hard for her, and if the something is structured in an intelligent, systematic way by someone who is knowledgable about intervening on your problem area (language disability), it's probably going to do some good. And you DON'T have to be rocket science perfect at it to get some good out of it. :)

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Edited January 20, 2017 by OhElizabeth

[Crimson Wife]

MERLD is a general diagnosis that just means her receptive and expressive language is outside the normal range for her age (specific cutoff varies but usually it's -1 standard deviation or <16th percentile, -1.5 sd or <10th, or -2 sd or <7th). Two kids could both have MERLD but a different pattern of subscores. We covered common patterns associated with various co-morbid disorders (ASD, Down Syndrome, Williams' Syndrome, Traumatic Brain Injury, etc.) in one of my classes last semester. As a general rule, good pragmatics and low vocab would be more typical of ID while the opposite pattern is common for ASD.

[geodob]

Do you have a clear explanation of  her 'hearing impairment'. So that you can gain an understanding of how she actually hears without a hearing aid?

It was also notable that her hearing impairment was only diagnosed at 8 years of age, when she got her first hearing aids. 

As the development of the brains ability to process sound, concludes around the age of 8.

 

So that it's important to know what was established, by the age of 8.

Though I would also ask about 'lip reading', and how much training she has had with this?

As this could be a strength, that could be made greater use of?

[imagine.more]

Geodob, yes we know her type and severity of hearing impairment with and without aids. She's moderate-sloping-to-profoundly deaf in both ears. With aids she is at roughly 85% understanding and when adding lip reading it's about 95%, and we ask questions to double check for understanding to catch any of those 5% errors. The best guess doctors have based on her articulation and history is that she began losing her hearing sometime after infancy but before kindergarten.

[imagine.more]

MERLD is a general diagnosis that just means her receptive and expressive language is outside the normal range for her age (specific cutoff varies but usually it's -1 standard deviation or <16th percentile, -1.5 sd or <10th, or -2 sd or <7th). Two kids could both have MERLD but a different pattern of subscores. We covered common patterns associated with various co-morbid disorders (ASD, Down Syndrome, Williams' Syndrome, Traumatic Brain Injury, etc.) in one of my classes last semester. As a general rule, good pragmatics and low vocab would be more typical of ID while the opposite pattern is common for ASD.

Her language scores were way low, from <1st percentile to a max of 5th percentile. I agree that the good pragmatics/low vocab does seem to also point to her ID versus being on the autism spectrum.

[imagine.more]

As an update, I came across a method for improving speech and writing in older kids with MERLD. Basically it codes grammar (which I was meaning to cover more with Ana anyway now that she can read okay). It's called Shape Coding. Seems really neat so I'm going to learn a bit more and see if some or all of the concepts could be helpful. :)

[PeterPan]

Ooo, that's interesting! Ds has little to no click with grammar either, so I'm actually interested in hearing how it goes for you. Winston Grammar uses colored cards, yes? (maybe similar?)

 

When you look at Shurley, they use a Q&A flow that essentially feeds them the answers, assuming they can actually answer the question. For my ds, even answering the questions were hard when we tried it. We haven't tried it again recently. It uses your normal who/what/when/where kind of questions, so he was having trouble answering because he was having trouble with Wh questions.

 

In other words, shapes and cards won't make much difference if they still don't have the language skill. But it's something you can watch for and sort out.

Edited January 22, 2017 by OhElizabeth

[8Arrows4theLord]

Just wondering if you have thought about adding some sign language to her therapy? It may help with her vocabulary and relive some stress of pronouncing words. She may enjoy it more if you all get involved as a family. Signing has helped our family and has been lots of fun! As for formal grammar, I wouldn't worry about it until you finish Barton. Barton does work on basic grammar skills. Keep persevering!

[Daria]

 

As for whether there is a difference between her expressive and receptive scores: Her expressive and receptive language is progressing (very very slowly) closely together. Receptive is slightly higher than Expressive usually.

 

2015 CELF-4:

Receptive - Standard Score (SS) 76

Expressive - SS 64 

 

2013 Picture Vocabulary:

Receptive - SS 74  (age equivalency of 7)

Expressive - SS 75 (age equivalency of 6)

 

 

 

If she meets criteria for ID, then all of those scores, other than the CELF expressive are higher than her full scale IQ, and the Expressive can't be much lower if it is lower at all.

 

If the ID diagnosis is accurate, and isn't a reflection of neglect, then it sounds like she's likely making the slow progress that is typical in kids with ID. 

 

You talk about her coming home 4 years ago.  Was she adopted domestically or internationally?  Is she an English Language Learner?  

[imagine.more]

If she meets criteria for ID, then all of those scores, other than the CELF expressive are higher than her full scale IQ, and the Expressive can't be much lower if it is lower at all.

 

If the ID diagnosis is accurate, and isn't a reflection of neglect, then it sounds like she's likely making the slow progress that is typical in kids with ID. 

 

You talk about her coming home 4 years ago.  Was she adopted domestically or internationally?  Is she an English Language Learner?  

 

This is kind of what we're wondering about. We're not sure the ID is an accurate diagnosis. Her language scores were very low, but everything else was like 15 points higher than the language stuff. So....we're wondering if maybe she was misdiagnosed? I mean, she's not a quick learner by any means, but I'm not sure she's fully intellectually disabled.

 

She was adopted domestically and grew up in a Spanish-English speaking home (all her family is fluent in both except her abuelo who speaks 90% spanish). But here's the thing: she never learned Spanish! She cannot even name all her colors accurately or count to 100. She knows basic greetings but cannot read it and doesn't know where a word ends and another begins. It's like she just memorized the phrase "Como estas" as a joint unit, all one word. It gets her by when she chats with her birth family. But anyway, my point is that she's not truly an ELL in the sense that English is her first and primary language. Being Hard of Hearing as a preschooler meant she never properly learned either until she went to school. She could hear, just not always accurately. At birth she heard fine, but sometime between age 1 and 5 she lost a good bit of hearing. So there are gaps. 

[imagine.more]

In terms of the vocabulary, I really like Landmark School's Thinking About Language. I went through the book and found lists that I had my DD's BCBA incorporate into the language portion of her ABA program. 

 

Landmark also has a new book out on LBLD's. I haven't read it yet but it's on my list of things I want to read.

 

Crimson Wife, I came back to this post to thank you for recommending this! I'm working through reading Landmark's books about language and I also got their "From Talking to Writing" book, which is helping her with putting thoughts on paper. It scaffolds from "kernel" sentences and explicitly teaches (or rather, shows me how and when to teach) grammatical concepts. It jives well with Barton too, talking about "where phrases" and "when phrases" and "adverb/ly words". We had tried Institute for Excellence in Writing, the lowest Student Writing Intensive but it was way too hard for Ana. Poor thing! I feel awful I'm never sure if things will work with her so we've had lots of duds  :(  

 

Anyway, the Landmark School's resources are really helping *me* understand her language disorder and what she needs instructionally. And the "From Talking to Writing" book's charts with sentence structures are helping me to teach her how to structure sentences. Her SLP's had done that with her twice but only twice and only with one concept, then they switch to something else, ugh! I still think they don't know what to do with her so they teach her random vocabulary and idioms. 

[Crimson Wife]

Glad to hear that the Landmark School books are helping. I've had my eye on the From Talking to Writing book for a while but my DD is nowhere near ready for it yet. She's still at the stage of writing extremely basic sentences such as "I like dogs." Gotta learn to walk before she can run :)

[Crimson Wife]

This is kind of what we're wondering about. We're not sure the ID is an accurate diagnosis. Her language scores were very low, but everything else was like 15 points higher than the language stuff. So....we're wondering if maybe she was misdiagnosed? I mean, she's not a quick learner by any means, but I'm not sure she's fully intellectually disabled.

 

If you can find someone to run a totally non-verbal IQ test like the Leiter or the CTONI, my guess is that she would score quite a bit higher than on a standard IQ test. She might still be below the median, but the "non-verbal" portions of a standard IQ test are still too verbally dependent for many language-delayed kids.

 

My child went from being exactly average on the "non-verbal" portion of WPPSI to gifted on the Leiter. The lowest subtest score on the Leiter was higher than the highest "non-verbal" subtest score on the WPPSI. If someone saw the two sets of scores and didn't know the background of the hearing impairment, the viewer would swear they came from totally different kids.

 

[imagine.more]

Glad to hear that the Landmark School books are helping. I've had my eye on the From Talking to Writing book for a while but my DD is nowhere near ready for it yet. She's still at the stage of writing extremely basic sentences such as "I like dogs." Gotta learn to walk before she can run :)

 

Absolutely! And at least you have the advantage of knowing generally what kind of thing works so when she is ready you can do it. I was very happy with the price and the density of the actual text. Lots of good info there. I got the Sentences workbook thing too so I can photocopy the charts to give her plenty of practice. And if it helps, Ana is at the point of writing basic sentences too. She basically only writes simple sentences, which is part of why I'm interested in this. I'm incorporating our vocabulary work with it using Landmarks' guidelines. So I have 5 verbs we're working on now in vocabulary and for writing practice we're writing article/noun/verb sentences using each of those verbs 2-3 times with different articles/nouns. Which is super helpful for her vocabulary because otherwise she gets stuck in only understanding the verb in one context. For example, with "flap" she kept saying "The bird flapped." but we brainstormed and she expanded to "A robin flapped." and "The hens flapped." 

 

Eventually my thought is to build on this until she's pulling key words from texts or jotting down brainstorming ideas and then entering them into these sentence frameworks, which we can use to create whole paragraphs and later essays. But that's more a "next year" kind of thing I think. 

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[imagine.more]

If you can find someone to run a totally non-verbal IQ test like the Leiter or the CTONI, my guess is that she would score quite a bit higher than on a standard IQ test. She might still be below the median, but the "non-verbal" portions of a standard IQ test are still too verbally dependent for many language-delayed kids.

 

My child went from being exactly average on the "non-verbal" portion of WPPSI to gifted on the Leiter. The lowest subtest score on the Leiter was higher than the highest "non-verbal" subtest score on the WPPSI. If someone saw the two sets of scores and didn't know the background of the hearing impairment, the viewer would swear they came from totally different kids.

 

 

That's interesting. I have an appointment scheduled to get referred to a neuropsych to update her testing and I am going to insist they use a totally non-verbal test that has been normed for hearing impaired kids! She did do a Non-Verbal Weschler (not totally nonverbal like the Leiter) at her public school 4 years ago and got an IQ of 87...which is not super smart but definitely not intellectually disabled either. That's part of why we were a bit surprised by the ID diagnosis from the Neuropsych. But that was just a school test so I don't want to totally trust that over a professional neuropsych either.

 

She is disabled, but I am just not sure ID is the best name for her disabilities. I think they can be summed up in Hearing-Impaired, ADHD, Dyslexia, and MERLD, all of which have been diagnosed already. In the end a diagnosis is just a name, but I'd like to make sure we've pegged the right disability so we can meet her needs best and not overshoot or underestimate her abilities. 

[Crimson Wife]

 Which is super helpful for her vocabulary because otherwise she gets stuck in only understanding the verb in one context. For example, with "flap" she kept saying "The bird flapped." but we brainstormed and she expanded to "A robin flapped." and "The hens flapped."

 

I'm not a psychologist but this does sound to me like LBLD in addition to the hearing impairment. It is common for kids with hearing loss to have difficulty with multiple-meaning words ("the envelope flap" vs. "the bird flapped") but what you describe goes beyond that to difficulties with generalizing even a single meaning.

[imagine.more]

I'm not a psychologist but this does sound to me like LBLD in addition to the hearing impairment. It is common for kids with hearing loss to have difficulty with multiple-meaning words ("the envelope flap" vs. "the bird flapped") but what you describe goes beyond that to difficulties with generalizing even a single meaning.

 

Yeah, I agree. And the fact that she's made significant progress in articulation through speech therapy, but almost no progress with vocabulary/language also points to a reason beyond the hearing impairment. Not to downplay that, because I know it affects things, but there's something else going on and I don't feel it's a global delay. Now that she's settled in our home and had some actual parenting she does all the typical teen stuff. She does her own laundry sometimes, can clean her room when told, knows how to take care of her hair (AA hair, so it requires more specific steps she hadn't been told of before), she cooks totally independently every Saturday morning, and she stays home alone for 1-3 hours at a time competently. We kept telling the neuropsych before "well, no she can't do laundry, but we've only had her 9 months" and "no, we don't trust her to use the stove yet...because she seems inattentive and we've only had her 9 months"... but he seemed to not take our caveats into account. :/