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Alphabet name/sound retention issues


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I found this, which is specific to the US:

https://www.autismspeaks.org/blog/2017/05/15/speech-language-pathologists-and-autism-learn-how-we-can-help

The behavioral is something that some SLPs may add to their resume, others may follow a play therapy approach. I cannot speak for motor-planning/ praxis as it is not something I have experienced with my two, I was referring to the challenges in language that can be specific to autism (see link).

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From when my older son was in pre-school speech.... honestly nothing about that timeline for g/k seems strange to me. Especially if maybe she started not being able to do either one. It can be hard to make that sound.

 

And because they are produced in a similar way it also means they sound similar to each other.

 

There is an apraxia website that tells signs of apraxia ---- my boys just don't fit it. They don't have any of the signs. I have also seen videos of kids with apraxia that you can watch -- it doesn't fit my boys.

 

I think it is worth looking up the signs -- but I don't think it is some huge red flag at this point.

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From when my older son was in pre-school speech.... honestly nothing about that timeline for g/k seems strange to me. Especially if maybe she started not being able to do either one. It can be hard to make that sound.

According to my book /g/ and /k/ are in the 5-6 year age range. I agree with Lecka.

 

You could check your library for this book while you are sorting out SLP evaluations etc. It is packed with info and activities, for a 150 page book.

 

Teach Me How to Say It Right by Dorothy P. Dougherty, MA, CCC-SLP

 

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According to my book /g/ and /k/ are in the 5-6 year age range. I agree with Lecka.

 

I'm not an expert and have not had articulation issues with my boys. I bought the book when my 8 yr old was 3 to help work on some of the issues he had with expressive language and to keep tabs on articulation. I posted the book title in another thread and I am posting it here as well. You could check your library while you are sorting out SLP evaluations etc. It is packed with info and activities, for a 150 page book.

 

Teach Me How to Say It Right by Dorothy P. Dougherty, MA, CCC-SLP

Really? that's interesting. According to my SLP, the typical time is around 3. 

This is the website I used initially to figure out if it was an issue or not:  http://mommyspeechtherapy.com/?p=754

 

I wonder why the discrepancy in ages? 

 

I think that since she had absolutely no idea how to form the sounds, the progress was pretty typical. We started with G and the moved on to K.Once she figured out how to make the sound, then it was just a matter of consistency. The therapist actually seemed please with how quickly she picked it up. 

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I think you may be looking at average age vs. age after which you should be concerned, which is what the book is showing.

 

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A quote from the book:

"THREE TO FOUR YEARS OF AGE

Experts agree that even though your three-year-old child may make sound errors, 75 to 100 percent of what he says should be understandable to family and caregivers. Generally, children are able to make the following sounds at three to four years of age (Smit et al. 1990)

/h/, /w/, /p/, /b/, /n/, /t/, /d/, /k/, /g/, /f/."

She gives examples for each letter and then at the end she gives examples of acceptable conversations, for this age group and before and after this age group.

My suggestion was not for you to use the book to do therapy yourself. It was not the reason she wrote the book and she recommends seeing a SLP. This is to alert you if there's a problem and to give you some activities to do on the side.

 

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  • 4 weeks later...

We had a speech and an OT evaluation last week. The SLP found definite things to work on. Her office works with an audiology center in Kansas City. The center won't do the audiology tests until 6 or 7, but she said that she can still get some help from them in the mean time. She did say we'll have to be careful what we work on and how so that insurance will pay for it until we get the diagnosis. She definitely thinks there are signs of APD, but she also needed time to score the CELF to see if there are other issues. We have our first appt with her on July 26, so we'll go over the scores then. 

The OT said that dd has very minimal retained reflexes. She said it's not bad at all. She said that DDs fine motor skills were fine for her age, but that she would probably do well to have OT for sensory issues. So, fingers crossed we meet the requirements after everything is scored. I am hoping to get a call this week about that. 

Things are definitely looking promising with the SLP, though. We'll go 2x a week. 

We also start swim lessons today. The aquatics director at the Y used to be a SPED teacher, has a daughter with Down Syndrome, and has several swim team members with special requirements. It was so encouraging to call and not have to feel like I was putting him out. He even made some suggestions that I wouldn't have thought of. 
Dd is super excited about lessons today. Let's hope it translates to excitement when she gets in the pool.  :) 

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We had a speech and an OT evaluation last week. The SLP found definite things to work on. Her office works with an audiology center in Kansas City. The center won't do the audiology tests until 6 or 7, but she said that she can still get some help from them in the mean time. She did say we'll have to be careful what we work on and how so that insurance will pay for it until we get the diagnosis. She definitely thinks there are signs of APD, but she also needed time to score the CELF to see if there are other issues. We have our first appt with her on July 26, so we'll go over the scores then. 

 

The OT said that dd has very minimal retained reflexes. She said it's not bad at all. She said that DDs fine motor skills were fine for her age, but that she would probably do well to have OT for sensory issues. So, fingers crossed we meet the requirements after everything is scored. I am hoping to get a call this week about that. 

 

Things are definitely looking promising with the SLP, though. We'll go 2x a week. 

 

We also start swim lessons today. The aquatics director at the Y used to be a SPED teacher, has a daughter with Down Syndrome, and has several swim team members with special requirements. It was so encouraging to call and not have to feel like I was putting him out. He even made some suggestions that I wouldn't have thought of. 

Dd is super excited about lessons today. Let's hope it translates to excitement when she gets in the pool.   :)

Minimal reflexes present are not good and require specific reintegration exercises.  

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This all sounds so good!!!!!! I hope swimming goes well :)

She LOVED it. The swim instructor gave her some goggles and she's been practicing going under the water in the bathtub. "I have to practice!" 

He was very please with how quickly she acclimated and he thinks she's going to do very well. We were the only ones in the pool area at the Y, so aside from the slide noise and general pool noises, it was quiet, which was good for her. 

 

Minimal reflexes present are not good and require specific reintegration exercises.  

I think she was saying she was not bad and that it wouldn't be a problem to get her on track. I still haven't heard anything and that was a week ago. :/ I'm not sure how long to wait...

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I'm just going to agree with the quiet thought that it's really not helpful for (idiot) practitioners to make stuff sound like it's just a "little." Reality is they're retained, they're issues, they're causing symptoms. And when the symptoms go away, you, as the parent, might kinda be like WOW that WAS a big deal. And maybe the reflex will be one that was minor in your world, but those of us who've gotten reflexes to integrate and seen radical changes get really, really irritable with any book or practitioner who makes it sound like oh it's just a little, don't worry. Hence the irritability. ;)

 

PS. That's awesome swimming went to well!! Score!! It's good to have something that goes well.  :thumbup:

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  • 4 weeks later...

Just updating in case anyone cares. :D 

Speech and OT are well under way. 

She was given the CELF and has decreased expressive language skills. We're working 2x a week on things like plurals, pronouns, making grammatically correct sentences and they're also working on following basic two-step directions. 
We have a different OT than the one who administered the evaluation - thank goodness. He is really nice and dd was immediately comfortable with him. We'll be working primarily on her sensory processing skills as her fine motor are age appropriate. 

So, now it's just a lot of driving and doing therapies, but we're at least getting somewhere. 

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Ooo, that sounds really good! And for my ds, I think the working on language specifics carried over to noticing more details in general. They have to listen really hard to the endings, etc. 

 

Did he have an explanation for *why* the language scores were low?  And did he happen to run a pragmatics? Pragmatics tests are a pain in the butt to score, so sometimes it isn't the first thing they offer.

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Ooo, that sounds really good! And for my ds, I think the working on language specifics carried over to noticing more details in general. They have to listen really hard to the endings, etc. 

 

Did he have an explanation for *why* the language scores were low?  And did he happen to run a pragmatics? Pragmatics tests are a pain in the butt to score, so sometimes it isn't the first thing they offer.

The SLP thinks that it sounds like APD, but she doesn't do the screenings until a bit older (around 6 or 7). She DOES want to do the screening next year though to see if it is beneficial to go to the Kansas City audiology center she teams with, or if we need to wait a few more years. (Speech is going to go for at least a year.) 

Riv works really, really hard in speech and generally does well with the SLP she was assigned. I REALLY like this therapy group. 

 

She ran the CELF and the Goldman-Fristoe Test of Articulation. So, no, I don't think she did a pragmatics assessment. 

Her Core Language Score was in the 30th percentile, Receptive - 55th; Language Content Index - 25th; and Language structure - 27th; They were all in normal limits. The one that wasn't was Expressive. 

Per the report:

Her receptive language was in the 55th percentile, but her expressive language was in the 13th percentile. It was a 19-point difference. A 6 point difference signifies an abnormality! :( 

 

 

 

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Those numbers don't make sense to me, but it's good you're getting it sorted out! Language issues are HUGE. And hurray for mother gut! Now you have definite confirmation you're not crazy.

 

Our SLP ran the TAPS on ds when he was 5 turning 6, like newly 6, and half the test was phonological processing. The SCAN is a much better test. I think that's more typically an audiologist, maybe a psych. Ideally they can even run it in a full booth set-up that the audiologist has. 

 

Pragmatics is going to be your social skills, perspective taking stuff. My ds passed overall with areas low (if you believe the ps SLP) but bombed it very clearly two years later. I've seen data behind that, saying that pragmatics testing isn't very reliable when they're really young. Like I think ds "passed" with a raw score of 1. I kid you not. But by the time he was 8, the discrepancies were more obvious in the testing.

 

That was a rabbit trail. I'm just really happy for you to have really good interventions going! You must be very relieved!! 

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Those numbers don't make sense to me, 

How so? 

 

Yeah, I'm not sure what all we're planning with speech (other than the goals laid out in the report). The owner of the center is the one who did the evaluation, but she's been out doing some things for the public schools and another organization. So, she and I haven't been able to meet yet to talk other stuff, plus Dd was sick for our last session.

But, I think at this point, we'll keep going forward with the SLP and OT and evaluate at the end of our times. 

Insurance will only pay for 30 OT sessions. *eye roll* So, I hope that's enough. If not, we'll have to figure it out.  

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She ran the CELF and the Goldman-Fristoe Test of Articulation. So, no, I don't think she did a pragmatics assessment. 

Her Core Language Score was in the 30th percentile, Receptive - 55th; Language Content Index - 25th; and Language structure - 27th; They were all in normal limits. The one that wasn't was Expressive. 

Per the report:

Her receptive language was in the 55th percentile, but her expressive language was in the 13th percentile. It was a 19-point difference. A 6 point difference signifies an abnormality! :( 

 

55-13 isn't 19. 6 isn't the standard deviation for the CELF. Were you typing it exactly? On the CELF the usually kick out scaled scores. Was it a preschool version or regular? CELF 4 or 5? I think my ds had the CELF5. Here's a link to understanding scores.

 

‎www.speechandlanguage.com/wp-content/uploads/2013/06/celf-5_determining_severity_lang_disorder.pdf

 

So on the CELF (I'm not an SLP), they usually put scaled scores, where the mean is 10, standard deviation 3. Other tests will kick out standard scores, where the mean is 100 and the standard deviation is say 10 or 15.

 

The reason you don't look at percentages is because those give you no sense of significance. Someone can have crazy low numbers by percentages but still be clustered within the bell curve in areas that represent "normal" for their population. That's what the standard deviations show you, where the bell curve starts to become significant. 

 

So if you take numbers to the ps, typically they won't care unless there is at least 1.5 standard deviations of discrepancy. And usually they're looking for discrepancy in the core (overall) score or at least enough areas to be significant. And for some things, like academics, they're going to consider discrepancy from IQ. So like if someone has 1.5-2SD of discrepancy in areas on their IQ testing, that's significant. If someone has an achievement test area that is 2 SD discrepant from IQ, that can be significant. And to make it easy to do those comparisons, they're going to look at standard scores, where the mean is 100. So IQ, achievement, a lot of things will kick out standard scores. Where they don't, they kick out scaled scores.

 

So your numbers don't add up on the percentages and you can't look at percentages to decide significance anyway. You ahve to look at the scaled scores and what the standard deviations were. 

 

I agree the issues are going on. I'm just saying the numbers weren't adding up. Or it's my headache. Or both. :)

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 I'm just saying the numbers weren't adding up. Or it's my headache. Or both. :)

CELF 5. 

 

The 55 and 13 was the percentile. The difference (not deviation) is based off the standard score. The Receptive raw score was 102. The Expressive score is 83. So, 102-83=19. The report states that a difference of 6 or higher indicates an abnormal finding. Not a "deviation" but the difference between the scores. ;) 

I left off the "standard score" portion of my first post, so I can see how confusing that could be. haha I had to go back and reread what I wrote, then look at the report again to figure out what I left off. 

 

To quote on the deviation portion (which is a different portion than what I mentioned above): 

Her Expressive Language Index - 12th percentile - fell greater than one standard deviation below the mean indicating skills below normal limits. 

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