Can someone explain Receptive and Expressive Language?

[TrixieB]

One of my kids received an ASD diagnosis last year.  They will be seeing a new doctor for evaluation of other issues.  The new doctor and I had a short meeting today and she asked me if my kid was evaluated for Receptive Language and Expressive Language issues.

 

I have no idea.  I can look at the eval; it doesn't mention those terms but it does have a list of tests that were administered.

 

What are the names of the tests for Receptive Language and Expressive Language? 

 

If the tests weren't given, what specialty does this testing?  Is high school age too old to test for this?

 

Actually, I'm not exactly sure what Receptive Language and Expressive Language are... or how they would affect school performance?

[Wheres Toto]

My son was tested for receptive and expressive language delays when he was little.  The way they explained it to me was that Receptive is how well he understands what other people are telling him, and Expressive is his ability to make himself understood by others.  

 

I'm sorry I don't know what tests they used to determine them.

[sweet2ndchance]

Like the previous poster said, receptive language is what one can understand when spoken to him. Expressive language is how well one can express his thoughts in spoken language. I don't know what specific test an SLP uses to evaluate these but the results are given in as an age level.

 

For example, my oldest daughter had speech testing with an SLP when she was 18 months old because she wasn't talking and only communicated in grunts and gestures. Her receptive language (what she could understand) was at the 36 months age level because she could follow any direction given to her, even multiple step directions. Her expressive language (how she used spoken language to communicate) however was at the 9 months age level because she did not use any intelligible words, only grunts.

 

A child with a receptive delay would have trouble following directions or understanding what is asked of them. A child with an expressive delay would struggle with putting the thoughts, wants and needs into spoken words. The severity of the delay would determine how much of an issue it would cause in school. My son who is currently 4 years old, has apraxia which translates to an expressive delay. He can talk but he can difficult to understand so we take him to speech therapy weekly to work on producing speech sounds accurately but he doesn't need any help with receptive, he understands what is said to him perfectly fine.

Edited October 11, 2017 by sweet2ndchance

[J-rap]

Receptive is understanding language, and expressive is speaking or expressing language.  It can be tested at any age, generally by a speech language therapist.

 

Interestingly, different parts of the brain handle these two different language tasks.

[TrixieB]

Thank you for the explanation. Maybe my dc doesn't have problems with Receptive and Expressive Language.

 

At school dc has difficulty in environments where a lot of people are talking at once. One example is foreign language class. The class breaks up into small groups for conversation and dc struggles to follow along and participate. After multiple repetitions dc either is finally able to figure out what is being said, or else gives up and shuts down. The same conversation is not a problem to follow and participate in if the small group is in a quiet environment.

 

Dc doesn't have trouble following specific directions, but does have difficulty with implied or unclear instructions. If the instructions are given during orally while there is a lot going on in class, dc misses the instructions.

 

These things don't seem like Receptive or Expressive Language issues?

[Crimson Wife]

Some common tests would be the CELF (Clinical Evaluation of Language Fundamentals or something along those lines), the CASL (Comprehensive Assessment of Spoken Language?), the Peabody Picture Vocabulary Test, the EOWVT (Expressive One Word Vocabulary Test), the OWLS (Oral and Written Language Scale), the Bracken Basic Concepts, the Boehm (I’m pretty sure this is a language rather than an articulation Test), and the Vineland has a language portion

 

 

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[Crimson Wife]

Thank you for the explanation. Maybe my dc doesn't have problems with Receptive and Expressive Language.

 

At school dc has difficulty in environments where a lot of people are talking at once. One example is foreign language class. The class breaks up into small groups for conversation and dc struggles to follow along and participate. After multiple repetitions dc either is finally able to figure out what is being said, or else gives up and shuts down. The same conversation is not a problem to follow and participate in if the small group is in a quiet environment.

 

Dc doesn't have trouble following specific directions, but does have difficulty with implied or unclear instructions. If the instructions are given during orally while there is a lot going on in class, dc misses the instructions.

 

These things don't seem like Receptive or Expressive Language issues?

I would recommend audiological testing to include screening for Central Auditory Processing Disorder

 

 

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[TrixieB]

Some common tests would be the CELF (Clinical Evaluation of Language Fundamentals or something along those lines), the CASL (Comprehensive Assessment of Spoken Language?), the Peabody Picture Vocabulary Test, the EOWVT (Expressive One Word Vocabulary Test), the OWLS (Oral and Written Language Scale), the Bracken Basic Concepts, the Boehm (I’m pretty sure this is a language rather than an articulation Test), and the Vineland has a language portion

 

 

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None of those are listed on the eval.

Edited October 11, 2017 by TrixieB

[TrixieB]

I would recommend audiological testing to include screening for Central Auditory Processing Disorder

 

 

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What type of provider does this testing? Is this something I can ask the PCP to refer for?

[sweet2ndchance]

What type of provider does this testing? Is this something I can ask the PCP to refer for?

 

Yes you would ask the PCP for a referral to a Speech-Language Pathologist (an SLP or speech therapist) or possibly an audiologist who has training in speech language pathology. I've had 3 out of 6 kids who needed this kind of testing and we saw both audiologists and SLPs for testing.

[Crimson Wife]

Yes you would ask the PCP for a referral to a Speech-Language Pathologist (an SLP or speech therapist) or possibly an audiologist who has training in speech language pathology. I've had 3 out of 6 kids who needed this kind of testing and we saw both audiologists and SLPs for testing.

 

SLP would do language testing and some SLP's are able to do CAPD screening. The specific tests to ask for for CAPD screening would be the Test of Auditory Processing Skills (TAPS) and the Auditory Processing Abilities Test (APAT). Be forewarned that the typical "jack of all trades" SLP probably doesn't own copies of these tests so you probably will need to call around to see if any in your area can run them.

 

The SLP can only screen for CAPD and it requires an audiologist doing specialized booth testing to confirm.

[PeterPan]

If screening for APD try to skip the TAPS and get the SCAN with an audiologist. TAPS is half stuff a dyslexic fails, not a fan.

 

Yes to CELF or CASL. I prefer CASL . More sub tests, more time spent administering, more useful. CELF is faster .

 

Btw without data you don't know. My ds has pockets of weakness masked by crazy strengths.

[PeterPan]

There are other useful tests the SLP could run that would give you actionable information. TONI, TOPS, SLDT, etc

 

The Social Thinking site has a referral list you could try.

[Crimson Wife]

 

Yes to CELF or CASL. I prefer CASL . More sub tests, more time spent administering, more useful. CELF is faster .

 

The CASL is longer than the screening version of the CELF (15 minutes) but the full version of the CELF is identical in length to the CASL. Both are 45 minutes.

[PeterPan]

We spent hours upon hours doing the CASL. There are tons of subtests and my ds is a major pill to work with. The SLP can choose a smaller number of the subtests and do a core score. We never even got through all the CASL tests we would have liked to do. I also just like the CASL better. The CELF is identical in administration to some of the therapy workbooks we were doing, so to me the results are sort of invalid at this point. Like literally, they're testing exactly what we did.

[PeterPan]

I think there may be younger and older kid versions of the CELF too. My ds has had the CELF twice, and I think even the 2nd time he was just below the cutoff to bump up. 

[Crimson Wife]

I think there may be younger and older kid versions of the CELF too. My ds has had the CELF twice, and I think even the 2nd time he was just below the cutoff to bump up. 

 

Yes, and this is why we saw a drop in scores after my DD turned 7. The CELF for 7+ has a lot more complex listening comprehension questions than the preschool-primary version. Typically developing kids can answer those more complex questions but they were too hard for my DD.

 

The drop was useful to us because it helped provide justification for needing the cochlear implant. But it was still depressing for me to see.

[PeterPan]

Oh he was 8, because it was this spring. Must have been a different test. She ran a bunch that day. 

[Storygirl]

Trixie, something for you to think about.... DS13 (not diagnosed with ASD but close to the spectrum) scored in the average range for expressive and receptive on language testing (he had the CASL) but still has language difficulties that impact him at school.  I sometimes wonder if we should pursue additional language testing to try to tease out the underlying issues, and maybe we will someday. In the meantime, there are two areas that we know he has trouble with that affect language and communication for him, and they are areas that are often troublesome for kids with ASD.

 

1) Pragmatic language. The CASL does test for this, and he was low in that one area. This is an aspect of language related to social skills https://en.wikipedia.org/wiki/Pragmatic_language_impairment

 

2) Nonverbal communication. DS has nonverbal learning disability, which means, among other things, that he does not process the underlying nonverbal cues of language. Nonverbals can account for around 50% of communication, so kids who miss nonverbal cues miss a lot. Here is an overview of the kind of things that are part of nonverbal communication https://www.skillsyouneed.com/ips/nonverbal-communication.html

 

We have found that DS really functions much better in a small group. By small group, I mean two or three people, instead of 10 or 20 (which some people would consider small, but is a large group for DS). In a larger group, DS disengages and misses tons of information. In a group of just a couple of people, he is much more able to interact and contribute and understand. It impacts his learning, for sure. When you think about it, the more people that he has around him, the more nonverbal communication he has to process, from all directions. Which he can't do, so he doesn't take things in.

 

Just something for you to ponder. Language issues go along with ASD, but they aren't always measurable by the expressive/receptive categories. It's good to have the language testing, to see if there are issues in those areas. But keep in mind that there are other aspects of language that can trip people up. Psychologists can test for pragmatic and nonverbal language skills.

 

By the way, I do think that you may want to consider whether auditory processing could be an issue, as others have mentioned. But the things you describe could be explained by language issues as well. DS13 struggles in the ways that you mentions, but he happens to be an auditory learner. In groups, however, the pragmatic and nonverbal language issues are just much more complex for him.

 

 

[Storygirl]

Does your child have to take foreign language? For anyone with language issues (of any sort), tackling a foreign language is going to be especially hard. Sometimes kids can be exempt from the foreign language requirement when they have a documented disability.