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Expressive language deficits caused by lagging executive functioning


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#1 amo_mea_filiis.

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Posted 22 October 2017 - 11:51 AM

Just turned 13 year old ds is finally behaving for his SLP! Only took 1 and a 1/4 school years! Lol

He initially qualified for speech under pragmatic deficits, but she's now seeing that it's really an expressive language delay. But she thinks that delay is caused by his lack of executive functioning skills.

What are some things, like games, that can help with executive functioning? Bonus if it targets expressive language.

He currently has an A+ in science despite very low work because he has 1:1 live lessons with his gen ed teachers and they can see understanding in his face and eyes, even though his output is next to nothing.

#2 OhElizabeth

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Posted 22 October 2017 - 03:37 PM

We had an SLP do the CEFI® - Comprehensive Executive Function Inventory™ | Multi Health Systems (MHS Inc.)  Given that the dc has ASD, it would be good to do some testing like the CASL as well and try to pinpoint what's going on.

 

With my ds, not only were issues and holes showing up in the CASL and CEFI, but they showed up STRONGLY, really strongly, like uber-seriously strongly, when we started doing anything requiring sequencing and putting words to a sequence. There actually is testing for that too (TONL=test of narrative language), but they also look at it during the dynamic assessment trained by the Social Thinking people.

 

Either way, jist is we had to go back and work on sequencing. Read, Think, Cut & Paste We FINALLY finished this book, like just finished it. Now we're starting Short Story Sequencing  There's an earlier book that is only pictures and a later Fairy Tale Sequencing book that is only text, no picture supports. 

 

For my ds, that stuff was rocket science! Like have behaviors, run from the room, seriously hard. So we tackled it slowly with lots of supports. Oh, I had another one as well and I'm feeling lazy about finding it. We just finished it as well. And we've been working in a WH-questions Flip and Fold book from Super Duper Inc I think. (sorry for the rhyme)

 

As my ds did those, he started being able to talk about his day, to explain things in order. Think about how much of school and academic discussions and narrations is actually a logical sequence. How are you supposed to give that sequence and have that discussion if you don't get that things go in an order or what the order is? I also got some really cool sequencing kits that give you prompts for writing (keywords, etc.) from Lakeshore Learning. We haven't started them yet. This is a real plod plod kinda thing for us. 

 

Also, I was kicking it up to be age-appropriate. Like with the sequencing, I'd say you show me your story, you tell me what title it should have, then I'll tell a DIFFERENT story with the same picks, give my dialogue, etc. So that was working on the flexibility component and allowed us to do your more traditional progymnasta things (retelling from a different starting point, changing the narrator, changing the time frame, adding description or dialogue, etc.). 

 

That's really good that your SLP is digging in and finding things. I agree it's frustrating to work with these kids. They're just functional enough that people wanna gloss and say things aren't happening, but then you dig in and realize there ARE holes, holes that CAN have intervention. 

 

Hmm, you asked for games. If you want overt speech therapy and expressive language games, you can go to Super Duper Inc and find all kinds of stuff. Does he have a perseverative interest? Might be natural to try to bring more language into that as you do it together, if it's something you can find a way to do together. For instance, I'll do playmobil scenes with my ds and take pictures and scribe for scenes. That's harnessing something he already has a strong interest in, but taking it to the next level.

 

For my ds, one of the things the SLP felt was happening was rigidity in his constructions. Like he was using the SAME sentence construction for EVERYTHING. So to her, that was EF, a rigidity thing. So if your SLP can explain how she feels it's showing up, that will help you target. But some things might be more easily targeted in a larger overall activity, something harnessing a special interest. I say that, and really most of our stuff for sequencing, etc. isn't in his interest. It's usually just brief, in/out, and he tolerates it.



#3 OhElizabeth

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Posted 22 October 2017 - 03:42 PM

Nonfiction Sequence & Write Tiles

 

Sequence & Write Story Tiles

 

These are what I got. They go to 6 steps. I think I got both on BOGO. Lakeshore runs lots of coupons. They aren't disability-specific, so they may or may not be a good starting point for your student. For my ds, they would have been way out of reach. We did other, simpler materials first. Like the picture sequencing we were doing was targeted K-2, kwim? 

 

My ds also struggles with word order like thisSequencing Sentences Magnetic Book  I don't have this yet, but that's a yet. We've done some things like this with a workbook and a kit of words, and it was REALLY hard for him. You wouldn't expect it to be THAT HARD from just talking with him. And again, anything like that I have, I'm going to tell my SLP about and say hey, how can I use this better, how can I use it more ways... Sometimes the ideas come and sometimes the SLP adds good ones. Like with the Wh-flip and fold, she says well after he answers the questions, then have him give his own! Now, after doing that a while, I've *started* by having him make his own. That's really, really, really terrific for building conversation skills.

 

I know I'm skirting your question in a way, but EF is such a big topic, heading, part of the brain that it's not one answer. It's like what aspect is affecting him, what are you needing to target? Sequencing, anything with your logic, cause effect, inferencing, rigidity, working memory, lots of things are going to be under EF.

 

 



#4 OhElizabeth

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Posted 22 October 2017 - 03:44 PM

I think in that situation you described, it might be effective to get the science teacher showing assignments or tasks or topics to the SLP, so the SLP could develop some tasks that are within reach to do using the topics the science teacher is covering. That could get him from looking at his eyes to him at least ordering or organizing or synthesizing the material in some way. There can be some coordination there, even if it's a topic and the 5 main points of the lesson or chapter or something and the SLP develops an activity.



#5 amo_mea_filiis.

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Posted 23 October 2017 - 08:57 AM

Thank you for the links!