Please advice on how to proceed with my daughter

[NYmomof4]

Hello All,

This is my first time posting, but I’ve been reading the boards for a long time and have seen so much good advice on here.

 

(sorry if it gets a bit long)

I need advice on what to do with my daughter. She is 10 and just finished 4^th grade at our local PS. This daughter has been slow to mature from the start and always in the catch up mode as far as milestones – late to talk, late to learn colors, late to learn ABCs, etc. Her most struggles early on were language related, both receptive and expressive. However, most teachers brushed it off as to be expected bc. we are a dual language family (though I pointed out many times that she is equally weak in the second language). As she entered 1^st grade, it became clear that something was very wrong. Homework that should’ve taken 10-15 min would take 3 hours. She couldn’t understand math at all. Progress in reading was terribly slow. We got a lot of evaluations done by neuropsychologist in the middle of 1^st grade, which rendered no diagnoses but a galore of problems. Every single area assessed had weaknesses. Both auditory and visual subsections were below 5^th percentile. We spent the next 2 years doing a number of programs/therapies: vision therapy, Audiblox, Earobics, Phonics instruction, and lots of math remediation. Things got much better schoolwise in 2^nd grade, she caught up with reading and math. However, as she entered 3^rd grade, she started falling behind again. Another round of evals done by school this time at the middle of 3^rd grade showed little to no improvement in scores compared to 1^st grade evals. Again, listening, comprehension, and visual subsections were very low. Memory was the only thing in 50^th %. We spend another year doing brainware safari, learning breakthrough movement program, visual spatial exercises, Idea Chain for comprehension, and homeschooling math curriculum as school just gave up on her altogether. Not sure what helped or did not. She finished 4^th grade with a mix of Bs and Cs. Her biggest struggle that’s holding her back is reading and comprehension. She LOVES to read, reads at least 2 books a week, but according to school, only on the early 3^rd grade level. She has been on the same level for the past 2 years. Despite lots of (silent) reading, she is not making any progress. Her comprehension is poor. She has poor vocabulary, struggles to understand longer sentences, etc. Her decoding and accuracy are pretty good. She knows her phonics, can decode 3-4 syllables words when asked, but in a sentence would frequently misread, not understand, and not even pick up on the fact that what she misread makes no sense.

 

So my question is, what do I do. It’s summer now, and she is out of school, I can work with her later in the eve when other kids are sleeping. I am at a loss what to do. Her memory is OK (and we’ve done a lot of work on it), yet she seems unable to retain new vocabulary. Her language skills are at least 2 years behind, as her reading and comprehension. Idea chain did not seem to help much with this particular issue. What can we try?

[PeterPan]

Did they give her an actual diagnosis? Pdd-nos? Something? Have you thought about pulling her out and homeschooling her? Sometimes, depending on what the issue is, a grade level adjustment (or two) can help.

 

Did she get any speech therapy for the language issues?

[gg142]

Hello, I have no advice but will be following your posts if you don't mind. I am new to the board and I have a 4 yr old daughter with global developmental delays form birth. Her biggest issue is speech and we are also bilingual.

They are leaning to say she has cognitive delays but it is difficult to say due to her poor expressive language, as a minimum she qualifies for specific language impairment or language processing disorder mostly expressive but also receptive is starting showing issues mostly with the short term memory or working memory as you describe.

Thank you for posting the techniques you tried with her, we are currently in the UK and the early intervention is a joke, plus private therapists are really not well versed in any of these techniques.

GG

[AliR]

I would head for a speech therapy assessment right away. Language impacts on all areas, and I would expect to see all the things you have described in your post. I am not an expert, but DD(newly 11) has a very significant receptive and expressive language disorder. She also is good at decoding, but has to work much, much harder making sense of what she reads. Math also becomes a language problem once you get past the stage of just learning math facts.

 

I would worry about what she is spending her time on at school. If she does have a language problem much, if not all, of the instruction will be missed altogether, and it would not be surprising if she was not making progress there. Even remedial programs are no use if they are not delivered in a way that the child can work with.

 

Hope this helps. Good luck.

[NYmomof4]

Hello All,

thank you for responding. A few more details that I missed in the original post to clarify. Yes, my daughter has been seeing a speech therapist for years through the school system. Unfortunately, I am yet to see a good or even a decent one. They just seem to reiterate through the material she covers in class in LA or science, with no actual speech therapy. To make things worse, the school kept on insisting on putting her into ESL class as a way to deal with her language issues. I refused explaining that there are no studies indicating that ESL is an effective way of treating language disorders, but that provided the school with a convenient excuse to explain away all lack of progress.

 

She's also had OT for a few years to help with fine motor skills but graduated from that.

 

No diagnoses was ever given, PDD was never mentioned, EI evaluations early on mentioned developmental delays, and IEP stated language disorder (or something like that). The neurosphyc who did the first eval was rude and unhelpful and at our last appointment said that if, with the visual and auditory deficits shown by the testing, she is keeping up with school, whatever we are doing is working, and we should stick with that -- needless to say, that's not super helfpul.

 

Homeschooling would probably benefit her greatly, but I work full time, and would not be able to fit in school in the eve in an acceptable way. I try to do as much afterschooling as I can fit, focusing on various programs and therapies, math, and reading, and that's the best I can do at the moment.

[PeterPan]

Have you thought about getting her a private speech eval? A good speech therapist (some are better than others, shop around) could help you sort through the language part at least and then help you target your efforts. Places like Super Duper and Linguisystems sell speech therapy materials and will sell to individuals. Super Duper especially has some things you could look at. Also, you might try searching the boards here for posts with "MERLD".

 

Sometimes kids with delays benefit from a grade adjustment (or two).

[Tokyomarie]

I missed your post when it was first posted. I understand the brush-off you get when you have a bilingually developing child. Grrrr, is what I say because while it is true that it can take time to develop full competence in academic language if the school language is different from the home language, there should not be evidence pointing to a language disorder. Our second child was bilingually developing in English (home language) and Japanese (community and school language) and it took me until she was 9.5yo to get to the point where I a) had the confidence to say this is NOT a bilingual issue and B) find someone who could assess her in English, since we lived in Japan at the time.

 

Has your daughter been assessed for an auditory processing disorder (CAPD/APD)? Has she had the tests for her phonological processing (such as CTOPP, rapid naming, LiPS screening)? We never did get quite the full eval we could get today if I were in the same situation as I was with her in the mid/late-90s, but in our case, now that she is an adult and I have seen her developmental trajectory out 15 more years, I believe her final diagnosis should have been dyslexia w/CAPD.

 

Here are a few options you can consider:

 

1) Find a private language therapist who is qualified to evaluate language functions thoroughly- oral and written- so you can get a better read on phonological processing, as well as receptive and expressive language in detail and can get a good synthesis of the results. Check out DyslexiaHelp, the testing & evaluation section under the professionals section for a thorough description of various tests of reading & language. Many school speech therapists are better trained to deal with articulation issues than language issues.

 

2) Consider an auditory processing eval with an audiologist. If a child isn't able to take in auditory information efficiently at the basic level, building language competence will be more difficult, because language instruction almost certainly has to be 1-on-1 or small group in order for the child to process incoming information without the stress of competing noise and to give the extra processing time the child needs.

 

3) Consider taking your child to a Lindamood-Bell center or having her assessed with a speech/language therapist who is fully trained in L-B techniques. Their Visualizing and Verbalizing program is specifically targeted to help reading comprehension through improving the ability to translate words into mental/visual images. Therapy at a Lindamood-Bell center is expensive, and you want to check out the experience levels of the person who would work with your daughter, but it's worth checking out as an option. Alternatively, you can purchase the materials from Gander Publishing and try to use them yourself and/or attend a L-B training if you decide you are really keen to try it yourself as a way of cutting costs.

 

4)Consider taking your daughter to a developmental pediatrician, especially if there are other difficulties besides the language comprehension issues. Often language comprehension difficulties can go along with an ASD. However, it can be hard to tease out and language comprehension difficulties do not always equal ASD. In our case, our daughter's social skills, especially during the adolescent years, seemed to indicate a possible ASD in the high-functioning range, but now that she is an adult, there isn't any real evidence of an ASD, though she still prefers to socialize one-on-one or in very small groups due to her CAPD. She simply cannot hear the speaker when there is lots of background noise or the signal is degraded. When she was young, she didn't know how to accommodate for that and her behaviors around it made her "look" ASD.

[NYmomof4]

All, thanks for responding. All advise is very appreciated.

 

No, i haven't looked into a private eval, but perhaps I should. She's had so many done by all the therapists she's worked with, I figured that an eval is an eval. It's the interpretation of the results that's lacking. All the scores were consistently 1-2 years behind what they should be with figurative speech being the worst one. I can post them here if anyone can help with interpretation.

 

Since she is in a public school, grade adjustment is not easy -- the only way it hold her back. Being that she is in 5th grade, March bday (so on the older side), and tall, holding her a year back seems like a bad choice.

 

Daughter did have an auditory eval which came back with terrible results. The test where she had information read in both ears (don't know the name), she got 0 answers right. We did hours and hours of earobics and Audiblox and the following year, the improvements were amazing. So I am sure she still has some deficiencies, but I felt that a big chunk of it was addressed.

[Tokyomarie]

I second the Super Duper and Linguisystems materials! I used materials from both when I worked with my daughter.

 

I would disagree on a grade adjustment if she's making Bs and Cs at current grade level. Depending on the school system, that's not always indicative of true proficiency, but it does show she's not so far behind her peers overall that she can't function in her current grade. It's just that w/o continued language remediation, she's likely to start falling behind in her grades in middle school or high school.

 

Have you thought about getting her a private speech eval? A good speech therapist (some are better than others, shop around) could help you sort through the language part at least and then help you target your efforts. Places like Super Duper and Linguisystems sell speech therapy materials and will sell to individuals. Super Duper especially has some things you could look at. Also, you might try searching the boards here for posts with "MERLD".

 

Sometimes kids with delays benefit from a grade adjustment (or two).

[Tokyomarie]

No, i haven't looked into a private eval, but perhaps I should. She's had so many done by all the therapists she's worked with, I figured that an eval is an eval. It's the interpretation of the results that's lacking. All the scores were consistently 1-2 years behind what they should be with figurative speech being the worst one. I can post them here if anyone can help with interpretation.

.........

 

Daughter did have an auditory eval which came back with terrible results. The test where she had information read in both ears (don't know the name), she got 0 answers right. We did hours and hours of earobics and Audiblox and the following year, the improvements were amazing. So I am sure she still has some deficiencies, but I felt that a big chunk of it was addressed.

 

I do feel it would be helpful to seek a consultation with a private language therapist. You would need to do some investigation to find someone who is experienced in working with a child doing language remediation, not just homework help. Oftentimes this person is a SLP who has developed a specialty practice and may call herself an educational therapist or language/learning specialist. It can also be an educational therapist who comes into the field from another background. Or sometimes just plain SLP but whose primary specialty is language disorders, not articulation. You could take all your previous eval reports to her to look over and discuss her impressions of what the results mean and how she would proceed, knowing the therapies your daughter has already had and your current concerns. You could interview a couple of therapists this way to see how a couple of different people would approach your situation.

 

Did an audiologist do your daughter's auditory eval? Those are some impressively low initial results. That's great that Earobics and Audiblox has improved her function so much!

 

If you would like to post results, I'm sure a couple of us could take a stab at our *Layperson's* interpretation. I'm always hesitant to post comprehensive results on a highly searchable board, but do remember that you can delete them as soon as you get some helpful information. Alternatively, you could PM me and a couple of other people to keep it from being searchable on Google.

[NYmomof4]

All, thank you so much for advise. Education therapist sounds like a good idea. How would I go about finding a qualified one?

 

I am posting auditory eval results from 1st and 2nd rounds. The audiologist gave us the results but no diagnosis. Speech evals are all at home, so I will be able to post later in the eve or tomorrow morning. thanks for any opinions.

 

1st round of evals:

Filtered words: 16th percentile

Auditory Figure-Ground: 9th

Competing Words: 1st (that's where she got all of the 100 questions wrong)

Competing Sentences: 37th

 

2nd round of evals by the same doctor a year later:

 

Filtered words: 25h percentile

Auditory Figure-Ground: 16th

Competing Words: 16th

Competing Sentences: 91st

 

The final impressions stated: "E. still exhibits difficulties in tolerance-fading memory (TFM) and decoding of auditory stimuli. However, scores from this evaluation are significantly better than for her previous evaluation." Overall, the audiologist said the improvements were great, and she almost never sees such great gains. That was a couple of years ago, and we've continued with doing various auditory exercises through Brainware safari and other programs, so while I have no confirmation of that, I expect that my daughter did not regress.

 

I don't know how to quote, but wanted to respond to holding my daughter back and her grades. Her grades were mostly Bs, with one C, and a couple of As. Her tests ranged from high 90s to 60s, depending on how difficult the tests were, with a fair number of them being in 80s and 90s. I can see my daughter having difficulty closer to high school as volume of homework increases, but holding her back at this point would not really gain her much unless she is spending a year doing nothing but therapy (and I have thought of doing Arrowsmith program for a year, but results seemed anecdotal, school could not really provide much data, and my husband was against it).

[Tokyomarie]

Her filtered words scores do show some nice gains, but she clearly still has difficulty with tasks that require her to distinguish the speaker's voice from the background noise. I'm assuming that she has an IEP if she's been seeing a speech therapist at school? If so, does she have any accommodations written into her IEP for managing the difficulty with listening, such as preferential seating in the classroom (right in front of the teacher) or even better, an FM system? What other provisions does she have in her IEP, if she has one?

 

Here are two sources that may be helpful for finding an academic language therapist: International Dyslexia Association and Association of Educational Therapists. Don't let the fact that your daughter doesn't have a dyslexia diagnosis put you off from searching the IDA database. You'll be looking primarily at those who list themselves as "Academic/Educ Therapist" or as an SLP. I have also heard that some people have found an SLP who is good with language remediation by going to a hospital that has a good rehabilitation services for brain injury and/or stroke patients. A major children's hospital might be a particularly good source for a therapist or referral to one.

 

Does your daughter's school have a curriculum for building vocabulary in an intentional way? I believe that building vocabulary intentionally and building internal strategies for categorizing words and "filing" words in the brain are incredibly important for a student like your daughter. My daughter was only able to overcome her listening weaknesses when she had built up her understanding of vocabulary and sentence structure well enough to be able to fill in auditory decoding gaps using cognitive strategies. She, somehow, because of language processing weaknesses had not intuitively built up a way of understanding how to think about words in a way that would allow her to file them in her brain by various categories. That made it more difficult for her to retrieve the words when she needed to use them and even to learn new words efficiently.

 

Hopefully, this gives you some more ideas to ponder.

[pantone]

Whaaaa? To do an evaluation with no conclusion seems beyond silly to me...

 

Private evaluation would be my recommendation, too.

 

I fall into the homeschooling camp as well since I've been doing it for the last 7 years.

 

DS11 has severe dyslexia, yet he can score in the 65th percentile on national tests and thus would *never* qualify for help of intervention from our public system out here. Apparently you need to fail for three years in a row before they'll agree that there's a problem.

[NYmomof4]

Marie, thanks for the information.

 

Yes, my daughter has an IEP. The only two accommodations she has is preferential seating and extra time for state testing. No school curriculum for building vocabulary that I've ever seen. Can you recommend some resources?

 

I looked up some more test results if anyone is willing to take a shot at interpreting them and advising.

 

WISC - IV

Similarities - 25%

Vocab - 5%

Comprehension - 9%

 

Block design - 2%

Picture Concepts - 9%

Matrix Reasoning - 37%

 

Digit Span - 37%

Letter Number Sequencing - 63%

 

Coding - 16%

Symbol Search - 16%

 

CELF - 4:

Concepts and Following directions - 42, 50%

Word structure - 27, 37%

Recalling sentences - 36, 9%

Formulating sentences - 34, 50%

World Classes Expressive - 1, 5%

Word Classes Receptive - 6, 25%

Word Classes Total - 7, 9%

Sentence structure - 26, 84%

Expressive Vocabulary - 33, 25%

 

Core language Score - 93, 32%

Receptive Lang index - 101, 53%

Expressive Lang. index - 91, 27%

 

CASL (assessment of spoken language)

Antonyms - 17, 10%

Syntax structure - 25, 14%

Paragraph Comprehension - 41, 84%

Nonliteral language - 2, 5%

Pragmatic judgement - 30, 23%

 

Overall IQ score based on WISC was 8% though I truly don't believe it accurately reflects her abilities and potential.

 

Thank you all in advance.

[Tokyomarie]

IQ testing is often considered to be invalid- or not truly reflective of cognitive ability when there is a significant language disorder. I'm more accustomed to working with the standard scores rather than percentile rankings, and will have to think a little to translate the scores. However, I see a significant amount of scatter (or discrepancy) in her language scores, some significant strengths and some significant weaknesses side by side.

 

Her word classes score and antonyms score, combined with expressive vocabulary indicate, to me, that she needs some intensive targeted work in learning to think about words- ways we classify them, antonyms, synonyms, nuances of word meaning, etc. A good SLP or educational therapist would have the skills to help your daughter in therapy and help you build a home program to improve these aspects of language.

 

I have a really nice Linguisystems book called 100% Vocabulary that was really useful in working with my daughter. I don't see it on the Linguisystems site anymore, so that particular book may be out of print. They have similar books for academic vocabulary, but I'm not sure they accomplish quite what I'm thinking about. Let me think a bit on other vocab. resources for her age/level.

 

Has your daughter had any assessment in her second language? Do you have a good sense for how balanced her language skills are? I'm looking at the definite weaknesses in non-verbal processing and trying to figure out if those are true lows or are reflective of maybe not understanding directions well. How long ago did she finish vision therapy and am wondering what their comments would be about the non-verbal processing. How are your daughter's social and life/adaptive skills? Do you see any significant problem-solving difficulties?

[NYmomof4]

Marie,

thanks so much. I posted raw scores above as well.

 

Vision therapy was finished about 6 months prior to this evaluation. She did 24 sessions at the SUNY college of optometry. Her doctor told me that she made gains and was doing OK, but I did not see any changes. She still skips lines when reading, and says she finds it very difficult to read books with small font.

 

Last time my daughter had an assessment in both english and second language was when she was aging out of EI, so maybe around age of 3 or so. At that time, the therapist agreed with me that her language skills were equal. Since then, she barely made any progress on it (not that we tried hard); she can barely string a sentence together. She understands pretty well, and so she is able to listen and understand, but almost always responds in english. She learned the language from grandparents and since they helped with child care in the early years, she got most of it then. Since age 4, she's been in in preschools, etc, and so second language hasn't really developed much.

 

Social skills seem OK. She is naturally shy and quiet, but gets along well with kids at school, and has a few friends. Life/adaptive skills - seem OK, though probably a bit behind. She seems clumsy and poorly coordinated, having difficulties with some stuff in the kitchen. Problem solving skills - not so great, she gives up too easily, gets frustrated, and asks for help.

[Tokyomarie]

Has your daughter ever had an OT or PT eval? If she's poorly coordinated and has difficulties with some kitchen tasks, I'd be wondering how her motor/ visual-motor control compares to her peers. I know it's sometimes hard to know what to and in what order to sort out the issues. With difficulties in more than just the language area, it seems that seeing a good developmental pediatrician could be a good step to take. It seems to me that the school not really identifying and addressing all issues. It's definitely time to bump up to whomever you can get to take your concerns seriously.

[blessedmom3]

NYmom, has she had an IQ testing ? Sometimes children with language delay,test poorly in IQ,but it is also true that children with low average IQ (85-95) have delayed language skills because of their low processing skills. These children,usually do not have memory deficiency.

 

You can after school her...many people do it here on this board. Work in her weak areas ( an IQ test will tell you what they are) , ask her to read to you at her level and tell you about it...first step in comprehension. Do word problems at her level, using manipulatives if necessary.

[VinNY]

My 11 yodd has the same issues. May I recommend the REWARDS program? It really helped her understand and decode multisyllabic words better. She made great progress this year and is at a 5th grade reading level. She also gets speech services in school where they work alot on language processing (figurative language, conjunctions, vocabulary). You could do the same with resources from Linguisystems, "What your children should know series...." Critical Thinking books, Intermediate Language Lessons , EPS's Writing Skills etc.

[NYmomof4]

Thank you all for suggestions. Yes, she had IQ testing, I posted results above. She had PT and OT for a few years through EI and then school, but graduated from both. The school would not provide any more as they are not interfering with learning at this point. She is still clumsy when doing chores...

 

Can you recommend specific resources or programs to try based on the scores above? I feel like we've tried a lot of things with mixed results... not sure what would be most helpful now.

[NYmomof4]

My 11 yodd has the same issues. May I recommend the REWARDS program? It really helped her understand and decode multisyllabic words better. She made great progress this year and is at a 5th grade reading level. She also gets speech services in school where they work alot on language processing (figurative language, conjunctions, vocabulary). You could do the same with resources from Linguisystems, "What your children should know series...." Critical Thinking books, Intermediate Language Lessons , EPS's Writing Skills etc.

 

Thank you for great suggestions. Unfortunately my dd's speech therapist is not doing those things you mentioned. Will try REWARDS, already doing Critical thinking, did EPS's paragraph book series which was fantastic, will look into the rest of things.

[VinNY]

Re: clumsy issues..I recommend the book "Developmental Dyspraxia" by Madeline Portwood. There are great (and at home doable) intervention exercises for kids pre-k to 10th grade. I still do them with my kids. Also I put my dtr in dance when she was young and now gymnastics (open gym format not competitive). Her EI OT thought it the best "fun" form of therapy. Also kids do well with martial arts type programs to build coordination.

[VinNY]

Speech goals are so important. Is this a private therapist you are using or the school's? If you have an IEP for speech, look at the goals on that document. I can share later my dtr goals for last year and this upcoming year regards language development. I help run a Special ed PTA and we have learned that the written goals drive instruction. If you want to get help in getting your dtr from point "A" to point "B" you need to give the directions:).

 

Does your school district have a Wilson trained literacy person?

[NYmomof4]

Speech goals are so important. Is this a private therapist you are using or the school's? If you have an IEP for speech, look at the goals on that document. I can share later my dtr goals for last year and this upcoming year regards language development. I help run a Special ed PTA and we have learned that the written goals drive instruction. If you want to get help in getting your dtr from point "A" to point "B" you need to give the directions:).

 

Does your school district have a Wilson trained literacy person?

 

 

DD is working with a school therapist. She has an IEP and has goals written. If they actually met those goals, she'd be in great place, but semester after semester I get a progress report stating that goals have not been met with no reason or explanation. I spoke about it with the Special Ed person at school, explaining that this is unacceptable, I want to know why they were not met, or what was met, but nothing changes. It's supposed to be a good school, but special ed is horrible.

 

No wilson trained person or anyone for that matter. No use of any programs in the resource room, they use the same curriculum as gen ed and just skip half of it. I've never seen any O-G methods or work, any reading or comprehension programs being used, writing, etc.

[Lecka]

I have been warned school SLPs here may just focus on increasing sentence complexity.

 

My younger son is delayed in language and is on categories. A speech therapist can work with him on categories (for him -- animals, clothes, etc) and that is appropriate. Working on sentence length would look better in immediate results but not help him as much.

 

There is a difference in what they are offering depending on the goal.

[NYmomof4]

Ladies, if you were able to focus on just one Linguisystem workbook, which would be most helpful? I was able to find 100% Vocab one that Marie mentioned above.

 

I was also looking at Language Wise Method book from Reading Reflex author and it seems to have a lot of the same activities bundled in a plain book and not a fancy workbook. Anyone has any opinion on that?

[Tokyomarie]

I haven't seen the Language Wise book, myself.

 

For a traditional vocabulary building program, I have used, to much benefit, two series by EPS, Wordly Wise 3000 and Vocabulary from Classical Roots. Wordly Wise is a really solid program, but the words are not organized in any specific pattern in the lessons. Both of my younger two have used the Worldly Wise series. I found it especially helpful for my daughter who I mentioned has similarities to your daughter in her profile of strengths and weaknesses.

 

Vocabulary From Classical Roots is for roughly 7th grade and up, so you could use it in a few years. What I like about it is that it organizes words by Latin & Greek roots, so it helps students learn the building blocks of words at the smallest level of meaning, or morphemes. This helps students to be able to expand their vocabulary more easily when they can look at another word and recognize the meaning of roots, prefixes, and suffixes which makes it easier to guess what the word means, even if they have not encountered it before. I've been away from elementary level resources for a bit. Does anyone else know a good program that teaches morphemes at a more basic level?

 

Another EPS program that could be good is Megawords. I used it with both of my younger two primarily for spelling, but it is also good for vocabulary building. It is usually used for 4th grade and up, so your daughter might be able to benefit from it if her spelling skills are at 4th grade level or higher.

 

I would truly concentrate at building language at the individual word level, based on your daughter's current skills. It looks like she does well with sentence structure and paragraph comprehension- that probably assumes that she understands most of the words used in a given sentence or paragraph. I believe a major part of what's limiting her right now (based only on what you've told us) is her lack of understanding of how language works at the word level and the overall number of words that she can use.

[happycc]

For what it is worth: Rewards helped greatly here. 

I am looking into Spotlight on Vocabulary from Linguisystems and checking out IdeaChain. 

I have also placed my child in dance---ballet, tap, jazz. This has helped my other child who had learning issues.