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PeterPan

Growth curves in SLI

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I've been thinking about this for days and wanted to open it for discussion. We've always heard the term "late bloomers" but I thought this data had strong implications. They are late, but they're also perpetually BEHIND. And it looks like once that early teen growth spurt and language spurt hits, then it's over and they're permanently behind. 

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I'm definitely going to read this, thanks! I've had a couple questions already this year about how well dyslexic students can learn to read, if given appropriate accommodations. I gave the unhelpful answer that it depends on the kid, but that dyslexia is a life-long disability. 

Thanks!

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12 minutes ago, Mainer said:

I'm definitely going to read this, thanks! I've had a couple questions already this year about how well dyslexic students can learn to read, if given appropriate accommodations. I gave the unhelpful answer that it depends on the kid, but that dyslexia is a life-long disability. 

Thanks!

Don't you suppose that really depends on what is going on in the dyslexia? I hang on some SLP lists, and they swear up and down that dyslexia is a LANGUAGE disability. Yet when you talk with people about dyslexia, they're only like reading reading reading. The major, stunning dyslexia school in town keeps like 3 SLPs on staff. That's a TON of language intervention for a school that small (sub-200 students k-12 I think). And that's with teachers OG-trained, trained in Zones, blah blah. Those SLPs are working language baby, they're working all the rest of what is impaired. Ok, I'm not in their sessions, but that totally caught my eye when we toured, how integrated and essential the SLP services were and how high the support level was.

So what other stuff would be affected? Beats me. I'm dealing with so much I don't know what causes what anymore. But I'm just saying if there are more issues, then those "more issues" like language and EF and the comorbid social thinking deficits (hello, we're allowed to say that, right?) that they know are there but nobody talks about, etc. etc. are still going to be there. It was more than decoding. So if the social thinking holds back reading comprehension (it does) and the language is delayed either because there's some language impairment or from lack of exposure because of lack of reading (both) or there are EF issues (ADHD 60% comorbid), then the person has a lot they're dealing with, not just a nicely remediable decoding problem.

I think some dyslexics can learn to read stunningly well. My ds is triple down, everybody agrees dyslexic, and you saw his scores. We've had other people on the boards here say their dh's read professional journals, etc. etc. But are there more issues? Is it fatiguing? Is it showing up other ways? Did they get optimal intervention? Did ALL the areas get intervention?

Our behaviorist and I were talking again about how services drop off at that 13 line. So you've got these curves plateauing and you have services dropping off. Any connection? Are we saying the brain can no longer learn? They're still anatomically growing, hello, till 18-21. Or are we dropping SERVICES and then their skill growth pleateaus? I don't know. Maybe a combo. You have to buy into some funky theory though that therapy doesn't work (in which case, why bother??) to say those curves HAVE to plateau. And if they don't HAVE to plateau, then why aren't we intervening? And for your SLD Reading, why aren't we acknowledging ALL the areas affected? I seldom see anyone admitting what the dyslexia school was readily willing to admit, that LOTS of areas were affected, not just decoding. 

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43 minutes ago, kbutton said:

The link doesn't seem to be working for me, and I have a vested interest in this, lol! I suspect we're there...

Yeah, it went to that funky document image, so thanks to Beckyjo for supplying a better link. Access should be free too. I use this browser add-on called UnPaywall and anything you google and find that is paid will show with an unlocked padlock to click if there's a free version somewhere. Snazzy.

As far as the plateau thing, I had a chat with our behaviorist. She was suggesting the plateau they're citing is correlating to the drop-off in services... There's also a horrific dropoff in availability of materials, open and go, age-appropriate materials for kids that age. So with no materials and no funding, it's hard to say what COULD be in intervention. 

I just think, on a philosophical level, you have to have concluded therapy doesn't work, that your therapy is not working with the neuroplasticity of the brain, to conclude it's hopeless and done. I don't know. It really could be. Neurons prune and who knows. I definitely think it means there should be FOCUS on front-loading as absolutely much as possible BEFORE that point, because that early teen growth spurt is going to pull it all together and push it forward. That part is definitely clear. But whether we can say it's over, hopeless, your intervention is worthless after that point, I don't know I mean, that flies in the face of the whole point of any therapy or intervention and denies neuroplasticity.

Edited by PeterPan

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47 minutes ago, PeterPan said:

Don't you suppose that really depends on what is going on in the dyslexia? 

Yes, yes, definitely! At my last school, there were 2 SLPs for 75 kids, and it wasn't even enough. So much language stuff. Sometimes (often, always) I feel uninformed because I'm not both an SLP and a special ed teacher. 

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It seems to me, in my completely non professional opinion that there are actually a bunch of different types of dyslexia.  Or possibly what we call dyslexia is actually a bunch of different disorders.  There are some kids where dyslexia seems to definitely be a language disorder.  There are other kids who have stunning comprehension even with fairly crummy decoding skills.  It really seems less like differing severities and more like totally different causes and etiologies.   

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Mainer, some of the SLPs are really keen on the TILLS for testing the broader picture. I think they run that and narrative language testing.

https://www.smartspeechtherapy.com/its-all-due-to-language-how-subtle-symptoms-can-cause-serious-academic-deficits/  

Here's an article to get you started. The TILLS hits a bunch of stuff, and then she's saying dig in on narrative language (woo-woo, we're up on this around here! using either informal or something like the TNL. she likes informal but whatever) 

It's more than comprehension. It's the word finding, spelling/morphology, social language/pragmatics, narrative language, etc. 

2 hours ago, Terabith said:

It seems to me, in my completely non professional opinion that there are actually a bunch of different types of dyslexia.

I've seen people talk about this with some categories, but interestingly there are lots of different GENES involved. I've posted in the past and don't know if I can find quickly the study that looked at 12 genes, all hitting different aspects of the overall picture of dyslexia. So someone like my ds trips maybe one of those genes, but there are 12. It's not rocket science then to figure that probably severe dyslexia means more genes affected, etc. And the genes in the study were correlated with symptoms, so a gene couple genes were associated with phonemic awareness challenges, others with word finding, etc. etc., that kind of thing. 

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Yeah, that makes total sense.  I just literally have no idea how Catherine could "read" a pictureless chapter in a chapter book, where she could only decode one out of every 7-10 words, and still answer 95% of the comprehension questions correctly.  Not even talking multiple choice.  She could narrate the story.  She has some weird savant like ability to glean understanding from almost no inputted information.  I keep wondering how to harness that....CIA or NSA intelligence maybe?  It's incredibly bizarre.

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When I studied Russian they would have us read texts that were WAY beyond our level, where we basically new SQUAT the first time through reading. Now this was a 3rd or 4th year college level class, I forget, so we had some background, grammatical knowledge, etc. You'd look at it and feel like you had no clue and were just running your eyes over the page. We looked up NOTHING, and by the 3rd reading our brains had pieced together to jist of the story and were comprehending it and were ready to discuss.

So yes, I think someone of profound ability like your dd could take all those pieces and assemble them into comprehension.

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Just now, PeterPan said:

When I studied Russian they would have us read texts that were WAY beyond our level, where we basically new SQUAT the first time through reading. Now this was a 3rd or 4th year college level class, I forget, so we had some background, grammatical knowledge, etc. You'd look at it and feel like you had no clue and were just running your eyes over the page. We looked up NOTHING, and by the 3rd reading our brains had pieced together to jist of the story and were comprehending it and were ready to discuss.

So yes, I think someone of profound ability like your dd could take all those pieces and assemble them into comprehension.

Wow!  That's crazy!  I struggle with foreign languages.  Like, I'm a bright person but absolutely dreadful at languages.  I can't imagine being able to do that, but it's crazy that you guys could piece together enough to make sense of it.  

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12 hours ago, Terabith said:

Yeah, that makes total sense.  I just literally have no idea how Catherine could "read" a pictureless chapter in a chapter book, where she could only decode one out of every 7-10 words, and still answer 95% of the comprehension questions correctly.  Not even talking multiple choice.  She could narrate the story.  She has some weird savant like ability to glean understanding from almost no inputted information.  I keep wondering how to harness that....CIA or NSA intelligence maybe?  It's incredibly bizarre.

Wow. That's wild and wacky. And so, so interesting!! I know kids who can comprehend way better than what you would expect, but nothing as extreme as what you describe. 

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I don't understand something.  What indicators indicate permanently behind?

My DS may score low avg on punctuation, spelling, reading fluency, and grammar, but he is functional by interacting with adults and peers and maintaining rewarding friendships.  He is currently assigned to read from 3 history journals. Reading comp, vocab, and narrative language scores remain high.  

Edited by Heathermomster
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13 hours ago, Terabith said:

Yeah, that makes total sense.  I just literally have no idea how Catherine could "read" a pictureless chapter in a chapter book, where she could only decode one out of every 7-10 words, and still answer 95% of the comprehension questions correctly.  Not even talking multiple choice.  She could narrate the story.  She has some weird savant like ability to glean understanding from almost no inputted information.  I keep wondering how to harness that....CIA or NSA intelligence maybe?  It's incredibly bizarre.

DD13 was like that. And it was both a gift and a curse! Because it was hard to get her to actually work on decoding, when she could read in great gulps like that.

Her NP testing at age almost 10 had her at the 99th percentile for comprehension, but her decoding was low enough that the NP said her "word level" dyslexia was severe.

She is to be re-tested this fall for her IEP, so it will be interesting to see how her scores in both of those areas have shifted after three years of intense intervention.

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6 minutes ago, Storygirl said:

DD13 was like that. And it was both a gift and a curse! Because it was hard to get her to actually work on decoding, when she could "read" in great gulps like that.

When we were trying to figure out what was going on (I knew it had to be dyslexia), we took her to a free 15 minute reading screening at a dyslexia school (not the school that she attends now), and they insisted that since she passed their little test (barely -- 24th percentile was passing, and I think she was at 25), they thought her reading was fine. ARGH! That was so frustrating. I argued with they guy, and he insisted that this test only missed the mark on finding problems 4% of the time.

Her NP testing at age almost 10 had her at the 99th percentile for comprehension, but her decoding was low enough that the NP said her "word level" dyslexia was severe. (So much for that previous screening test!)

She is to be re-tested this fall for her IEP, so it will be interesting to see how her scores in both of those areas have shifted after three years of intense intervention.

So weird! I edited my post to add a comment, and instead of just editing my previous post, it ended up as a new post quoting the old one.

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22 minutes ago, Heathermomster said:

I don't understand something.  What indicators indicate permanently behind?

They ran a bunch of different tests to generate the graphs you see in the study. But it's SLI (specific language impairment), not dyslexia. Even though SLPs consider dyslexia a language disability, they're not saying it's the same thing as SLI. I think they also tease things apart like developmental language disorder, specific language impairment, and autism, and they say well you can diagnose this on top of autism but not this or it's redundant or blah blah. I think they kinda do swirlies mentally sometimes. 

My point was that when you jump over to autism, to NVLD, to what people are calling "late bloomers" because they don't like psych evals, etc., etc., you're seeing anecdotally people saying what in fact these curves are saying. And people in that kind of late bloomer, naturalistic approach to autism say well we don't have to worry because we'll get there eventually. I'm saying the data doesn't say that. The data says you're progressing just like you say you're progressing, you're late which you already know, and you're gonna plateau. And the question is why, can it be intervened in, does the dc HAVE to be permanently behind after that early teen growth spurt or can we move the bar, etc.

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PeterPan, not to diminish what you are saying about language issues being involved in dyslexia, because I'm sure they are, for many people.

But DD13, who attends the dyslexia school, does not have any language impairments and does not receive intervention from the SLPs at the school. So it's really still only the kids who have that help in their IEPs who work with the SLPs.

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Peter Pan, I am going to link a study of “blooming” in autism.  

This statement:  “we don’t have to worry we’ll get there eventually.”  I say things like this, but I *don’t* mean by it that I think my son is going to reach typical development.  I mean he is making progress on his own developmental timeline, and for a lot of things — he will get there eventually.  But I don’t mean by that — that I think he is going to be a typically development non-autistic person with an extra 5 years.  I mean it more like — “it will work out okay, he’s going to keep making progress.”  But even when I say “it will work out okay” — I mean “we love him and we will support him as needed.”  That is what I mean by “it will work out okay.”  I don’t mean “he will not have any problems as an adult.”  

I also see a lot that people who talk a lot about naturalistic interventions ———— I think they are a lot like my impression of a lot of unschoolers.  They always talk about what they don’t do, but in practice they are doing *so much.*  So — I think a lot of people saying “naturalistic interventions” implies a very intense level of interaction, very carefully chosen social engagement, highly supervised and supported, etc.  It’s still intense and very thought-out, but the form is naturalistic.  It is not really “letting nature take its course, standing back and watching.” 

Anyway though, this is not my situation, but a lot of parents do not want to present their kids as needing a lot of support, they want to underplay that, because it can help their kids socially, if they are underplaying the social supports they provide.  It doesn’t mean they aren’t doing it, but they might not advertise that they are doing it.  

And I will link the study..... depending on context maybe this study is being referenced.  It wouldn’t be if context is very generic discussion of late bloomers.  But I have heard it referencing this study from people who are more in-depth on autism.  

http://pediatrics.aappublications.org/content/pediatrics/early/2012/03/28/peds.2011-1601.full.pdf

 

 

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51 minutes ago, Heathermomster said:

I don't understand something.  What indicators indicate permanently behind?

 

I haven't gotten through the whole article yet, but there are comments regarding this in the bottom two paragraphs on page 7. The word "permanent" is not used, but the words "stuck" and "deceleration" are.

Also the first full summary paragraph on page 10 says, "Most striking,children with SLI, on average, increase their language levels at the same rate as children without SLI, indicating robust change over time, until they reach early adolescence when the rate of change seems to level off, leaving them with language levels below age expectations."

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23 minutes ago, PeterPan said:

They ran a bunch of different tests to generate the graphs you see in the study. But it's SLI (specific language impairment), not dyslexia. Even though SLPs consider dyslexia a language disability, they're not saying it's the same thing as SLI. I think they also tease things apart like developmental language disorder, specific language impairment, and autism, and they say well you can diagnose this on top of autism but not this or it's redundant or blah blah. I think they kinda do swirlies mentally sometimes. 

My point was that when you jump over to autism, to NVLD, to what people are calling "late bloomers" because they don't like psych evals, etc., etc., you're seeing anecdotally people saying what in fact these curves are saying. And people in that kind of late bloomer, naturalistic approach to autism say well we don't have to worry because we'll get there eventually. I'm saying the data doesn't say that. The data says you're progressing just like you say you're progressing, you're late which you already know, and you're gonna plateau. And the question is why, can it be intervened in, does the dc HAVE to be permanently behind after that early teen growth spurt or can we move the bar, etc.

I have never believed in that whole late bloomer thing except for possibly with EF and tons of supports.  Even with EF, I've never fooled myself into thinking that DS would be 100% with accommodations. 

 

 

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30 minutes ago, Storygirl said:

PeterPan, not to diminish what you are saying about language issues being involved in dyslexia, because I'm sure they are, for many people.

But DD13, who attends the dyslexia school, does not have any language impairments and does not receive intervention from the SLPs at the school. So it's really still only the kids who have that help in their IEPs who work with the SLPs.

I've wondered this. The people (SLPs) who are saying this are also making some other really absolute, b&w statements (all people with xyz diagnosis also have blah blah, etc.). But I do think it's kind of interesting to broaden it beyond decoding, since there is other stuff going on (the ADHD, the effect on writing, etc.). And I was really struck when I toured by how many SLPs they had. You get in our ps and they'll have 1-2 SLPs for an entire school, and the school may have double the number of kids and be an elementary school where intervention should be highest. And actually the SLP on our IEP team services the elementary AND either middle or high school. Seriously, lol. So then you're looking at really wide spread, really high caseloads. 

So that's why it caught my eye that the dyslexia school had so many SLPs on staff with so few kids. Even if they're working part-time or something, it's still pretty high support. I thought it was good. They have a few kids with autism is their classes, so I was looking very carefully at all these supports to see if it would be a place where ds could thrive. Right now he's a lot more custom, but still it was interesting.

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6 minutes ago, Storygirl said:

Also the first full summary paragraph on page 10 says, "Most striking,children with SLI, on average, increase their language levels at the same rate as children without SLI, indicating robust change over time, until they reach early adolescence when the rate of change seems to level off, leaving them with language levels below age expectations."

And that was where our behaviorist was asking whether that HAD to happen or whether that was correlating to a decrease in services through the school.

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I find this topic interesting, because DS14 had early speech delay (never diagnosed with SLI but had early intervention) but then seemingly caught up to peers, starting around age 3, and became quite verbal. He has been able to pass the language tests given him so far by being in the typical range (for everything other than pragmatics). But his SLP at his last school was convinced (when he was around 12)  that functionally he had both expressive and receptive language deficits, regardless of testing results.

He would not meet the criteria for that paper's group of test subjects, however, because he has NVLD, and the paper also indicates they were not testing kids with autism. Although the paper does not say this, I would presume that kids in those categories are likely to have funkier language results.

 

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5 minutes ago, Heathermomster said:

I have never believed in that whole late bloomer thing except for possibly with EF and tons of supports.  Even with EF, I've never fooled myself into thinking that DS would be 100% with accommodations. 

But see I did. I thought he only had praxis of speech and that if we got his motor planning there everything would be fine. I thought decoding was what the dyslexia was and that if I got him decoding he would read. So I then had a boy who could talk but wasn't saying much original and a boy who could decode but wouldn't read. So I fought the school for several years, trying to get it answered, hitting walls, until I begged an SLP to buy the tests that would show the disability. 

And the ugly thing is, by not collecting data we're able to say anything. Like I can say my dd is fine in college (which she basically is now), but that's not quantifying whether she's using sentence variety, only writing about a single pet topic, etc. etc. So even anecdotal stuff on the boards is really tricky, because we can correspond and think we know how it's turning out. 

So yeah, we've had this whole idea of the Gaddis, it's just slower but it will come, it pans out in the wash thing, and I'm looking at this data and going ok either they intervened and BEAT what was going to happen *or* they didn't quantify the parts that didn't come together. 

What I can definitely say, or at least personally think, is that if you have a dc who is behind the curve then not intervening will not result in beating that plateauing effect and being left behind when the plateau occurs. That part seems pretty obvious to me. It's not gonna just happen on its own. Or is it? Does that data mean that we can't fight the SLI and that we're constantly held back in our interventions, banging against a wall, only getting breakthroughs when the dc is developmentally ready, and that we're fooling ourselves and should sit back and relax? 

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6 minutes ago, Storygirl said:

I find this topic interesting, because DS14 had early speech delay (never diagnosed with SLI but had early intervention) but then seemingly caught up to peers, starting around age 3, and became quite verbal. He has been able to pass the language tests given him so far by being in the typical range (for everything other than pragmatics). But his SLP at his last school was convinced (when he was around 12)  that functionally he had both expressive and receptive language deficits, regardless of testing results.

He would not meet the criteria for that paper's group of test subjects, however, because he has NVLD, and the paper also indicates they were not testing kids with autism. Although the paper does not say this, I would presume that kids in those categories are likely to have funkier language results.

Boom. By not having the tests to quantify it, they skirt the whole thing. The CELF provides models, has multiple choice, and is just fast-food testing. It's not gonna dig in and show what is wrong with expressive language. Life is not multiple choice. 

Yeah, that's that whole SLI vs DLD vs. autism. Sorta like the non-polio polio going through the US right now.

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Story, the SPELT is normed through age 9, but that's only because by age 8/9 basically all the kids were getting everything right on it. Might be fascinating to run on him, just to see. There are SLPs who like running informal narrative assessments instead of something quantified like the TNL, but either way I think narrative language and being able to quantify the holes there is huge. And those are both tests with no multiple choice. The kid can either get his thoughts out and do it or he can't. Our ps didn't give a rip about the SPELT, but I found it shocking and informative. I should probably re-run it after it has been a year, so next spring. At that point we'll just be saying hey has he caught up to an 8 yo...

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2 minutes ago, PeterPan said:

But see I did. I thought he only had praxis of speech and that if we got his motor planning there everything would be fine. I thought decoding was what the dyslexia was and that if I got him decoding he would read. So I then had a boy who could talk but wasn't saying much original and a boy who could decode but wouldn't read. So I fought the school for several years, trying to get it answered, hitting walls, until I begged an SLP to buy the tests that would show the disability. 

And the ugly thing is, by not collecting data we're able to say anything. Like I can say my dd is fine in college (which she basically is now), but that's not quantifying whether she's using sentence variety, only writing about a single pet topic, etc. etc. So even anecdotal stuff on the boards is really tricky, because we can correspond and think we know how it's turning out. 

So yeah, we've had this whole idea of the Gaddis, it's just slower but it will come, it pans out in the wash thing, and I'm looking at this data and going ok either they intervened and BEAT what was going to happen *or* they didn't quantify the parts that didn't come together. 

What I can definitely say, or at least personally think, is that if you have a dc who is behind the curve then not intervening will not result in beating that plateauing effect and being left behind when the plateau occurs. That part seems pretty obvious to me. It's not gonna just happen on its own. Or is it? Does that data mean that we can't fight the SLI and that we're constantly held back in our interventions, banging against a wall, only getting breakthroughs when the dc is developmentally ready, and that we're fooling ourselves and should sit back and relax? 

This breaks my heart.  Establishing reasonable expectations while facing real limits and accepting them is a challenge.

I'm with you.  Push early and hard.

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I've seen some studies recently trying to connect genes and SLI. The genes are the same ones they're looking at for apraxia and ASD. We'll see, but I'm just not a real fan of the splitting hairs thing and saying labels are so dramatically different. The labels were never based on reality (genetics, blood tests, something) but sort of a dictionary approach to symptoms and groupings and categories. So me, I read across labels and look at everything that seems to relate, because I can't establish that they're biologically, neurologically that different and they seem to relate.

They may piece this together over the next 10-15 years. They're trying hard and people are finally asking these questions. There's a lot they don't know. They don't even know what a developmentally normal progression is for interoception in typically developing children. No one bothered to study it. The major evidence-based narrative language program (SKILL) doesn't refer to the developmentally normal pattern of narrative language development. I mean, think about that. They just make stuff up, make up labels, make up systems, make up interventions, and they have so many holes.

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Genetics isn't enough either though.  The health of the mother, environment, an early childhood accident, and a traumatic birth can all affect learning. 

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1 minute ago, Heathermomster said:

This breaks my heart.  Establishing reasonable expectations while facing real limits and accepting them is a challenge.

I'm with you.  Push early and hard.

Broke mine too! All my asthma stuff stopped after we got the autism scholarship and I finished those fights. I had that round of bronchitis from the bug I got at the IEP meeting because I was in a weakened state, but since then I have had NO ASTHMA stuff at all. Nothing. It's crazy. It was just so much stress, fighting these people, trying to learn enough to explain why they were wrong, trying to figure out what tests to run to show the stuff they were denying. It's insane. Now I waste time and energy trying to teach therapists how to do their job (how to collaborate, how to work on our goals and not just picky easy targets that are your pets, etc.). Crazy.

Yes, that's what I think right now, that I don't KNOW how far we can get and what we can do but we're gonna WORK HARD and get through what we can and only acknowledge walls when we HIT them. 

But then think about Kbutton's position. Like not to bring her up or something, but if her ds is at that age and she's hitting walls, is it developmental or is that the system doesn't have the tools to bust through it again? (ie. the therapist, the lack of materials to make it easy for the therapist, etc.) I don't know. I don't have an answer for that. I know since ds is 10 now we're headed for that same question and I probably won't have an answer either. I'll probably just have to make peace with whatever I decide.

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2 minutes ago, Heathermomster said:

Genetics isn't enough either though.  The health of the mother, environment, an early childhood accident, and a traumatic birth can all affect learning. 

I wonder what part audiobooks and seeding language play in this. My ds has curbed his audiobook use, and I think some of it is that it's just hard to keep someone in audiobooks THAT MUCH like we used to. Dd was picking her own books at this point. And I get stymied by whether I should be systematic or random, modern or classic, etc. I've got the new NLS catalog here and I keep trying. Sometimes he boggles my mind, not enjoying books I thought for sure he'd like (Follow My Leader which is on the SL 1/2 list, etc.). 

But yeah, some of the amazing stories I've heard have people continuing to listen at high levels. There's definitely, definitely evidence behind reading amounts (time per day) and the cumulative effect on scores. So I would think audiobooks would have that same effect. 

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I think we may spring for more detailed language testing eventually, because we can't count on the school to do so, but right now I'm thinking to do it next summer, instead of taking him out of school for appointments. I don't know that it would end up making a difference regarding the services he receives at school, but I would find it fascinating to understand better where his holes are.

Interestingly, the psych we started seeing a year ago was initially working with DS on managing his tic disorder, and our secondary concern that we brought as parents was managing anger.

But it was language skills that the psych wanted to work on. Not because we asked for that, but because he saw the deficit for himself. DS would pretty much only give him one word answers and would not look at him.

It will be interesting to see what his teachers say at the IEP meeting, though, because so far their comments about his verbal participation in class have all been positive. I think DS's use of language is affected by his comfort with his environment and the people. He was not comfortable with the psych. He is comfortable in his classes this year. His teachers say that he is quiet but participates and even volunteers to answer questions and is always respectful.

With his peers, I know that he is not concerned about being respectful and is in fact drawn toward language (swearing, insulting people) that is rebellious.

At home he talks a lot and is NOT quiet, and he is more likely to be oppositional and refuse to answer questions than to participate in a conversation.

But see, his teachers only see one side of him. And the therapist only saw one side of him. We as parents are the only ones who see all sides of him.

I'm glad he is doing well, but knowing that his language usage is situational not only makes it hard for it to show up at a certain time during a certain test, but also means he can seem to do well but then not do well in a different setting.

I veered off of SLI there, but this is where my concerns about language are for him. Really, I think the situational differences are partly related to pragmatics. His expressive and receptive language ability SEEMS to go down in certain environments, but maybe the root of that is the pragmatics???

I don't know. It's a mystery.

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It was interesting to me that the school shifted his social/speech goals from what they were for 6th and 7th grades to what was placed in his IEP for 8th grade.

For 6th and 7th, his goals were related to conversation, nonverbal cues, smiling, etc. He, by the way, did not make significant progress on those goals.

And then the school changed them so that the goals are all integrated into the academics. The goal is now basically about expressing himself in his schoolwork:  "given verbal prompts and content area text, articles, or reading passages, DS will verbally describe the main idea, give a verbal summary, and answer inference questions with supporting details and the expansion of thoughts and ideas in 3/4 trials with 80% accuracy by the end of the IEP period."

And the SLP comes to the language arts class instead of him having private sessions.

So there has been a shift for him in the tools they are teaching, even though he did not master the previous goals. Whether that is typical or not, I don't know, but they indicated at the IEP meeting that merging the speech goals with the academics was appropriate as he got older.

So I don't know. Maybe schools and therapists are shifting focus at that age, and it is slowing down momentum. Or maybe they shift focus at that age, because it is actually a response to the fact (?) that kids don't progress in the more basic goals after a certain age.

Chicken or eggs???

 

Edited by Storygirl
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1 hour ago, Storygirl said:

But it was language skills that the psych wanted to work on. Not because we asked for that, but because he saw the deficit for himself. DS would pretty much only give him one word answers and would not look at him.

You might find the new interoception stuff coming out really interesting. It's the merging of realizing how your body is feeling, realizing what the words are for those, and then applying it to other people. Mahler puts it that interoception is the missing piece for the other therapies that aren't working.

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1 hour ago, Storygirl said:

With his peers, I know that he is not concerned about being respectful and is in fact drawn toward language (swearing, insulting people) that is rebellious.

At home he talks a lot and is NOT quiet, and he is more likely to be oppositional and refuse to answer questions than to participate in a conversation.

I've thought a lot about things you've shared about your ds at meals, etc. I realized, after we quit gymnastics, that ds was doing that too. I think the bombastic behavior is covering up for their deficits and not knowing how to deal with the deficits. So then working on language fills in that gap. 

But like I said, hanged if I could find anybody who had a half-thorough approach to language AT ALL. Even the SLP I'm paying now doesn't bother. Seriously. I did it all myself, buying materials and going through them with him.

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1 hour ago, Storygirl said:

I'm glad he is doing well, but knowing that his language usage is situational not only makes it hard for it to show up at a certain time during a certain test, but also means he can seem to do well but then not do well in a different setting.

I veered off of SLI there, but this is where my concerns about language are for him. Really, I think the situational differences are partly related to pragmatics. His expressive and receptive language ability SEEMS to go down in certain environments, but maybe the root of that is the pragmatics???

I also think it's drawing assumptions without data. Like if a teacher says he talks "a lot" or "seems fine" or something like that, that's not the same as passes the SPELT with flying colors and is socially anxious or shy, kwim? 

With what you're describing was happening at the psych, I'd be shocked if he didn't go autism in a fresh psych eval. But I'm not trained in the ADOS, so who am I to say. I'm just saying sounds like it. 

We would NEVER have anticipated ds would bomb those language tests the way he did. Like we knew there were issues, but it wasn't like he wasn't talking. He just didn't have the understanding at the word level of language and it was glitching everything. Pair that with your comment that his pleasure reading has plateaued at a 3rd gr level, yes? Something like that. You said that they've worked and worked but his reading plateaued. Maybe the language and reading plateaued together.

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58 minutes ago, Storygirl said:

So there has been a shift for him in the tools they are teaching, even though he did not master the previous goals.

This is the shift in intervention our behaviorist was talking about. She's saying it's why those curves are plateauing. The school only has the legal responsibility to make sure he can access his education. So if he tests as borderline IQ because his language is low and they drop the academic expectations, then everything starts to fit. Then they go well this is what he needs to function in our classes, which he DOES NEED THOSE THINGS!!! But as the parent then you're going ok, what could have been. I don't know if these charts are telling us that. 

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1 hour ago, Storygirl said:

Or maybe they shift focus at that age, because it is actually a response to the fact (?) that kids don't progress in the more basic goals after a certain age.

It's a good question. My guess is money and time drives it more than neuroplasticity and what could be. Money is everything. What would it cost in real money to do the therapy work I did with my ds this spring/summer? I did 2-3 hours a day of intensive speech therapy work with probably $1k in speech therapy materials. No SLP is going to spend it. They're like oh no I can just use some random picture book or game and get to the same place. Not. And 2-3 hours a day billing at $100-140 an hour, well, we'll be conservative and call that $300 a day. I did it 6 days a week, and we hit 6-8 weeks of that. That's the equivalent of $10-15k in therapy. And how many hours is that? How many YEARS does that translate to at 30 minutes a week? And the data shows intensive interventions like that for 9 weeks actually get better results than 2 years of therapy spread out. This is comparing intensive vs. traditional therapy and there's data on it.

It's always money. 

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What class of test is the SPELT? That's just a total rabbit trail, but it might not be a restricted purchase. Some are like class B, this or that, and they limit who can buy them. 

By not running the tests, they get around everything. Did they even run the CELF-Metalinguistics? And a tool for narrative language? People just expect problems if they give the SLD Writing label, but think about that. You're saying SLD Writing explains someone's narrative language issues or excuses inability to get out their thoughts verbally??? Then we're back to language deficits, but they might say they've given SLD Writing and to stop complaining. That's what they did to us with ds when I said well what about this and this and this. They're like oh well we put that language thing as a reading goal and we put that other thing as a writing goal. Then we got the TNL results and said no, you can't just put it as SLDs, it's actually a language issue that needs service, something connecting across all the areas and affecting all the areas.

But it's hard because they're not doing service at that age, not making materials for that age, and therefore not developing testing for that age.

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And I do think that DS's new speech/social goal is appropriate for him. But my point is that they dropped working on the other language issues.

 

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2 hours ago, PeterPan said:

This is the shift in intervention our behaviorist was talking about. She's saying it's why those curves are plateauing. The school only has the legal responsibility to make sure he can access his education. So if he tests as borderline IQ because his language is low and they drop the academic expectations, then everything starts to fit. Then they go well this is what he needs to function in our classes, which he DOES NEED THOSE THINGS!!! But as the parent then you're going ok, what could have been. I don't know if these charts are telling us that. 

It's interesting, because his new school is actually switching him to a higher placement than we thought. He started in the resource room (they don't call it that -- it's specialized learning center, I think), but he's moved up to the gen ed classes co-taught with an intervention teacher for all but LA. His language arts teacher actually would move him up, too, but his schedule won't accommodate the class change, so she's just going to bump up the expectations for him within her class.

We actually are facing the opposite of what you describe, in a way, because it is the verbal scores that are the highest for his IQ, which makes him seem more competent. I'm glad he is able to track better with the gen ed classes than we thought, but I still feel hesitant, because when he hits high school and the expectations increase, he's going to need that additional support that they think he doesn't need right now.

The good thing is that this new school seems to be really responsive and flexible, and I think if he starts to flounder in the high school gen ed classes, they won't let him drown.

I may have missed in when skimming the article, but I wonder what ages they are using when they say "adolescent." Having a 13 year old stall in language development is different than having a 16 year old stall.

DS has actually had some good growth, apparently, over the last three years, and I'm interested to see what the ETR testing will show. So early adolescence has been a growth period for him, whether that shows up on the testing or not.

But I'm not expecting them to do a ton of language testing and think we will need to tackle that privately. I need to check with the SLP to see what she intends to do, because the school psych said that he didn't know (SLP will do some updated testing, but the psych didn't know what that would entail).

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Just to follow up my comment -- DS has made strides in his academic skills and in his ability to participate in group work and answer questions in class. He has not made strides in other areas of nonverbal communication, and those goals were dropped from his IEP, even though he didn't master them. Just wanted to specify, because I first said he didn't meet his social goals, then I said he had make good progress in a follow-up post.

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2 hours ago, PeterPan said:

You might find the new interoception stuff coming out really interesting. It's the merging of realizing how your body is feeling, realizing what the words are for those, and then applying it to other people. Mahler puts it that interoception is the missing piece for the other therapies that aren't working.

I don't doubt that DS has poor interoception, though it is not something that anyone said about him but just what I myself have observed. There is a definite disconnect, where he doesn't understand what his body is feeling. When I have the time, I'll think more about the info in that other thread.

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Story, your ds' progress is exciting!!! And I wondered about the ages too, like whether it would be 13 plateauing for typical and more like 16 for delayed. We've had people on the boards saying things with their ASD kids gelled around 16. I think you're onto something there.

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I have a musing....  what about the sensitivity of testing instruments?

This is what I have heard it called when kids who are pretty behind make great, obvious progress, but they are behind enough that it just won’t show up in testing.

For example — for my younger son, I have a kind of personal goal for him to reach a 3rd grade reading level.  And then we’ll go from there, but it is something I think of as a goal.  There is an older boy whom multiple people have said is very, very similar to my son, and I happen to know that he was reading, independently and with good comprehension, at a 3rd grade level (this is based on me knowing some books and then looking at their reading level).  

Anyway — it is totally obvious to me that it is worthwhile for my son to read at a 3rd grade level!  That is much better than the alternative of not reaching that level!  It’s clearly so worthwhile.  

But in testing, when that is so many years behind, as kids get older, my understanding/impression is that scores could even go down as the expectations are increasing with age.  

So my understanding is, that there are ways to track progress and use assessments to target skills...... but that a lot of testing is going to show lowering scores or no improvement, just because the child is out of the range of the testing.  

So for this kind of circumstance, I know for a fact that kids can be making very good progress, of the kind that opens doors in life and  adds opportunities, and improves social opportunities and success, and all these kinds of things......

But on a lot of testing, scores will either not change at all, or decrease.  

So for this kind of situation some healthy skepticism is needed.  

Also, different assessments or methods of progress monitoring can be more helpful, if a goal of testing is to monitor progress or choose appropriate goals.

Sometimes a goal of testing is to help determine if special services are needed, and then those low scores are what they want to see.  But that is a pretty limited use, really.  

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This is also an aside but since I know op’s child has autism....

I am finding out more and more about a difference in reading level and comprehension between fiction and non-fiction, with autism.

I am hearing more and more that there are a lot of kids who test at a lower reading level when the content is fiction, but much higher when the content is non-fiction.

So the older boy I reference.... he was reading-for-pleasure, fiction, at a 3rd grade level........ but that doesn’t say *anything at all* about his reading level in non-fiction, and I’m sure it was much higher.

But definitely everyone where I lived then was very, very big on understanding social content in fiction, and so for him to be reading fiction implied a lot of social understanding, and that was what was being talked about, in a way that is often not what people are talking about when they talk about reading levels.  

I feel like the amount of inferencing needed just goes through the roof, in fiction!  

But that is not an issue, in the same way, in non-fiction.  

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And then as far as dyslexia — it is not necessarily going to have any impact on inferencing.  Inferencing is often listed as a strength!

And then as far as the study — one of the things it mentioned scores declining in is vocabulary.  

I just have some thoughts as my younger son has low vocabulary scores.  First, it is very hard for him to learn words from context.  Very, very hard.  Second, the more abstract the words are, the harder they are.  For him to learn a label is not an issue, he can learn labels just from context.  But more abstract words are a lot harder. 

I think that the more difficult vocabulary words are what are going to be measured more as kids get older.  

And then if kids are still learning new words, but the words they are learning are not the words being tested on an age-level test, then they could have a score either stay the same or decline, but in reality, they could still be learning new words!  But maybe at a lower level, or maybe with fewer literary words being added.  

Right now I know my son is making good progress with his vocabulary, and I’m sure it could be measured by some tests.  But for other tests, I bet his score wouldn’t change.  But he is making good progress either way.  

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