Sunday, September 5, 2010

Speech and Language Evaluation for Preschool

I've heard that children generally drop either the beginning or ending sounds in one-syllable words when learning to speak but that children with Down syndrome tend to drop beginning sounds while typically developing children tend to drop ending sounds. I don't know if this is fact based on research or just a speech pathologist's observation from experience. It is interesting though.

The Evaluation - Preschool Language Scale (PLS)
We were in the evaluation room for about an hour. I was allowed to stay in there with him. Some schools do not allow parents to be present in the evaluation room. Matthew fully cooperated for about 20 minutes. There were a few toys used at the beginning of the evaluation to test his receptive language by following one and two-step directions.

He also did fine with pointing to body parts and clothing items. He listened and pointed to pictures of objects in response to "where" questions such as "Where is the dog?" However, he didn't understand "who" and "what" questions such as "Who is sleeping?' - when shown pictures of a baby sleeping and a boy eating - and "What do you wear on your feet?" - when shown pictures of a banana and shoes. It's not because he cannot identify a sleeping baby. He definitely knows to wear shoes on his feet, not his head. He didn't understand the question and what was being asked of him. I guess this is one of the many aspects of expressive language that he needs work on.

Picture after picture after picture, Matthew was asked to say what he saw. This was to get an idea of how he articulated words and substituted certain letters. For example, he says "doh" for "no", substituting a 'd' for the 'n'. And with picture after picture after picture, Matthew's patience and attention span started waning. It was quite gruelling, especially for a 35-month old. Then he was "ah dah" (all done) and turning away. Neither I nor his speech therapist, who also works at the school, could get him to say any more words for the evaluator.

We wrapped up the evaluation with me answering the evaluator's questions. Elizabeth had fallen asleep on my shoulder.

Hot Tip: Prepare a Developmental Achievement Chart
I brought an updated copy of the Developmental Achievement Chart (mentioned in my previous post "Transition Meeting") to this evaluation and it helped answer many of the evaluator's questions in far less time than it would've taken otherwise. Some of the information I included in the Communication section are:
- a list of words Matthew understands.
- a list of words Matthew signs.
- a list of words Matthew verbalizes with consistent sounds, including how he says them. For example, help (ehp).
- a list of songs he "sings" and knows the fingerplay/ actions to.
- a list of one-step directions he understands.

I also listed specific things that I think he needed to work on or is currently working on. For example, opposite the list of one-step directions, I wrote that he needed to work on understanding 2-step directions, related and unrelated, and in the order they were given to him.

The information I provided in the Developmental Achievement Chart will be included in the school's evaluation reports in addition to the progress notes from his therapists in the Early Intervention program. Hopefully this will give everyone involved in his education the most accurate picture of his strengths and weaknesses and a good starting point for discussing and formulating his IEP (Individualized Education Program) goals.

What's Next?
Matthew will have two more evaluations - one by an occupational therapist and the other by a physical therapist.

Then we'll have the staffing meeting to discuss the results and finally the IEP meeting right before his birthday.

Related post:
1st Screening for Preschool
Transition Meeting


Dina said...

Thank you for posting this stuff. I have a little time but it is nice to read what to expect instead of just dreading the unknown. At least now I can dread the known. Uggh! But it sounds like Matthew is doing so well. A testament to all your hard work and patience.

Brandie said...

Goldie drops beginning sounds on a lot of words. I'm really enjoying reading about this process. It is different than our experience. At Goldie's eval the ST was not interested in hearing what sounds she could make. When discussing goals, she also told me that Goldie would be a language kid and not an articulation kid, so they wouldn't (normally) do oral motor activities with her.

Ria said...

@Dina, "dread the known" - funny when you put it that way. :-) I'm sure you'll be well-prepared when it's your turn.

@Brandie, that is interesting! Mathew drops beginning sounds on a lot of words too! I'd also never heard about being a 'language kid' vs an 'articulation kid'. That's interesting. Maybe I'll hear about that at our staffing meeting when the results are discussed. In the meantime, I'll ask our speech therapist about those terms. She doesn't do oral motor activities with Matthew either when she comes for the home visits. But I do them with him in between her visits. Anyway, I hear the process can vary even between school districts within a state. Thanks for sharing your experience with us.

Ellen Stumbo said...

We are having Nichole's evaluations done soon. I am not looking forward to them because it seems ridiculous to evaluate her in a given time where Nichole might or might not chose to show them what she really can do.

Interesting, Nichole substitutes sounds too, but she drops the end of words :)

MaggieMae said...

Congrats to Matthew for staying focused for 20 minutes for such a grueling test. And you all should know that no matter the outcome, none of these evals accurately depict what our kids with DS can actually do/accomplish. Not just trying to make you feel better... it's the God's honest truth (and backed by research).

Monica Crumley said...

I so appreciate your info during the transition and assessments. Our transition meeting is 9/23. A friend of mine suggested showing a photo montage showing John Michael "in real life" doing different things that he wouldn't do for strangers in an unfamiliar environment.

Looking Up said...

My son is only 21 months old, & I am already dreading the "transition" process. Thanks so much for giving us an idea as to what to expect. Personally, I think that staying focused for 20 minutes is pretty darned great for a little guy who isn't even 3 yet. I know grown men who can't do that LOL. :)

Pallavi said...

Hi Ria, thanks for Sharing.
After reading this I realised I hardly ask 'Who', 'What' questions to NAvya. Need to work on that too.. Veru helpful tips..

Pallavi said...

Hi Ria, thanks for Sharing.
After reading this I realised I hardly ask 'Who', 'What' questions to NAvya. Need to work on that too.. Veru helpful tips..

Ria said...

@Ellen, I agree that our kids may not "perform" when and as they are expected to during evaluations. In our case, Matthew cooperated really well for his first screening and not as well for his speech & language screening. The evaluators asked me questions for the part of the evaluation that he did not "perform" for. The Developmental Achievement Chart was also invaluable for filling them in on what Matthew could do even if he wasn't showing them during the eval. Photos or videos of Nichole doing things that might be tested in the eval would be helpful too. Or the evaluation can also be rescheduled. I view the evals as just a way for the school to get a current picture of how our kids are doing to know where to start when they are in school.

@MaggieMae, thanks! I agree with you. The outcomes of these types of evaluations are not predictors of our kids' success.

@Monica, the photo montage is a great idea. Videos would be good too. The Developmental Achievement Chart I prepared was invaluable to the evaluators and they were very appreciative that I got all that info together for them as there were some things that Matthew did not do during the eval but he does at home.

@Looking Up, the good news is that so far there's really been nothing much to dread. At least in my experience so far. At first it was daunting to think about the process. But now that we're in the middle of it, it's fine. So far, anyway...

Anna said...

Ria, thank you for great info. I love that about your blog. Weve only had little G home a month and are in a transition of sorts ourselves. I am hoping alot of my questions can be answered at our Drs appt on Thursday. Since she will be 5 in Nov we missed all the at home therapies. Many people that we know, and even strangers, have been asking us about school etc. I feel its too soon for her to be out and about with such a HUGE transition in her life. We havent been able to settle into a "new normal " yet.(or bonded as a family) She is learning signs rapidly and when she tries to mimick speech she leaves off the beginning sounds as well.......

Unknown said...


I read your blog from time to time and have recently saved it on my favorites bar. I always enjoy the information you share. Thank you for the tips regarding the preschool evaluation. I am currently in the process myself. Unfortunately our school district is horrible, and am preparing myself now. I have started documenting all the new things Zachery does and with your tips added all the speech information as well. I have a question for you (totally off the speech topic), do you feel treadmill walking helped? Zachery is 30 months old and not yet walking. He pulls to stand, cruises, and will walk holding on to two hands, but will not take steps on his own. Both the pt and I are frustrated (he was born with mild hypotonia - as the dr's stated). He has pt 2x's a week plus aqua therapy for half an hour once a week. I would love to hear your opinion. Thanks