By the time these children reach preschool age (3+ years) they may present with obvious signs and symptoms of language processing deficits, which may require further screening and intervention. Continue reading Language Processing Checklist for Preschool Children 3:0-5:11 Years of Age
You can find it in my online store HERE
This checklist was created to assist speech-language pathologists (SLPs) with figuring out whether the student presents with language processing deficits which require further follow-up (e.g., screening, comprehensive assessment). The SLP should provide this form to both teacher and caregiver/s to fill out to ensure that the deficit areas are consistent across all settings and people.
- Listening Skills and Short Term Memory
- Verbal Expression
- Emergent Reading/Phonological Awareness
- General Organizational Abilities
- Social-Emotional Functioning
- Supplemental* Caregiver/Teacher Data Collection Form
- Select assessments sensitive to Auditory Processing Deficits
In recent years there has been a substantial rise in awareness pertaining to reading disorders in young school-aged children. Consequently, more and more parents and professionals are asking questions regarding how early can “dyslexia” be diagnosed in children.
In order to adequately answer this question it is important to understand the trajectory of development of literacy disorders in children.
According to the definition set forth by the International Dyslexia Association: “Dyslexia is a specific learning disability that is neurobiological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge.”
Thus, despite the significant controversy over the use of the label “dyslexia”, as being ‘unscientific and conceptually problematic’, the above definition affirms the fact that it is undisputedly a linguistically based disability. While it is true that merely using the term “dyslexia” does not automatically evoke our understanding of what type of specific reading-related deficits the child is experiencing, which prevents him/her from reading effectively, it does alert us right away to the fact that a reading disability exists.
In this post, rather than utilizing the term “dyslexia”, I will use a more broad term “literacy deficits” to refer to children who develop trouble reading, writing, and spelling.
So who exactly are those children? Well, with respect to genetic inheritance, children with immediate and/or extended family members who have in the past received diagnoses such as “dyslexia”, “reading disability”, “learning disability” or who had experienced special education placements during school years are significantly more at risk of developing literacy based deficits than children with no history of above problems in the family.
Unfortunately, the situation is further complicated by the fact that some children with no recognizable family history of learning disabilities, may be at risk for future literacy deficits if they display a pattern of linguistic difficulties during early development (e.g., delayed developmental milestones).
Below is the approximate hierarchy of language development in young children:
- Exploration of the environment (early socio-emotional development)
- Play (continuation of socio-emotional development)
- Receptive Language
- Comprehension of words, phrases, sentences, stories
- Expressive Language
- Speaking single words, phrases, sentences, engaging in conversations, producing stories
- Social Emotional Development (Pragmatics) continues to be refined and becomes more sophisticated
- Words, sentences, short stories, chapter books, etc.
- General topics
- Domain specific topics (science, social studies, etc)
- Words, sentences, short stories, essays
The fact is that if the child experiences any deficits in the foundational language areas such as listening and speaking, s/he will most certainly experience difficulties in more complex areas of language: reading, writing, and spelling.
So now that we know that children with a history of language delay/disorder are at a significant risk of having the disorder turn into a learning disability when they’re older, let’s talk about how early can these children be assessed in order to better plan their future literacy based interventions for optimal functional outcomes.
The first scenario is a more obvious one. If a child has a documented history of language impairments and is receiving services from a very early age (e.g., early intervention, preschool, etc.) then given what we know about the connection between language disorders and learning disabilities, professionals can begin administering phonological awareness/emergent reading interventions during the early preschool years in order to optimally facilitate the child’s literacy outcomes.
Now our second scenario is not so clear-cut. In our second scenario, the child may have never been identified as having language difficulties during toddlerhood or even early preschool years. However, as the child grows older (e.g., 4-5 years of age) his/her parents may be noticing some subtle difficulties such as difficulty remembering nursery rhymes and songs, trouble remembering the letters of the alphabet, trouble recognizing simple rhyming words, etc. A such, even without a pertinent family history of literacy disabilities it may be important for a child to undergo an early literacy assessment in order to determine whether intervention is warranted.
Now let’s talk about various assessment options available for preschool children with suspected literacy deficits. Firstly, if the child has never received a language assessment it is paramount that the child’s language abilities in the areas of listening comprehension, verbal expression, problem-solving and social communication be assessed prior to assessment of literacy to ensure that the child does not present with any unrecognized/previously undetected deficits in any of the above areas. This is done in order to ensure optimal intervention outcomes as failure to address gaps/deficits in foundational language areas may significantly impede any potential literacy gains even when the child is provided with optimal literacy based interventions (click HERE to view my post discussing select speech-language tests for preschool children 2-6 years of age).
Now that we’ve covered some basics let us move on to discuss how early can select literacy tests be administered. Luckily, there are a number of tests pertaining to literacy which can be administered to children as young as 3:6 years of age.
To illustrate: The Auditory Skills Assessment (ASA) can be administered to children 3:6—6:11 years of age. Present controversy over CAPD notwithstanding, it does assess important areas related to early phonological awareness development including nonsense word repetition, phonemic blending, as well as rhyming.
The Comprehensive Test of Phonological Processing-2 (CTOPP-2), starts at 4 years of age and assesses such areas as:
- Phonological Segmentation
- Blending Words
- Sound Matching
- Initial, Medial and Final Phoneme Isolation
- Blending Nonwords*
- Segmenting Nonwords*
- Memory for Digits
- Nonword Repetition*
- Rapid Digit Naming
- Rapid Letter Naming
- Rapid Color Naming
- Rapid Object Naming
(Assesses the ability to manipulate real and *nonsense words)
(Assesses word fluency skills via a host of rapid naming tasks)
For children 4:6 years of age and older the Emerging Literacy & Language Assessment (ELLA) deserves a mention. It assesses the following literacy related abilities:
- Section 1 – Phonological Awareness and Flexibility assesses rhyming (awareness and production), initial sound identification, blending and segmenting sounds, words, and syllables, and deleting and substituting sounds in the initial and final positions of words.
- Section 2 – Sign and Symbol Recognition and Interpretation assesses environmental symbol identification, letter-symbol identification, word reference association, and reading comprehension for one to three sentences.
- Section 3 – Memory, Retrieval, and Automaticity assesses rapid naming, word associations (name items that start with the “S” sound), and story retell (includes three story levels based on the child’s age).
For children between 5:0-9:11 years of age, The Phonological Awareness Test-: NU (PAT 2: NU) assesses the following areas:
- Rhyming: Discrimination and Production—identify rhyming pairs and provide a rhyming word
- Segmentation: Sentences, Syllables, and Phonemes—dividing by words, syllables and phonemes
- Isolation: Initial, Final, Medial—identify sound position in words
- Deletion: Compound Words, Syllables, and Phonemes—manipulate root words, syllables, and phonemes in words
- Substitution With Manipulatives—isolate a phoneme in a word, then change it to another phoneme to form a new word
- Blending: Syllables and Phonemes—blend units of sound together to form words
- Graphemes—assess knowledge of sound/symbol correspondence for consonants, vowels, consonant blends, consonant digraphs, r-controlled vowels, vowel digraphs, and diphthongs
- Decoding—assess general knowledge of sound/symbol correspondence to blend sounds into nonsense words
- Invented Spelling (optional)—write words to dictation to show encoding ability
The new Test of Auditory Processing Skills-4 (TAPS-4) begins at 5 years of age and covers several areas pertaining to phonological awareness including word discrimination of words, phonological deletion and blending segmentation, as well as supplemental syllabic blending abilities.
Furthermore, starting from 5 years of age the Rapid Automatized Naming and Rapid Alternating Stimulus Test RAN/RAS tests can be administered in order to assess the child’s word fluency skills. Decreased word fluency is a significant indicator of reading deficits, which is why this ability is very important to test.
In addition to the above assessments, there are several tests of early reading and writing abilities which are available for younger children with suspected literacy deficitsThe Test of Early Reading Ability–Fourth Edition (TERA-4) assesses the emergent reading abilities of children starting from 4-0 years of age. Similarly, the Test of Early Written Language, Third Edition (TEWL-3) assesses the emergent writing abilities of children also starting from 4:0 years of age.
So there you have it! Now you know that if needed children as young 3:6 years of age can undergo early literacy assessments in order to determine their potential risk of developing literacy deficits when older.
Of course, due to the precociously young age of the children, it is important for examiners to exercise significant caution when it comes to interpretation of standardized testing results. It is a well-documented fact that standardized tests present with numerous limitations when it comes to identification of children with language and literacy disorders.
As such, due to the children’s young age there will be a number of instances when testing may reveal “false negative results” (show that there are no deficits when deficits still exist). Consequently, in such cases, it is important to carefully monitor the child’s school performance in order to perform a literacy reassessment (if needed) when the child is older and his/her difficulties may be more apparent (click HERE to view my 4-part post discussing Components of Comprehensive Dyslexia Testing for further details).
Finally, it is very important to reiterate that children presenting with language and literacy deficits will not outgrow these deficits on their own. While there may be periods of “illusory recovery” when it looks like children with early language disorders have caught up with their peers, such “spurts” are typically followed by a “post-spurt plateau” (Sun & Wallach, 2014). This is because due to the ongoing challenges and an increase in academic demands “many children with early language disorders fail to “outgrow” these difficulties or catch up with their typically developing peers” (Sun & Wallach, 2014). That is why it is crucial that we identify language and literacy deficits in children at a very early age in order to ensure their optimal educational outcomes.
- Components of Comprehensive Dyslexia Testing: Part I- Introduction and Language Testing
- Part II: Components of Comprehensive Dyslexia Testing – Phonological Awareness and Word Fluency Assessment
- Part III: Components of Comprehensive Dyslexia Testing – Reading Fluency and Reading Comprehension
- Part IV: Components of Comprehensive Dyslexia Testing – Writing and Spelling
- Review of the Test of Integrated Language and Literacy (TILLS)
- Special Education Disputes and Comprehensive Language Testing: What Parents, Attorneys, and Advocates Need to Know
- Why (C) APD Diagnosis is NOT Valid!
- What Are Speech Pathologists To Do If the (C)APD Diagnosis is NOT Valid?
- What do Auditory Memory Deficits Indicate in the Presence of Average General Language Scores?
- Why Are My Child’s Test Scores Dropping?
- Comprehensive Assessment of Adolescents with Suspected Language and Literacy Disorders
Helpful Smart Speech Therapy Resources Pertaining to Preschoolers:
- Pediatric History Questionnaire
- Speech Language Assessment Checklist For Preschool Children
- Language Processing Checklist for Preschool Children 3:0-5:11 Years of Age
- Social Pragmatic Deficits Checklist for Preschool Children
- Recognizing the Warning Signs of Social Emotional Difficulties in Language Impaired Toddlers and Preschoolers
- Narrative Assessment Bundle
- Behavior Management Strategies for Speech Language Pathologists
- Effective Behavior Management Techniques for Parents and Professionals
- Executive Function Impairments in At-Risk Pediatric Populations
- General Assessment and Treatment Start Up Bundle
- Comprehensive Assessment of Monolingual and Bilingual Children with Down Syndrome
- Multicultural Assessment Bundle
- Creating A Learning Rich Environment for Language Delayed Preschoolers
- Strategies of Language Facilitation with Picture Books For Parents and Professionals
- Assessment of sound and syllable imitation in Russian speaking infants and toddlers
- Russian Articulation Screener
So you’ve completed a thorough evaluation of your student’s speech and language abilities and are in the process of creating goals and objectives to target in sessions. The problem is that many of the students on our caseloads present with pervasive deficits in many areas of language.
While it’s perfectly acceptable to target just a few goals per session in order to collect good data, both research and clinical experience indicate that addressing goals comprehensively and thematically (the whole system or multiple goals at once from the areas of content, form, and use) via contextual language intervention vs. in isolation (small parts such as prepositions, pronouns, etc.) will bring about the quickest change and more permanent results.
So how can that be done? Well, for significantly language impaired students it’s very important to integrate semantic language components as well as verbal reasoning tasks into sessions no matter what type of language activity you are working on (such as listening comprehension, auditory processing, social inferencing and so on). The important part is to make sure that the complexity of the task is commensurate with the student’s level of abilities.
Let’s say you are working on a fall themed lesson plans which include topics such as apples and pumpkins. As you are working on targeting different language goals, just throw in a few extra components to the session and ask the child to make, produce, explain, list, describe, identify, or interpret:
- Associations (“We just read a book about pumpkin: What goes with a pumpkin?”)
- Synonyms (“It said the leaves felt rough, what’s another word for rough?”)
- Antonyms (“what is the opposite of rough?”)
- Attributes 5+ (category, function, location, appearance, accessory/necessity, composition) (“Pretend I don’t know what a pumpkin is, tell me everything you can think of about a pumpkin”)
- Multiple Meaning Words (“The word felt has two meanings, it could mean _____ and it could also mean _______”)
- Definitions (“what is a pumpkin”)
- Compare and Contrast (“How are pumpkin and apple alike? How are they different?”)
- Idiomatic expressions (“Do you know what the phrase turn into a pumpkin means?” )
Ask ‘why’ and ‘how’ questions in order to start teaching the student how to justify, rationalize, evaluate, and make judgments regarding presented information (“Why do you think we plant pumpkins in the spring and not in the fall?”)
Don’t forget the inferencing and predicting questions in order to further develop the client’s verbal reasoning abilities (“What do you think will happen if no one picks up the apples from the ground?)
If possible attempt to integrate components of social language into the session such as ask client to relate to a character in a story, interpret the character’s feelings (“How do you think the girl felt when her sisters made fun of her pumpkin?”), ideas and thoughts, or just read nonverbal social cues such as body language or facial expressions of characters in pictures.
Select materials which are both multipurpose and reusable as well as applicable to a variety of therapy goals. For example, let’s take a simple seasonal word wall such as the (free) Fall Word Wall from TPT by Pocketful of Centers. Print it out in color, cut out the word strips and note how many therapy activities you can target for articulation, language, fluency, literacy and phonological awareness, etc.
Practice Categorization skills via convergent and divergent naming activities: Name Fall words, Name Halloween/Thanksgiving Words, How many trees whose leaves change color can you name?, how many vegetables and fruits do we harvest in the fall? etc.
Practice naming Associations: what goes with a witch (broom), what goes with a squirrel (acorn), etc
Practice providing Attributes via naming category, function, location, parts, size, shape, color, composition, as well as accessory/necessity. For example, (I see a pumpkin. It’s a fruit/vegetable that you can plant, grow and eat. You find it on a farm. It’s round and orange and is the size of a ball. Inside the pumpkin are seeds. You can carve it and make a jack o lantern out of it).
Practice providing Definitions: Tell me what a skeleton is. Tell me what a scarecrow is.
Practice naming Similarities and Differences among semantically related items: How are pumpkin and apple alike? How are they different?
Practice explaining Multiple Meaning words: What are some meanings of the word bat, witch, clown, etc?
Practice Complex Sentence Formulation: what happens in the fall? Make up a sentence with the words scarecrow and unless, make up a sentence with the words skeleton and however, etc
Practice Rhyming words (you can do discrimination and production activities): cat/bat/ trick/leaf/ rake/moon
Practice Syllable and Phoneme Segmentation (I am going to say a word (e.g., leaf, corn, scarecrow, etc) and I want you to clap one time for each syllable or sound I say)
Practice Isolation of initial, medial, and final phonemes in words ( e.g., What is the beginning/final sound in apple, hay, pumpkin etc?) What is the middle sound in rake etc?
Practice Initial and Final Syllable and Phoneme Deletion in Words (Say spider! Now say it without the der, what do you have left? Say witch, now say it without the /ch/ what is left; say corn, now say it without the /n/, what is left?)
Practice production of select sounds/consonant clusters that you are working on or just production at word or sentence levels with those clients who just need a little bit more work in therapy increasing their intelligibility or sentence fluency.
So next time you are targeting your goals, see how you can integrate some of these suggestions into your data collection and let me know whether or not you’ve felt that it has enhanced your therapy sessions.
- Creating Functional Therapy Plan
- Selecting Clinical Materials for Pediatric Therapy
- Vocabulary Development: Working With Disadvantaged Populations
- General Assessment and Treatment Start-Up Bundle