As a speech-language pathologist (SLP) working in a psychiatric setting, I routinely address social pragmatic language goals as part of my clinical practice. Finding the right approach to the treatment of social pragmatic language disorders has been challenging to say the least. That is because the efficacy of social communication interventions continues to be quite limited. Studies to date continue to show questionable results and limited carryover, while measurements of improvement are frequently subjective, biased, and subject to a placebo effect, maturation effect, and regression to the mean. However, despite the significant challenges to clinical practice in this area, the usage of videos for treatment purposes shows an emergent promise. Continue reading On the Value of Social Pragmatic Interventions via Video Analysis
Today due to popular demand I am reviewing the Clinical Assessment of Pragmatics (CAPs) for children and young adults ages 7 – 18, developed by the Lavi Institute and sold by WPS Publishing. Readers of this blog are familiar with the fact that I specialize in working with children diagnosed with psychiatric impairments and behavioral and emotional difficulties. They are also aware that I am constantly on the lookout for good quality social communication assessments due to a notorious dearth of good quality instruments in this area of language. Continue reading Test Review: Clinical Assessment of Pragmatics (CAPs)
Today I am introducing my newest report template for the Test of Integrated Language and Literacy.
This 16-page fully editable report template discusses the testing results and includes the following components: Continue reading Editable Report Template and Tutorial for the Test of Integrated Language and Literacy
Those of you who read my blog on a semi-regular basis, know that I spend a considerable amount of time in both of my work settings (an outpatient school located in a psychiatric hospital as well as private practice), conducting language and literacy evaluations of preschool and school-aged children 3-18 years of age. During that process, I spend a significant amount of time reviewing outside speech and language evaluations. Interestingly, what I have been seeing is that no matter what the child’s age is (7 or 17), invariably some form of receptive and/or expressive vocabulary testing is always mentioned in their language report. Continue reading On the Limitations of Using Vocabulary Tests with School-Aged Students
In my last post, I described how I use obscurely worded newspaper headlines to improve my students’ interpretation of ambiguous and figurative language. Today, I wanted to further delve into this topic by describing the utility of interpreting music lyrics for language therapy purposes. I really like using music lyrics for language treatment purposes. Not only do my students and I get to listen to really cool music, but we also get an opportunity to define a variety of literary devices (e.g., hyperboles, similes, metaphors, etc.) as well as identify them and interpret their meaning in music lyrics. Continue reading What are They Trying To Say? Interpreting Music Lyrics for Figurative Language Acquisition Purposes
Many of my students with Developmental Language Disorders (DLD) lack insight and have poorly developed metalinguistic (the ability to think about and discuss language) and metacognitive (think about and reflect upon own thinking) skills. This, of course, creates a significant challenge for them in both social and academic settings. Not only do they have a poorly developed inner dialogue for critical thinking purposes but they also because they present with significant self-monitoring and self-correcting challenges during speaking and reading tasks. Continue reading Have I Got This Right? Developing Self-Questioning to Improve Metacognitive and Metalinguistic Skills
Because the children I assess, often require supplementary reading instruction services, many parents frequently ask me how they can best determine if a reading specialist has the right experience to help their child learn how to read. So today’s blog post describes what type of knowledge reading specialists ought to possess and what type of questions parents (and other professionals) can ask them in order to determine their approaches to treating literacy-related difficulties of struggling learners. Continue reading Dear Reading Specialist, May I Ask You a Few Questions?
Recently I did a presentation for Rutgers University on the subject of “Speech, Language, & Literacy Disorders in School-Aged Children with Psychiatric Impairments“. The learning objectives for this presentation were as follows:
- Explain the comorbidity between language impairments and psychiatric disturbances of school-aged children
- Describe language and literacy deficits of school-aged children with psychiatric impairments
- List warning signs of language and literacy deficits in school-aged children that warrant a referral to speech-language pathologists for a potential assessment
A substantial portion of my caseload is comprised of adolescent learners. Since standardized assessments possess significant limitations for that age group (as well as in general), I am frequently on the lookout for qualitative clinical measures that can accurately capture their abilities in the areas of discourse, critical thinking, and social communication.
One type of an assessment that I find particularly valuable for this age group is a set of two Peer Conflict Resolution Tasks. First described in a 2007 article by Dr. Marylin Nippold and her colleagues, they assess expository discourse of adolescent learners. Continue reading Analyzing Discourse Abilities of Adolescents via Peer Conflict Resolution (PCR) Tasks
When it comes to the identification of social communication deficits, SLPs are in a perpetual search for quick and reliable strategies that can assist us in our quest of valid and reliable confirmation of social communication difficulties. The problem is that in some situations, it is not always functional to conduct a standardized assessment, while in others a standardized assessment may have limited value (e.g., if the test doesn’t assess or limitedly assesses social communication abilities).
So what type of tasks are sensitive to social communication deficits? Quite a few, actually. For starters, various types of narratives are quite sensitive to social communication impairment. From fictional to expository, narrative analysis can go a long way in determining whether the student presents with appropriate sequencing skills, adequate working memory, age-level grammar, and syntax, adequate vocabulary, pragmatics, perspective taking abilities, critical thinking skills, etc. But what if one doesn’t have the time to record and transcribe a narrative retelling, what then? Actually, a modified version of a narrative assessment task can still reveal a great deal about the student’s social communication abilities.
For the purpose of this particular task, I like to use photos depicting complex social communication scenarios. Then I simply ask the student: “Please describe what is happening in this photo.” Wait a second you may say: “That’s it? This is way too simple! You can’t possibly determine if someone has social communication deficits based on a single photo description!”
I beg to differ. Here’s an interesting fact about students with social communication deficits. Even the ones with FSIQ in the superior range of functioning (>130) with exceptionally large lexicons, still present with massive deficits when it comes to providing coherent and cohesive descriptions and summaries.
Here are just a few reasons why this happens. Research indicates that students with social communication difficulties present with Gestalt Processing deficits or difficulty “seeing/grasping the big picture”(Happe & Frith, 2006). Rather than focusing on the main idea, they tend to focus on isolated details due to which they have a tendency to provide an incomplete/partial information about visual scenes, books, passages, stories, or movies. As such, despite possessing an impressive lexicon, such students may say about the above picture: “She is drawing” or “They are outside” and omit a number of relevant to the picture details.
Research also confirms that another difficulty that students with impaired social communication abilities present with is assuming perspectives of others (e.g., relating to others, understanding/interpreting their beliefs, thoughts, feelings, etc.) (Kaland et al, 2007). As such they may miss relevant visual clues pertaining to how the boy and girl are feeling, what they are thinking, etc.
Students with social communication deficits also present with anaphoric referencing difficulties. Rather than referring to individuals in books and pictures by name or gender, they may nonspecifically utilize personal pronouns ‘he’, ‘she’ or ‘they’ to refer to them. Consequently, they may describe the individuals in the above photo as follows: “She is drawing and the boy is looking”; or “They are sitting at the table outside.”
Finally, students with social communication deficits may produce poorly constructed run-on (exceedingly verbose) or fragmented utterances (very brief) lacking in coherence and cohesion to describe the main idea in the above scenario (Frith, 1989).
Of course, by now many of you want to know regarding what constitutes as pragmatically appropriate descriptions for students of varying ages. For that, you can visit a thread in the SLPs for Evidence-Based Practice Group on Facebook entitled: GIANT POST WITH FREE LINKS AND RESOURCES ON THE TOPIC OF TYPICAL SPEECH AND LANGUAGE MILESTONES OF CHILDREN 0-21 YEARS OF AGE to locate the relevant milestones by age.
Interested in seeing these assessment strategies in action? Download a FREEBIE HERE and see for yourselves.
- Frith, U., (1989). Autism: Explaining the Enigma. Blackwell, Oxford.
- Happe, F. & Frith, U. (2006). The weak coherence account: Detail-focused cognitive style in Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 36 (1), 5-25.
- Kaland, N., Callesen, K., Moller-Nielsen, A., Mortensen, E. L., & Smith, L. (2007). Performance of children and adolescents with Asperger Syndrome or High-functioning Autism on advanced theory of mind tasks. Journal of Autism and Developmental Disorders. 38, 1112-1123.