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Why “good grades” do not automatically rule out “adverse educational impact”

Image result for good grades?As a speech-language pathologist (SLP) working with school-age children, I frequently assess students whose language and literacy abilities adversely impact their academic functioning.   For the parents of school-aged children with suspected language and literacy deficits as well as for the SLPs tasked with screening and evaluating them, the concept of ‘academic impact’ comes up on daily basis. In fact, not a day goes by when I do not see a variation of the following question: “Is there evidence of academic impact?”, being discussed in a variety of Facebook groups dedicated to speech pathology issues.

At first glance, the issue of academic impact appears to be rather straightforward. For example, many SLPs will readily assert that if a child is receiving good grades (A’s and B’s) in the school setting and is not exhibiting any “significant” maladaptive and challenging behaviors, then there is no evidence of adverse academic impact, and screening/evaluation/intervention services are unnecessary.

Unfortunately, things are not as “crystal clear” as they appear. That is because of the relative subjectivity pertaining to the grading practices of the students’ work in the school setting. Now, before you accuse me of inventing a problem where there is none, please hear me out.

In this post, I would like to illustrate how the subjectivity of grading practices can obfuscate the issue of academic impact to such an extent that students with significant language and learning needs may not be identified as being in need of help until it’s far too late – if identified at all.

Related imageLet’s begin with reading, an incredibly complex and deeply misunderstood process, especially in settings which do not utilize scientifically informed practices (e.g., synthetic phonics) when teaching young children to read.  When it comes to the teaching and assessment of reading, it is an absolute Wild West out there! And no one is more familiar with it, than parents of reading impaired children.

One of the first things these parents notice about their children in the early grades is that their reading abilities are highly inconsistent and are not commensurate with those of their peers.  These parents will notice that it takes their kids an extraordinary amount of time to master the alphabetic principle (remember the letters of the alphabet, match letters to sounds, etc.). They will notice that their children have an extraordinarily difficult time blending simple three letter words involving initial and final consonants with a medial vowel (e.g., “nob”). They will complain that their children display inconsistent knowledge of “sight words” from day to day, as well as misread and skip words when reading.

Here is the problem though, unless objective measures are used to test their children’s phonemic awareness and phonics abilities, there is a very strong possibility that these issues will persist well into upper elementary years, completely unnoticed in the school system, given the subjectivity involved in assessing reading mastery.

Indeed, numerous studies highlight the lack of efficacy of build-in assessments in programs such as Fountas and Pinnell, Reading Recovery, as well as the utility of utilizing Running Records, for reading assessment purposes.  My clinical observations of struggling readers in a variety of school settings, as part of the independent evaluation process, certainly support and corroborate available research on the subject. Namely, in many educational disputes, there’s a significant mismatch between teacher claims “S/he is reading at grade level as per (insert subjective method here)”  and observed student’s abilities (child is functionally illiterate) during reading tasks in the classroom. 

Related imageNow, let’s move on to discuss the subjectivity of the weekly spelling test. A number of scientific studies on this subject have shown that spelling instruction needs to be direct, explicit and systematic in order to be effective for struggling learners. When teaching spelling, best instruction practices involve consistently addressing and grouping words according to specific spelling patterns rather than teaching random “grade level” or topically related words. However, in the vast majority of instances, the weekly spelling test continues to consist of random words which are expected to be memorized by students. As a result of these memorization practices, numerous students will attain high marks on spelling tests but will be absolutely unable to correctly spell these words in a variety of writing assignments even a week later.

Image result for children taking a testThe practice of teaching to the test is certainly not restricted to spelling.  I have also seen similar practices pertaining to the subjects of science and social studies, whereas children are provided with specific handouts pertaining to a particular topic to memorize for the test. While this allows these children to perform well on such tests, unfortunately, their topic knowledge remains minimal to nonexistent given the fact that the memorized information will be long forgotten in a period of just a few weeks, if not sooner.

Similarly, science projects and social studies book reports may not even be necessarily completed by the children themselves. Many parents of struggling learners will readily acknowledge the mammoth work they had contributed to such projects just so their children could attain good marks which were worth a significant percentage of the overall class grade.

Many parents of struggling learners will also readily admit their significant involvement in the homework process and how stressful and frustrating it is on the students. They report spending numerous hours each day explaining information, their children’s tears of frustration and rage, significant tantrum behavior, and in some extreme cases even visits to a hospital, subsequent to accidental injuries stemming from challenging behaviors.

Finally, the subjectivity of grading written assignments is another important factor that needs to be explicitly acknowledged. Many parents and professionals tasked with the evaluation of the students’ spontaneous written work will readily confirm that oftentimes the grades some struggling learners receive on written assignments appear to be almost ridiculously overinflated.  Despite seemingly clear rubrics provided to the students explaining the breakdown of points for a particular written composition, many students end up receiving much higher marks than they deserve.  I myself have observed this phenomenon firsthand by reviewing the written work of my clients in private practice following parental complaints of grade inflation.

Related imageWe’re talking essays, blatantly lacking in coherence and cohesion, peppered with run-on and fragmented sentences, lacking subject-verb agreement, and full of grammatical errors, given A- and B+ grades, when the grading rubrics which came with the assignment, clearly indicate that the work is at the best deserving of a C- or a D+ grade.

These are just some of the many reasons why students of all ages with very noticeable language and learning needs, may end up being denied much-needed language and literacy assessments to determine the extent of their difficulties in order to receive targeted assistance.

Further complicating this issue is the fact that even when these students are finally tested in the school setting, due to the relative “mildness”  of their deficits,  coupled with the use of general (vs. targeted), often psychometrically weak tests, a lack of or under-identification of their deficit areas often occurs.

So what can parents and professionals do with this information? For starters, all are encouraged to examine the available information through a critical lens, albeit in different ways. Parents are encouraged to collect the samples of the child’s work (independent writing and spelling, audio samples of their reading, etc.) highlighting the discrepancies between the grades they receive and their actual abilities. They should absolutely request child study team assessments and if they are unsatisfied with the results of those tests they can seek out independent evaluations pertaining to the child’s areas of concern.

Image result for high sensitivity high specificitySimilarly, SLPs are encouraged to review their testing practices to ensure that they accurately reflect the students’ deficit areas. They are also strongly encouraged to review the psychometric properties of the tests they are using to better understand the sensitivity and specificity of these instruments with respect to the appropriate identification of language disorders. Finally, SLPs are strongly encouraged to familiarize themselves with the language and literacy expectations of older students and utilize clinical assessment procedures which reflect more sensitive assessment practices.

Image result for falling dominoesSo the next time someone has concerns regarding the language and literacy abilities of students with seemingly good grades, do not be so hasty in dismissing their worries due to a “lack of academic impact”. Depending on the setting and testing in question,  that impact may be far greater than we know!

Helpful Related Posts: 

  1. Special Education Disputes and Comprehensive Language Testing: What Parents, Attorneys, and Advocates Need to Know
  2. What Makes an Independent Speech-Language-Literacy Evaluation a GOOD Evaluation?
  3. What Research Shows About the Functional Relevance of Standardized Language Tests
  4. Part II: Components of Comprehensive Dyslexia Testing – Phonological Awareness and Word Fluency Assessment
  5. On the Limitations of Using Vocabulary Tests with School-Aged Students
  6. It’s All Due to …Language: How Subtle Symptoms Can Cause Serious Academic Deficits
  7. Dear Reading Specialist, May I Ask You a Few Questions?
  8. Help, My Student has a Huge Score Discrepancy Between Tests and I Don’t Know Why?
  9.  The Reign of the Problematic PLS-5 and the Rise of the Hyperintelligent Potato
  10. Components of Qualitative Writing Assessments: What Exactly are We Trying to Measure?

 

 

 

 

 

 

 

 

 

 

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Editable Report Template and Tutorial for the Test of Integrated Language and Literacy

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:

  • Table of testing results
  • Recommendations for using severity ratings of percentile ranks
  • Recommendations of which information to include in the background history section of the report
  • Teacher Interview Samples for Adolescent and Elementary Aged Students
  • Classroom Observations Sample
  • Adaptive behavior section sample
  • Assessment findings
    • All subtests descriptions
    • Extensive descriptions of how to analyze error patterns on all subtests
    • Descriptions of how to analyze scenarios when a student obtains average performance but it contradicts academic functioning.
    • Elaborations regarding specific subtests, weaknesses on which are not as apparent or straightforward (e.g., Nonword Repetition, Following Directions, etc.)
    • Recommendations for supplemental testing when the performance on select subtests (e.g., Social Communication) is within the average range despite glaring weaknesses
    • Extensive error descriptions that can be found on the Reading Fluency subtest
    • Extensive footnotes with clarifying information
    • Links to a variety of TILLS FREE tutorials created by the authors
    • Impressions section formulation
    • Possible ICD-10 diagnoses that can result based on TILLS assessment
    • Accommodations Section
    • Adaptive Recommendations Section
    • Maintaining Factors Section
    • Suggested Therapy Long and Short Term Goals Sampler for
      • Listening Comprehension
      • Oral Communication
      • Social Communication
      • Phonological Awareness
      • Phonics
      • Reading Fluency
      • Reading Comprehension
      • Spelling
      • Writing Conventions
      • Writing Composition
      • Reward System and Rationale
      • Expected duration of treatment
      • Prognosis
      • Therapy Discharge Recommendations

You can access it HERE in my online store.  My review of the TILLS is available HERE 

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On the Limitations of Using Vocabulary Tests with School-Aged Students

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.

Many of you may be wondering, “What’s wrong with having a vocabulary test as part of an assessment battery? Isn’t vocabulary hugely correlated with both language and literacy outcomes?”  The answer is, “It is more complicated than that.” Here’s why.

Children with robust lexicons formulate longer sentences and more interesting stories, better comprehend complex texts, and even compensate to some degree for reading deficits (Colozzo et al, 2011Law and Edwards, 2015; Rvachew and Grawburg, 2006).

In contrast, studies have found that children with Developmental Language Disorder (DLD) (formerly known as Specific Language Impairment or SLI) have limited expressive vocabularies (Leonard, 2014), have trouble learning new words (Alt & Spaulding, 2011; Storkel et al, 2016), and have clinically significant word retrieval deficits (Dockrell, Messer, George, & Wilson, 1998).

Due to these deficits, one-word vocabulary tests are often used in the assessment process to qualify children for speech and language services (Betz, Eickhoff, & Sullivan, 2013). However, studies have found that single word vocabulary tests have poor psychometric properties and/or are not representative of linguistic competence embedded in life-activities (Gray et al., 1999; Ukrainetz & Blomquist, 2002; Bogue, DeThorne, Schaefer, 2014).

Furthermore, because of this, single word vocabulary tests can overinflate testing scores and not represent the child’s true expressive language competence. Finally, even when a student truly has solid or even superior vocabulary knowledge and naming skills, doesn’t mean that s/he can effectively utilize these abilities during the narrative production as well as reading and writing tasks.

Image result for test resultsDon’t believe me?  Consider reviewing language evaluations of current or former students who received outstanding scores on one-word vocabulary tests, yet who were unable to utilize these words to perform semantic flexibility tasks (e.g., name antonyms, synonyms, provide clear definitions as well as define multiple meaning words), produce coherent and cohesive narratives, comprehend these words in the context of read texts, or utilize them during writing composition tasks.

The problem is that numerous SLPs overuse these tests and rely on them for qualification purposes when diagnosing language impairment (Betz, Eickhoff, & Sullivan, 2013). However, the practice of qualifying students based on single-word vocabulary testing in conjunction with psychometrically weak comprehensive testing (visit HERE for a compilation of psychometric data on major SLP testing), can often result in many language-impaired students not being qualified for language therapy services despite desperately needing them.

Image result for informed decisionNow it’s important to understand that I am not recommending elimination of vocabulary tests from SLP assessment batteries.  I am merely suggesting that SLPs use these tests wisely during the assessment process, and utilize them with children who truly benefit from their administration. Such populations include toddlers and preschoolers (under 5 years of age) as well as any children presenting with severe language deficits regardless of age, secondary to intellectual and neuro/developmental impairments such as ASD, DS, FXS, FASD, etc.  They are especially relevant for children with limited vocabularies who are unable to effectively participate in semantic flexibility tasks or produce narratives. As such, we want to learn more about the types of words they know and use on a daily basis to express their wants/needs, so we can increase their lexicon for functional communication purposes and prepare them for effective engagement in both semantic flexibility as well as narrative tasks, in order to further improve their language abilities.

In contrast, for children age 5-6 and older, it is far more practical for SLPs to functionally determine their linguistic flexibility skills as pertaining to the use of language.  This can be accomplished via standardized as well as informal measures. As mentioned above, broadly speaking, linguistic flexibility tasks focus on the manipulation of language.  Tasks such as generation of attributes, production of synonyms and antonyms, formulation of clear and precise definitions of words as well as explanations of multiple meaning, figurative, and ambiguous words and sentences are all examples of language manipulation tasks.

As such, these tasks are far more representative of the student’s language ability in an academic setting versus selecting a picture out of a visual field of four items (receptive identification) or naming a word in the presented picture (expressive generation).

Now there are numerous tests which possess subtests relevant to this purpose.  I, personally, often use select subtests from the below tests:

  • The WORD Tests (Elementary and Adolescent)
    • Associations
    • Antonyms
    • Synonyms
    • Definitions
    • Flexible Meanings
  • Language Processing Test – 3 (LPT-3)
    • Similarities and Differences
    • Multiple Meaning Words
    • Attributes
  • Expressive Language Test – 2 (ELT-2)
    • Metalinguistics
    • Defining Categories
  • Test of Integrated Language and Literacy 
    • Vocabulary Awareness
  • Clinical Evaluation of Language Fundamentals – 5 Metalinguistics (CELF-5M)
    • Multiple Meanings
    • Figurative Language

There are a number of other tests which contain subtests suitable for this purpose. SLPs can also easily create their own informal assessment procedures, similar to the above, for clinical assessment purposes.

However, even these tasks, though a huge improvement over one-word vocabulary tests are not sufficient. In addition to these, research strongly recommends the inclusion of narrative assessment (which is highly correlated with social, reading, as well as academic outcomes), as part of SLP assessment battery.

Related imageNarrative language skills have routinely been identified as one of the single best predictors of future academic success (Bishop & Edmundson, 1987; Feegans & Appelbaum 1986; Dickinson and McCabe, 2001). Language produced during story retelling is positively related to monolingual and bilingual reading achievement (Reese et al, 2010; Miller et al, 2006) Narratives provide insights into child’s verbal expression by tapping into multiple language features and organizational abilities simultaneously (Hoffman, 2009; Ukrainetz, 2006;Bliss & McCabe, 2012). They encompass a number of higher-level language and cognitive skills (Paul et al, 1996) such as event sequencing, text cohesiveness, use of precise vocabulary to convey ideas without visual support, comprehension of cause-effect relationships, etc. Narratives bridge the gap between oral and written language and are needed for solid reading and writing development (Snow et al, 1998).

Contrastingly, poor discourse and narrative abilities place children at risk for learning and literacy-related difficulties including reading problems (McCabe & Rosenthal-Rollins, 1994), while narrative weaknesses significantly correlate with social communication deficits (Norbury, Gemmell & Paul, 2014). As a result, narrative analyses help SLPs with distinguishing children with DLD from their typically developing (TD) peers (Allen et al 2012).

So the next time you are tasked with selecting appropriate language testing to determine whether a student presents with language and literacy deficits, don’t be so hasty in picking up that single-word vocabulary test.  Take a moment to carefully consider its utility for the student in question. After all, it may very well be a determining factor in deciding whether the student will qualify for language therapy services.

References: 

  1. Allen, M,  Ukrainetz, T & Carswell, A (2012) The narrative language performance of three types of at-risk first-grade readersLanguage, Speech, and Hearing Services in Schools, 43(2), 205-221.
  2. Alt, M., & Spaulding, T. (2011). The effect of time on word learning: An examination of decay of the memory trace and vocal rehearsal in children with and without specific language impairmentJournal of Communication Disorders44(6), 640–654
  3. Betz, Eickhoff, & Sullivan,( 2013) Factors Influencing the Selection of Standardized Tests for the Diagnosis of Specific Language Impairment. Language, Speech, and Hearing Services in Schools, 44, 133-146.
  4. Bishop, D. V. M., & Edmundson, A. (1987). Language-impaired 4-year-olds: Distinguishing transient from persistent impairment. Journal of Speech and Hearing Disorders, 52, 156–173.
  5. Bliss, L. & McCabe, A (2012, Oct) Personal Narratives: Assessment and InterventionPerspectives on Language Learning and Education. 19:130-138.
  6. Bogue, E. L., DeThorne, L. S., & Schaefer, B. A. (2014). A psychometric analysis of childhood vocabulary tests. Contemporary Issues in Communication Science and Disorders, 41, 55-69.
  7. Colozzo, P., Gillam, R. B., Wood, M., Schnell, R. D., & Johnston, J. R. (2011). Content and form in the narratives of children with specific language impairment. Journal of Speech, Language, and Hearing Research, 54(6), 1609-1627.
  8. Dickinson D. K., McCabe A. (2001). Bringing it all together: the multiple origins, skills and environmental supports of early literacy. Learning Disabilities Research and Practice. 16, 186–202.
  9. Dockrell, J. E., Messer, D., George, R., & Wilson, G. (1998). Children with word-finding difficulties: Prevalence, presentation and naming problems. International Journal of Language & Communication Disorders, 33, 445–454.
  10. Feegans, L.,& Appelbaum, M (1986). Validation of language subtypes in learning disabled childrenJournal of Educational Psychology78, 358–364.
  11. Gray, S., Plante, E., Vance, R., & Henrichsen, M. (1999). The diagnostic accuracy of four vocabulary tests administered to preschool-age children. Language, Speech, and Hearing Services in Schools30(2), 196–206.
  12. Hoffman, L. M. (2009). Narrative language intervention intensity and dosage: Telling the whole story. Topics in Language Disorders29, 329–343.
  13. Law, F., II, & Edwards, J.R. (2015). Effects of vocabulary size on online lexical processing by preschoolers. Language Learning and Development11, 331–355.
  14. Leonard, L. B. (2014). Children with specific language impairment. Cambridge, MA: MIT Press.
  15. McCabe, A., & Rollins, P. R. (1994). Assessment of preschool narrative skills. American Journal of Speech-Language Pathology, 3(1), 45–56
  16. Miller, J et al (2006). Oral language and reading in bilingual childrenLearning Disabilities Research and Practice, 21, 30–43
  17. Norbury, C. F., Gemmell, T., & Paul, R. (2014). Pragmatics abilities in narrative production: a cross-disorder comparison. Journal of child language, 41(03), 485-510.
  18. Paul R, Hernandez R, Taylor L, Johnson K. (1996) Narrative development in late talkers: early school age. Journal of Speech and Hearing Research, 39(6):1295–1303
  19. Reese E., Suggate S., Long J., Schaughency E. (2010). Children’s oral narrative and reading skills in the first three years of reading instruction. Reading & Writing: An Interdisciplinary Journal, 23, 627–644.
  20. Rvachew S., Grawburg M. (2006). Correlates of phonological awareness in preschoolers with speech sound disorders. Journal of Speech, Language, and Hearing Research, 49: 74–87.
  21. Snow, C.E., Burns, M.S., & Griffin, P. (eds.) (1998). Preventing reading difficulties in young children. Washington, DC: National Academy Press
  22. Ukrainetz, T. A. (2006). Teaching narrative structure: Coherence, cohesion, and captivation. In T. A. Ukrainetz (Ed.), Contextualized language intervention: Scaffolding PreK–12 literacy achievement (pp. 195–246). Austin, TX: Pro-Ed.
  23. Ukrainetz, T. A., & Blomquist, C. (2002). The criterion validity of four vocabulary tests compared with a language
    sample. Child Language Teaching and Therapy, 18, 59–78.

 

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What are They Trying To Say? Interpreting Music Lyrics for Figurative Language Acquisition Purposes

Image result for music lyricsIn 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.

Lyrics interpretation is a complex task.   There is definitely a myriad of ways one can interpret the lyrics of a particular song, the sky is the limit!  As such, I am always mindful of the complexity of this task and typically tend to target this as a language goal with my adolescent students.  I don’t always target the interpretation of lyrics in the entire song, especially because many great recording artists use quite a healthy amount of profanities in their lyrics that I do not necessarily want the students to hear. As such, I may play portions of songs or present clean versions of lyrics to my students for their interpretation. Prior to choosing particular lyrics I typically review the following wikiHow article: How to Figure Out a Song’s Meaning as it provides some helpful advice to students regarding the parameters which they could use to analyze music lyrics.

Typically, I like to approach language goals pertaining to music lyrics interpretation, thematically. So, if I am working with my students on the identification of particular literary devices/figurative language, I will use that opportunity to introduce a variety of songs containing that particular literary device.

To illustrate, if my students are working on the identification and description of 1hyperboles, I will locate a number of songs containing hyperboles for them to identify and utilize in a variety of contexts.

Working on 2alliteration? There are plenty of songs available on this topic.

Looking for songs that utilize 3similes? There are literally so many of them! You can find them HERE, HERE, and HERE for starters.

How about 4metaphors? Sure thing!Image result for metaphors and similes

5Personification? Oh, yes, plenty of sources!

6Onomatopoeia?  Ono mono, no problem! 

Finally, how about some 7 irony? Definitely got it!

Now that we have identified just some of the potential sources we can use for this purpose,  let me describe how I address this goal with my students. Prior to initiating a unit on the interpretation of music lyrics, I typically ensure that my students are highly familiar with the expected literary terms (e.g., similes, metaphors, personification, alliteration, onomatopoeia, hyperboles, as well as irony).  We use a variety of worksheets at first, then find these terms in a variety of texts, and later transition to using the above terms in conversational exchanges via oral and written sentence formulation tasks.

Some basic questions to ask the students:

  • What is figurative language?
  • What are the most common figurative language types? (metaphors and similes)
  • What is a metaphor? (definition)
  • Can you give me some examples of metaphors?
  • What is a simile? (definition)
  • Can you give me some examples of similes?
  • What are some other examples of figurative language?  (ask for definitions and examples of personification, alliteration etc.)
  • Why do songwriters use figurative language in their lyrics?

After ensuring that my students have the solid knowledge of definitions and can use examples of these terms in sentences, I introduce them to the mutually selected music videos and ask them whether they know what the lyrics signify. Many of my students frequently report that while they had memorized some of the lyrics in the past, they’ve never actually thought about their meaning.  After listening to a portion of the video/audio I then present the words in writing and ask them to answer a few questions.

For example, after listening to “Tik Tok” by Ke$ha I will ask them: “What type of figurative language is Ke$ha using here?’

“Tick! Tock! on the clock but the party don’t stop”. 

What makes it __________?

Image result for lyric writingIn addition to defining the literary terms, locating their examples of music lyrics, using them in sentences, etc. there are numerous other extension activities that SLPs could use for the purpose of targeting this goal.  One suggestion is to ask the students to create their own simple music lyrics utilizing figurative language and then have them explain their songwriting process.

There are numerous fun and educational activities which can be targeted via this goal with the help of the selected FREE resources below. So if you didn’t get a chance to target this therapy goal in sessions, give it a try. It definitely goes a long way toward improving our students metacognitive and metalinguistic abilities for social and academic purposes.

Helpful FREE Online Resources:

Helpful FREE TPT Worksheets

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Have I Got This Right? Developing Self-Questioning to Improve Metacognitive and Metalinguistic Skills

Image result for ambiguousMany 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.

There are numerous therapeutic goals suitable for improving metalinguistic and metacognitive abilities for social and academic purposes. These include repairing communicative breakdowns, adjusting tone of voice to different audiences, repairing syntactically, pragmatically, and semantically incorrect sentences, producing definitions of various figurative language expressions, and much, much more. However, there is one goal, which both my students and I find particularly useful, and fun, for this purpose and that is the interpretation of ambiguously worded sentences.

Image result for amphibologySyntactic ambiguity, or amphibology, occurs when a sentence could be interpreted by the listener in a variety of ways due to its ambiguous structure.  Typically, this occurs not due to the range of meanings of single words in a sentence (lexical ambiguity), but rather due to the relationship between the words and clauses in the presented sentence.

This deceptively simple-looking task is actually far more complex than the students realize.  It requires a solid vocabulary base as well as good manipulation of language in order for the students to formulate coherent and cohesive explanations that do not utilize and reuse too many parts of the original ambiguously worded sentence.

Very generally speaking, sentence ambiguities can be local or global.  If a sentence is locally ambiguous (aka “garden path”), the listeners’ confusion will be cleared once they heard the entire sentence.   However, if a sentence is globally ambiguous, then it will continue to remain ambiguous even after its heard in its entirety.

Lets’ take a look at an example of an ambiguously worded global phrase, which I’ve read, while walking on the beach during my vacation: ‘Octopus Boarding’.  Seems innocuous enough, right?  Well, as adults we can immediately come up with a myriad of explanations.  Perhaps that particular spot was a place where people boarded up their octopedes into boxes.  Perhaps, the sign indicated that this was a boarding house for octopedes where they could obtain room and board. Still, another explanation is that this is where octopedes went to boarding school, and so on and so forth.  By now you are probably mildly intrigued and would like to find out what the sign actually meant.  In this particular case, it was an indication that this was a location for a boarding of the catamaran entitled, you guessed it, Octopus!

Of course, when I presented the written text (without the picture) to my 13-year-old adolescent students, they had an incredibly difficult time generating even one, much less several explanations of what this ambiguously-phrased statement actually meant. This, of course, gave me the idea not only to have them work on this goal but to A. create a list of globally syntactically ambiguously worded sentences; b. locate websites containing many more ambiguously worded sentences, so I could share them with my fellow SLPs.  A word of caution, though! Make sure to screen the below sentences and website links very carefully in order to determine their suitability for your students in terms of complexity as well as subject matter (use of profanities; adult subject matter, etc.).

Below are 20 ambiguously worded newspaper and advertisement headlines for your use from a variety of online sources.Image result for ambiguous sentences

  1. The professor said on Monday he would give an exam.
  2. The chicken is ready to eat.
  3. The burglar threatened the student with the knife.
  4. Visiting relatives can be boring.
  5. I saw the man with the binoculars 
  6. Look at that bird with one eye 
  7. I watched her duck 
  8. The peasants are revolting 
  9. I saw a man on a hill with a telescope.
  10. He fed her cat food.
  11. Police helps dog bite victim
  12.  Enraged cow injures farmer with ax
  13. Court to try shooting defendant
  14. Stolen painting found by tree
  15. Two sisters reunited after 18 years in checkout counter
  16. Killer sentenced to die for second time in 10 years
  17. Most parents and doctors trust Tylenol
  18. Come meet our new French pastry chef
  19. Robert went to the bank. 
  20. I shot an elephant in my pajamas.

You can find hundreds more ambiguously worded sentences in the below links.

  1. Ambiguous newspaper headlines  Catanduanes Tribune (32 sentences)
  2. Ambiguous Headlines   Fun with Words Website (33 sentences)
  3. Actual Newspaper Headlines davidvanalstyne.com website (~100 sentences; *contains adult subject matter)
  4. Linguistic Humor Headlines  Univ. of Penn. Dept of Linguistics (~120 sentences)
  5. Bonus: Ambiguous words  Dillfrog Muse rhyming dictionary, which happens to be a really cool site  which you should absolutely check out.

Interested in creating your own ambiguous sentences? Here is some quick advice, use a telegraphic style and omit the copulas, which will, in turn, create a syntactic ambiguity.

Image result for goalsSo now that they have this plethora of sentences to choose from, here’s a quick example of how I approach ambiguous sentence interpretation in my sessions. First, I provide the students with a definition and explain that these sentences could mean different things depending on their context. Then, I provide a few examples of ambiguously worded sentences and generate clear, coherent and cohesive explanations regarding their different meanings.

For example, let’s use sentence # 18 on my list: ‘Robert went to the bank’.  Here I may explain, that ‘Robert went to visit his financial institution where he keeps his money‘, or ‘Robert went to the bank of a river, perhaps to do some fishing‘. Of course, the language that I use with my students varies with their age and level of cognitive and linguistic abilities. I may use the word ‘financial institution’, with a 14-year-old, but use the explanation, ‘a bank where Robert keeps his money’ with a 10-year-old.

Then I provide my students with select sentences (I try to arrange them in a hierarchy from simple to more complex) and ask them to generate their own explanations of what the sentences could potentially mean.  I also make sure to provide them with plenty of prompts, cues, as well as scaffolding to ensure that their experience success in their explanations.

Image result for read it write it learn itHowever, I don’t just stop with the oral portion of this goal. Its literacy-based extensions include having the students read the sentences rather than have me present them orally. Furthermore, once the students have provided me with two satisfactory explanations of the presented ambiguous sentence, I ask them to select at least one explanation and clarify it in writing, so the meaning of the sentence becomes clear.

I find that this goal goes a long way in promoting my students metalinguistic and metacognitive abilities, deepens their insight into their own strengths and weaknesses, as well as facilitates critical thinking in the form of constant self-questioning as well as the evaluation of self-produced information.  Even students as young as 8-9 years of age can benefit significantly from this goal if adapted correctly to meet their linguistic needs.

So give it a try, and let me know what you think!

 

 

 

 

 

 

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Components of Qualitative Writing Assessments: What Exactly are We Trying to Measure?

Writing! The one assessment area that challenges many SLPs on daily basis! If one polls 10 SLPs on the topic of writing, one will get 10 completely different responses ranging from agreement and rejection to the diverse opinions regarding what should actually be assessed and how exactly it should be accomplished.

Consequently, today I wanted to focus on the basics involved in the assessment of adolescent writing. Why adolescents you may ask? Well, frankly because many SLPs (myself included) are far more likely to assess the writing abilities of adolescents rather than elementary-aged children.

Often, when the students are younger and their literacy abilities are weaker, the SLPs may not get to the assessment of writing abilities due to the students presenting with so many other deficits which require precedence intervention-wise. However, as the students get older and the academic requirements increase exponentially, SLPs may be more frequently asked to assess the students’ writing abilities because difficulties in this area significantly affect them in a variety of classes on a variety of subjects.

So what can we assess when it comes to writing? In the words of Helen Lester’s character ‘Pookins’: “Lots!”  There are various types of writing that can be assessed, the most common of which include: expository, persuasive, and fictional. Each of these can be used for assessment purposes in a variety of ways.

To illustrate, if we chose to analyze the student’s written production of fictional narratives then we may broadly choose to analyze the following aspects of the student’s writing: contextual conventions and writing composition.

The former looks at such writing aspects as the use of correct spelling, punctuation, and capitalization, paragraph formation, etc.

The latter looks at the nitty-gritty elements involved in plot development. These include effective use of literate vocabulary, plotline twists, character development,  use of dialogue, etc.

Perhaps we want to analyze the student’s persuasive writing abilities. After all, high school students are expected to utilize this type of writing frequently for essay writing purposes.  Actually, persuasive writing is a complex genre which is particularly difficult for students with language-learning difficulties who struggle to produce essays that are clear, logical, convincing, appropriately sequenced, and take into consideration opposing points of view. It is exactly for that reason that persuasive writing tasks are perfect for assessment purposes.

But what exactly are we looking for analysis wise? What should a typical 15 year old’s persuasive essays contain?

With respect to syntax, a typical student that age is expected to write complex sentences possessing nominal, adverbial, as well as relative clauses.

With the respect to semantics, effective persuasive essays require the use of literate vocabulary words of low frequency such as later developing connectors (e.g., first of all, next, for this reason, on the other hand, consequently, finally, in conclusion) as well as metalinguistic and metacognitive verbs (“metaverbs”) that refer to acts of speaking (e.g., assert, concede, predict, argue, imply) and thinking (e.g., hypothesize, remember, doubt, assume, infer).

With respect to pragmatics, as students  mature, their sensitivity to the perspectives of others improves, as a result, their persuasive essays increase in length (i.e., total number of words produced) and they are able to offer a greater number of different reasons to support their own opinions (Nippold, Ward-Lonergan, & Fanning, 2005).

Now let’s apply our knowledge by analyzing a writing sample of a 15-year-old with suspected literacy deficits. Below 10th-grade student was provided with a written prompt first described in the Nippold, et al, 2005 study, entitled: “The Circus Controversy”.   “People have different views on animals performing in circuses. For example, some people think it is a great idea because it provides lots of entertainment for the public. Also, it gives parents and children something to do together, and the people who train the animals can make some money. However, other people think having animals in circuses is a bad idea because the animals are often locked in small cages and are not fed well. They also believe it is cruel to force a dog, tiger, or elephant to perform certain tricks that might be dangerous. I am interested in learning what you think about this controversy, and whether or not you think circuses with trained animals should be allowed to perform for the public. I would like you to spend the next 20 minutes writing an essay. Tell me exactly what you think about the controversy. Give me lots of good reasons for your opinion. Please use your best writing style, with correct grammar and spelling. If you aren’t sure how to spell a word, just take a guess.”(Nippold, Ward-Lonergan, & Fanning, 2005)

He produced the following written sample during the allotted 20 minutes.

Analysis: This student was able to generate a short, 3-paragraph, composition containing an introduction and a body without a definitive conclusion. His persuasive essay was judged to be very immature for his grade level due to significant disorganization, limited ability to support his point of view as well as the presence of tangential information in the introduction of his composition, which was significantly compromised by many writing mechanics errors (punctuation, capitalization, as well as spelling) that further impacted the coherence and cohesiveness of his written output.

The student’s introduction began with an inventive dialogue, which was irrelevant to the body of his persuasive essay. He did have three important points relevant to the body of the essay: animal cruelty, danger to the animals, and potential for the animals to harm humans. However, he was unable to adequately develop those points into full paragraphs. The notable absence of proofreading and editing of the composition further contributed to its lack of clarity. The above coupled with a lack of a conclusion was not commensurate grade-level expectations.

Based on the above-written sample, the student’s persuasive composition content (thought formulation and elaboration) was judged to be significantly immature for his grade level and is commensurate with the abilities of a much younger student.  The student’s composition contained several emerging claims that suggested a vague position. However, though the student attempted to back up his opinion and support his position (animals should not be performing in circuses), ultimately he was unable to do so in a coherent and cohesive manner.

Now that we know what the student’s written difficulties look like, the following goals will be applicable with respect to his writing remediation:

Long-Term Goals:  Student will improve his written abilities for academic purposes.

  • Short-Term Goals
  1. Student will appropriately utilize parts of speech (e.g., adjectives, adverbs, prepositions, etc.)  in compound and complex sentences.
  2. Student will use a variety of sentence types for story composition purposes (e.g., declarative, interrogative, imperative, and exclamatory sentences).
  3. Student will correctly use past, present, and future verb tenses during writing tasks.
  4. Student will utilize appropriate punctuation at the sentence level (e.g., apostrophes, periods, commas, colons, quotation marks in dialogue, and apostrophes in singular possessives, etc.).
  5. Student will utilize appropriate capitalization at the sentence level (e.g., capitalize proper nouns, holidays, product names, titles with names, initials, geographic locations, historical periods, special events, etc.).
  6. Student will use prewriting techniques to generate writing ideas (e.g., list keywords, state key ideas, etc.).
  7. Student will determine the purpose of his writing and his intended audience in order to establish the tone of his writing as well as outline the main idea of his writing.
  8. Student will generate a draft in which information is organized in chronological order via use of temporal markers (e.g., “meanwhile,” “immediately”) as well as cohesive ties (e.g., ‘but’, ‘yet’, ‘so’, ‘nor’) and cause/effect transitions (e.g., “therefore,” “as a result”).
  9. Student will improve coherence and logical organization of his written output via the use of revision strategies (e.g., modify supporting details, use sentence variety, employ literary devices).
  10. Student will edit his draft for appropriate grammar, spelling, punctuation, and capitalization.

There you have it. A quick and easy qualitative writing assessment which can assist SLPs to determine the extent of the student’s writing difficulties as well as establish writing remediation targets for intervention purposes.

Using a different type of writing assessment with your students? Please share the details below so we can all benefit from each others knowledge of assessment strategies.

References:

  • Nippold, M., Ward-Lonergan, J., & Fanning, J. (2005). Persuasive writing in children, adolescents, and adults: a study of syntactic, semantic, and pragmatic development. Language, Speech, and Hearing Services in Schools, 36, 125-138.

 

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Making Our Interventions Count or What’s Research Got To Do With It?

Two years ago I wrote a blog post entitled: “What’s Memes Got To Do With It?” which summarized key points of Dr. Alan G. Kamhi’s 2004 article: “A Meme’s Eye View of Speech-Language Pathology“. It delved into answering the following question: “Why do some terms, labels, ideas, and constructs [in our field] prevail whereas others fail to gain acceptance?”.

Today I would like to reference another article by Dr. Kamhi written in 2014, entitled “Improving Clinical Practices for Children With Language and Learning Disorders“.

This article was written to address the gaps between research and clinical practice with respect to the implementation of EBP for intervention purposes.

Dr. Kamhi begins the article by posing 10 True or False questions for his readers:

  1. Learning is easier than generalization.
  2. Instruction that is constant and predictable is more effective than instruction that varies the conditions of learning and practice.
  3. Focused stimulation (massed practice) is a more effective teaching strategy than varied stimulation (distributed practice).
  4. The more feedback, the better.
  5. Repeated reading of passages is the best way to learn text information.
  6. More therapy is always better.
  7. The most effective language and literacy interventions target processing limitations rather than knowledge deficits.
  8. Telegraphic utterances (e.g., push ball, mommy sock) should not be provided as input for children with limited language.
  9. Appropriate language goals include increasing levels of mean length of utterance (MLU) and targeting Brown’s (1973) 14 grammatical morphemes.
  10. Sequencing is an important skill for narrative competence.

Guess what? Only statement 8 of the above quiz is True! Every other statement from the above is FALSE!

Now, let’s talk about why that is!

First up is the concept of learning vs. generalization. Here Dr. Kamhi discusses that some clinicians still possess an “outdated behavioral view of learning” in our field, which is not theoretically and clinically useful. He explains that when we are talking about generalization – what children truly have a difficulty with is “transferring narrow limited rules to new situations“. “Children with language and learning problems will have difficulty acquiring broad-based rules and modifying these rules once acquired, and they also will be more vulnerable to performance demands on speech production and comprehension (Kamhi, 1988)” (93). After all, it is not “reasonable to expect children to use language targets consistently after a brief period of intervention” and while we hope that “language intervention [is] designed to lead children with language disorders to acquire broad-based language rules” it is a hugely difficult task to undertake and execute.

Next, Dr. Kamhi addresses the issue of instructional factors, specifically the importance of “varying conditions of instruction and practice“.  Here, he addresses the fact that while contextualized instruction is highly beneficial to learners unless we inject variability and modify various aspects of instruction including context, composition, duration, etc., we ran the risk of limiting our students’ long-term outcomes.

After that, Dr. Kamhi addresses the concept of distributed practice (spacing of intervention) and how important it is for teaching children with language disorders. He points out that a number of recent studies have found that “spacing and distribution of teaching episodes have more of an impact on treatment outcomes than treatment intensity” (94).

He also advocates reducing evaluative feedback to learners to “enhance long-term retention and generalization of motor skills“. While he cites research from studies pertaining to speech production, he adds that language learning could also benefit from this practice as it would reduce conversational disruptions and tunning out on the part of the student.

From there he addresses the limitations of repetition for specific tasks (e.g., text rereading). He emphasizes how important it is for students to recall and retrieve text rather than repeatedly reread it (even without correction), as the latter results in a lack of comprehension/retention of read information.

After that, he discusses treatment intensity. Here he emphasizes the fact that higher dose of instruction will not necessarily result in better therapy outcomes due to the research on the effects of “learning plateaus and threshold effects in language and literacy” (95). We have seen research on this with respect to joint book reading, vocabulary words exposure, etc. As such, at a certain point in time increased intensity may actually result in decreased treatment benefits.

His next point against processing interventions is very near and dear to my heart. Those of you familiar with my blog know that I have devoted a substantial number of posts pertaining to the lack of validity of CAPD diagnosis (as a standalone entity) and urged clinicians to provide language based vs. specific auditory interventions which lack treatment utility. Here, Dr. Kamhi makes a great point that: “Interventions that target processing skills are particularly appealing because they offer the promise of improving language and learning deficits without having to directly target the specific knowledge and skills required to be a proficient speaker, listener, reader, and writer.” (95) The problem is that we have numerous studies on the topic of improvement of isolated skills (e.g., auditory skills, working memory, slow processing, etc.) which clearly indicate lack of effectiveness of these interventions.  As such, “practitioners should be highly skeptical of interventions that promise quick fixes for language and learning disabilities” (96).

Now let us move on to language and particularly the models we provide to our clients to encourage greater verbal output. Research indicates that when clinicians are attempting to expand children’s utterances, they need to provide well-formed language models. Studies show that children select strong input when its surrounded by weaker input (the surrounding weaker syllables make stronger syllables stand out).  As such, clinicians should expand upon/comment on what clients are saying with grammatically complete models vs. telegraphic productions.

From there lets us take a look at Dr. Kamhi’s recommendations for grammar and syntax. Grammatical development goes much further than addressing Brown’s morphemes in therapy and calling it a day. As such, it is important to understand that children with developmental language disorders (DLD) (#DevLang) do not have difficulty acquiring all morphemes. Rather studies have shown that they have difficulty learning grammatical morphemes that reflect tense and agreement  (e.g., third-person singular, past tense, auxiliaries, copulas, etc.). As such, use of measures developed by (e.g., Tense Marker Total & Productivity Score) can yield helpful information regarding which grammatical structures to target in therapy.

With respect to syntax, Dr. Kamhi notes that many clinicians erroneously believe that complex syntax should be targeted when children are much older. The Common Core State Standards do not help this cause further, since according to the CCSS complex syntax should be targeted 2-3 grades, which is far too late. Typically developing children begin developing complex syntax around 2 years of age and begin readily producing it around 3 years of age. As such, clinicians should begin targeting complex syntax in preschool years and not wait until the children have mastered all morphemes and clauses (97)

Finally, Dr. Kamhi wraps up his article by offering suggestions regarding prioritizing intervention goals. Here, he explains that goal prioritization is affected by

  • clinician experience and competencies
  • the degree of collaboration with other professionals
  • type of service delivery model
  • client/student factors

He provides a hypothetical case scenario in which the teaching responsibilities are divvied up between three professionals, with SLP in charge of targeting narrative discourse. Here, he explains that targeting narratives does not involve targeting sequencing abilities. “The ability to understand and recall events in a story or script depends on conceptual understanding of the topic and attentional/memory abilities, not sequencing ability.”  He emphasizes that sequencing is not a distinct cognitive process that requires isolated treatment. Yet many SLPs “continue to believe that  sequencing is a distinct processing skill that needs to be assessed and treated.” (99)

Dr. Kamhi supports the above point by providing an example of two passages. One, which describes a random order of events, and another which follows a logical order of events. He then points out that the randomly ordered story relies exclusively on attention and memory in terms of “sequencing”, while the second story reduces demands on memory due to its logical flow of events. As such, he points out that retelling deficits seemingly related to sequencing, tend to be actually due to “limitations in attention, working memory, and/or conceptual knowledge“. Hence, instead of targeting sequencing abilities in therapy, SLPs should instead use contextualized language intervention to target aspects of narrative development (macro and microstructural elements).

Furthermore, here it is also important to note that the “sequencing fallacy” affects more than just narratives. It is very prevalent in the intervention process in the form of the ubiquitous “following directions” goal/s. Many clinicians readily create this goal for their clients due to their belief that it will result in functional therapeutic language gains. However, when one really begins to deconstruct this goal, one will realize that it involves a number of discrete abilities including: memory, attention, concept knowledge, inferencing, etc.  Consequently, targeting the above goal will not result in any functional gains for the students (their memory abilities will not magically improve as a result of it). Instead, targeting specific language and conceptual goals  (e.g., answering questions, producing complex sentences, etc.) and increasing the students’ overall listening comprehension and verbal expression will result in improvements in the areas of attention, memory, and processing, including their ability to follow complex directions.

There you have it! Ten practical suggestions from Dr. Kamhi ready for immediate implementation! And for more information, I highly recommend reading the other articles in the same clinical forum, all of which possess highly practical and relevant ideas for therapeutic implementation. They include:

References:

Kamhi, A. (2014). Improving clinical practices for children with language and learning disorders.  Language, Speech, and Hearing Services in Schools, 45(2), 92-103

Helpful Social Media Resources:

SLPs for Evidence-Based Practice

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New Products for the 2017 Academic School Year for SLPs

Image result for back to schoolSeptember is quickly approaching and  school-based speech language pathologists (SLPs) are preparing to go back to work. Many of them are looking to update their arsenal of speech and language materials for the upcoming academic school year.

With that in mind, I wanted to update my readers regarding all the new products I have recently created with a focus on assessment and treatment in speech language pathology.

My most recent product Assessment of Adolescents with Language and Literacy Impairments in Speech Language Pathology  is a 130-slide pdf download which discusses how to effectively select assessment materials in order to conduct comprehensive evaluations of adolescents with suspected language and literacy disorders. It contains embedded links to ALL the books and research articles used in the development of this product.

Effective Reading Instruction Strategies for Intellectually Impaired Students is a 50-slide downloadable presentation in pdf format which describes how speech-language pathologists (SLPs) trained in assessment and intervention of literacy disorders (reading, spelling, and writing) can teach phonological awareness, phonics, as well as reading fluency skills to children with mild-moderate intellectual disabilities. It reviews the research on reading interventions conducted with children with intellectual disabilities, lists components of effective reading instruction as well as explains how to incorporate components of reading instruction into language therapy sessions.

Dysgraphia Checklist for School-Aged Children helps to identify the students’ specific written language deficits who may require further assessment and treatment services to improve their written abilities.

Processing Disorders: Controversial Aspects of Diagnosis and Treatment is a 28-slide downloadable pdf presentation which provides an introduction to processing disorders.  It describes the diversity of ‘APD’ symptoms as well as explains the current controversies pertaining to the validity of the ‘APD’ diagnosis.  It also discusses how the label “processing difficulties” often masks true language and learning deficits in students which require appropriate language and literacy assessment and targeted intervention services.

Checklist for Identification of Speech Language Disorders in Bilingual and Multicultural Children was created to assist Speech Language Pathologists (SLPs) and Teachers in the decision-making process of how to appropriately identify bilingual and multicultural children who present with speech-language delay/deficits (vs. a language difference), for the purpose of initiating a formal speech-language-literacy evaluation.  The goal is to ensure that educational professionals are appropriately identifying bilingual children for assessment and service provision due to legitimate speech language deficits/concerns, and are not over-identifying students because they speak multiple languages or because they come from low socioeconomic backgrounds.

Comprehensive Assessment and Treatment of Literacy Disorders in Speech-Language Pathology is a 125 slide presentation which describes how speech-language pathologists can effectively assess and treat children with literacy disorders, (reading, spelling, and writing deficits including dyslexia) from preschool through adolescence.  It explains the impact of language disorders on literacy development, lists formal and informal assessment instruments and procedures, as well as describes the importance of assessing higher order language skills for literacy purposes. It reviews components of effective reading instruction including phonological awareness, orthographic knowledge, vocabulary awareness,  morphological awareness, as well as reading fluency and comprehension. Finally, it provides recommendations on how components of effective reading instruction can be cohesively integrated into speech-language therapy sessions in order to improve literacy abilities of children with language disorders and learning disabilities.

Improving critical thinking via picture booksImproving Critical Thinking Skills via Picture Books in Children with Language Disorders is a partial 30-slide presentation which discusses effective instructional strategies for teaching language disordered children critical thinking skills via the use of picture books utilizing both the Original (1956) and Revised (2001) Bloom’s Taxonomy: Cognitive Domain which encompasses the (R) categories of remembering, understanding, applying, analyzing, evaluating and creating.

from wordless books to reading From Wordless Picture Books to Reading Instruction: Effective Strategies for SLPs Working with Intellectually Impaired Students is a full 92 slide presentation which discusses how to address the development of critical thinking skills through a variety of picture books  utilizing the framework outlined in Bloom’s Taxonomy: Cognitive Domain which encompasses the categories of knowledge, comprehension, application, analysis, synthesis, and evaluation in children with intellectual impairments. It shares a number of similarities with the above product as it also reviews components of effective reading instruction for children with language and intellectual disabilities as well as provides recommendations on how to integrate reading instruction effectively into speech-language therapy sessions.

Best Practices in Bilingual LiteracyBest Practices in Bilingual Literacy Assessments and Interventions is a 105 slide presentation which focuses on how bilingual speech-language pathologists (SLPs) can effectively assess and intervene with simultaneously bilingual and multicultural children (with stronger academic English language skills) diagnosed with linguistically-based literacy impairments. Topics include components of effective literacy assessments for simultaneously bilingual children (with stronger English abilities), best instructional literacy practices, translanguaging support strategies, critical questions relevant to the provision of effective interventions, as well as use of accommodations, modifications and compensatory strategies for improvement of bilingual students’ performance in social and academic settings.

Comprehensive Literacy Checklist For School-Aged Children was created to assist Speech Language Pathologists (SLPs) in the decision-making process of how to identify deficit areas and select assessment instruments to prioritize a literacy assessment for school aged children. The goal is to eliminate administration of unnecessary or irrelevant tests and focus on the administration of instruments directly targeting the specific areas of difficulty that the student presents with.

You can find these and other products in my online store (HERE). Wishing all of you a highly successful and rewarding school year!

Image result for happy school year

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The Importance of Narrative Assessments in Speech Language Pathology (Revised)

Image result for narrativeAs SLPs we routinely administer a variety of testing batteries in order to assess our students’ speech-language abilities. Grammar, syntax, vocabulary, and sentence formulation get frequent and thorough attention. But how about narrative production? Does it get its fair share of attention when the clinicians are looking to determine the extent of the child’s language deficits? I was so curious about what the clinicians across the country were doing that in 2013, I created a survey and posted a link to it in several SLP-related FB groups.  I wanted to find out how many SLPs were performing narrative assessments, in which settings, and with which populations.  From those who were performing these assessments, I wanted to know what type of assessments were they using and how they were recording and documenting their findings.   Since the purpose of this survey was non-research based (I wasn’t planning on submitting a research manuscript with my findings), I only analyzed the first 100 responses (the rest were very similar in nature) which came my way, in order to get the general flavor of current trends among clinicians, when it came to narrative assessments. Here’s a brief overview of my [limited] findings. Continue reading The Importance of Narrative Assessments in Speech Language Pathology (Revised)

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Improving Executive Function Skills of Language Impaired Students with Hedbanz

Image result for hedbanzThose of you who have previously read my blog know that I rarely use children’s games to address language goals.  However, over the summer I have been working on improving executive function abilities (EFs) of some of the language impaired students on my caseload. As such, I found select children’s games to be highly beneficial for improving language-based executive function abilities.

For those of you who are only vaguely familiar with this concept, executive functions are higher level cognitive processes involved in the inhibition of thought, action, and emotion, which located in the prefrontal cortex of the frontal lobe of the brain. The development of executive functions begins in early infancy; but it can be easily disrupted by a number of adverse environmental and organic experiences (e.g., psychosocial deprivation, trauma).  Furthermore, research in this area indicates that the children with language impairments present with executive function weaknesses which require remediation.

Image result for executive functions brain

EF components include working memory, inhibitory control, planning, and set-shifting.

  • Working memory
    • Ability to store and manipulate information in mind over brief periods of time
  • Inhibitory control
    • Suppressing responses that are not relevant to the task
  • Set-shifting
    • Ability to shift behavior in response to changes in tasks or environment

Simply put, EFs contribute to the child’s ability to sustain attention, ignore distractions, and succeed in academic settings. By now some of you must be wondering: “So what does Hedbanz have to do with any of it?”

Well, Hedbanz is a quick-paced multiplayer  (2-6 people) game of “What Am I?” for children ages 7 and up.  Players get 3 chips and wear a “picture card” in their headband. They need to ask questions in rapid succession to figure out what they are. “Am I fruit?” “Am I a dessert?” “Am I sports equipment?” When they figure it out, they get rid of a chip. The first player to get rid of all three chips wins.

The game sounds deceptively simple. Yet if any SLPs or parents have ever played that game with their language impaired students/children as they would be quick to note how extraordinarily difficult it is for the children to figure out what their card is. Interestingly, in my clinical experience, I’ve noticed that it’s not just moderately language impaired children who present with difficulty playing this game. Even my bright, average intelligence teens, who have passed vocabulary and semantic flexibility testing (such as the WORD Test 2-Adolescent or the  Vocabulary Awareness subtest of the Test of Integrated Language and Literacy ) significantly struggle with their language organization when playing this game.

So what makes Hedbanz so challenging for language impaired students? Primarily, it’s the involvement and coordination of the multiple executive functions during the game. In order to play Hedbanz effectively and effortlessly, the following EF involvement is needed:

  • Task Initiation
    • Students with executive function impairments will often “freeze up” and as a result may have difficulty initiating the asking of questions in the game because many will not know what kind of questions to ask, even after extensive explanations and elaborations by the therapist.
  • Organization
    • Students with executive function impairments will present with difficulty organizing their questions by meaningful categories and as a result will frequently lose their track of thought in the game.
  • Working Memory
    • This executive function requires the student to keep key information in mind as well as keep track of whatever questions they have already asked.
  • Flexible Thinking
    • This executive function requires the student to consider a situation from multiple angles in order to figure out the quickest and most effective way of arriving at a solution. During the game, students may present with difficulty flexibly generating enough organizational categories in order to be effective participants.
  • Impulse Control
    • Many students with difficulties in this area may blurt out an inappropriate category or in an appropriate question without thinking it through first.
      • They may also present with difficulty set-shifting. To illustrate, one of my 13-year-old students with ASD, kept repeating the same question when it was his turn, despite the fact that he was informed by myself as well as other players of the answer previously.
  • Emotional Control
    • This executive function will help students with keeping their emotions in check when the game becomes too frustrating. Many students of difficulties in this area will begin reacting behaviorally when things don’t go their way and they are unable to figure out what their card is quickly enough. As a result, they may have difficulty mentally regrouping and reorganizing their questions when something goes wrong in the game.
  • Self-Monitoring
    • This executive function allows the students to figure out how well or how poorly they are doing in the game. Students with poor insight into own abilities may present with difficulty understanding that they are doing poorly and may require explicit instruction in order to change their question types.
  • Planning and Prioritizing
    • Students with poor abilities in this area will present with difficulty prioritizing their questions during the game.

Image result for executive functionsConsequently, all of the above executive functions can be addressed via language-based goals.  However, before I cover that, I’d like to review some of my session procedures first.

Typically, long before game initiation, I use the cards from the game to prep the students by teaching them how to categorize and classify presented information so they effectively and efficiently play the game.

Rather than using the “tip cards”, I explain to the students how to categorize information effectively.

This, in turn, becomes a great opportunity for teaching students relevant vocabulary words, which can be extended far beyond playing the game.

I begin the session by explaining to the students that pretty much everything can be roughly divided into two categories animate (living) or inanimate (nonliving) things. I explain that humans, animals, as well as plants belong to the category of living things, while everything else belongs to the category of inanimate objects. I further divide the category of inanimate things into naturally existing and man-made items. I explain to the students that the naturally existing category includes bodies of water, landmarks, as well as things in space (moon, stars, sky, sun, etc.). In contrast, things constructed in factories or made by people would be example of man-made objects (e.g., building, aircraft, etc.)

When I’m confident that the students understand my general explanations, we move on to discuss further refinement of these broad categories. If a student determines that their card belongs to the category of living things, we discuss how from there the student can further determine whether they are an animal, a plant, or a human. If a student determined that their card belongs to the animal category, we discuss how we can narrow down the options of figuring out what animal is depicted on their card by asking questions regarding their habitat (“Am I a jungle animal?”), and classification (“Am I a reptile?”). From there, discussion of attributes prominently comes into play. We discuss shapes, sizes, colors, accessories, etc., until the student is able to confidently figure out which animal is depicted on their card.

In contrast, if the student’s card belongs to the inanimate category of man-made objects, we further subcategorize the information by the object’s location (“Am I found outside or inside?”; “Am I found in ___ room of the house?”, etc.), utility (“Can I be used for ___?”), as well as attributes (e.g., size, shape, color, etc.)

Thus, in addition to improving the students’ semantic flexibility skills (production of definitions, synonyms, attributes, etc.) the game teaches the students to organize and compartmentalize information in order to effectively and efficiently arrive at a conclusion in the most time expedient fashion.

Now, we are ready to discuss what type of EF language-based goals, SLPs can target by simply playing this game.

1. Initiation: Student will initiate questioning during an activity in __ number of instances per 30-minute session given (maximal, moderate, minimal) type of  ___  (phonemic, semantic, etc.) prompts and __ (visual, gestural, tactile, etc.) cues by the clinician.

2. Planning: Given a specific routine, student will verbally state the order of steps needed to complete it with __% accuracy given (maximal, moderate, minimal) type of  ___  (phonemic, semantic, etc.) prompts and __ (visual, gestural, tactile, etc.) cues by the clinician.

3. Working Memory: Student will repeat clinician provided verbal instructions pertaining to the presented activity, prior to its initiation, with 80% accuracy  given (maximal, moderate, minimal) type of  ___  (phonemic, semantic, etc.) prompts and __ (visual, gestural, tactile, etc.) cues by the clinician.

4. Flexible Thinking: Following a training by the clinician, student will generate at least __ questions needed for task completion (e.g., winning the game) with __% accuracy given (maximal, moderate, minimal) type of  ___  (phonemic, semantic, etc.) prompts and __ (visual, gestural, tactile, etc.) cues by the clinician.

5. Organization: Student will use predetermined written/visual cues during an activity to assist self with organization of information (e.g., questions to ask) with __% accuracy given (maximal, moderate, minimal) type of  ___  (phonemic, semantic, etc.) prompts and __ (visual, gestural, tactile, etc.) cues by the clinician.

6. Impulse Control: During the presented activity the student will curb blurting out inappropriate responses (by silently counting to 3 prior to providing his response) in __ number of instances per 30 minute session given (maximal, moderate, minimal) type of  ___  (phonemic, semantic, etc.) prompts and __ (visual, gestural, tactile, etc.) cues by the clinician.

7. Emotional Control: When upset, student will verbalize his/her frustration (vs. behavioral activing out) in __ number of instances per 30 minute session given (maximal, moderate, minimal) type of  ___  (phonemic, semantic, etc.) prompts and __ (visual, gestural, tactile, etc.) cues by the clinician.

8. Self-Monitoring:  Following the completion of an activity (e.g., game) student will provide insight into own strengths and weaknesses during the activity (recap) by verbally naming the instances in which s/he did well, and instances in which s/he struggled with __% accuracy given (maximal, moderate, minimal) type of  ___  (phonemic, semantic, etc.) prompts and __ (visual, gestural, tactile, etc.) cues by the clinician.

There you have it. This one simple game doesn’t just target a plethora of typical expressive language goals. It can effectively target and improve language-based executive function goals as well. Considering the fact that it sells for approximately $12 on Amazon.com, that’s a pretty useful therapy material to have in one’s clinical tool repertoire. For fancier versions, clinicians can use “Jeepers Peepers” photo card sets sold by Super Duper Inc. Strapped for cash, due to highly limited budget? You can find plenty of free materials online if you simply input “Hedbanz cards” in your search query on Google. So have a little fun in therapy, while your students learn something valuable in the process and play Hedbanz today!

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