Search Results for: auditory processing

Professional Portfolio

Workshops, Lectures, Presentations and Webinars

  • Elleseff, T (2021, Dec 3).  Components of Comprehensive Preschool Evaluations. POWER UP Online Conference, Lavi Institute.
  • Elleseff, T (2021, Dec 2).  Targeted Pragmatic Assessments of School-Aged Children with Psychiatric Diagnoses. POWER UP Online Conference, Lavi Institute.
  • Elleseff, T (2021, Nov 2).  Inattention, Hyperactivity and Impulsivity in At-Risk Children: Differential Diagnosis of ADHD in Speech Language Pathology: Focus on Assessment and Treatment. Webinar for Garfield Public Schools. Garfield, NJ.
  • Elleseff, T (2021, Oct 20) Reading Disorders 101: A Tutorial for Parents and Professionals. Webinar for the Apraxia Kids, Pittsburg, PA.
  • Elleseff, T (2021, Sep 30) On the Value of Language Assessments for Children with Confirmed/Suspected Dyslexia.    Webinar for the Kansas Speech Language Hearing Association Convention, Wichita, KS.
  • Elleseff, T (2021, Sep 30) Improving Critical Thinking Skills via Use of Picture Books in Children with Language Disorders.  Webinar for the Kansas Speech Language Hearing Association Convention, Wichita, KS.
  • Elleseff, T (2021, Sep 2).  Practical Strategies for Monolingual SLPs Assessing and Treating Bilingual Children.  Elmont Union Free School District Webinar, Elmont, NY.
  • Elleseff, T (2021, Aug 25).  A Reading Program is NOT Enough: A Deep Dive into the Dyslexia Diagnosis. International Dyslexia Association Georgia Branch Webinar. Atlanta, GA.
  • Elleseff, T (2021, Aug 5). Clinical Assessment of Grade-Level Reading Abilities: Focus on Fluency and Comprehension. CEU SmartHub Recorded Webinar, Lavi Institute.
  • Elleseff, T (2021, Aug 5). Teaching Emergent Readers via the Synthetic Phonics Approach. CEU SmartHub Recorded Webinar, Lavi Institute.
  • Elleseff, T (2021, Jul 16). Improving Critical Thinking Skills via Use of Picture Books in Children with Language Disorders. The Ohio School Speech Pathology Educational Audiology Coalition Online Webinar
  • Elleseff, T (2021, Jul 16).  Strategies for Monolingual SLPs Assessing and Treating Bilingual Children. The Ohio School Speech Pathology Educational Audiology Coalition Online Webinar
  • Elleseff, T (2021, Jul 15).  Assessing Social Skills in Children with Psychiatric Disturbances. The Ohio School Speech Pathology Educational Audiology Coalition Online Webinar
  • Elleseff, T (2021, Jun 9).  Auditory Processing Disorder Diagnosis: Science or Pseudoscience?  International Dyslexia Association Georgia Branch Online Webinar.
  • Elleseff, T (2021, Mar 5). Accurate Test Selection for Assessment Purposes. POWER UP Online Conference, Lavi Institute.
  • Elleseff, T (2021, Mar 4). Behavior Management for SLPs. POWER UP Online Conference, Lavi Institute.
  • Elleseff, T (2021, Mar 4). Background History Matters: Conducting IEEs. POWER UP Online Conference, Lavi Institute.
  • Elleseff, T (2020, Dec 29). Neuropsychological or Language/Literacy Assessment: Which One is Right for the Student? International Dyslexia Association Georgia Branch Online Webinar.
  • Elleseff, T (2020, Dec 2). Clinical Assessment of Narrative Skills. POWER UP Online Conference, Lavi Institute.
  • Elleseff, T (2020, Oct 20) How Language Affects Reading: What Parents and Professionals Need to Know. BUILD Tredyffrin-Easttown. Online Webinar.
  • Elleseff, T (2020, Aug 27) Measurement and Interpretation of Standardized Reading Assessments for Professionals and Parents (Webinar) EBP REEL TALK, Smart Speech Therapy LLC
  • Elleseff, T (2020, Aug 04) Components of Effective Reading Intervention.  POWER UP Online Conference, Lavi Institute.
  • Elleseff, T (2020, Aug 03) Improving Critical Thinking Skills via Use of Picture Books in Children with Language Disorders. POWER UP, Online Conference, Lavi Institute.
  • Elleseff, T (2020, Feb 27) Assessing Preschool Children with Challenging Behaviors. American Speech Language and Hearing Association Online Conference. Rockville, MD
  • Elleseff, T (2019, Oct 19) On the Value of Language Assessments for Children with Confirmed/Suspected Dyslexia. 41st Annual Conference of the Pennsylvania Branch, International Dyslexia Association (PBIDA). West Conshohocken, PA
  • Elleseff, T (2019, Oct 18) Comorbidity of Language and Literacy Disorders in Children With Psychiatric Impairments: What Psychiatrists Need to Know. 66th Annual Meeting of the American Academy of Child and Adolescent Psychiatry. Chicago, IL
  • Elleseff, T (2019, Oct 16) Assessing Preschool Children with Challenging Behaviors. American Speech Language and Hearing Association Online Conference. Rockville, MD
  • Elleseff, T (2019, Jul 19-21) Behavior Management Strategies for SLPs. American Speech Language and Hearing Association Schools Connect Conference. Chicago, IL
  • Elleseff, T (2019, Jul 19-21) Speech-Language Assessment and Treatment of Children with Alcohol-Related Disorders. American Speech Language and Hearing Association Schools Connect Conference. Chicago, IL
  • Elleseff, T (2019, Jul 19-21) Language Difference vs. Disorder: Assessment Strategies for Children Who Are Bilingual. American Speech Language and Hearing Association Schools Connect Conference. Chicago, IL
  • Elleseff, T (2019, Jun 5) From Wordless Picture Books to Reading Instruction: Effective Strategies for SLPs Working with Intellectually Impaired Students. Workshop for the New York City Board of Education – District 9, Brooklyn, NY
  • Elleseff, T (2019, May 15) Assessing Social Communication from Toddlerhood through Adolescence: What SLPs need to Know. Workshop for the Hamilton County Educational Service Center, Cincinnati, OH.
  • Elleseff, T & Caruso, C (2019, May 2)  Research-Based Treatment Approaches for Childhood Apraxia of Speech Workshop for the New Jersey Speech Language Hearing Association Convention, Long Branch, NJ
  • Elleseff, T (2019, May 1) Practical Strategies for Monolingual SLPs Assessing Bilingual Children Workshop for the New Jersey Speech Language Hearing Association Convention, Long Branch, NJ
  • Elleseff, T (2019, Feb 20) Assessing Preschool Children with Challenging Behaviors Presented for the American Speech Language and Hearing Association Online Conference. Rockville, MD
  • Elleseff, T (2018, Nov 15) Practical Strategies for Monolingual SLPs Assessing Bilingual Children Presented for the American Speech Language and Hearing Association Convention. Boston, MA
  • Elleseff, T (2018, Oct 25) Behavior Management Strategies for Speech-Language Pathologists. Presented for the Milestone Therapeutic Services, Washington, DC.
  • Elleseff, T (2018, Oct 19) Behavior Management Strategies for Speech-Language Pathologists. Scheduled presentation for the Clinical Connection Conference of the Maryland Speech Language and Hearing Association, Baltimore, MD
  • Elleseff, T (2018, Sep 26) Red Flags for Undiagnosed Fetal Alcohol Spectrum Disorders in Children and Adolescents Rutgers Health UBHC Monthly Child Division Lecture Series, Piscataway, NJ
  • Elleseff, T (2018, May 22) Speech, Language, & Literacy Disorders in School Aged Children with Psychiatric Impairments Rutgers Health UBHC Monthly Child Division Lecture Series, Piscataway, NJ
  • Elleseff, T (2018, Feb 16) Impact of Cultural and Linguistic Variables On Speech-Language Services presented for the Eatontown Board of Education, Eatontown, NJ
  • Elleseff, T (2018, Jan 9) Normal Simultaneous Bilingual Language Development and Milestones Acquisition. Webinar presented for the New Jersey Speech Language and Hearing Association. Princeton, NJ.
  • Elleseff, T (2017, Nov 14) Best Practices in Bilingual Language and Literacy Interventions.  Webinar presented for the Speech-Language & Audiology Canada.
  • Elleseff, T (2017, Nov 11) Practical Strategies for Monolingual SLPs Assessing Bilingual Children Presented for the American Speech Language and Hearing Association Convention. Los Angeles, CA.
  • Elleseff, T (2017, Nov 7) Assessment and Treatment of Social-Communication Deficits in Children With/out Psychiatric Impairments. Workshop presented for the Butler County Educational Service Center, Hamilton, OH.
  • Elleseff, T (2017, Oct 19 & 26) From First Words through Preschool: Recognizing the Warning Signs of Language Delay. Development through the Life Cycle Lecture Series. Presented for the Child and Adolescent Psychiatry Medical Residents Rutgers University/Robert Wood Johnson Medical School, Piscataway, NJ 
  • Elleseff, T (2017, Oct 19) Recognizing and Assessing Primary Language Impairment in Bilingual Learners.  Webinar presented for the Speech-Language & Audiology Canada.
  • Elleseff, T (2017, June 15) Behavior Management for SLPs and Assessment of Social Communication in Children with Psychiatric Impairments Workshop presented for the Los Angeles Unified School District, Los Angeles, CA
  • Elleseff, T; Caruso, C (2017, Apr 28) Bilingualism: Birth to Adulthood. Workshop presented at the New Jersey Speech Language Hearing Association Convention, Long Branch, NJ
  • Elleseff, T (2017, Apr 24) From Wordless Picture Books to Reading Instruction: Effective Strategies for SLPs Working with Intellectually Impaired Students. Workshop presented  for the New York City Board of Education – District 75, NY, NY
  • Elleseff, T (2017, Mar 24) Best Practices in Bilingual Language and Literacy Interventions.  Workshop presented for the Speech-Language & Audiology Canada, Montreal, Canada
  • Elleseff, T (2016, Dec 7) Best Practices in Bilingual Language and Literacy Interventions. Workshop presented for the New York City Department of Education: Bilingual Providers Conference. Woodside, NY.
  • Elleseff, T (2016, Nov 8) Narrative Assessments of Preschool and School Aged Children.  Webinar presented for the Greenwich Public Schools, Greenwich CT
  • Elleseff, T (2016, Nov 1). Recognizing the Warning Signs of Social Emotional Difficulties in Language Impaired Toddlers and Preschoolers Workshop presented for the Regional Professional Development Academy. Eatontown, NJ.
  • Elleseff, T (2016, Oct 13 & 20) From First Words through Preschool: Recognizing the Warning Signs of Language Delay. Development Through the Life Cycle Lecture Series. Presented for the Child and Adolescent Psychiatry Fellows Rutgers University/Robert Wood Johnson Medical School, Piscataway, NJ 
  • Elleseff, T (2016, Oct 11) Psychiatric Impairments and Language Disorders in School Aged Children. Presented for the Child and Adolescent Psychiatry Residents Rutgers University/Robert Wood Johnson Medical School, Piscataway, NJ 
  • Elleseff, T (2016, Oct 10) Introduction to Dyslexia and Learning Disabilities.  Lecture presented at Rutgers University Behavioral Health Care: Rutgers Day School. Piscataway, NJ.
  • Elleseff, T (2016, Oct 5) Differential Assessment and Treatment of Processing Disorders in Speech Language Pathology. Workshop presented for the Wayne County Speech Language Hearing Association, Livonia, MI
  • Elleseff, T (2016, July 13) Practical Strategies for Monolingual SLPs Assessing and Treating Bilingual Children. Workshop presented for the Long Island Speech Language Hearing Association, Hauppauge, NY
  • Elleseff, T (2016, May 25) Strategies for Monolingual SLPs Treating Bilingual Children New York City Department of Education: Monolingual Providers Conference. NY, NY.
  • Wesler, J & Elleseff, T (2016, Apr 14) Overview of NJ Education Mandates: The Law and the SLP Workshop presented at the New Jersey Speech Language Hearing Association Convention, Long Branch, NJ
  • Elleseff, T (2016, Mar 4) Assessment and Treatment of Non-Verbal Language Disorder (NVLD) in Speech Language Pathology Workshop presented at the Mississippi Speech Language Hearing Association, Jackson, MS.
  • Elleseff, T (2016, Mar 3) Creating a Functional Therapy Plan and Selecting Clinical Materials for Pediatric Therapy Workshop presented at the Mississippi Speech Language Hearing Association, Jackson, MS.
  • Elleseff, T (2016, Feb 15) Differential Diagnosis of ADHD (and C/APD) in Speech Language Pathology. Workshop presented for the Montville Public Schools. Montville, NJ.
  • Elleseff, T (2015, Dec 4) Translanguaging in the classroom: Tips for educators on enrichment multicultural activities. Session presented at the William Paterson University 35th Bilingual/ESL Conference. Wayne, NJ.
  • Elleseff, T (2015, Dec 3) Assessing and Treating Bilingual Children: Practical Strategies for SLPs. New York City Department of Education: Bilingual Providers Conference. Woodside, NY.
  • Elleseff, T (2015, Nov 3) Assessing Social Communication Skills of School Aged Children Workshop presented for the Linden Public Schools, Linden, NJ.
  • Elleseff, T (2015, Oct 25) Assessment of Children With/Without Psychiatric and Emotional Disturbances from Preschool through Adolescence. Northeastern Speech-Language-Hearing Association of Pennsylvania Pocono Manor, PA.
  • Elleseff, T (2015, Oct 15) Inattention, Hyperactivity and Impulsivity in At-Risk Children: Differential Diagnosis of ADHD in Speech Language Pathology and Education. Regional Professional Development Academy. Eatontown, NJ.
  • Elleseff, T (2015, Sept 1) Assessment of Children With/Without Psychiatric and Emotional Disturbances from Preschool through Adolescence Workshop presented for the Rahway Public Schools, Rahway, NJ
  • Caruso, C & Elleseff, T (2015, April 30) Working with CLD Populations: An Interactive Student Experience. Workshop presented at the New Jersey Speech Language Hearing Association Convention, Long Branch, NJ
  • Elleseff, T (2015, Feb 13) Assessment and Treatment of Social Pragmatic Deficits in School Aged Children. Workshop presented at the 2015 Annual Illinois Speech Hearing Language Association, Chicago, IL
  • Elleseff, T (2014, Dec 5) CLD Learners’ Pathway to Success: A Lexical Enhancement Approach. Session presented at the William Paterson University 34th Bilingual/ESL Conference. Wayne, NJ.
  • Elleseff, T (2014, Nov 10) Creating a Functional Therapy Plan: Therapy Goals & SOAP Note Documentation. Webinar presented for speechpathology.com, San Antonio, TX
  • Elleseff, T (2014, Nov 6) Impact of Cultural and Linguistic Variables on Speech-Language Services. Guest lecture presented at Seton Hall University, South Orange, NJ.
  • Elleseff, T (2014, May 6) Narrative Assessments of Preschool and School Aged Children. Workshop presented at the  Union County Speech and Hearing Association, New Providence, NJ.
  • Elleseff, T (2014, May 2). Speech Language Assessment of Older Internationally Adopted Children. Workshop presented at the New Jersey Speech Language Hearing Association Convention, Long Branch, NJ
  • Elleseff, T (2014, Mar 21) Assessment and Treatment of Social Pragmatic Deficits in School Aged Children. Lecture presented at the 11th Annual Symposium for Speech Language Specialists. Rowan University, Glassboro, NJ
  • Elleseff, T (2014, Jan 14) Executive Function Impairment and At-Risk Populations. Webinar presented for Advance for Speech Language Pathologists and Audiologists.
  • Elleseff, T (2013, Oct 29) Assessing Social Functioning in Language Impaired Young Children. Webinar presented for Advance for Speech Language Pathologists and Audiologists.
  • Elleseff, T (2013, Oct 17 & 24) From First Words through Preschool: Recognizing the Warning Signs of Language Delay. Development Through the Life Cycle Lecture Series scheduled for the Child and Adolescent Psychiatry Fellows Rutgers University/Robert Wood Johnson Medical School, Piscataway, NJ 
  • Gordina, A, Elleseff, T (2013, Aug 10) Inattention, Hyperactivity and Impulsivity in Adopted and Foster Children. Workshop presented at the 39th North American Council on Adoptable Children, Toronto, CA.
  • Elleseff, T (2013, Jul 16) Impact of Cultural and Linguistic Variables on Speech-Language Services. Webinar presented for the New Jersey Speech Language Hearing Association. Princeton, NJ.
  • Elleseff, T (2013, May 20) Language Difference vs. Language Disorder:  An Overview of Assessment and Intervention Strategies for Speech Language Pathologists Working with Bilingual Children. Workshop presented for the Warren County Speech, Language, Hearing Association, Hackettstown, NJ.
  • Elleseff, T (2013, Mar 25) Fetal Alcohol Spectrum Disorders Part II: Assessment & Intervention.  Webinar presented for speechpathology.com, San Antonio, TX
  • Elleseff, T (2013, Feb 5) Selecting Clinical Materials for Pediatric Therapy. Guest lecture presented at Seton Hall University, South Orange, NJ.
  • Elleseff, T (2013, Jan 28) Fetal Alcohol Spectrum Disorders Part I: Overview of Deficits.  Webinar presented for speechpathology.com, San Antonio, TX
  • Elleseff, T (2013, Jan 22) Creating a Functional Therapy Plan: Therapy Goals & SOAP Note Documentation. Guest lecture presented at Seton Hall University, South Orange, NJ.
  • Elleseff, T (2013, Jan 17) Inattention, Hyperactivity and Impulsivity In At Risk Children: Differential Diagnosis of ADHD in Speech Language Pathology. Webinar presented for Advance for Speech Language Pathologists and Audiologists.
  • Gordina, A, Elleseff, T. (2013, Jan 13). Inattention, Hyperactivity and Impulsivity in Adopted and Foster Children. Workshop presented at the  New Jersey’s 31stAnnual “Let’s Talk Adoption”sm Conference Piscataway, NJ
  • Gordina, A, Elleseff, T. (2013, Jan 13). Sobering Thoughts on Attitudes Towards the Fetal Alcohol Spectrum Disorders. Workshop presented at the New Jersey’s 31st Annual “Let’s Talk Adoption”sm Conference Piscataway, NJ
  • Elleseff, T (2013, Nov 15) Language Difference vs. Language Disorder: Assessment  & Intervention Strategies for SLPs Working with Bilingual Children.  Workshop presented for Educational Service Unit #3, Omaha, NE.
  • Elleseff, T (2012, Oct 28) Behavior Management Strategies for Related Professionals. Session presented for the New Jersey Occupational Therapy Association, 38th Annual Convention. Seton Hall University, South Orange, NJ.
  • Elleseff, T (2012, Oct 24) Narrative Assessments of Preschool and School Aged Children. Session presented for the Morris County Speech and Hearing Association, Whippany, NJ.
  • Elleseff, T (2012, Oct 18) Psychiatric Impairments and Language Disorders in School Aged Children:
    Why Psychiatrists and Speech Pathologists Should Collaborate More Together.     Development Through the Life Cycle Lecture Series for the Child and Adolescent Psychiatry Fellows University of Medicine and Dentistry of New Jersey/Robert Wood Johnson Medical School, Piscataway, NJ 
  • Elleseff, T (2012, Oct 11) From First Words through Preschool: Recognizing the Warning Signs of Language Delay. Development Through the Life Cycle Lecture Series for the Child and Adolescent Psychiatry Fellows University of Medicine and Dentistry of New Jersey/Robert Wood Johnson Medical School, Piscataway, NJ 
  • Gordina, A,  Elleseff, T, & Shifrin, L (2012, Jul 27) Inattention, Hyperactivity and Impulsivity in Adopted and Foster Children. Workshop presented at the 38th North American Council on Adoptable Children, Crystal City, VA.
  • Elleseff, T (2012, July) Improving Social Skills of Children with Psychiatric Disturbances.   Webinar presented for speechpathology.com, San Antonio, TX
  • Elleseff, T (2012, May) Assessing Social Skills of Children with Psychiatric Disturbances.   Webinar presented for speechpathology.com, San Antonio, TX
  • Elleseff, T (2012, April) Behavior Management Strategies for School Based Speech Language Pathologists Workshop presented at New Jersey Speech Language Hearing Association Convention, Long Branch, NJ
  • Elleseff, T (2012, April) Social Pragmatic Assessment of Children Diagnosed with Emotional/Psychiatric Disturbances in the Schools. Workshop presented at New Jersey Speech Language Hearing Association Convention, Long Branch, NJ
  • Elleseff, T (2012, Jan) Special Considerations and Challenges in Assessment and Treatment of Bilingual Children with Developmental Disabilities. Workshop presented for Middlesex Regional Educational Services Commission, Metuchen NJ.
  • Gordina, A & Elleseff, T (2011, Oct) A Case of Isolated Social Pragmatic Language Deficits and Sensory Integration Dysfunction  in an Internationally Adopted Child: Implications for Medical Referral   Workshop presented at the American Academy of Pediatrics: Council on Foster Care, Adoption and Kinship Care, Boston, MA.
  • Gordina, A, Elleseff, T, & Shifrin, L (2011, Oct) Inattention, Hyperactivity and Impulsivity in At-Risk Children Workshop presented at the Opening Doors: Partnerships for Prevention and Healing, New Jersey Taskforce on Child Abuse and Neglect, East Brunswick, NJ.
  • Elleseff, T (2011, June) The Role of Frontal Lobe in Speech and Language Functions.  Lecture presented at the University of Medicine and Dentistry of New Jersey: Child Therapeutic Day Program. Piscataway, NJ.

Article Publications

  • Elleseff, T (2016)  Embracing ‘Translanguaging’ Practices: A Tutorial for SLPs New Jersey Speech Language Hearing Association.  VOICES, Summer, 9.
  • Elleseff, T (2015, Aug). Assessing social communication of school-aged children Perspectives on School-Based Issues  16 (3): 79-86
  • Caruso, C, Concepcion-Escano, Y & Elleseff, T (2015, Jan). Technical Manual: A guide for the appropriate assessment of culturally & linguistically diverse and internationally adopted individuals. New Jersey Speech Language Hearing Association.
  • Elleseff, T (2014).  Creating Successful Team Collaboration: Behavior Management in the Schools. Perspectives on School-Based Issues, 15(1): 37-43.
  • Elleseff, T (2014). ELL Spotlight on Russian: Considerations for Assessment and Treatment. New Jersey Speech Language Hearing Association: VOICES, Winter: 9-11.
  • Elleseff, T (2013, Dec) Recognizing FASD-Related Speech and Language Deficits in Internationally Adopted Children. National Adoption Advocate. No. 66, pp 1-8.
  • Elleseff, T(2013) Changing Trends in International Adoption: Implications for Speech-Language Pathologists. Perspectives on Global Issues in Communication Sciences and Related Disorders, 3: 45-53
  • Elleseff, T (2013, Aug) FASD and Background History Collection: Asking the Right Questions Adoption Today, pp 32-35.
  • Elleseff, T (2012, Dec 24) Understanding the risks of social pragmatic deficits in post institutionalized internationally adopted children. Published in Advance for Speech Language Pathologists and Audiologists. Pp 6-9.
  • Elleseff, T (Jan 2, 2012) Speech-Language Strategies for Multisensory Stimulation of Internationally Adopted Children:   Activity Suggestions for Parents and Professionals. Adoption Today Magazine. pp 40-43.
  • Elleseff, T (Nov 16, 2011) The importance of pediatric orofacial assessments in speech pathology. Advance for Speech Language Pathologists and Audiologists
  • Elleseff, T (Oct 1, 2011) Understanding the extent of speech and language delays in older internationally adopted children: Implications for School Based Speech and Language Intervention Adoption Today Magazine, pp 32-35
  • Elleseff, T (June 6, 2011) Differential diagnosis of AD/HD and Auditory Processing Disorders in Internationally Adopted School Age Children Post Adoption Learning Center, International Adoptions Articles Directory
  • Elleseff, T (Mar 14, 2011) What are social pragmatic language deficits and how do they impact international adoptees years post adoption?  Post Adoption Learning Center, International Adoptions Articles Directory
  • Elleseff, T (Feb 23, 2011) A case for early speech-language assessments of adopted children in the child’s birth language Post Adoption Learning Center, International Adoptions Articles Directory
  • Elleseff, T (June 30, 2009) How to improve the feeding abilities of young adopted picky eaters Post Adoption Learning Center, International Adoptions Articles Directory
  • Elleseff, T (May 27, 2009) Speech Language Services and Insurance Coverage: What Parents Need to Know Post Adoption Learning Center, International Adoptions Articles Directory
  • Elleseff, T (May 11, 2009) How to select the right speech language pathologist for your adopted child? Post Adoption Learning Center, International Adoptions Articles Directory
  • Elleseff, T (Feb 20, 2009) Functional Strategies for Improving the Language Abilities of Your Adopted School-Age Child  Post Adoption Learning Center, International Adoptions Articles Directory
  • Elleseff, T (Feb 15, 2009) Creating a learning rich environment to facilitate language development in adopted preschoolers.  Post Adoption Learning Center, International Adoptions Articles Directory

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Creating a Comprehensive Speech Language Therapy Environment

Image result for comprehensiveSo 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.

fall word wall

Language:

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

Phonological Awareness:

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?)

Articulation/Fluency:

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.

Happy Speeching! Thankful Clip Art Printable owl card

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What do Auditory Memory Deficits Indicate in the Presence of Average General Language Scores?

I frequently see a variation of the following question on a variety of speech language forums: “My student scored within the average range on all the tested subtests with the exception of working memory and sentence recall. What other testing do you recommend to determine whether these difficulties are impacting their academics?”

First, lets provide a definition of working memory (WM). WM is the memory used for temporarily storing and manipulating information so we can perform a particular task. It’s one of the executive functions (EFs) and contains two important subcomponents: a phonological loop that stores verbal information and a visuo-spatial ‘sketchpad’ which stores visual and spatial information (Baddeley & Hitch, 2007). Together they are responsible for acquisition of sound-letter correspondence, phonemic awareness and ultimately reading comprehension since WM influences the duration the information stays in memory as well as its eventual transfer (or lack of thereof) to long-term memory.

In other words, students with adequate working memory will have enough capacity to appropriately decode, fluently read and adequately comprehend text while students with poor working memory will expend all their capacity on basic tasks such as decoding, which leaves them with very little capacity to devote to comprehension of read material.

Outside of testing, WM deficits typically become glaringly apparent as students move up grade levels and are given challenging subject-specific abstract texts, requiring in-depth analysis.  This is when parents and professionals start to see that in addition to experiencing difficulty comprehending the read texts, students with poor WM also tire easily when presented with lengthy texts, and tend to evidence increased frustration and decreased self-efficacy during reading tasks.

Now let’s get back to our original question: “What other testing do you recommend to determine whether these [memory] difficulties are impacting their academics?”

Typically when asked that question I always tend to recommend that a trained SLP  performs a series of tests aimed to determine whether the student presents with reading and writing deficits.

In my clinical experience (which is of course substantiated by research) in 99% of cases, reading disabilities are the hidden culprit behind seemingly average oral language skills and working memory deficits.   For more information on what testing is recommended to tease out the presence of reading disorders, see my series posts on Comprehensive Dyslexia Testing (HERE) as well as on the validity of (C)APD diagnosis (HERE).

keep calm and don't ignore the signs

So the next time you encounter this perplexing pattern of strengths and weaknesses don’t just ignore it as inconsequential and not recommend or dismiss the student from language services.  Delve into it further! You will often find that it is representative of reading difficulties, the cumulative impact of which may significantly affect the student’s academic performance and ultimately school outcomes, unless appropriate therapeutic interventions are provided.

References:

  • Baddeley, A. D., & Hitch, G. J. (2007). Working memory: Past, present…and future? In N.Osaka, R. Logie & M. D’Esposito (Eds), Working Memory – Behavioural & Neural Correlates. Oxford University Press.

Useful Resources:

  1. Help, Student Tested Average on ALL Standardized Tests but is Still Struggling
  2. Is “Dyslexia” a Useful Label for Diagnostic and Treatment Purposes?
  3. Quality Assessments for Students with Suspected/Confirmed “APD”

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Effective Vocabulary Instruction: What SLPs Need to Know

vocabulary-picHaving a solid vocabulary knowledge is key to academic success. Vocabulary is the building block of language. It allows us to create complex sentences, tell elaborate stories as well as write great essays. Having limited vocabulary is primary indicator of language learning disability, which in turn blocks students from obtaining critical literacy skills necessary for reading, writing, and spelling. “Indeed, one of the , most enduring findings in reading research is the extent to which students’ vocabulary knowledge relates to their reading comprehension” (Osborn & Hiebert, 2004)

Teachers and SLPs frequently inquire regarding effective vocabulary instruction methods for children with learning disabilities. However, what some researchers have found  when they set out to “examine how oral vocabulary instruction was enacted in kindergarten” was truly alarming.

In September 2014, Wright and Neuman,  analyzed about 660 hours of observations over a course of 4 days (12 hours) in 55 classrooms in a range of socio-economic status schools.

They found that teachers explained word meanings during “teachable moments” in the context of other instruction.

They also found that teachers:

  • Gave one-time, brief word explanations
  • Engaged in unsystematic word selection
  • And spent minimal time on vocabulary devoted to subject areas (e.g., science and social studies in which word explanations were most dense)

They also found an economic status discrepancy, namely:

Teachers serving in economically advantaged schools explained words more often and were more likely to address sophisticated words than teachers serving in economically disadvantaged schools.

They concluded that “these results suggest that the current state of instruction may be CONTRIBUTING to rather than ameliorating vocabulary gaps by socioeconomic status.”

Similar findings were reported by other scholars in the field who noted that “teachers with many struggling children often significantly reduce the quality of their own vocabulary unconsciously to ensure understanding.” So they “reduce the complexity of their vocabulary drastically.” “For many children the teacher is the highest vocabulary example in their life. It’s sort of like having a buffet table but removing everything except a bowl of peanuts-that’s all you get“. (Excerpts from Anita Archer’s Interview with Advance for SLPs) 

It is important to note that vocabulary gains are affected by socioeconomic status as well as maternal education level. Thus, children whose family incomes are at or below the poverty level fare much more poorly in the area of vocabulary acquisition than middle class children. Furthermore, Becker (2011) found that children of higher educated parents can improve their vocabulary more strongly than children whose parents have a lower educational level.

Limitations of Poor Readers:

—Poor readers often lack adequate vocabulary to get meaning from what they read. To them, reading is difficult and tedious, and they are unable (and often unwilling) to do the large amount of reading they must do if they are to encounter unknown words often enough to learn them.

—Matthew Effect, “rich get richer, poor get poorer”, or interactions with the environment exaggerate individual differences over time. Good readers read more, become even better readers, and learn more words. Poor readers read less, become poorer readers, and learn fewer words. —The vocabulary problems of students who enter school with poorer limited vocabularies only exacerbate over time. 

However, even further exacerbating the issue is that students from low SES households have limited access to books. 61% of low-income families have NO BOOKS at all in their homes for their children (Reading Literacy in the United States: Findings from the IEA Reading Literacy Study, 1996.) In some under-resourced communities, there is ONLY 1 book for every 300 children. Neuman, S., & Dickinson, D. (Eds.). (2006) Handbook of Early Literacy Research (Vol. 2). In contrast, the average middle class child has 13+ books in the home.

The above discrepancy can be effectively addressed by holding book drives to raise books for under privileged students and their siblings. Instructions for successful book drives HERE.

So what are effective methods of vocabulary instruction for children with language impairments?

According to (NRP, 2000) a good way for students to learn vocabulary directly is to explicitly teach them individual words and word-learning strategies .

For children with low initial vocabularies, approaches that teach word meanings as part of a semantic field are found to be especially effective (Marmolejo, 1991).

Many vocabulary scholars (Archer, 2011; Biemiller, 2004; Gunning 2004, etc.) agree on a number of select instructional strategies which include:

  • Rich experiences/high classroom language related to the student experience/interests
  • Explicit vs. incidental instruction with frequent exposure to words
  • Instructional routine for vocabulary
    • Establishing word relationships
    • Word-learning strategies to impart depth of meaning
    • Morphological awareness instruction

Response to Intervention: Improving Vocabulary Outcomes

For students with low vocabularies, to attain the same level of academic achievement as their peers on academic coursework of language arts, reading, and written composition, targeted Tier II intervention may be needed.

Tier II words are those for which children have an understanding of the underlying concepts, are useful across a variety of settings and can be used instructionally in a variety of ways 

According to Beck et al 2002, Tier II words should be the primary focus of vocabulary instruction, as they would make the most significant impact on a child’s spoken and written expressive capabilities.

Tier II vocabulary words

  • High frequency words which occur across a variety of domains conversations, text, etc.
  • Contain multiple meanings
  • Descriptive in nature
  • Most important words for direct instruction as they facilitate academic success
    • Hostile, illegible, tolerate, immigrate, tremble, despicable, elapse, etc.

According to Judy Montgomery “You can never select the wrong words to teach.”

Vocabulary Selection Tips:

  • Make it thematic
  • Embed it in current events (e.g., holidays, elections, seasonal activities, etc)
  • Classroom topic related (e.g., French Revolution, the Water Cycle, Penguin Survival in the Polar Regions, etc)
  • Do not select more than 4-5 words to teach per unit to not overload the working memory (Robb, 2003)
  • Select difficult/unknown words that are critical to the passage meaning, which the students are likely to use in the future (Archer, 2015)
  • Select words used across many domains

Examples of Spring Related Vocabulary 

Adjectives: 

  • Flourishing
  • Lush
  • Verdant
  • Refreshing

Nouns: 

  • Allergies
  • Regeneration
  • Outdoors
  • Seedling
  • Sapling

Verbs 

  • Awaken
  • Teem
  • Romp
  • Rejuvenate

Idiomatic Expressions:

  • April Showers Bring May Flowers
  • Green Thumb
  • Spring Chicken
  • Spring Into Action

Creating an Effective Vocabulary Intervention Packets and Materials 

Sample Activity Suggestions:

  • Text Page (story introducing the topic containing context embedded words)HVD text
  • Vocabulary Page (list of story embedded words their definitions, and what parts of speech the words are)
  • Multiple Choice Questions or Open Ended Questions Page
  • Crossword Puzzle Page
  • Fill in the Blank Page
  • True (one word meaning) Synonym/Antonym Matching Page
  • Explain the Multiple Meaning of Words Page
  • Create Complex Sentences Using Story Vocabulary Page

Intervention Technique Suggestions:

 1.Read vocabulary words in context embedded in relevant short texts

2.Teach individual vocabulary words directly to comprehend classroom-specific texts (definitions)

3.Provide multiple exposures of vocabulary words in multiple contexts, (synonyms, antonyms, multiple meaning words, etc.)

4.Maximize multisensory intervention when learning vocabulary to maximize gains (visual, auditory, tactile, etc.)

5.Use multiple instructional methods for a range of vocabulary learning tasks and outcomes (read it, spell it, write it in a sentence, practice with a friend, etc.)

6.Use morphological awareness instruction (post to follow)

  • An ability to recognize, understand, and use word parts (prefixes, suffixes that “carry significance” when speaking and in reading tasks

 Conclusion:

Having the right tools for the job is just a small first step in the right direction of creating a vocabulary-rich environment even for the most disadvantaged learners. So Happy Speeching!

Helpful Smart Speech Resources:

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How Early can “Dyslexia” be Diagnosed in Children?

Image result for dyslexiaIn 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. Continue reading How Early can “Dyslexia” be Diagnosed in Children?

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Quality Assessments for Students with Suspected/Confirmed “APD”

Recently I wrote a blog post offering a free handout for parents and professionals entitled, “Deconstructing Auditory Processing Disorder (APD) for Parents and Professionals: Informational Handout“. While it was incredibly well-received, it resulted in numerous professionals asking the same questions:

  1. How do we help students with “APD?
  2. What constitutes a good quality assessment for a student with “APD”?

Today I would like to answer the above questions by providing further helpful information and links for parents and professionals seeking evidence-based assistance for students with suspected/confirmed “APD”.

Continue reading Quality Assessments for Students with Suspected/Confirmed “APD”
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Thematic Language Intervention with Language Impaired Children Using Nonfiction Texts

FullSizeRender (3)In the past a number of my SLP colleague bloggers (Communication Station, Twin Sisters SLPs, Practical AAC, etc.) wrote posts regarding the use of thematic texts for language intervention purposes. They discussed implementation of fictional texts such as the use of children’s books and fairy tales to target linguistic goals such as vocabulary knowledge in use, sentence formulation, answering WH questions, as well as story recall and production.

Today I would like to supplement those posts with information regarding the implementation of intervention based on thematic nonfiction texts to further improve language abilities of children with language difficulties.

First, here’s why the use of nonfiction texts in language intervention is important. While narrative texts have high familiarity for children due to preexisting, background knowledge, familiar vocabulary, repetitive themes, etc. nonfiction texts are far more difficult to comprehend. It typically contains unknown concepts and vocabulary, which is then used in the text multiple times. Therefore lack of knowledge of these concepts and related vocabulary will result in lack of text comprehension. According to Duke (2013) half of all the primary read-alouds should be informational text. It will allow students to build up knowledge and the necessary academic vocabulary to effectively participate and partake from the curriculum.

So what type of nonfiction materials can be used for language intervention purposes. While there is a rich variety of sources available, I have had great success using Let’s Read and Find Out Stage 1 and 2 Science Series with clients with varying degrees of language impairment.

Here’s are just a few reasons why I like to use this series.

  • They can be implemented by parents and professionals alike for different purposes with equal effectiveness.
  • They can be implemented with children fairly early beginning with preschool on-wards 
  • The can be used with the following pediatric populations:
    • Language Disordered Children
    • Children with learning disabilities and low IQ
    • Children with developmental disorders and genetic syndromes (Fragile X, Down Syndrome, Autism, etc.)
    • Children with Fetal Alcohol Spectrum Disorders
    • Internationally adopted children with language impairment
    • Bilingual children with language impairment
    • Children with dyslexia and reading disabilities
    • Children with psychiatric Impairments
  • The books are readily available online (Barnes & Noble, Amazon, etc.) and in stores.
  • They are relatively inexpensive (individual books cost about $5-6).
  • Parents or professionals who want to continuously use them seasonally can purchase them in bulk at a significantly cheaper price from select distributors (Source: rainbowresource.com)
  • They are highly thematic, contain terrific visual support, and are surprisingly versatile, with information on topics ranging from animal habitats and life cycles to natural disasters and space.
  • They contain subject-relevant vocabulary words that the students are likely to use in the future over and over again (Stahl & Fairbanks, 1986).
  • The words are already pre-grouped in semantic clusters which create schemes (mental representations) for the students (Marzano & Marzano, 1988).

For example, the above books on weather and seasons contain information  on:

1. Front Formations
2. Water Cycle
3. High & Low Pressure Systems

Let’s look at the vocabulary words from Flash, Crash, Rumble, and Roll  (see detailed lesson plan HERE). (Source: ReadWorks):

Word: water vapor
Context: Steam from a hot soup is water vapor.

Word: expands
Context: The hot air expands and pops the balloon.

Word: atmosphere
Context:  The atmosphere is the air that covers the Earth.

Word: forecast
Context: The forecast had a lot to tell us about the storm.

Word: condense
Context: steam in the air condenses to form water drops.

These books are not just great for increasing academic vocabulary knowledge and use. They are great for teaching sequencing skills (e.g., life cycles), critical thinking skills (e.g., What do animals need to do in the winter to survive?), compare and contrast skills (e.g., what is the difference between hatching and molting?) and much, much, more!

So why is use of nonfiction texts important for strengthening vocabulary knowledge and words in language impaired children?

As I noted in my previous post on effective vocabulary instruction (HERE): “teachers with many struggling children often significantly reduce the quality of their own vocabulary unconsciously to ensure understanding” (Excerpts from Anita Archer’s Interview with Advance for SLPs).  

The same goes for SLPs and parents. Many of them are under misperception that if they teach complex subject-related words like “metamorphosis” or “vaporization” to children with significant language impairments or developmental disabilities that these students will not understand them and will not benefit from learning them.

However, that is not the case! These students will still significantly benefit from learning these words, it will simply take them longer periods of practice to retain them!

By simplifying our explanations, minimizing verbiage and emphasizing the visuals, the books can be successfully adapted for use with children with severe language impairments.  I have had parents observe my intervention sessions using these books and then successfully use them in the home with their children by reviewing the information and reinforcing newly learned vocabulary knowledge.

Here are just a few examples of prompts I use in treatment with more severely affected language-impaired children:

  • —What do you see in this picture?
  • —This is a _____ Can you say _____
  • What do you know about _____?
  • —What do you think is happening? Why?
  • What do you think they are doing? Why?
  • —Let’s make up a sentence with __________ (this word)
  • —You can say ____ or you can say ______ (teaching synonyms)
  • —What would be the opposite of _______? (teaching antonyms)
  • — Do you know that _____(this word) has 2 meanings
    • —1st meaning
    • —2nd meaning
  • How do ____ and _____ go together?

Here are the questions related to Sequencing of Processes (Life Cycle, Water Cycle, etc.)

  • —What happened first?
  • —What happened second?
  • —What happened next?
  • —What happened after that?
  • —What happened last?

As the child advances his/her skills I attempt to engage them in more complex book interactions—

  • —Compare and contrast items
  • — (e.g. objects/people/animals)
  • —Make predictions and inferences about will happen next?
  • Why is this book important?

“Picture walks” (flipping through the pages) of these books are also surprisingly effective for activation of the student’s background knowledge (what a student already knows about a subject). This is an important prerequisite skill needed for continued acquisition of new knowledge. It is important because  “students who lack sufficient background knowledge or are unable to activate it may struggle to access, participate, and progress through the general curriculum” (Stangman, Hall & Meyer, 2004).

These book allow for :

1.Learning vocabulary words in context embedded texts with high interest visuals

2.Teaching specific content related vocabulary words directly to comprehend classroom-specific work

3.Providing multiple and repetitive exposures of vocabulary words in texts

4. Maximizing multisensory intervention when learning vocabulary to maximize gains (visual, auditory, tactile via related projects, etc.)

To summarize, children with significant language impairment often suffer from the Matthew Effect (—“rich get richer, poor get poorer”), or interactions with the environment exaggerate individual differences over time

Children with good vocabulary knowledge learn more words and gain further knowledge by building of these words

Children with poor vocabulary knowledge learn less words and widen the gap between self and peers over time due to their inability to effectively meet the ever increasing academic effects of the classroom. The vocabulary problems of students who enter school with poorer limited vocabularies only worsen over time (White, Graves & Slater, 1990). We need to provide these children with all the feasible opportunities to narrow this gap and partake from the curriculum in a more similar fashion as typically developing peers. 

Helpful Smart Speech Therapy Resources:

References:

Duke, N. K. (2013). Starting out: Practices to Use in K-3. Educational Leadership, 71, 40-44.

Marzano, R. J., & Marzano, J. (1988). Toward a cognitive theory of commitment and its implications for therapy. Psychotherapy in Private Practice 6(4), 69–81.

Stahl, S. A. & Fairbanks, M. M. “The Effects of Vocabulary Instruction: A Model-based Metaanalysis.” Review of Educational Research 56 (1986): 72-110.

Strangman, N., Hall, T., & Meyer, A. (2004). Background knowledge with UDL. Wakefield, MA: National Center on Accessing the General Curriculum.

White, T. G., Graves, M. F., & Slater W. H. (1990). Growth of reading vocabulary in diverse elementary schools: Decoding and word meaning. Journal of Educational Psychology, 82, 281–290.

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Working with Russian-speaking clients: implications for speech-language assessment

United States boasts an impressive Russian-speaking population.  Numerous Russian-Americans live in various parts of the country with large concentrations in states such as New York, New Jersey, Pennsylvania, Ohio, Washington, Oregon, Illinois, California, and Florida, with smaller numbers found in most of the remaining states. According to the 2010 United States Census the number of Russian speakers was 854,955, which made Russian the 12th most spoken language in the country (link to statistics). Continue reading Working with Russian-speaking clients: implications for speech-language assessment

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Recommendations for Assessing Language Abilities of Verbal Children with Down Syndrome (DS)

Kid-1Assessment of children with DS syndrome is often complicated due to the wide spectrum of presenting deficits (e.g., significant health issues in conjunction with communication impairment, lack of expressive language, etc) making accurate assessment of their communication a difficult task. In order to provide these children with appropriate therapy services via the design of targeted goals and objectives, we need to create comprehensive assessment procedures that focus on highlighting their communicative strengths and not just their deficits.

Today I’d like to discuss assessment procedures for verbal monolingual and bilingual children with DS 4-9 years of age, since testing instruments as well as assessment procedures for younger as well as older verbal and nonverbal children with DS do differ.

When it comes to dual language use and genetic disorders and developmental disabilities many educational and health care professionals are still under the erroneous assumption that it is better to use one language (English) to communicate with these children at home and at school.  However, studies have shown that not only can children with DS become functionally bilingual they can even become functionally trilingual (Vallar & Papagno, 1993; Woll & Grove, 1996).  It is important to understand that “bilingualism does not change the general profile of language strengths and weaknesses characteristic of DS—most children with DS will have receptive vocabulary strengths and expressive language weaknesses, regardless of whether they are monolingual or bilingual.” (Kay-Raining Bird, 2009, p. 194)

Furthermore, advising a bilingual family to only speak English with a child will cause a number of negative linguistic and psychosocial implications, such as create social isolation from family members who may not speak English well as well as adversely affect parent-child relationships (Portes & Hao, 1998).

Consequently, when preparing to assess linguistic abilities of children with DS we need to first determine whether these children have single or dual language exposure and design assessment procedures accordingly.

Pre-assessment Considerations

It is very important to conduct a parental interview no matter the setting you are performing the assessment in. One of your goals during the interview will be to establish the functional goals the parents’ desire for the child which may not always coincide with the academic expectations of the program in question.

Begin with a detailed case history and review of current records and obtain information about the child’s prenatal, perinatal and postnatal development, medical history as well as the nature of previous assessments and provided related services. Next, obtain a detailed history of the child’s language use by inquiring what languages are spoken by household members and how much time do these people spend with the child?

Choosing Testing Instruments 

A balanced assessment will include a variety of methods, including observations of the child as well as direct interactions in the form of standardized, informal and dynamic assessments. If you will be using standardized assessments (e.g., ROWPVT-4) YOU MUST use descriptive measures vs. standardized scores to describe the child’s functioning. The latter is especially applicable to bilingual children with DS. Consider using the following disclaimer: “The following test/s __________were normed on typically developing English speaking children. Testing materials are not available in standardized form for child’s unique developmental and bilingual/bicultural backgrounds. In accordance with IDEA 2004 (The Individuals with Disabilities Education Act) [20 U.S.C.¤1414(3)],official use of standard scores for this child would be inaccurate and misleading so the results reported are presented in descriptive form.  Raw scores are provided here only for comparison with future performance.”

Selecting Standardized Assessments 

Depending on the child’s age and level of abilities a variety of assessment measures may be applicable to test the child in the areas of Content (vocabulary), Form (grammar/syntax), and Use(pragmatic language).

For children over 3 years of age whose linguistic abilities are just emerging you may wish to use a vocabulary inventory such as the MacArthur-Bates (also available in other languages) as well as provide parents with the Developmental Scale for Children with Down Syndrome to fill out. This will allow you to compare where child with DS features in their development as compared to typically developing peers. For older, more verbal children who are using words, phrases, and/or sentences to express themselves, you may want to use or adapt (see above) one of the following standardized language tests:

Informal Assessment Procedures 

Depending on your setting (hospital vs. school), you may not perform a detailed assessment of the child’s feeding and swallowing skills. However, it is still important to understand that due to low muscle tone, respiratory problems, gastrointestinal disorders and cardiac issues, children with DSoften present with feeding dysfunction which is further exacerbated by concomitant issues such as obesity, GERD, constipation, malnutrition (restricted food group intake lacking in vitamins and minerals), and fatigue. With respect to swallowing, they may experience abnormalities in both the oral and pharyngeal phases of swallow, as well as present with silent aspiration, due to which instrumental assessment (MBS) may be necessary (Frazer & Friedman, 2006).

In contrast to feeding and swallowing the oral-peripheral assessment can be performed in all settings. When performing oral-peripheral exam, you need to carefully describe all structural (anatomical) and functional (physiological) abnormalities (e.g., macroglossia, micrognathia, prognathism, etc).   Note any issues with:

  • —  Dentition (e.g., dental overcrowding, occlusion, etc)
  • —  Tongue/jaw disassociation  (ability to separate tongue from jaw when speaking)
  • —  Mouth Posture (open/closed) and tongue positioning  at rest (protruding/retracted)
  • —  Control of oral secretions
  • —  Lingual and buccal strength, movement (e.g., lingual protrusion, elevation, lateralization, and depression for volitional tasks) and control
  • —  Mandibular (jaw) strength, stability and grading

Take a careful look at the child’s speech. Perform dual speech sampling (if applicable) by considering the child’s phonetic inventory, syllable lengths and shapes as well as articulatory/phonological error patterns.  Make sure to factor in the combined effect of the child’s craniofacial anomalies as well as system wide impairment (disturbances in respiration, voice, articulation, resonance, fluency, and prosody) on conversational intelligibility. Impaired intelligibility is a serious concern for individuals with DS, as it tends to persist throughout life for many of them and significantly interferes with social and vocational pursuits (Kent & Vorperian, 2013)

Don’t forget to assess the child’s voice, fluency, prosody, and resonance. Children with DS may have difficulty maintaining constant airstream for vocal production due to which they may occasionally speak with low vocal volume and breathiness (caused by air loss due to vocal fold hypotonicity). This may be directly targeted in treatment sessions and taught how to compensate for.  When assessing resonance make sure to screen the child for hypernasality which may be due to velopharyngeal insufficiency secondary to hypotonicity as well as rule out hyponasality which may be due to enlarged adenoids (Kent & Vorperian, 2013). Furthermore, since stuttering and cluttering occur in children with DS at rates of 10 to 45%, compared to about 1% in the general population, a detailed analysis of disfluencies may be necessary(Kent & Vorperian, 2013). Finally, due to limitations with perception, imitation, and spontaneous production of prosodic features secondary to motor difficulties, motor coordination issues, and segmental errors that impede effective speech production across multisyllabic sequences, the prosody of individuals with DS will be impaired and might require a separate intervention. (Kent & Vorperian, 2013)

When it comes to auditory function, formal hearing testing and retesting is mandatory due to the fact that many children with DS have high prevalence of conductive and sensorineural hearing loss (Park et al, 2012). So if the child in question is not receiving regular follow-ups from the audiologist, it is very important to make the appropriate referral. Similarly, it is also very important that the child’s visual perception is assessed as well since children with DS frequently experience difficulties with vision acuity as well as visual processing, consequentially a consultation with developmental optometrist may be recommended/needed.

Describe in detail the child’s adaptive behavior and learning style, including their social strengths and weaknesses. Observe the child’s eye contact, affect, attention to task, level of distractibility, and socialization patterns. Document the number of redirections and negotiations the child needed to participate as well as types and level of reinforcement used during testing.

Perform dual language sampling and look at functional vocabulary knowledge and use, grammar measures, sentence length, as well as the child’s pragmatic functions (what is the child using his/her language for: request, reject, comment, etc.) Perform a dynamic assessment to determine the child’s learnability (e.g., how quickly does the child learns and adapts to being taught new concepts?) since “even a minimal mediation in the form of ‘focusing’ improves the receptive language performance of children with DS” (Alony & Kozulin, 2007, p 323)

After all the above sections are completed, it is time to move on to the impressions section of the report.  While it is important to document the weaknesses exposed by the assessment, it is even more important to document the child’s strengths or all the things the child did well, since this will help you to determine the starting treatment point and allow you to formulate relevant treatment goals.

When making recommendations for treatment, especially for bilingual children with DS, make sure to provide a strong rationale for the provision of services in both languages (if applicable) as well as specify the importance of continued support of the first language in the home.

Finally, make sure to provide targeted and measurable [suggested] treatment goals by breaking the targets into measurable parts:

Given ___time period (1 year, 1 progress reporting period, etc), the student will be able to (insert specific goal) with ___accuracy/trials, given ___ level of, given _____type of prompts.

Assessing communication abilities of children with developmental disabilities may not be easy; however, having the appropriate preparation and training will ensure that you will be well prepared to do the job right!  Use multiple tasks and activities to create a balanced assessment, use descriptive measures instead of standard scores to report findings, and most importantly make your assessment functional by making sure that your testing yields relevant diagnostic information which could then be effectively used to provide effective quality treatments for clients with DS!

For comprehensive information on “Comprehensive Assessment of Monolingual and Bilingual Children with Down Syndrome” which discusses how to assess young (birth-early elementary age) verbal and nonverbal monolingual and bilingual children with Down Syndrome (DS) and offers comprehensive examples of write-ups based on real-life clients click HERE.

Other Helpful Resources