How would you understand this? Updated

PipSqueak0313

This is something that has been churning in my brain since our last EI visit at the beginning of the month. After I asked ds's EI teacher about doing a speech evaluation on ds she wrote on the report form for the visit that "thinking skills and language skills usually parallel". Ds has zero words at 17 months even though the EI teacher claims a grunt is ds's vocalization of more in response to her asking and signing more. During our conversation the teacher indicated that she didn't think ds would qualify for speech due to not having a large enough discrepancy between his thinking and language skills. How would you interpret the note on the visit report? Is she claiming that his grunts and vowel sound only vocalizations ARE words and therefore his language skills are higher or is she saying that she believes his thinking skills are lower?

thefuturemrskudla

I don't know what she meant, but I would request an eval by an SLP.

PipSqueak0313

I started requesting a speech evaluation from the school 6months ago. We just completed a private speech evaluation and are waiting for the SLP to write her report.

PipSqueak0313

-auntie- said:

PipSqueak0313 said:

This is something that has been churning in my brain since our last EI visit at the beginning of the month. After I asked ds's EI teacher about doing a speech evaluation on ds she wrote on the report form for the visit that "thinking skills and language skills usually parallel".

Wut?

What does she mean by "thinking skills"? Is she considering cognition or something more along the lines of IQ?

IME, this is not always the case. I know plenty of typical kids who were clearly bright who just talked later than peers- often they were kids who were stronger in motor skills. I know a lot of kids with ASD who had very delayed language and speech who are served in mainstream classes by middle school. 

Ds has zero words at 17 months even though the EI teacher claims a grunt is ds's vocalization of more in response to her asking and signing more.

It could be. Language is about more than talking. He could be communicating via a grunt and it's great that he knows interacting via grunt gets him stuff.

During our conversation the teacher indicated that she didn't think ds would qualify for speech due to not having a large enough discrepancy between his thinking and language skills. 

This is more commonly seen in school aged kids around academics. It can be hard to advocate for some kinds of interventions if the team feels the child doesn't have the potential IQ to fully access the program. When getting supports for DS, his IQ always played into advocating. Always.

Any way, it's the SLPs call and most states don't offer EI SLPs until 18-24 months. I'd consider a private speech eval just to get a second opinion on this if he doesn't qualify.

 How would you interpret the note on the visit report? Is she claiming that his grunts and vowel sound only vocalizations ARE words and therefore his language skills are higher or is she saying that she believes his thinking skills are lower?

TBH, I'd ask her to be specific. I find sometimes professionals sugar coat what they right out of sensitivity to parents. To my eye it looks as if she doesn't think he has the bandwidth to learn speech at this time rather than suggesting grunts are words in the usual sense. I'd want to know what she means by "thinking skills"- cognition vs IQ. Example- DS has a high average IQ based on WISC; the number isn't so important because it could be any number within a range of 30 points- one direction would make him gifted and the other direction dead average. But his cognition around certain concepts- cause and effect and math (for some reason) was more in line with his emotional age which is lower than his chronological one.

Regarding ds grunting to be a vocal response to more....I would have an easier time agreeing if that was how he usually responded but it's not. Normally he doesn't respond at all. We did have him evaluated by private Speech.....an interesting event to watch. The SLP held out two objects, I.e. the eyes and the nose from Mr. Potatohead and asked ds which one was the eyes.. Ds identified the item requested correctly enough for me to say it's not a fluke. She'd tell him to put the item in the box and he would. As a result of observing the speech evaluation, dh and I have started to realize that he has learned and is learning more than we thought. I knew he understood more language that he expresses based on his response (stop crying) to me telling him I'm getting his cup/bottle when he'd cry his hungry cry. I hadn't thought about if he was learning body parts and animals and animal sounds because no one had worked with him, or taught us to, in manner that allowed him to express what he knows before that evaluation. I did know that it's good to name things for babies/toddlers as you use the items and as part of play so I have been doing that for a while. Ds has Down Syndrome so we already know there is some level of intellectual disability AND we know ds has hypotonia in his core muscles and mouth muscles. Language is more than talking but speech also includes being able to position the mouth to make the sounds necessary for speech and that is something ds cannot do. He's already a year behind typical peers in making speech sounds. The only speech sounds he produces consistently are vowel sounds. I don't know.....it's just that different conversations over the past 6 months are really leaving dh and I questioning the services provided by the school district and really seriously considering what our options are.

Assembly_Reqd

Nate does not have an ID, but he is a vowel talker due to dysarthria. We did not start speech until he was 22 months old. Honestly, we should have waited until 3. There was very little progress for the amount of time we have been working on speech. 

He started at 1xWeek for 30 min. When he turned three we asked for an additional 30 minutes per week and got it since his progress was sooooo slow. Speech really started to take off at 3.5 when we added another 30 min private session per week.

We were concerned about his cognitive function back then because we really didn't have a way to measure it. At age 2 we got an ipad and we were really able to see how smart he was. A lot of people poo poo it, but for me it was a saving grace. I could stop worrying about it. He now also has more 'bandwidth' to work at speech drills.

PipSqueak0313

Had another EI visit yesterday. I intentionally provided as little information about ds as I could/didn't answer questions and it must have made them pay more attention to ds instead of me....also had pt and teacher there. Pt was surprised that ds was army crawling and attempting to side step aka cruise furniture and they made a couple comments regarding ds thinking/problem solving that they would have missed while writing or talking to me. So that might be what I have to do for future visits is just not respond to their questions unless it's something that can't be answered by observing ds.

PipSqueak0313

Update to this......got the results of private speech therapy evaluation....mild/moderate for receptive language and moderate for expressive language so we are starting private ST tomorrow. Also, had an EI visit end of last week, with ot, pt, and the teacher present. (4 of 5 IFSP team members present). I commented that I had started naming/teaching the colors to ds and the teacher responded that it's too early to be teaching ds his colors. Yeah, right, dd could identify the colors at 12 months, even before she could talk so teaching them at 18 months is not too early. Anyway, as I was talking with my mom about that visit, something came out of my mouth that made me decide that it's time to have the teacher replaced on the team. I was describing how the teacher had pulled out ds's IFSP during the home visit and was wanting to start updating it a month before the IFSP meeting and without my husband there to provide his input. The OT even had a surprised expression and commented that dh and I probably need time to discuss the IFSP on our own first. NOT acceptable behavior from the teacher, at least not in my book. It happened last year too, and dh vocally objected to not knowing anything about what was input as parental concerns and all that. I agree with dh since he IS a team member too.

hopecounts

To be fair to the teacher learning colors is developmentally a young preschooler skill not a toddler skill and depending on the specifics there might be more developmentally appropriate cognitivegoals to work on. 

But given the other issues you did the right thing.

PipSqueak0313

hopecounts said:

To be fair to the teacher learning colors is developmentally a young preschooler skill not a toddler skill and depending on the specifics there might be more developmentally appropriate cognitivegoals to work on. 

But given the other issues you did the right thing.

Spending a few minutes playing with my son and telling him this is a blue block and this is a red block......let's put the red block on the blue block is hardly developmentally inappropriate for a toddler....nor is adding colors and other descriptive words while talking to ds about the world around you. That's what I mean by teaching him his colors......Consciously adding colors to descriptions when talking to ds. I do the same thing with the alphabet....until my letters refused to stick to the wall I had them up on a wall we walked past frequently and I would stop and point to one of the letters and say it's name and sound.

hopecounts

PipSqueak0313 said:

hopecounts said:

To be fair to the teacher learning colors is developmentally a young preschooler skill not a toddler skill and depending on the specifics there might be more developmentally appropriate cognitivegoals to work on. 

But given the other issues you did the right thing.

Spending a few minutes playing with my son and telling him this is a blue block and this is a red block......let's put the red block on the blue block is hardly developmentally inappropriate for a toddler....nor is adding colors and other descriptive words while talking to ds about the world around you. That's what I mean by teaching him his colors......Consciously adding colors to descriptions when talking to ds. I do the same thing with the alphabet....until my letters refused to stick to the wall I had them up on a wall we walked past frequently and I would stop and point to one of the letters and say it's name and sound.

I misunderstood what you meant.