Speech and Language assessment

[llisa32]

Hiya - J had his assessment today with the speech and language therapist .

 

It was a horrible long drive through tons of traffic and rotten roads to get there and I feel like it was a waste of time

 

The therapist was really nice, but I felt the assessment questions were totally not age appropriate.

 

She took another history (bout the 5th one I've done so far!) and J was in the room while she did this - which made it quite difficult for me to get overly descriptive and he kept interupting. When he was given the option of leaving the room he wouldn't - so we continued with him there.

 

The assessment work she did with him contained a lot of using phrases and deducing actions from pictures. The phrases were all for the most part ones that have cropped up and thus we've explained and he understands, and the sceraios that the pictures were based on were also fairly mundane everyday stuff that has most definately cropped up - and therefore he had the 'experience' to make an educated guess.

 

J will always asl me when he hears a new phrase or new word if he doesn't understand them.

 

At the end she concluded that she could see 'traits' of AS and that he definately has problems with auditory memory.

 

I guess I feel like it was a waste of time because we already know he has problems with auditory processing and I thought she would look at more detil re conversation 'flow' or lack of etc. I feel now that this report will be neither one thing or the other - and have no idea how it will 'fit' into all the other reports.

 

We're due to get a diagnosis mid feb, and I don't really feel that today will add anything of value, and I'm a little worried I guess that it might hold some weight 'against' giving a diagnosis.

 

I know the Ed Psch quite firmly thinks AS, and I think the ADOS scores suggested AS - just not sure how it all gets 'put together' and on what they base a diagnosis.

 

Hope all of this has made sense - apologies I'm waffling a little! - just had to get it out!

 

Oh...and forgot to add....she kept going on and on about how J made 'lovely' eye contact with me, and then i kept feeling compelled to say 'yes....he always has done with me...but have u noticed not so much for you!?'

Edited January 18, 2008 by llisa32

[Karen A]

Hi Lisa.It is a stressful time wading through assessments. <'> Karen.

[stressedmumto2]

Sounds like a bit of a stressfull apointment and I can definatly tell you I have had my fair share of those!!!

 

The eye contact was interesting, my son gives me eye contact but other people he either wont look at at all, over-stare or his eyes fleet, with most professionals it's a case of I wont talk to you let alone look at you!!!

 

With diagnosing they have to take everything into accout and what the other professionals have also said. Is there any chance you could write a list down of extras you wanted to say to her but felt it wasn't apporpiate cos your son was there? I have done this in the past cos I find it really difficult to remember things at appointment, plus you don't always want to discuss things in front of child.

 

Good luck <'>

[JsMum]

Hi I kind of had a similair assessment with the SALT and she said the same with me about J and his Lovely eye contact, however this is defo different with other people, in the assessment J was in a familiar place and felt safe so there so this wasnt much of an issue, he was able to say why he didnt like school and she has said that though his communication and expressive skills (note he has a diagnosed speech and language delay and expressive disorder) are good she said that he isnt understanding language ques, ie knowing when people are joking, if anything was to help you tell it would be eyes yet he cant stinguish this.

 

Can anyone help explain the lack of eye contact in ASDs, it isnt always the case in every ASD as I visited a special school many had ASDs and they gave good eye contact and they talked and talked to me, so I dont know how people can suggest just AS Traits when there is other diagnosed ASD children who have eye contact and are verbal, any one who can place a little light on eye contact and communication would really help me understand too.

 

JsMum

[pearl]

Sorry it was a frustrating appointment llisa. I do wish these peeps would realise we feel inhibited talking about our children when they are with us - its not a case of us talking behind their backs, but of not wanting to hurt their feelings, so its hard to tell it as it is.

[Bagpuss]

Don't you just feel you repeat yourself over, and over, and over, and over

 

I used to dread these appts Lisa, because I just don't remember milestones

 

Hope you get some concrete answers soon <'>

[krystaltps]

I know . I felt like that too. Out of all the assessments the SALT one was the most frustrating. Like you said, all it did was tell us what we already knew.

I was under the impression that the SALT assessment was supposed to be carried out before the ADOS, as it helped in the selection of which grade of ADOS to use.

As for the eye-contact thing, I'm aware of all the theory re lack of eye-contact and why, but C is quite the opposite most of the time. If he's interested and wants to talk to you, he stares right into your eyes in a very penetrating way that sometimes makes you feel as if you need to look away.

As usual, it's not a one-size-fits-all kind of thing. There are too many sweeping generalisations.

[llisa32]

Thanks all for your replies <'> it was definately a frustrating appt and I'm still stewing over it I think.

 

I'd thought that it would cover the conversational difficulties he has, and the trouble with expressing his own thoughts and emotions into words but nothing I saw yesterday touched on those aspects.

 

I'd been told the appt was to check expressive and receptive language....I didn't see anything yesterday that would have indicated either of those areas.

 

He's been in either small nursery or small school since he was a baby, and he's been bright enough to ask me or someone else for the last year or two everytime he doesn't understand a 'phrase' etc.

 

He's very literal, but she couldn't seen to decide if he was 'pretending' to give her the literal interpretation yestredayt because on one occasion he'd told her he was 'tricking her with his answer' - but she'd been telling him she'd been trying to trick him with her questions!! - so what did she expect!

 

I just found it really frustrating and particularly odd that the Ed Psch could be so far definately one way on the scale and the SALT ending up a wishy washy kind of 'sitting on the fence' opinion.

 

It made me feel that she made generalisations that she perhaps might not have done, had she had more experience. I think I'm going to follow up with a letter on Monday and send a copy to all involved just highligting my thoughts about what the assessment covered and why I didn't think it was very useful.

[pumpkinpie]

Was this an nhs salt? Best thing I ever did was get an independant report done by a specialist salt. Most nhs salts seem to go though the motions and arent interested in kids with long term difficulties~

[Bard]

B makes good eye contact with me, because since he was tiny, I've been his interpreter of what to do, what's going on and what I expect of him. So he looks at me if he's uncertain what he's doing or about to do is correct. He looks if he's trying to work out what the chances are of sneaking something past me as well. When he was younger, most of our discipline and behaviour strategies were based on visual signals from me as he found processing words under stress and at speed difficult.

So I would sign for stop, too loud, control your temper, don't touch, come here, you can run ahead to the next lamppost, move away from... and dozens of other needs. And he would watch me and usually comply. whereas a shout just startled and angered him. Signals work well over distance. We still use this a lot.

He stares at me if he's explaining something that he wants me to really listen to, holding and turning my head if he thinks I'm not concentrating, or if I talk to someone else whilst watching. He knows that his concentration fluctuates, so he expects me to need to behave like him and focus.

He can't pick up on other people's emotions very well, and so he watches me to work out if I'm annoyed or upset about something. I usually tell him as well, and I point out other people's body language and reactions that let you know what that person might be feeling. So sometimes he stares at someone he's trying to understand.

The SLT sounds as if she had a 'one size fits all' approach and so she trotted out the same, standard tests and bits and bobs. It would be more useful for you to have a meeting alone to talk specifics, or to write/email with your worries and concerns so that she was more focused and less hit and miss. It is the fault of her generalised approach, and not you.

[pearl]

Was this an nhs salt? Best thing I ever did was get an independant report done by a specialist salt. Most nhs salts seem to go though the motions and arent interested in kids with long term difficulties~

 

Our experience was v different once we got nhs salts but who specialised in ASD. We had superb service from them for around 10 years.

[JsMum]

Hi I did some research into eye contact and came across this pdf about Facts and what others sometimes perseve as Autism, its really interesting as it does state that some Autistic Children have good eye contact and I have certainly met a few with really good eye contact and they are in the severe end to the high functioning.

 

here is the link

 

http://www.asdatoz.com/Documents/website-%...cts%20ltrhd.pdf

 

I would let her write her report and state all her facts about your son in how she see's it, then if your not happy ask for a specialist salt in ASD and let them read it.

 

I think writing a letter to accompany it will help and can add to the overall discussion.

 

Hope you find the pdf helpful I sure have and printing it off to give to Js Salt.

 

 

Good luck with the outcome and you can always ask for a second opinion.

 

JsMum

[Karen A]

Hi.I thought it worth mentioning that if the Assessment was for ASD or specific difficulties with speach related to ASD then if the SALT has not had further training in ASD then he/she may not pick up on ASD.Ben was seen weekly for over a year by a SALT because he had dysfluency.The fact that he might have AS was never noticed in all that time .If the SALT is not trained to assess for ASD then it may be worth asking for a reassessment with a specialist SALT if you are not happy.Karen.