Poway Unified School District Chaparral Elementary School 17250 Tannin Drive Poway, CA 92064 SPEECH AND LANGUAGE EVALUATION SUMMARY DATE OF REPORT: NAME: SCHOOL YEAR: DATE OF BIRTH: AGE: GRADE: CURRENT PROGRAM: PARENTS/GUARDIAN: SCHOOL OF ATTENDANCE: ADDRESS: SCHOOL OF RESIDENCE: TEACHER: PHONE NUMBER: PRIMARY LANGUAGE: ASSESSOR: EL: No REASON FOR REFERRAL Jeffrey was referred for evaluation by the IEP team as part of his triennial review to determine if he continues to demonstrate eligibility for speech and/or language services. He is currently enrolled in the 5th grade. EDUCATIONALLY RELEVANT HEALTH, DEVELOPMENTAL AND/OR MEDICAL FINDINGS Jeffrey initially qualified for special education services through PUSD in October 2004 under the eligibility category of Autism. He has been receiving speech therapy 30 times direct, 5 times push-in, and 4 consults at 30 minutes each year. He has made excellent progress towards all pragmatic language goals. Additionally, he has been receiving consultative Occupation Therapy services 4 times per year for 30 minute sessions to work on sensory processing. Please see Psycho-Educational report for more details (dated March 2012). LANGUAGE BACKGROUND Jeffrey’s primary language is English; the primary language of the home is English as well. RELEVANT BEHAVIOR NOTED DURING OBSERVATION Jeffrey was assessed over several sessions in a quiet room by this examiner. He came to the speech room willingly and engaged in conversation with this examiner. He was compliant throughout testing procedures and responded well to praise and encouragement. He appeared to be comfortable and worked hard to complete all tasks presented. It was a pleasure working with Jeffrey. © 2007 North Inland SELPA Page | 1 EVALUATION PROCEDURES The assessment instruments and procedures used are valid for the purpose of this evaluation, are nondiscriminatory, and were administered by qualified personnel. The student’s language proficiency was considered in the administration of all instruments and procedures. The evaluation included review of records, speech/language evaluation, clinical observation, progress review, and teacher/parent feedback. SPEECH AND LANGUAGE EVALUATION RESULTS This speech and language evaluation was conducted by Morwenna Kehoe, Speech-Language Pathologist. ARTICULATION/PHONOLOGY Based on informal observation and assessment, Jeffrey presents with age appropriate articulation skills. His intelligibility is greater than 80% in conversational speech when the context is unknown. VOICE Based on informal observation and assessment, Jeffrey’s voice is within normal limits for age and gender. FLUENCY Jeffrey’s fluency is within normal limits. LANGUAGE Cognitive Measure: Jeffrey’s Full Scale IQ is 129, in the above average range. Please see Psycho-Educational Report (dated March 2012). Formal Language Assessment Results The Social Language Development Test – Elementary was administered to assess Jeffrey’s social language skills. It is a diagnostic test of social language skills, including nonverbal communication for elementary students aged 6.0 to 11.11. The tasks focus on taking someone else’s perspective, making correct inferences, negotiating conflicts with peers, being flexible in interpreting situations, and supporting friends diplomatically. Following is a description of each subtest: 1. Making Inferences: The student takes the perspective of someone in a photograph and, based on the context clues (facial expression, gesture, posture, background clues, etc.) tells what the person is thinking as a direct quote from the character. The student, therefore, must state a relevant thought from that character’s perspective and then state the relevant visual clues suggesting the character’s thought. 2. Interpersonal Negotiations: The student is asked to imagine being in a conflict situation with a friend. The student must then state the problem, propose an appropriate solution, and explain why that solution would be a good one. 3. Multiple Interpretations: The student provides two distinctly different, plausible interpretations to the same photo. 4. Supporting Peers: The student assumes the perspective of a main character in a situation with a friend. The student tells the friend something that supports or pleases the friend, even if the comment isn’t truthful. © 2007 North Inland SELPA Page | 2 The following tables illustrate Jeffrey’s performance on this test: MAKING Expressing Stating Visual Cues INFERENCES Perspective Standard Score 88- Low Average 81 – Below Average Percentile Rank 21 11 INTERPERSONAL NEGOTIATIONS Standard Score Percentile Rank MULTIPLE INTERPRETATIONS Standard Score Percentile Rank Stating Problems 99 - Average 47 Stating Solutions 97 - Average 43 Total 83 – Below Average 13 Justifying Solutions 102 – Average 55 Total 99 - Average 48 Multiple Interpretations 95 – Average 38 SUPPORTING Supporting PEERS Peers Standard Score 108 – Average Percentile Rank 69 Average standard scores are achieved between 85-115 Jeffrey achieved an overall Test Total Standard Score of 97, indicating average performance, in the 43rd percentile. Jeffrey demonstrated strengths in the areas of stating problems from a mutual perspective (i.e.: We want to do different things.), stating solutions to problems, justifying solutions for the current situation, providing multiple interpretations of a photograph, and telling a friend something that supports or pleases the friend, even if the comment isn’t truthful (i.e.: friend gets bad haircut – “Your hair looks nice.”). Jeffrey demonstrated relative weakness in the area of expressing someone’s perspective by formulating a direct quote relevant to a person’s situation and the emotional intensity exhibited (i.e.: I finally got a car!) and identifying and stating a visual clue in a picture to suggest what a character was thinking (i.e.: holding up keys and smiling). The Children’s Communication Checklist –Second Edition (CCC-2), a measure designed to assess children’s communication skills in the areas of pragmatics, syntax, morphology, semantics, and speech, was given to Jeffrey’s teacher to fill out. It is administered using a Caregiver Response Form on which the caregiver rates the fluency that the child demonstrates the communication behavior described in each item. The first four scales – A: Speech, B: Syntax, C: Semantics, and D: Coherence – assesses aspects of articulation and phonology, language structure, vocabulary, and discourse. These are areas that are often impaired in children with Speech Language Impairment. The next four scales – E: Initiation, F: Scripted Language, G: Context, and H: Nonverbal Communication – address pragmatic aspects of communication that are not readily assessed by conventional language assessments. Pragmatic skills can be impaired in children with or without structural language difficulties. In other words, Scales E, F, G, and H identify children whose language is not impaired in the areas of content and form, but is impaired in the area of use. The last two scales – I: Social Relations and J: Interests – assess behaviors that are © 2007 North Inland SELPA Page | 3 usually impaired in children with Autism Spectrum Disorders (ASD). These scales are included because pragmatic language impairment is a hallmark feature of Autism Spectrum Disorders (ASD). CCC-2 cannot be used to diagnose ASD, but a finding of disproportionately poor scores on the scales assessing pragmatics, in addition to evidence of impairment on Scales I and J, would suggest that the child needs further evaluation. The following table illustrates teacher ratings: Scaled Scores of 7-13 are in the average range Scaled Scores Percentile Ranks A. Speech 12 – High Average 75% B. Syntax C. Semantics D. Coherence 12– High Average 10– Average 8– Average 75% 50% 25% Scaled Scores Percentile Ranks E. Initiation F. Scripted Lang 11 – Average 13 – High Average 63% 84% G. Context H. Nonverbal Communication 9 – Average 9 – Average 37% 37% I. Social Relations J. Interests TEACHER COMPOSITE SCORES (TOTALS) General Communication Composite (GCC) Social Interaction Difference Index (SIDI) Scaled Scores Percentile Ranks 6 – Slightly Below Average 11– Average 9% 63% Standard Score Percentile Rank Summary of Performance 104 61 (Sum of Scores A – H) AVERAGE ---------------- ---------------- Index score of -5 = performance in typical range (-10 to 10 typical; >10 indicates characteristics similar to Speech Language Impairment; <-10 indicates characteristics similar to Autism Spectrum Disorder) © 2007 North Inland SELPA Page | 4 The GCC is a norm-referenced standard score which enables the examiner to compare the child’s performance to the performances of other children the same age. The GCC is on a normalized standard score scale that has a mean of 100 and a standard deviation of 15. The GCC may be used to identify children likely to have significant communication problems. Overall, based on teacher ratings, Jeffrey achieved a General Communication Composite (GCC) Standard Score of 104, in the 61st percentile, indicating average communication skills in the classroom. The Social Interaction Difference Index (SIDI) was designed to be helpful in identifying children with a communication profile that might be characteristic of language impairment or Autism Spectrum Disorder (ASD). Based on teacher ratings, Jeffrey achieved a SIDI score of -5, indicating typical communication skills for his age. Based on this checklist, in the area of language content and form (A, B, C, D), Jeffrey presented with average language skills with strengths in the area of speech (articulation and phonology), syntax, and semantics. He presented with relative weakness in the area of coherence. In the area of pragmatics (E, F, G, H), Jeffrey presented with average skills with relative strengths in the areas of initiation and scripted language. He presented with relative weakness in the areas of context and nonverbal communication. On the last two scales (I, J) which assess behaviors that are usually impaired in children with Autism Spectrum Disorders (ASD), Jeffrey presented with strengths in the area of initiation but weakness in the area of social relations. Examples of areas of weakness are outlined below: Coherence: Occasionally talks about things in the past or future Context: Occasional difficulty talking in different situations; less than once a week he appreciates humor that is ironic Nonverbal Communication: occasionally stands too close when talking to someone; occasionally uses gestures to get meaning across Social Relations: occasionally seems inattentive with adults; less than once a week he shows concern when others are upset; less than once a week he talks about his friends Portions of the Comprehensive Assessment of Spoken Language (CASL) were administered to Jeffrey to assess his ability to use language for special tasks requiring higherlevel cognitive functions and to assess his knowledge and use of language in communicative contexts. The following areas of language were assessed with this measure 1. Supralinguistic language skills - measures comprehension of complex language in which meaning is not directly available from lexical or grammatical information (nonliteral language subtest and inference subtest). 2. Pragmatic language skills–measures awareness of the appropriateness of language in relation to the situation in which it is used and ability to modify language to the situation (pragmatic judgement subtest). © 2007 North Inland SELPA Page | 5 The following table illustrates Jeffrey’s performance on this measure. Please note that Standard Scores of 85-115 are within the average range. CASL Subtest Standard Score Nonliteral Language 110 Inference 97 Pragmatic Judgment 122 Performance High Average Average Above Average Descriptions of the subtests of the CASL are provided below: Nonliteral Language: On this subtest, Jeffrey listened to a sentence read aloud by the examiner that contained a nonliteral expression, followed by a question such as, “What does that mean?” Jeffrey then needed to state what the nonliteral expression meant. This subtest measures a student’s understanding of the meaning of spoken messages independent of literal interpretation (i.e.: figurative speech, indirect requests, and sarcasm). Jeffrey correctly responded to 26 of 36 presented items. He achieved a standard score of 110, indicating average skills in the area of supralinguistics. Inference: On this subtest, Jeffrey listened to 2 to 3 sentence episodes read aloud by the examiner, followed by a question that required Jeffrey to use his background and world knowledge to infer the answer. This subtest measures a student’s use of previously acquired world knowledge to derive meaning from inferences. Jeffrey correctly responded to 25 of 39 presented items. He achieved a standard score of 97, indicating average skills in the area of supralinguistics. Pragmatic Judgment: On this subtest, Jeffrey listened to a series of vignettes read aloud by the examiner. He then was required to judge the appropriateness of the language used by the characters in the vignette or to supply the appropriate language for the situation. This subtest measures a student’s knowledge and use of pragmatic language rules and judgment of their appropriate application. Jeffrey correctly responded to 63 out of 68 presented items. He achieved a standard score of 122, indicating above average skills in the area of pragmatics. Additionally, the Pragmatics Profile from the Clinical Evaluation of Language Fundamentals-4 (CELF-4) was distributed and completed by Jeffrey’s current classroom teacher. The purpose of the Pragmatics Profile is to identify verbal and nonverbal pragmatic deficits that may negatively influence social and academic communication. Rituals and Conversational skill; Asking For, Giving, and Responding to Information; and Nonverbal Communication Skills are the areas that are assessed. The evaluator can respond with “Never,” “Sometimes,” “Often,” “Always,” “Not Observed,” or “Not Appropriate” for each behavior. The table below represents the teacher’s score regarding Jeffrey’s pragmatic language: Evaluator Classroom Teacher Score 147 The Average Criterion score for a student aged 10:0-11:11 is > 136. Jeffrey achieved a total scores of 147 on the Pragmatics Profile which does meet the criterion score of greater than or equal to 136, indicating adequate communication abilities in context. The following areas were rated as “Sometimes” by the classroom teacher: Sometimes maintains eye contact, appropriate body position during conversations © 2007 North Inland SELPA Page | 6 Sometimes participates/interacts appropriately in unstructured group activities Sometimes adjusts body distance appropriate to the situation Informal Language Assessment Results: The following informal assessments from Michelle Garcia Winner’s Social Thinking Dynamic Assessment were also conducted to further assess Jeffrey’s language skills: writing sample, the double interview, thinking with eyes, sequencing pictures, language sample, classroom observations. Descriptions and observations are outlined below: Writing Sample: Jeffrey was asked to complete a worksheet containing basic information such as name, birthday, address, parent’s names, etc. This task assesses the student’s ability to ask for help and provide general information about self. Jeffrey was familiar with all information requested and asked for help effortlessly indicating strengths in asking for clarification of information and personal knowledge. The Double Interview: This task consisted of the therapist interviewing Jeffrey about his life at home and at school and then having Jeffrey interview the therapist. During the interview process, Jeffrey answered all questions quickly and appropriately about himself and his family. He needed a verbal prompt to provide additional important information to only one question (provided names of pets but didn’t provide animal type). After the therapist led interview 2 additional tasks were presented, both of which required Jeffrey to take the perspective of the therapist. In the first task Jeffrey was shown 3 photographs of the therapist and her family and was asked to describe the people in the pictures. Jeffrey was able to shift his perspective during this task and interpret the photographs based on the therapist’s perspective. He was also able to account for contextual cues and make inferences about the photos. In the second task Jeffrey was asked to interview the therapist. Strengths noted during this task were the ability to generate questions with ease. Weaknesses noted during this task were difficulty taking the therapist’s perspective as evidenced by asking some similar questions that the therapist asked him that weren’t appropriate given the age difference (i.e.: If your mom had a day to herself, when she did not have to focus on being a mom, what would she choose to do on that day?), prompting to ask follow-up questions to gain more information, and asking questions about areas of interest other than Jeffrey’s interests. These areas of weakness may indicate some difficulty generating language to learn about other’s interests (limited perspective taking) and that conversations involve both what you know about someone and what you think they might want to talk about. Thinking with Eyes: During this task, Jeffrey was asked to look at the therapist’s eyes and determine what the therapist was looking at and thinking about. Jeffrey was able to easily and quickly engage in all parts of this task. Sequencing Pictures: During this task, Jeffrey was presented with 8 pictures that he needed to order in the correct sequence, narrate the story, create a title, and discuss what people in the story may be saying to each other. This task assesses the student’s gestalt processing (ability to see the big picture and relate pieces to an overarching thought or concept) and to arrange items in a logical flow. Jeffrey was able to sequence all pictures appropriately, narrate the story, and identify conversation. The titles that he generated, however (The Pizza Panic or The Pizza Pacman) were rather abstract and may indicate some difficulty recognizing the main idea of the story and how that relates to a more comprehensive and descriptive title. Language Sample: A conversational language sample was obtained and analyzed by this therapist. Please see last page of report for transcription. Jeffrey easily engaged in © 2007 North Inland SELPA Page | 7 conversation with this therapist about a past event, The Superbowl. Semantics, syntax, and morphology all appeared within normal limits during conversational sample. Appropriate eye contact, body language and proximity were observed during sample. Additionally, Jeffrey utilized the following appropriately: initiating response, requesting information, conveying information, expressing emotion, turn-taking, and narrative skills. Areas of weakness included topic maintenance (went off topic about made up games), monitoring the length of talking time paired with taking the perspective of the therapist and her background knowledge of the topic (talking about all sorts of made-up games he plays which therapist is already familiar with). Observations: Two observations were completed by this therapist: one in the classroom and one on the playground. The classroom observation occurred during Mr. Voorhees advanced math lesson. The activity consisted of discussion and independent work on word problems. Jeffrey was observed to follow all directions given by the teacher in a timely fashion and complete all tasks when instructed to do so. The teacher sporadically called on Jeffrey to explain 3 components of a chart that he needed to interpret in order to answer the word problem and Jeffrey successfully described each chart to the class. Some fidgeting behaviors with his hand and his pencil were observed; however, Jeffrey appeared to be able to maintain attention and complete the activity successfully. The second observation was completed during morning recess time. Jeffrey was observed to pick up a ball from the ball bin and walk to the snack tables while chatting with a friend. He saw a group of his peers sitting and looking at a NOOK at the snack tables. Jeffrey independently walked over to the group of peers and initiated communication with the owner of the tablet. He was observed to ask questions and make comments while chatting with his peer and looking at the tablet while he ate his snack. The results of these assessment tasks will be reviewed and discussed using the I LAUGH model of social understanding as a framework. This framework was developed by Michelle Garcia Winner in 2000 in order to help parents and professionals understand the impact of social thinking/social skill deficits on academic learning and classroom participation. I LAUGH is an acronym describing social communication components that affect the student’s social thinking and his ability to engage in academic curriculum that requires social thinking, such as reading comprehension, written expression, group work, perspective taking, etc. Each of the components will be described along with Jeffrey’s strengths and weaknesses noted across the assessment. Jeffrey’s profile is reviewed below: I=Initiation of Language: This is the ability to initiate socialization or requests for help across the day. Students with social cognitive deficits often have difficulty asking for help, seeking clarification, and initiating appropriate social entrance and exit with other people. During formal testing Jeffrey independently asked for repetition of testing material as needed and initiated communication to ask for clarification during writing sample. As per recess observation, Jeffrey initiated conversations with students independently. As per the Initiation section on the CCC-2, Jeffrey scored in the average range. Additionally, during a language sample, when given a topic Jeffrey independently initiated his response. Overall, this is a strength for Jeffrey. L=Listening with Eyes and Brain: This speaks to the fact that in classrooms children need to not only process auditory information, but they also need to use the knowledge gained from what they see to help make sense of their surroundings. This also requires the student to notice nonverbal cues of other people in the group to fully interpret the spoken or unspoken messages. Formal testing revealed that Jeffrey demonstrated weaknesses on the Stating Visual Cues section of the Social Language Development Test as measured by a standard score of 81 indicating weakness in the ability to consistently interpret nonverbal cues in other people. As per informal assessment, Jeffrey demonstrated strength in the area of determining where © 2007 North Inland SELPA Page | 8 people’s eyes were looking and what they were thinking about. Additionally, as per the Nonverbal Communication section on the CCC=2, Jeffrey presented with a scaled score of 9 which is within the average range; however, teacher did report some difficulty using appropriate proximity during interactions. Overall, Jeffrey may benefit from some cueing to fully interpret nonverbal cues and use appropriate personal space. A= Abstract and Inferential Language: Communication comprehension depends on one’s ability to recognize that most language/communication is not intended for literal interpretation. To interpret adequately one must be able to flexibly make smart guesses about the intended meaning of the message. At times one must pursue the analysis of language/communication to seek the intended meaning. Formal testing revealed that Jeffrey demonstrated strength in the area of understanding the meaning of spoken messages independent of literal interpretations as measured by a standard score of 110 on the Nonliteral subtest and a standard score of 97 on the Inference subtest on the CASL. However, Jeffrey achieved a standard score of 83 on the Making Inferences subtest of the Social Language Development Test indicating that he demonstrates some difficulty with this task when he is only provided with visual cues and no language content. U= Understanding Perspective Taking: This is the ability to understand the moods, emotions, thoughts, intents, and motives of other people through your interactions or observations of them. The ability to take perspective is key to participation in any type of group. Formal testing revealed that Jeffrey demonstrated strengths in this area on the Pragmatic Judgment subtest of the CASL, as measured by a standard score of 122. However, he demonstrated weakness on the Expressing Perspectives section on the Social Language Development Test, as measured by a standard score of 81 indicating difficulty when he is only provided with visual cues and no language content. As per informal assessments, Jeffrey demonstrated some difficulty with perspective taking during The Double Interview and during the Language Sample. G= Getting the Big Picture/ Gestalt Processing: This is the ability to take the information you have and understand it in terms of a larger concept. In social relationships, underlying concepts are woven throughout conversational language, play, or even your desire or lack of desire to be with another person. Difficulty with organizational strategies is born from problems with conceptual processing. This skill is an example of an executive function task. Informal assessment and observations revealed that Jeffrey performed well in this area as measured by language abilities that appear within the average range in the areas of semantics, syntax, and morphology. Jeffrey also demonstrated strengths in this area during the Sequencing Pictures task when required to sequence the pictures and narrate the story. His only weakness in the area was evident when asked to formulate an appropriate title for the story. H= Humor and Human Relatedness: This is the ability to understand and use humor appropriately based on timing, subject matter, and the subjective quality of humor. As per the Context section on the CCC-2, Jeff demonstrated difficultly understanding humor and irony consistently. However, during the Language Sample, Jeffrey communicated humorous activities that he likes to take part in. Functional/Education Language Skills: Jeffrey’s language deficits have minimal impact social/emotional, educational and/or vocational functioning at this time. © 2007 North Inland SELPA Page | 9 SUMMARY The results indicate that Jeffrey presents with a mild pragmatic language delay in comparison to his age/developmental level as evidenced by mild difficulty with making inferences that involve interpreting nonverbal cues when no language context is provided and perspective taking during conversations. These mild difficulties, however, have minimal impact on Jeffrey’s social/emotional and educational functioning at this time. Jeffrey’s speech or language performance is not due to cultural, environmental, or economic disadvantages, limited school attendance, or second language acquisition. The results of this evaluation will be brought to the IEP team for consideration. A copy of this evaluation will be provided to the parent(s). 3/1/2012 © 2007 North Inland SELPA Page | 10