"My daughter has that blank look on her face. I'm wondering if Mallory is really paying attention or truly can't understand what I'm requesting?"
"Jake just seems to ramble at times. At other times, he has trouble saying what he thinks. Jake also uses words like, ‘stuff,' and ‘that thing' a lot. He is so smart but you can't tell when he talks."
"Everyone says my granddaughter is shy. She doesn't say too much."
"I call my niece the ‘minimizer.' She says very little and writes very little. Lizzi is now 13 years old. I'm getting notes from her teachers in Language Arts and History. They are very concerned."
"My son is quite the collector. David is really into the brain. He knows everything about it and is so smart. The problem is he can't write about anything else. There's another problem. It seems like David ‘doesn't get it' when he gets ‘those looks' from his peers. I wish that he had more friends. At least, he has one good friend who is into the same things as David but I'm still worried."
"My husband is just like my son. He rambles on and on and doesn't have a clue how that affects people. It really turns people off sometimes."
These are all examples of how language problems can affect children. Weaknesses in language can influence a child's learning and social skills. Problems may not be noticed until the child is in early elementary school, when work and social demands become more complex.
A speech and language evaluation is one of the testing procedures you may want to consider if you suspect something is a little off with your child's speech and language skills. I asked speech-language pathologist, Robin Burkholz M.A. CCC-SLP from Westlake Village, California to help us understand what a speech and language evaluation is all about.
Karen Schiltz, Ph.D.: "Thank you, Robin for joining this blog. First, what is a speech and language assessment?"
Robin Burkholz, M.A. CCC-SLP: "A comprehensive speech and language assessment includes formal testing, language samples, clinical observations, and information provided by parents and teachers. Standardized assessment tools evaluate a child's strengths and weaknesses in the areas of auditory processing, receptive and expressive language, phonological processing, articulation, voice, fluency, and pragmatic functioning.
While formal assessments provide data on children as compared to their peers, clinical observation and language samples allow us to go beyond what standardized testing provides us. Information provided by parents and teachers gives us a picture of how the child is functioning in the classroom and everyday life. This compilation of information assists the Speech-Language Pathologist in making a diagnosis and developing a treatment plan with goals to target the areas of weakness and improve a child's overall functioning."
Dr. S.: "What is the standard of training for the speech language therapist?"
Robin: "The requirements for becoming a certified Speech-Language Pathologist include holding a masters degree in Speech Pathology from an institution accredited by the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA) of the American Speech-Language-Hearing Association. In addition, the therapist must pass a nationally recognized examination, have successfully completed a yearlong clinical fellowship, and applied for state licensure. When these requirements are met, The American Speech-Language-Hearing Association (ASHA) provides the clinician with a certificate of clinical competence. To maintain state licensure and national certification, Speech-Language Pathologists are required to stay informed about advancements in their field by taking professional development courses and meeting the requirements for continuing education."
Dr. S.: "What types of speech and language disorders affect a child's ability to learn in elementary school?"
Robin: "Since language is integrated into most aspects of the curriculum, children with disorders in auditory processing, receptive and expressive language, and pragmatics struggle in the classroom and school setting. For example, some children will have trouble following classroom directions and understanding information presented in direct instruction. If they have weak vocabulary skills and poor critical thinking, then they may have difficulties comprehending what they read or hear, making if difficult for them to grasp new concepts and connect ideas. Children with expressive language disorders typically don't participate in classroom discussion since it takes them longer to formulate their ideas and retrieve the language to express them. This weakness can also be seen in their written language, where children have trouble organizing their ideas and producing sentences using grade level vocabulary and correct grammar. Finally, children with pragmatic language and social communication disorders struggle in developing peer relationships and working cooperatively with others in the classroom. "
Dr. S.: "Why would a speech and language assessment help a child with learning challenges such as their ability to talk with others?"
Robin: "The ability to have a conversation is actually a complex process involving multiple exchanges where both the speaker and listener need to use their verbal abilities as well as their social thinking skills. Social thinking is a set of skills we use to interpret non-verbal forms of communication such as facial expressions, perspective taking, and interpretation of another person's mood. The ability to tune into what others are thinking, quickly formulate a thought, retrieve and organize the language needed to effectively communicate that thought, and use it appropriately in a conversation requires a specific set of skills. A speech and language assessment will target the specific areas of strength and weakness, providing an overall picture of how a child is functioning and the goals we need to establish to improve their ability to communicate with others."
Dr. S.: "Can you please tell us why an assessment would also help a child who has social challenges such as making and keeping friends?"
Robin: "Developing friendships and maintaining these relationships is critical for a child's development and a necessary life skill. Most children with social challenges want friends, but they lack the skills to make and keep them. We evaluate pragmatics and social thinking skills using standardized tests and observational rating scales. Then we use this information to determine their areas of weakness in verbal and non-verbal forms of communication, as well as their perspective taking and interpretation of facials expressions and moods. Finally, a treatment plan can be designed to train specific skills for using language and social thinking to build friendships, as well as strategies for social problem solving so a child can successfully navigate conflicts and repair miscommunications."
Dr. S.: "Thank you, Robin. One more question. Can you please tell us about your private practice in Westlake Village, California?"
Robin: "Thank you, Dr. Schiltz for the opportunity to participate in your blog and help educate others about the field of Speech-Language Pathology and the assessment process. I specialize in evaluating and treating children, adolescents, and young adults with autistic spectrum disorders, language disorders, learning challenges, articulation disorders, and traumatic brain injury. My approach is both clinical and functional in which I strive to connect my therapy with a client to their home and school environment, thus creating a triangle where all three connect and unite as a team. In addition, I work closely with other professionals in related fields who may be simultaneously treating my client so we can collaborate on treatment goals and progress. Finally, I would like to add that I have worked in my field for the past 29 years and I continue to feel deeply passionate about helping my clients improve their speech and language skills as well as their quality of life."
Dr. S.: "I appreciate your time on this blog, Robin. We can see the speech and language evaluation brings another critical perspective to the overall assessment process. Such an evaluation is critical so that interventions and educational accommodations can be targeted to a child's specific needs."
I will be interviewing pediatrician, Peter Antall, M.D., next month. Dr. Antall is a partner of the Conejo Children's Medical Group and President of Pediatric Hospitalist Services located in Thousand Oaks, California. The medical checkup is a good starting point when you think that something is a little off.
Happy Valentines Day and thank you for following this blog!
Karen L. Schiltz, Ph.D.
Psychologist (CA PSYCH 9508)
Private Neuropsychology Practice of Karen Schiltz Ph.D. and Associates
Associate Clinical Professor (Voluntary)
Medical Psychology Assessment Center
Semel Institute for Neuroscience and Human Behavior
Department of Psychiatry and Biobehavioral Sciences
David Geffen School of Medicine at UCLA