OT: Speech question

[taximomfor4]

We have been dealing with my ds7's school for quite some time, trying to get him evaluated for Speech. We live with him, and often (VERY often) have to make him repeat things 4-5 times before we understand him. We finally figured out to request eval IN WRITING. At the meeting, the teacher insisted SHE has no trouble understanding him ever. We signed a paper to ok speech therapy if the eval showed he qualified (they assured us it wouldn't, of course).

Lo and behold, he comes home last week, telling us he went to Speech. TWICE. (Snow day, so our I-team meet was cancelled). yesterday, dh went to the new meeting. Glanced at the papers, and saw 27th percentile. We were told he had to score below the 80th. From the research I've been doing, that seems an overly generous cutoff. Our school is NOT generous. Anyone know what that 27th percentile means, or if DH Misread it?

Also, funny enough, the teacher had to miss the meeting so sent a letter. In it, she gushed about ds's leadership qualities, helpfulness, how courteous he is....BUT.....he often gets frustrated when she has to have him repeat things over and over. Funny, she understood him FINE before his test results came back!!

Anyway, does 80th sound right as a therapy cutoff? Is 27th something that SHOULD have been addressed earlier? (I tried all this last year, but got pooh-poohed.)

Beth

 

[Mickey'snewestfan]

I'm going to guess that you're dealing with 2 different kinds of scores -- percentile and standard score.

A percentile ranking tells you what portion of children your child's age are performing less well than your child at a given task. So a child with a percentile ranking of 80 would be doing better than 80% of his peers. 80th percentile wouldn't make any sense as a cut off for services -- it would mean than in an average class of 20, 16 of the children would have an I.E.P. for speech. 27th percentile might make sense for a cut off (basically it means that 1/4 of the class (5 in my hypothetical class of 20) are below and 3/4 are above. It's still a pretty high cut off. If you think about a hypothetical bell curve, there are generally a lot of kids clustered around the middle -- there's not that much difference between the 6th kid from the bottom (the 25th percentile), and the 14th kid from the bottom (the 70th percentile)and all of them could be described as "average". Around hers we use a cut of of 15th percentile to qualify kids, so a child with a 27th percentile wouldn't qualify at all.

A standard score is a score that works like an I.Q. score. 100 is the exact middle, 90-110 is average, 80-90 is "low average" and 110 - 120 is "high average". Below 80 a child is considered to have a delay and above 120 they are considered to be "above average" -- 130+ is considered gifted. So from a standard score of 80 makes a lot of sense as a cut off for speech. A standard score of 80 translates to a percentile ranking of about 10th. A standard score of 27 for speech in a 7 year old would basically mean that child had zero intelligible speech, so it's a fair assumption that your DS didn't get a SS of 27.

My guess is that 27th percentile will not qualify your son unless they can prove that his difficulties are impacting him significantly in the classroom -- for example, if they're causing his reading to be delayed.

 

[taximomfor4]

I'm going to guess that you're dealing with 2 different kinds of scores -- percentile and standard score.

A percentile ranking tells you what portion of children your child's age are performing less well than your child at a given task. So a child with a percentile ranking of 80 would be doing better than 80% of his peers. 80th percentile wouldn't make any sense as a cut off for services -- it would mean than in an average class of 20, 16 of the children would have an I.E.P. for speech. 27th percentile might make sense for a cut off (basically it means that 1/4 of the class (5 in my hypothetical class of 20) are below and 3/4 are above. It's still a pretty high cut off. If you think about a hypothetical bell curve, there are generally a lot of kids clustered around the middle -- there's not that much difference between the 6th kid from the bottom (the 25th percentile), and the 14th kid from the bottom (the 70th percentile)and all of them could be described as "average". Around hers we use a cut of of 15th percentile to qualify kids, so a child with a 27th percentile wouldn't qualify at all.

A standard score is a score that works like an I.Q. score. 100 is the exact middle, 90-110 is average, 80-90 is "low average" and 110 - 120 is "high average". Below 80 a child is considered to have a delay and above 120 they are considered to be "above average" -- 130+ is considered gifted. So from a standard score of 80 makes a lot of sense as a cut off for speech. A standard score of 80 translates to a percentile ranking of about 10th. A standard score of 27 for speech in a 7 year old would basically mean that child had zero intelligible speech, so it's a fair assumption that your DS didn't get a SS of 27.

My guess is that 27th percentile will not qualify your son unless they can prove that his difficulties are impacting him significantly in the classroom -- for example, if they're causing his reading to be delayed.

So apparently dh is royally confused about what he saw. I might get copies from the school, with the IEP paperwork, once it is all drawn up. I'll look then. You are probably correct that the 80 as the standard score is the "magic number" to qualify. That makes much more sense. And the 27 could have been ANYTHING, subtest, whatever. DH isn't good at this stuff.--so I usually do it all.

I know ds's score was pretty NOT GOOD. They started him in speech therapy right away, before we even had the IEP meeting. In the end, ds apparently "emphatically" qualified for services. Once they finally got around to testing him as we requested!!

Beth

 

[Goofyluver]

I am a speech therapist with the schools here in New Mexico. The info you got from Mickey's Newest Fan is right on. You are talking about 2 different scores here. In my school district, we can qualify off of their percentile score or their Standard Score. We qualify anything below an 85 for standard score and anything below 25 for percentile, depending on what you are evaluating for. Depending on your school districts cut-off, a score in the 27th percentile, which would be a standard score above 85, he may or may not qualify for services.

I will say this, as a 7 year old child, he should be 100% intelligible in his speech, meaning you should be able to understand 100% of what he says. I'm sorry it has taken so long to get you guys through this. Hopefully, everything works out well since he is now in services.

 

[taximomfor4]

I am a speech therapist with the schools here in New Mexico. The info you got from Mickey's Newest Fan is right on. You are talking about 2 different scores here. In my school district, we can qualify off of their percentile score or their Standard Score. We qualify anything below an 85 for standard score and anything below 25 for percentile, depending on what you are evaluating for. Depending on your school districts cut-off, a score in the 27th percentile, which would be a standard score above 85, he may or may not qualify for services.

I will say this, as a 7 year old child, he should be 100% intelligible in his speech, meaning you should be able to understand 100% of what he says. I'm sorry it has taken so long to get you guys through this. Hopefully, everything works out well since he is now in services.

I don't know much about the test they did, like I said, DH is NOT a good historian!!
Ble
I do know that ds7 can't make an L sound at all (can't get his tongue to go up there...my speech pathologist bil has tried with him in the past). His list of sounds he can't do that I know of off the top of my head: R, L, J, TH, SH, CH, Z....and any combinations of consonents, like Tr, St, etc. Sad to say, I feel like we understand him LESS as he gets older, perhaps because what he says is in longer sentences and on less predictable topics. I probably, as his mother, understand about half of what he says -- if I am standing with him and looking at his face as he speaks. Otherwise, it often sounds like "pblgheruoiojksdjhfkjngdkjndfjkdjosjpaidjfodnjgna,nms."

I'll update this as soon as I get some kind of paperwork from the school, since I cannot make sense out of what DH picked up in his snooping. He's not like me...in the meetings, I demand numbers, plans, interpretations, advice for home, etc. They take notes on my questions, and include the answers in the paperwork unless they can answer that very day.

Thanks again!

Beth

 

[Earstou]

Be sure to ask for work you can do at home. At our request, our therapist used to send home the words he was currently working on. She gaves us hints and tips on working with him. We practiced at home and he progressed faster.

 

[Forevryoung]

Be sure to ask for work you can do at home. At our request, our therapist used to send home the words he was currently working on. She gaves us hints and tips on working with him. We practiced at home and he progressed faster.

I'm a masters student in speech/language pathology- I have 5 kids I see at a school once a week. some of them get services a second day from another student in my class.

We give them homework EVERY week and 9 times out of 10 they dont do it. We've started giving lunch detention for not bringing back their homework now (they need a parent signature on it). The kids working on articulation would change so much faster if they were actually practicing it for more than 30 minutes a week!!!!!

It's a peeve of mine, sorry, (my adult client who has had a stroke and is severely affected even does his homework and more He was disappointed that I didn't give him enough homework at our first session)

 

[taximomfor4]

I'm a masters student in speech/language pathology- I have 5 kids I see at a school once a week. some of them get services a second day from another student in my class.

We give them homework EVERY week and 9 times out of 10 they dont do it. We've started giving lunch detention for not bringing back their homework now (they need a parent signature on it). The kids working on articulation would change so much faster if they were actually practicing it for more than 30 minutes a week!!!!!

It's a peeve of mine, sorry, (my adult client who has had a stroke and is severely affected even does his homework and more He was disappointed that I didn't give him enough homework at our first session)

Thanks for sharing. My ds (first grader) will apparently be getting services at school 2x/week. As for speech homework, I had better not have to sign anything. There are too many variables for us, we are really, really, bad at getting the math log and reading log signed. We end up signing like 3 weeks at a time...my kids (especially ds) come right home, do all homework, pack it in their backpacks, and put them by the door. Due to scattered after-school-care arrangements, his speech homework would likely have been done but not signed by a parent. We just drop the ball. And I know that around here, we are among the more on-top-of-things parents. I can't imagine some of the kids around here trying to get signatures from parents they rarely see, or are afraid of, or whatever. Yikes.

Beth

 

[Ambassador]

Our experience in receiving speech therapy for our preschooler has been similar over the past three years. He has finally 'empathetically' qualified for services; thirty minutes per week. A teacher wrote a letter to the school board which did not help, stating that she had no problem understanding them at all. Yet she meets with us to express concern that our child is frustrated in situations where other children cannot understand them.

 

[WDWfor5]

Thanks for sharing. My ds (first grader) will apparently be getting services at school 2x/week. As for speech homework, I had better not have to sign anything. There are too many variables for us, we are really, really, bad at getting the math log and reading log signed. We end up signing like 3 weeks at a time...my kids (especially ds) come right home, do all homework, pack it in their backpacks, and put them by the door. Due to scattered after-school-care arrangements, his speech homework would likely have been done but not signed by a parent. We just drop the ball. And I know that around here, we are among the more on-top-of-things parents. I can't imagine some of the kids around here trying to get signatures from parents they rarely see, or are afraid of, or whatever. Yikes.

Beth

As the mom of 2 DS's in speech I just wanted to tell you that the homework we get for them to do is homework we must to with them. for example, my Ds 5 is working on his "L" sounds and so his speech therapist sent home a game to play where he has to roll a dice and each space it lands on is a picture of something with an L on it and he has to use that word in a sentence. We take turns and I correct his articulation if neccesary. If he does it himself (meaning on his own) it will have no real benefit.

As for speech services, it is amazing how much of a difference it makes. My DS 3 1/2 has had services since 2 for oral-motor apraxia and started at school at 3. He went from under 50 words at 3 (most unclear to all but me) to 6 months later having a vocab in the thousands and most people understand most of what he says especially considering he's only 3 1/2. My 5 yo DS just started speech last month and already has mastered L's and nearly mastered F's

It is the coolest thing to finally understand your children - congrats on getting what you need from the school and good luck with it - it's a pain but so worth it.

 

[taximomfor4]

I told you all I would update once I got the paperwork, since DH doesn't tend to remember things clearly!! The 27% was his "stimulability." His errors I had listed pretty accurately in a pp, the S.T. found "Th, L, R, S, z, SH, CH, J, and all consonent blends."

His articulation, in order to qualify, apparently had to be below 80%, and it was, in fact, below that...about 70% (The S.T. will send the papers but was recalling on the phone for me). The test was the Weiss Articulation Test.

His receptive and expressive language skills were both above average.


He will start out with 2 half-hour S.T. sessions per week. That is really great. They have not said anything about homework yet, but we'll be prepared.

Beth

 

[Goofyluver]

As a speech therapist, I only send home homework once the kiddo can produce the sounds with me in the classroom without constant reminders. Once I know the kid can produce the sound without me having to give verbal cues, then I send home homework. The worst thing would be to send home work and for the kid to practice producing sounds incorrectly. That is for sound productions. But, from your ppost, I noticed that your DS had difficulty with some tongue elevation in order to produce certain sounds. Oral motor exercises can abolutely be done at home! Ask the therapist for an at home oral motor program. If you want, I can send you some ideas!

 

[taximomfor4]

As a speech therapist, I only send home homework once the kiddo can produce the sounds with me in the classroom without constant reminders. Once I know the kid can produce the sound without me having to give verbal cues, then I send home homework. The worst thing would be to send home work and for the kid to practice producing sounds incorrectly. That is for sound productions. But, from your ppost, I noticed that your DS had difficulty with some tongue elevation in order to produce certain sounds. Oral motor exercises can abolutely be done at home! Ask the therapist for an at home oral motor program. If you want, I can send you some ideas!

I'd appreciate it!! Thanks! Also, I have wasted all day so far trying to make sense of what "stimulability" is, since ds's was so "low." Also, I think I found that the articulation cutoff for services is 80...does that sound right? IS that like the composite, where one considers standard deviations, etc (like IQ tests)? The school seemed more concerned over the low "stimulability" score than anything else, and they cited that as why he qualified for the twice weekly sessions.

Beth

 

[Goofyluver]

I'd appreciate it!! Thanks! Also, I have wasted all day so far trying to make sense of what "stimulability" is, since ds's was so "low." Also, I think I found that the articulation cutoff for services is 80...does that sound right? IS that like the composite, where one considers standard deviations, etc (like IQ tests)? The school seemed more concerned over the low "stimulability" score than anything else, and they cited that as why he qualified for the twice weekly sessions.

Beth

Stimulability refers to your child's ability to produce the sounds he has errors on. Meaning, is he able to produce his "l" with a model or some direction? 27% stimulability means that when asked to produce the sounds he had errors on in the eval, he could only produce 27% of those sounds. The concern with a low stimulability level is that the child cannot produce the error sounds at all, even with a model or verbal cues. This DOES NOT mean that your DS will be unable to produce these sounds. It simply means it may take longer to remediate these sounds due to the fact that exact tongue placement, or voicing techniques will have to be taught.

As for the score of 80 on the articulation assessment, or the cutoff of 80, this score is comparable to IQ scores. 80-90 would be low average. A score of 80 would be a borderline average to a slightly below average score. So, this score by itself does not indicate a severe delay. But, when you factor in the low stimulability score, the articulation delay becomes more of a concern.

As for activities to help your DS at home (oral motor exercises), you have to get that tongue moving! The /l, sh, r/ sounds...those all require tongue strength and mobility. I'll PM you with some activities! Hope this helps!

 

[taximomfor4]

Stimulability refers to your child's ability to produce the sounds he has errors on. Meaning, is he able to produce his "l" with a model or some direction? 27% stimulability means that when asked to produce the sounds he had errors on in the eval, he could only produce 27% of those sounds. The concern with a low stimulability level is that the child cannot produce the error sounds at all, even with a model or verbal cues. This DOES NOT mean that your DS will be unable to produce these sounds. It simply means it may take longer to remediate these sounds due to the fact that exact tongue placement, or voicing techniques will have to be taught.

As for the score of 80 on the articulation assessment, or the cutoff of 80, this score is comparable to IQ scores. 80-90 would be low average. A score of 80 would be a borderline average to a slightly below average score. So, this score by itself does not indicate a severe delay. But, when you factor in the low stimulability score, the articulation delay becomes more of a concern.

As for activities to help your DS at home (oral motor exercises), you have to get that tongue moving! The /l, sh, r/ sounds...those all require tongue strength and mobility. I'll PM you with some activities! Hope this helps!

His articulation score was like a 70, actually, but I was pretty sure I heard the school say (before they ever tested ds) that while he had some pronunciation problems, they were confident he wouldn't test low enough (below 80 or 85, I forget) to qualify for therapy. Guess they were wrong. I am just glad he is getting some help, finally. I hate to see him say "Fo-get it"...and stomp down the hall to his room when we have trouble understanding what he says.

Beth

 

[Forevryoung]

Regarding the signing of homework- I only see my kiddos once a week. Besides, it is homework that I state must be done every day/three times a week (depending on the kid and the amount of work) and a parent's initial must appear. The point of the signature is that I want to make sure that a parent SEES the homework and knows what we are working on and works on it at home as well. Put the 6 words of the week in the car and have the kid say them when driving to ____________ every day or before bed. You must have a conversation with your kids at some point during the day.

For example: J must say these SH words in a sentence every day. Please sign and return next Thursday when I see her for speech. The words (with corresponding pictures) are shirt, shells, ship, shiney, shaving, shape. Would take 5 minutes tops.

 

[taximomfor4]

Regarding the signing of homework- I only see my kiddos once a week. Besides, it is homework that I state must be done every day/three times a week (depending on the kid and the amount of work) and a parent's initial must appear. The point of the signature is that I want to make sure that a parent SEES the homework and knows what we are working on and works on it at home as well. Put the 6 words of the week in the car and have the kid say them when driving to ____________ every day or before bed. You must have a conversation with your kids at some point during the day.

For example: J must say these SH words in a sentence every day. Please sign and return next Thursday when I see her for speech. The words (with corresponding pictures) are shirt, shells, ship, shiney, shaving, shape. Would take 5 minutes tops.

Sorry! I really do understand why you would have that policy, I really do. But I still would hate for my kid to be given lunch detention because I didn't sign something. It's not that we wouldn't do it -- I could call on my break at school (evenings), and have him say the words over the phone to me, or to Grandma when she babysits, or to older sister when she babysits. And they could even sign the form....I just would feel bad if I thought Grandma signed it, but she didn't (or signed the wrong square) or I forgot to sign, and went straight to bed when I got home. We'd work it out -- we always do...things DO get signed, and are ALWAYS done even if not signed by me. I just would hate to have him be punished. I could see if it was a recurrent problem, but not each time.

Anyway, we are very excited to get this going, and have some sort of direction on what we can do. We have been trying to get his tongue up behind his top front teeth (to make an L sound) for over a year now. Poor kid contorts his mouth, leans his head to the side, etc but that tongue just won't get there. (BIL, a Speech-Language Pathologist, is the one that was really pushing us to get our school to assess, already!)

Beth

 

[Forevryoung]

Sorry! I really do understand why you would have that policy, I really do. But I still would hate for my kid to be given lunch detention because I didn't sign something. It's not that we wouldn't do it -- I could call on my break at school (evenings), and have him say the words over the phone to me, or to Grandma when she babysits, or to older sister when she babysits. And they could even sign the form....I just would feel bad if I thought Grandma signed it, but she didn't (or signed the wrong square) or I forgot to sign, and went straight to bed when I got home. We'd work it out -- we always do...things DO get signed, and are ALWAYS done even if not signed by me. I just would hate to have him be punished. I could see if it was a recurrent problem, but not each time.

I totally see your point and if a kid forgets to get it signed once in awhile it's no big deal but I've seen these kids THREE weeks in a row and NONE of them have done their homework. So after three weeks of not doing their homework... and it's not my decision about the lunch detention, it's my supervisor's. She has known these kids much longer than I have. I wouldn't give lunch detention but I would probably start sending notes home with the kid of the reasons why the homework should at least be returned every week (done or not).

I can tell if a kid has been practicing at home- they do better during the half hour a week I have with them. If I knew that the homework would be done during the week and might not be signed, no biggie. I just want the parent to know that their child had speech homework and worked on it with them. (there are parents who wouldnt/couldnt do the homework with their children- I was told of those families ahead of time and I give them written work).

Always a way to work around something

ETA: I dont make them sign a square... I just want them to sign/initial somewhere on the actual homework assignment that they saw it. You can sign it at any time during the week... But I definitely see your point.

 

[belle&beast]

I am also an SLP in the school system (preschool now but I have worked with older children in the past) and I agree with Goofyluvr 100%. I also do not send homework unless the child is independent with the sound and the parents want the extra practice at home. I am glad your son is receiving some services! Good luck!