Confused about expressive speech delay

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:As an SLP, I'm a little frustrated by how unethical some SLPs in the area are, framing average scores as "low" or "borderline" to worry parents into paying a significant amount of money to fix something that isn't actually a problem. The test authors designated 85-115 as average scores. Not low average or borderline. We also collect a range of 90% probability that a child falls into which will include higher scores into the mid-90s based on an 86 which takes into account that some children don't perform their best during testing situations, or on certain days, etc. Your child received average scores on two well-respected tests, and the CELF contains a large cognitive load component which can lead to over-identifying. She will almost certainly continue being average, barring any unforeseen circumstances. Those scores are a good thing, and one or two word changes on that report would drastically impact how you felt about your daughter's future.

If you choose to give her ST, it certainly won't hurt her. She'll continue developing typically and therefore make progress. Just know that if you have better things to spend that money on, you shouldn't feel obligated. Your concern wasn't even in this area, nor were the results of the screening. ChildFind offers free screenings if you want a free second opinion, otherwise you may want to consult with another SLP in the area.

(Sorry for how negative the tone of this post is, it just frustrates me to no end. Parents worry enough about their children and those who actually need the help don't need fudging on reports to know it.)

I appreciate your thoughts and can understand your frustration. On the other hand, I'm also an educator and evaluator...I understand standard deviation and the range of 85 - 115 but think that scoring at the 16th %ile is worthy of concern. Certainly, most people would have some concerns over a WISC-V Verbal Scale Score of 85.

NP here. But, you are not a speech pathologist and you have misinterpreted the percentile. The standard scores are average. And speech therapy is not really going to change that. If this child was to be tested years later,the scores would most likely be the same. The private practice is telling the parent that this child needs speech therapy and that implies that there is a speech language delay when there really isn't. That is unethical.

How was the 16th %ile misinterpreted? I'm not saying it's a severe delay but was pointing out that falling within the low average range (some tests give a qualitative performance descriptor at that level as below average) is worthy of concern. In our school system, a child may (depending on the eligibility team's decision) qualify for services if he/she obtained several speech/lang scores at that level.

Because the scores are interpreted by standard scores. And scores are grouped into ranges. If you fall below a certain range - usually by a standard deviation and a half - then it is of concern and a true delay. Being on the lower range of average is still average. Not everybody is going to be above average. I highly doubt your school system would give services to someone who scored in the average range. If so, then you are wasting tax payers money. 85 and even a few points below (there is a range) is still average whether it be low average. We do not go by percentiles as it is just a comparison to how other children scored. Again, you are not a speech pathologist. I am.

No, I'm not a speech pathologist but recognize your area of expertise. Nonetheless, I have years of experience in the special education field. Whether you agree or not, our school system does (not all the time) often qualify children with speech/lang scores of 85 and below--especially if they're obtained IQ scores are significantly higher.

They shouldn't be. It's not a true delay. And it certainly shouldn't be coded as a speech language delay. I hope the state doesn't audit your school system. Please be careful about spreading wrong information. This thread is about the OP and her child. Your response that a 16% should warrant looking into is what the speech paths on this thread are responding to. The OP asked if she was being given misinformation about scores and she was. 16% is not what is being looking at when coding a language delay, it's the standard scores. The OP's child does not have the standard scores to be diagnosed with a speech language delay.

Were a large, progressive school system and have been audited with no particular concerns noted about our speech/lang pathologists' evaluations, our eligibility consideration process, or our students' IEP's. Just for the record, I understand about standard scores, percentiles, etc. It's a difference of professional opinion.

Then they are misinterpreting the results of the test as determined by the actual test makers, which is against our code of ethics.

[Anonymous]

Anonymous wrote:
For those interested in seeing CELF-5 info:

http://www.speechandlanguage.com/wp-content/uploads/2013/06/celf-5_determining_severity_lang_disorder.pdf

Standard scores of 78 - 85 fall within the classification of Marginal/Below Average/Mild.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:As an SLP, I'm a little frustrated by how unethical some SLPs in the area are, framing average scores as "low" or "borderline" to worry parents into paying a significant amount of money to fix something that isn't actually a problem. The test authors designated 85-115 as average scores. Not low average or borderline. We also collect a range of 90% probability that a child falls into which will include higher scores into the mid-90s based on an 86 which takes into account that some children don't perform their best during testing situations, or on certain days, etc. Your child received average scores on two well-respected tests, and the CELF contains a large cognitive load component which can lead to over-identifying. She will almost certainly continue being average, barring any unforeseen circumstances. Those scores are a good thing, and one or two word changes on that report would drastically impact how you felt about your daughter's future.

If you choose to give her ST, it certainly won't hurt her. She'll continue developing typically and therefore make progress. Just know that if you have better things to spend that money on, you shouldn't feel obligated. Your concern wasn't even in this area, nor were the results of the screening. ChildFind offers free screenings if you want a free second opinion, otherwise you may want to consult with another SLP in the area.

(Sorry for how negative the tone of this post is, it just frustrates me to no end. Parents worry enough about their children and those who actually need the help don't need fudging on reports to know it.)

I appreciate your thoughts and can understand your frustration. On the other hand, I'm also an educator and evaluator...I understand standard deviation and the range of 85 - 115 but think that scoring at the 16th %ile is worthy of concern. Certainly, most people would have some concerns over a WISC-V Verbal Scale Score of 85.

NP here. But, you are not a speech pathologist and you have misinterpreted the percentile. The standard scores are average. And speech therapy is not really going to change that. If this child was to be tested years later,the scores would most likely be the same. The private practice is telling the parent that this child needs speech therapy and that implies that there is a speech language delay when there really isn't. That is unethical.

How was the 16th %ile misinterpreted? I'm not saying it's a severe delay but was pointing out that falling within the low average range (some tests give a qualitative performance descriptor at that level as below average) is worthy of concern. In our school system, a child may (depending on the eligibility team's decision) qualify for services if he/she obtained several speech/lang scores at that level.

Because the scores are interpreted by standard scores. And scores are grouped into ranges. If you fall below a certain range - usually by a standard deviation and a half - then it is of concern and a true delay. Being on the lower range of average is still average. Not everybody is going to be above average. I highly doubt your school system would give services to someone who scored in the average range. If so, then you are wasting tax payers money. 85 and even a few points below (there is a range) is still average whether it be low average. We do not go by percentiles as it is just a comparison to how other children scored. Again, you are not a speech pathologist. I am.

No, I'm not a speech pathologist but recognize your area of expertise. Nonetheless, I have years of experience in the special education field. Whether you agree or not, our school system does (not all the time) often qualify children with speech/lang scores of 85 and below--especially if they're obtained IQ scores are significantly higher.

They shouldn't be. It's not a true delay. And it certainly shouldn't be coded as a speech language delay. I hope the state doesn't audit your school system. Please be careful about spreading wrong information. This thread is about the OP and her child. Your response that a 16% should warrant looking into is what the speech paths on this thread are responding to. The OP asked if she was being given misinformation about scores and she was. 16% is not what is being looking at when coding a language delay, it's the standard scores. The OP's child does not have the standard scores to be diagnosed with a speech language delay.

You disagree with the speech/language pathologist who evaluated OP's child. That's your professional opinion. The professional who evaluated her child appears to have a different one. Since we haven't read the complete report or seen all the results, you may be correct or not in your assessment of the situation.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:As an SLP, I'm a little frustrated by how unethical some SLPs in the area are, framing average scores as "low" or "borderline" to worry parents into paying a significant amount of money to fix something that isn't actually a problem. The test authors designated 85-115 as average scores. Not low average or borderline. We also collect a range of 90% probability that a child falls into which will include higher scores into the mid-90s based on an 86 which takes into account that some children don't perform their best during testing situations, or on certain days, etc. Your child received average scores on two well-respected tests, and the CELF contains a large cognitive load component which can lead to over-identifying. She will almost certainly continue being average, barring any unforeseen circumstances. Those scores are a good thing, and one or two word changes on that report would drastically impact how you felt about your daughter's future.

If you choose to give her ST, it certainly won't hurt her. She'll continue developing typically and therefore make progress. Just know that if you have better things to spend that money on, you shouldn't feel obligated. Your concern wasn't even in this area, nor were the results of the screening. ChildFind offers free screenings if you want a free second opinion, otherwise you may want to consult with another SLP in the area.

(Sorry for how negative the tone of this post is, it just frustrates me to no end. Parents worry enough about their children and those who actually need the help don't need fudging on reports to know it.)

I appreciate your thoughts and can understand your frustration. On the other hand, I'm also an educator and evaluator...I understand standard deviation and the range of 85 - 115 but think that scoring at the 16th %ile is worthy of concern. Certainly, most people would have some concerns over a WISC-V Verbal Scale Score of 85.

NP here. But, you are not a speech pathologist and you have misinterpreted the percentile. The standard scores are average. And speech therapy is not really going to change that. If this child was to be tested years later,the scores would most likely be the same. The private practice is telling the parent that this child needs speech therapy and that implies that there is a speech language delay when there really isn't. That is unethical.

How was the 16th %ile misinterpreted? I'm not saying it's a severe delay but was pointing out that falling within the low average range (some tests give a qualitative performance descriptor at that level as below average) is worthy of concern. In our school system, a child may (depending on the eligibility team's decision) qualify for services if he/she obtained several speech/lang scores at that level.

Because the scores are interpreted by standard scores. And scores are grouped into ranges. If you fall below a certain range - usually by a standard deviation and a half - then it is of concern and a true delay. Being on the lower range of average is still average. Not everybody is going to be above average. I highly doubt your school system would give services to someone who scored in the average range. If so, then you are wasting tax payers money. 85 and even a few points below (there is a range) is still average whether it be low average. We do not go by percentiles as it is just a comparison to how other children scored. Again, you are not a speech pathologist. I am.

No, I'm not a speech pathologist but recognize your area of expertise. Nonetheless, I have years of experience in the special education field. Whether you agree or not, our school system does (not all the time) often qualify children with speech/lang scores of 85 and below--especially if they're obtained IQ scores are significantly higher.

They shouldn't be. It's not a true delay. And it certainly shouldn't be coded as a speech language delay. I hope the state doesn't audit your school system. Please be careful about spreading wrong information. This thread is about the OP and her child. Your response that a 16% should warrant looking into is what the speech paths on this thread are responding to. The OP asked if she was being given misinformation about scores and she was. 16% is not what is being looking at when coding a language delay, it's the standard scores. The OP's child does not have the standard scores to be diagnosed with a speech language delay.

+1,000 (another SLP chiming in on this thread)

I'm not an SLP, I'm a special educator and the parent of a child with some special needs, but I have a question about this.

If I am working in a public school, I have to follow specific requirements when finding a kid eligible for services, or writing an IEP. If a child comes to me with scores that are within normal limits, even if they're on the border, then they're ineligible unless there are other factors. Similarly, my own child who has scores in this range, is not eligible for an IEP and receives no specialized instruction.

However, if I'm contracting for private services, whether as a tutor or as a parent, the guidelines are different. There is nothing in my code of ethics that prevents me from working with a child whose parents would like to see him in a higher reading group, or from doing SAT prep with a student who got a 1500 (50th %ile) first round. If a parent asks me "what would you do?" there's nothing that prevents me from saying that I think the child would benefit from spending an hour each week with me playing phonics games, or that I heard that Kumon does a wonderful job with kids who need to work on math fluency.

In this case, the parent seems to have contracted with the SLP privately. Does that not change things similarly?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:As an SLP, I'm a little frustrated by how unethical some SLPs in the area are, framing average scores as "low" or "borderline" to worry parents into paying a significant amount of money to fix something that isn't actually a problem. The test authors designated 85-115 as average scores. Not low average or borderline. We also collect a range of 90% probability that a child falls into which will include higher scores into the mid-90s based on an 86 which takes into account that some children don't perform their best during testing situations, or on certain days, etc. Your child received average scores on two well-respected tests, and the CELF contains a large cognitive load component which can lead to over-identifying. She will almost certainly continue being average, barring any unforeseen circumstances. Those scores are a good thing, and one or two word changes on that report would drastically impact how you felt about your daughter's future.

If you choose to give her ST, it certainly won't hurt her. She'll continue developing typically and therefore make progress. Just know that if you have better things to spend that money on, you shouldn't feel obligated. Your concern wasn't even in this area, nor were the results of the screening. ChildFind offers free screenings if you want a free second opinion, otherwise you may want to consult with another SLP in the area.

(Sorry for how negative the tone of this post is, it just frustrates me to no end. Parents worry enough about their children and those who actually need the help don't need fudging on reports to know it.)

I appreciate your thoughts and can understand your frustration. On the other hand, I'm also an educator and evaluator...I understand standard deviation and the range of 85 - 115 but think that scoring at the 16th %ile is worthy of concern. Certainly, most people would have some concerns over a WISC-V Verbal Scale Score of 85.

NP here. But, you are not a speech pathologist and you have misinterpreted the percentile. The standard scores are average. And speech therapy is not really going to change that. If this child was to be tested years later,the scores would most likely be the same. The private practice is telling the parent that this child needs speech therapy and that implies that there is a speech language delay when there really isn't. That is unethical.

How was the 16th %ile misinterpreted? I'm not saying it's a severe delay but was pointing out that falling within the low average range (some tests give a qualitative performance descriptor at that level as below average) is worthy of concern. In our school system, a child may (depending on the eligibility team's decision) qualify for services if he/she obtained several speech/lang scores at that level.

Because the scores are interpreted by standard scores. And scores are grouped into ranges. If you fall below a certain range - usually by a standard deviation and a half - then it is of concern and a true delay. Being on the lower range of average is still average. Not everybody is going to be above average. I highly doubt your school system would give services to someone who scored in the average range. If so, then you are wasting tax payers money. 85 and even a few points below (there is a range) is still average whether it be low average. We do not go by percentiles as it is just a comparison to how other children scored. Again, you are not a speech pathologist. I am.

No, I'm not a speech pathologist but recognize your area of expertise. Nonetheless, I have years of experience in the special education field. Whether you agree or not, our school system does (not all the time) often qualify children with speech/lang scores of 85 and below--especially if they're obtained IQ scores are significantly higher.

They shouldn't be. It's not a true delay. And it certainly shouldn't be coded as a speech language delay. I hope the state doesn't audit your school system. Please be careful about spreading wrong information. This thread is about the OP and her child. Your response that a 16% should warrant looking into is what the speech paths on this thread are responding to. The OP asked if she was being given misinformation about scores and she was. 16% is not what is being looking at when coding a language delay, it's the standard scores. The OP's child does not have the standard scores to be diagnosed with a speech language delay.

+1,000 (another SLP chiming in on this thread)

I'm not an SLP, I'm a special educator and the parent of a child with some special needs, but I have a question about this.

If I am working in a public school, I have to follow specific requirements when finding a kid eligible for services, or writing an IEP. If a child comes to me with scores that are within normal limits, even if they're on the border, then they're ineligible unless there are other factors. Similarly, my own child who has scores in this range, is not eligible for an IEP and receives no specialized instruction.

However, if I'm contracting for private services, whether as a tutor or as a parent, the guidelines are different. There is nothing in my code of ethics that prevents me from working with a child whose parents would like to see him in a higher reading group, or from doing SAT prep with a student who got a 1500 (50th %ile) first round. If a parent asks me "what would you do?" there's nothing that prevents me from saying that I think the child would benefit from spending an hour each week with me playing phonics games, or that I heard that Kumon does a wonderful job with kids who need to work on math fluency.

In this case, the parent seems to have contracted with the SLP privately. Does that not change things similarly?

Yes, the possibility of benefiting from additional support is different from meeting the eligibility guidelines for a certain category. It's also true that some professionals try to make judgment calls based only on scores, without looking at the whole picture regarding the child's medical and developmental history, demonstrated potential on nonverbal measures, possible lack of exposure to language, etc.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:As an SLP, I'm a little frustrated by how unethical some SLPs in the area are, framing average scores as "low" or "borderline" to worry parents into paying a significant amount of money to fix something that isn't actually a problem. The test authors designated 85-115 as average scores. Not low average or borderline. We also collect a range of 90% probability that a child falls into which will include higher scores into the mid-90s based on an 86 which takes into account that some children don't perform their best during testing situations, or on certain days, etc. Your child received average scores on two well-respected tests, and the CELF contains a large cognitive load component which can lead to over-identifying. She will almost certainly continue being average, barring any unforeseen circumstances. Those scores are a good thing, and one or two word changes on that report would drastically impact how you felt about your daughter's future.

If you choose to give her ST, it certainly won't hurt her. She'll continue developing typically and therefore make progress. Just know that if you have better things to spend that money on, you shouldn't feel obligated. Your concern wasn't even in this area, nor were the results of the screening. ChildFind offers free screenings if you want a free second opinion, otherwise you may want to consult with another SLP in the area.

(Sorry for how negative the tone of this post is, it just frustrates me to no end. Parents worry enough about their children and those who actually need the help don't need fudging on reports to know it.)

I appreciate your thoughts and can understand your frustration. On the other hand, I'm also an educator and evaluator...I understand standard deviation and the range of 85 - 115 but think that scoring at the 16th %ile is worthy of concern. Certainly, most people would have some concerns over a WISC-V Verbal Scale Score of 85.

NP here. But, you are not a speech pathologist and you have misinterpreted the percentile. The standard scores are average. And speech therapy is not really going to change that. If this child was to be tested years later,the scores would most likely be the same. The private practice is telling the parent that this child needs speech therapy and that implies that there is a speech language delay when there really isn't. That is unethical.

How was the 16th %ile misinterpreted? I'm not saying it's a severe delay but was pointing out that falling within the low average range (some tests give a qualitative performance descriptor at that level as below average) is worthy of concern. In our school system, a child may (depending on the eligibility team's decision) qualify for services if he/she obtained several speech/lang scores at that level.

Because the scores are interpreted by standard scores. And scores are grouped into ranges. If you fall below a certain range - usually by a standard deviation and a half - then it is of concern and a true delay. Being on the lower range of average is still average. Not everybody is going to be above average. I highly doubt your school system would give services to someone who scored in the average range. If so, then you are wasting tax payers money. 85 and even a few points below (there is a range) is still average whether it be low average. We do not go by percentiles as it is just a comparison to how other children scored. Again, you are not a speech pathologist. I am.

No, I'm not a speech pathologist but recognize your area of expertise. Nonetheless, I have years of experience in the special education field. Whether you agree or not, our school system does (not all the time) often qualify children with speech/lang scores of 85 and below--especially if they're obtained IQ scores are significantly higher.

They shouldn't be. It's not a true delay. And it certainly shouldn't be coded as a speech language delay. I hope the state doesn't audit your school system. Please be careful about spreading wrong information. This thread is about the OP and her child. Your response that a 16% should warrant looking into is what the speech paths on this thread are responding to. The OP asked if she was being given misinformation about scores and she was. 16% is not what is being looking at when coding a language delay, it's the standard scores. The OP's child does not have the standard scores to be diagnosed with a speech language delay.

+1,000 (another SLP chiming in on this thread)

I'm not an SLP, I'm a special educator and the parent of a child with some special needs, but I have a question about this.

If I am working in a public school, I have to follow specific requirements when finding a kid eligible for services, or writing an IEP. If a child comes to me with scores that are within normal limits, even if they're on the border, then they're ineligible unless there are other factors. Similarly, my own child who has scores in this range, is not eligible for an IEP and receives no specialized instruction.

However, if I'm contracting for private services, whether as a tutor or as a parent, the guidelines are different. There is nothing in my code of ethics that prevents me from working with a child whose parents would like to see him in a higher reading group, or from doing SAT prep with a student who got a 1500 (50th %ile) first round. If a parent asks me "what would you do?" there's nothing that prevents me from saying that I think the child would benefit from spending an hour each week with me playing phonics games, or that I heard that Kumon does a wonderful job with kids who need to work on math fluency.

In this case, the parent seems to have contracted with the SLP privately. Does that not change things similarly?

The rules for private services are more lax, it's true. I believe this goes along with what the first SLP was complaining about, that some private SLPs are not clear about how they offer their services. If in this case the SLP had said, "Your daughter is in the average range for expressive language skills, but right on the border between average and low-average. She should continue developing typically, but please bring her back if you start to see signs of her falling behind her peers. Alternatively, I can offer some support for some areas where I saw a relative weakness for her, if you would prefer that." Do you see how you can offer support without misrepresenting the problem? The OP's child was described as *needing* services, which is what I think the SLPs in this thread are taking umbrage with.

[Anonymous]

Also, the ST is being recommended to address a problem that was not a concern of the parent-OP was worried about artic and had no concerns in this area. The screener suggested concerns in receptive language! It just all seems very poorly done.

[Anonymous]

Anonymous wrote:Also, the ST is being recommended to address a problem that was not a concern of the parent-OP was worried about artic and had no concerns in this area. The screener suggested concerns in receptive language! It just all seems very poorly done.

It's certainly possible that the SLP didn't communicate results and concerns as well as expected, but sometimes parents and teachers may not be aware of a language, fine-motor, medical, or other weakness until a professional shares the eval results. That's certainly understandable because none of us knows everything!