Receptive language delay/processing disorder

[Anonymous]

I have an almost 5 year old with a history of speech delays, initially both expressive and receptive, but now just receptive/how he processes verbal information. He talks a lot, although not always novel language, but it's clear that he still struggles to understand spoken language - instructions, questions, etc. He also has great difficulty recalling events. We think it's processing vs. cognition, as pictures make sense to him, and in general he seems like much more of a visual learner.

What's the best kind of therapy to help with what seems like processing issues and inability to recall things? Speech? ABA? I have gotten different answers from professionals on this so would love parents input. Thanks...

[Anonymous]

Have you gotten a formal, full speech language assessment? I would start there. You need to understand if there are slow processing issues and/or working memory issues v. language issues.

If you're not clear whether to choose speech or ABA, it's another red flag for assessment. It suggests to me that you don't have a diagnosis beyond "speech delays" flagged by a pediatrician. That's not enough info to understand what the problem is and therefore what the therapies should be.

If you can't afford a full assessment, you can ask school for one. Do you have an IEP?

[Anonymous]

Anonymous wrote:I have an almost 5 year old with a history of speech delays, initially both expressive and receptive, but now just receptive/how he processes verbal information. He talks a lot, although not always novel language, but it's clear that he still struggles to understand spoken language - instructions, questions, etc. He also has great difficulty recalling events. We think it's processing vs. cognition, as pictures make sense to him, and in general he seems like much more of a visual learner.

What's the best kind of therapy to help with what seems like processing issues and inability to recall things? Speech? ABA? I have gotten different answers from professionals on this so would love parents input. Thanks...

Sounds like a combination of working memory challenges + speech.

For this I would suggest a combination of OT and ST. The OT for the working memory issues, and ST for the receptive language portion

[Anonymous]

Don't use ABA for speech. It is not meant for that.

[Anonymous]

Anonymous wrote:

Don't use ABA for speech. It is not meant for that.

+1

[Anonymous]

Anonymous wrote:

Don't use ABA for speech. It is not meant for that.

+1. It's not really for things like working memory either. It sounds like some providers believe this it's autism and others don't. ABA is often recommended for autism, but not every autistic responds well to it, and it requires many hours a week, which can negatively impact kids and families. I concur with PP who suggested you need a comprehensive assessment to get a diagnosis and detailed recommendation for areas of need. Sounds like OP needs a developmental pediatrician.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Don't use ABA for speech. It is not meant for that.

+1. It's not really for things like working memory either. It sounds like some providers believe this it's autism and others don't. ABA is often recommended for autism, but not every autistic responds well to it, and it requires many hours a week, which can negatively impact kids and families. I concur with PP who suggested you need a comprehensive assessment to get a diagnosis and detailed recommendation for areas of need. Sounds like OP needs a developmental pediatrician.

I am PP who suggested full assessment. IMO, a developmental pediatrician really cannot assess speech and language issues in depth and you should get full assessment anyway.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Don't use ABA for speech. It is not meant for that.

+1. It's not really for things like working memory either. It sounds like some providers believe this it's autism and others don't. ABA is often recommended for autism, but not every autistic responds well to it, and it requires many hours a week, which can negatively impact kids and families. I concur with PP who suggested you need a comprehensive assessment to get a diagnosis and detailed recommendation for areas of need. Sounds like OP needs a developmental pediatrician.

I am PP who suggested full assessment. IMO, a developmental pediatrician really cannot assess speech and language issues in depth and you should get full assessment anyway.

Yes I would go to language experts. University programs are best --- just another league of their own.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Don't use ABA for speech. It is not meant for that.

+1. It's not really for things like working memory either. It sounds like some providers believe this it's autism and others don't. ABA is often recommended for autism, but not every autistic responds well to it, and it requires many hours a week, which can negatively impact kids and families. I concur with PP who suggested you need a comprehensive assessment to get a diagnosis and detailed recommendation for areas of need. Sounds like OP needs a developmental pediatrician.

I am PP who suggested full assessment. IMO, a developmental pediatrician really cannot assess speech and language issues in depth and you should get full assessment anyway.

I agree that she should go to an SLP for speech issues, but it seems like there is more than just a speech problem going on, so she might need other evaluations as well.

[Anonymous]

Add attention to list of potential factors that can affect receptive language.

[Anonymous]

And hearing too.

[Anonymous]

What services is he in now? The best window for that stuff is 3-5 from what we found for services. Best help is a really good SLP/Speech Therapist several times a week. Ours worked on so many different things.

ABA is ok for basic starting to talk but not at that level/age. If you have behavioral issues then ABA may be ok. We didn't find it helpful at all for a language disorder.

Agree you need a full evaluation - I would go to an SLP. The universities can do a really good evaluation if insurance/money is tight. U of MD, GW and Loyola in Columbia all have programs at the speech pathology schools. I would not just do a language evaluation at this point depending on what you have done in the past. You should also do a hearing test as others suggested as a rule out.

Is child in school? They should have an IEP but we found that the school does not recognize receptive issues, just articulation and expressive. Though our experience is that speech therapy at school isn't helpful as its a group of 4-6 kids for 30 minutes with a huge range of needs, none similar.

Receptive language can continue to get better. My child's started getting noticeably better at 6-7. It may be as simple as time, but you really should have him in speech therapy a few days a week to work on it.

OT was a waste of time for language issues. Focus on speech and a full evaluation to make sure it isn't something else.

[Anonymous]

Speech eval is a great idea but you should go somewhere with a psychologist so you can get intellectual/cognition done as well too. I know your perception is that it is just language but you may be surprised. That's what I thought for my kid and then his cognitive came out around 80. He was 4 1/2 and they used the DAS-2. We went through the school system and they did it all for free.

We had it redone a few years later privately and it was closer to 95. I don't think the first one was wrong, I think intervention and time/development were helpful.

[Anonymous]

Anonymous wrote:Speech eval is a great idea but you should go somewhere with a psychologist so you can get intellectual/cognition done as well too. I know your perception is that it is just language but you may be surprised. That's what I thought for my kid and then his cognitive came out around 80. He was 4 1/2 and they used the DAS-2. We went through the school system and they did it all for free.

We had it redone a few years later privately and it was closer to 95. I don't think the first one was wrong, I think intervention and time/development were helpful.

With a language disorder you want to do non-verbal and verbal testing. My child had both the non-verbal and verbal IQ tests (and did well). Its a good idea to get tested. We found the testing important with the school as the school was very much underestimating our child.

[Anonymous]

My DC has this profile and gets speech therapy and has a resource educator as well, both through Ffx Co schools. Speech therapy will target conceptual language issues, esp. abstract concepts like before, after, but, and because, and maybe also patterning, etc., and much more. If you can get an eval through Child Find (if you're in FFC) or whatever the diagnostic special ed arm of your public school system is, that's the best place to start. KKI and Children's can also do a full workup (which you need) and take insurance. You'll want an IEP in place for kindergarten, so start now. Good luck!