Anonymous
Post 11/01/2022 17:43     Subject: Re:receptive delay?
Anonymous wrote:Speech disorders can be a stand alone diagnosis, that is true. Language disorder generally can be, too. But, receptive language disorders are not a stand alone diagnosis. If your DC received a diagnosis of receptive language disorder from an SLP, you need to keep digging and get a very thorough evaluation done because there is ALWAYS more to the story. There are no exceptions.

It is also not true that there are lots of tools that SLPs use to work on receptive language. Expressive language, absolutely true. Any supposed treatment of receptive language is actually focusing on expressive language or compensatory strategies. These strategies don't actually improve the receptive language but rather accommodate whatever is interfering with reception. But, the strategies have nothing to do with language.

Receptive language delays simply cannot occur in isolation. Logically, we cannot express what we have not already receptively learned/comprehended. So, reception always comes first followed by expression. So, if expression language is typical, there is no linguistic basis for delay receptive language. You need to look for other things that are interfering with the child's ability to perform in natural contexts (memory, hearing loss, adhd, low cognition, autism, etc.).

I've yet to hear of an evidence based receptive language disorder treatment. I am an SLP and research this area deeply. There is nothing there. But, if you go to a private clinic and come away with isolated receptive delay, they will be happy to make you think they are treating it.


I am a different poster and I would give a child an EL/RL delay diagnosis based on testing, but I certainly am not going to give the diagnosis of autism or ADHD. I am going to dx EL or RL or mixed for billing and then send them to a doctor for further testing.

I just don't want people to think they are supposed to be getting these diagnoses from SLPs.

I will definitely tell the parents what I suspect however and I will recommend which doctors they should see.
Anonymous
Post 11/01/2022 16:04     Subject: receptive delay?
Anonymous wrote:Op, I don't know if you're the same poster from the thread who's child has some delays but didn't qualify for early intervention services. If you are though, I've got to tell you that it's really too early to know. Your best bet is to get referral from your pediatrician with speech therapist and do therapy if indicated.

Get on the waiting list for assessments, those are long, in the meanwhile pursue speech and go from there. It's just too early to know if they receptive language is with anything else. You can't generalize.


+1 My oldest (now 19) was diagnosed with MERLD at age 4 and ADHD at age 5. We did ST for a while but the SLP indicate she thought the delays were a result of the ADHD and the slower brain maturation of his ADHD brain (this is well document in NIH research - the ADHD brain can have up to a 30% delay in maturation). This was true for my oldest and by about 4th grade, his speech/language was within normal range.

My youngest (now 16) was diagnosed at age 5 with apraxia of speech/language disorder/ADHD. Until he was in about 4th grade he was LEP - he wasn't proficient in any language even though he is our bio kid. He never met the criteria for ASD (his first evaluation was with NIH researchers at age 2). He required intensive ST and language support in all academic areas until he was in middle school. Even now, his speech isn't completely 'normal' and he still qualifies for ESOL support (he doesn't get it because English is his first/only language).

Both boys are of at least average intelligence and college bound.
Anonymous
Post 11/01/2022 09:35     Subject: receptive delay?
Anonymous wrote:
Anonymous wrote:Mine didn't talk until he was 4. Combo of developmental delay and a tongue tie. School system wanted to label him eligible under Autism even though Dev Ped. still adamantly says no, even after 5 years.

Once his language started catching up, a lot of the social emotional problems improved or resolved because he could understand what we wanted and also express how he was feeling.

Also, labels/diagnoses are not supposed to drive services. Mine still did self contained enhanced autism until this year so he could get more intensive services.


Different poster , but what do you mean that diagnoses aren't supposed to drive services? Isn't that exactly what they do?


PP. I see where I should have clarified that statement. For school and the IEP, labels/diagnoses are not supposed to drive services. Meaning, they look at education impacts and work out placement accordingly. My DC needed a program focused on language, a low ratio and the ability work on social/emotional skills with help. That is the Enhanced Autism classroom in FCPS. I've had more than one Sped professional wish they named it something else because it's a bit misleading. Now he's in the GenEd with supports and pull out for more intensive Reading/Writing.

For the medical side, yes, it's all about the billing codes and justifications for getting insurance to cover things.
Anonymous
Post 11/01/2022 09:24     Subject: Re:receptive delay?
Anonymous wrote:Speech disorders can be a stand alone diagnosis, that is true. Language disorder generally can be, too. But, receptive language disorders are not a stand alone diagnosis. If your DC received a diagnosis of receptive language disorder from an SLP, you need to keep digging and get a very thorough evaluation done because there is ALWAYS more to the story. There are no exceptions.

It is also not true that there are lots of tools that SLPs use to work on receptive language. Expressive language, absolutely true. Any supposed treatment of receptive language is actually focusing on expressive language or compensatory strategies. These strategies don't actually improve the receptive language but rather accommodate whatever is interfering with reception. But, the strategies have nothing to do with language.

Receptive language delays simply cannot occur in isolation. Logically, we cannot express what we have not already receptively learned/comprehended. So, reception always comes first followed by expression. So, if expression language is typical, there is no linguistic basis for delay receptive language. You need to look for other things that are interfering with the child's ability to perform in natural contexts (memory, hearing loss, adhd, low cognition, autism, etc.).

I've yet to hear of an evidence based receptive language disorder treatment. I am an SLP and research this area deeply. There is nothing there. But, if you go to a private clinic and come away with isolated receptive delay, they will be happy to make you think they are treating it.


OP here- You are absolutely right. Kid has receptive and expressive delay. But I am more concerned about receptive delay as that is more worrisome and indicates some other issue. Was just wondering what else can it be besides autism . Thanks for you detailed response.
Anonymous
Post 11/01/2022 00:55     Subject: Re:receptive delay?
Speech disorders can be a stand alone diagnosis, that is true. Language disorder generally can be, too. But, receptive language disorders are not a stand alone diagnosis. If your DC received a diagnosis of receptive language disorder from an SLP, you need to keep digging and get a very thorough evaluation done because there is ALWAYS more to the story. There are no exceptions.

It is also not true that there are lots of tools that SLPs use to work on receptive language. Expressive language, absolutely true. Any supposed treatment of receptive language is actually focusing on expressive language or compensatory strategies. These strategies don't actually improve the receptive language but rather accommodate whatever is interfering with reception. But, the strategies have nothing to do with language.

Receptive language delays simply cannot occur in isolation. Logically, we cannot express what we have not already receptively learned/comprehended. So, reception always comes first followed by expression. So, if expression language is typical, there is no linguistic basis for delay receptive language. You need to look for other things that are interfering with the child's ability to perform in natural contexts (memory, hearing loss, adhd, low cognition, autism, etc.).

I've yet to hear of an evidence based receptive language disorder treatment. I am an SLP and research this area deeply. There is nothing there. But, if you go to a private clinic and come away with isolated receptive delay, they will be happy to make you think they are treating it.
Anonymous
Post 10/31/2022 22:29     Subject: Re:receptive delay?
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:OP, I am an SLP and have provided service to many students who have a receptive delay (based on S/L testing), but who do not have Autism and I do not suspect they have Autism. Low receptive language in isolation, is secondary to another condition not related to language. The most typical are autism, adhd, low working memory, low processing speed, hearing loss.


Usually, but not always secondary.


Tell me how receptive language delays (without expressive language delays) can be a primary diagnosis. It's not possible logically and according to research. Also, there are zero evidence based treatment approaches for SLPs to address receptive language successfully...because it isn't a stand alone entity.


Usually there are expressive delays as well but it's generally under auditory processing, especially as kids get older. Speech disorders can be a stand alone diagnosis. There are lots of tools that SLP's use to work on both expressive and receptive language.

https://www.medicalnewstoday.com/articles/communication-disorders#types

Anonymous
Post 10/31/2022 20:49     Subject: Re:receptive delay?
Anonymous wrote:
Anonymous wrote:OP, I am an SLP and have provided service to many students who have a receptive delay (based on S/L testing), but who do not have Autism and I do not suspect they have Autism. Low receptive language in isolation, is secondary to another condition not related to language. The most typical are autism, adhd, low working memory, low processing speed, hearing loss.


Usually, but not always secondary.


Tell me how receptive language delays (without expressive language delays) can be a primary diagnosis. It's not possible logically and according to research. Also, there are zero evidence based treatment approaches for SLPs to address receptive language successfully...because it isn't a stand alone entity.
Anonymous
Post 10/31/2022 18:19     Subject: Re:receptive delay?
Anonymous wrote:OP, I am an SLP and have provided service to many students who have a receptive delay (based on S/L testing), but who do not have Autism and I do not suspect they have Autism. Low receptive language in isolation, is secondary to another condition not related to language. The most typical are autism, adhd, low working memory, low processing speed, hearing loss.


Usually, but not always secondary.
Anonymous
Post 10/31/2022 18:16     Subject: Re:receptive delay?
OP, I am an SLP and have provided service to many students who have a receptive delay (based on S/L testing), but who do not have Autism and I do not suspect they have Autism. Low receptive language in isolation, is secondary to another condition not related to language. The most typical are autism, adhd, low working memory, low processing speed, hearing loss.
Anonymous
Post 10/31/2022 18:02     Subject: receptive delay?
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Mine didn't talk until he was 4. Combo of developmental delay and a tongue tie. School system wanted to label him eligible under Autism even though Dev Ped. still adamantly says no, even after 5 years.

Once his language started catching up, a lot of the social emotional problems improved or resolved because he could understand what we wanted and also express how he was feeling.

Also, labels/diagnoses are not supposed to drive services. Mine still did self contained enhanced autism until this year so he could get more intensive services.


Different poster , but what do you mean that diagnoses aren't supposed to drive services? Isn't that exactly what they do?


The diagnostic label doesn't drive services, the individualized needs do.


No, the diagnostic label absolutely drives services as some insurances will only pay with an ASD label, which is why some doctors are so quick to give it early on (and others not so quick which makes it very hard for some families to access therapies).
Anonymous
Post 10/31/2022 18:01     Subject: receptive delay?
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Mine didn't talk until he was 4. Combo of developmental delay and a tongue tie. School system wanted to label him eligible under Autism even though Dev Ped. still adamantly says no, even after 5 years.

Once his language started catching up, a lot of the social emotional problems improved or resolved because he could understand what we wanted and also express how he was feeling.

Also, labels/diagnoses are not supposed to drive services. Mine still did self contained enhanced autism until this year so he could get more intensive services.


You are more talking about expressive language, not receptive.


There were, and still are, receptive issues as well. For example, he's working on answering reading comprehension questions along with answering opinion questions like "would you rather". They would have been there regardless of the tongue tie. Difference now is that he can say "I don't know, I need help".

The odd combo of issues sure did point to ASD when he was 2-3 years old, but it turned out not to be the case. Whenever I hear of some saying that their child outgrew ASD, I often wonder if there are more kids out there like mine and were misdiagnosed early on. I don't have an opinion of if one can outgrow ASD, but it does seem like some many conditions overlap. It's confusing for parents just trying to get appropriate early intervention.


Kids don't outgrow ASD, so they were misdiagnosed, which is very easy to do early on. All the interventions are pretty much the same and tweaked to each child - you really only have ST, OT, PT, ABA and some other ones, many of which are money grabs like music and horse therapy.
Anonymous
Post 10/31/2022 17:53     Subject: receptive delay?
Anonymous wrote:
Anonymous wrote:Mine didn't talk until he was 4. Combo of developmental delay and a tongue tie. School system wanted to label him eligible under Autism even though Dev Ped. still adamantly says no, even after 5 years.

Once his language started catching up, a lot of the social emotional problems improved or resolved because he could understand what we wanted and also express how he was feeling.

Also, labels/diagnoses are not supposed to drive services. Mine still did self contained enhanced autism until this year so he could get more intensive services.


Different poster , but what do you mean that diagnoses aren't supposed to drive services? Isn't that exactly what they do?


The diagnostic label doesn't drive services, the individualized needs do.
Anonymous
Post 10/31/2022 17:49     Subject: receptive delay?
Anonymous wrote:Mine didn't talk until he was 4. Combo of developmental delay and a tongue tie. School system wanted to label him eligible under Autism even though Dev Ped. still adamantly says no, even after 5 years.

Once his language started catching up, a lot of the social emotional problems improved or resolved because he could understand what we wanted and also express how he was feeling.

Also, labels/diagnoses are not supposed to drive services. Mine still did self contained enhanced autism until this year so he could get more intensive services.


Different poster , but what do you mean that diagnoses aren't supposed to drive services? Isn't that exactly what they do?
Anonymous
Post 10/31/2022 17:21     Subject: receptive delay?
Anonymous wrote:
Anonymous wrote:Mine didn't talk until he was 4. Combo of developmental delay and a tongue tie. School system wanted to label him eligible under Autism even though Dev Ped. still adamantly says no, even after 5 years.

Once his language started catching up, a lot of the social emotional problems improved or resolved because he could understand what we wanted and also express how he was feeling.

Also, labels/diagnoses are not supposed to drive services. Mine still did self contained enhanced autism until this year so he could get more intensive services.


You are more talking about expressive language, not receptive.


There were, and still are, receptive issues as well. For example, he's working on answering reading comprehension questions along with answering opinion questions like "would you rather". They would have been there regardless of the tongue tie. Difference now is that he can say "I don't know, I need help".

The odd combo of issues sure did point to ASD when he was 2-3 years old, but it turned out not to be the case. Whenever I hear of some saying that their child outgrew ASD, I often wonder if there are more kids out there like mine and were misdiagnosed early on. I don't have an opinion of if one can outgrow ASD, but it does seem like some many conditions overlap. It's confusing for parents just trying to get appropriate early intervention.
Anonymous
Post 10/30/2022 06:45     Subject: receptive delay?
Anonymous wrote:Mine, but he has a low IQ.


Same