Assessment of SpeechLanguageCommunication Skills Terri Carrington, M'A', CCCSLP

1
Assessment of Speech/Language/Communication
SkillsTerri Carrington, M.A., CCC-SLP
2
Purpose of Assessment

• Qualifying for Services

• Programming Services

3
Qualification for Services

• Students do not have to meet criteria for
  services for speech/language disorder.
• By definition, students with autism qualify for
  speech/language services
• Speech/language services are often the primary
  service for high functioning students.
• The speech/language pathologist contributes
  information to educationally diagnose autism, but
  more importantly indicates programming priorities.

4
Characteristics of Communication in Individuals
with Autism

• Difficulties with comprehension of
• Spoken Language
• Gestures and body postures
• Facial expression

5
Characteristics of Communication (cont.)

• Social awareness is lacking, or very poor,
  resulting in
• Impoverished strategies for beginning to
  understand the communication process
• Difficulty initiating social contact, or lack of
  awareness of need to direct message at
  communication partner
• Difficulties in responding to others reciprocally

6
Characteristics of Communication (cont.)

• Cognitive deficits, resulting in problems with
• Assigning meaning
• Perspective taking and empathy
• Generalization
• Organization and sequencing
• Abstract thinking

7
Characteristics of Communication (cont.)

• Language production problems, such as
• Mutism, lack of gestures and facial expressions
• Nonfunctional use of speech
• Echolalic speech
• Verbal perseveration
• Unusual rate, voice quality, fluency, intonation
• Unconventional or challenging behaviors used as
  means to communicate messages

8
CELF

• The Clinical Evaluation of Language Fundamentals
  (CELF-4) is useful as an overall look at
  receptive and expressive language.
• Ages 5 to 21
• CELF-P Preschool to Early Elementary
• Difference between language disordered and
  autistic individuals was the large variance in
  the scores of the group with autism
• Authors report a 1.5 to 2 standard deviation
  difference in the scores of normally developing
  students and their peers with autism.

9
ABLLS

• Assessment of Basic Language Skills
• Assessment curriculum guide
• Skills tracking system
• Task analysis
• Purpose to help identify those language and
  other critical skills that are in need of
  intervention in order for a child to become more
  capable of learning from his everyday experiences
• Tested skills are arranged in an approximate
  developmental sequence

10
Comprehensive Assessment of Spoken Language (CASL)

• Especially relevant
• Supralinguistic Tests
• Nonliteral Language
• Meaning from Content
• Inference
• Ambiguous Sentences

11
Looking at Speech

• Articulation is usually not the primary concern
  with these individuals, and deficits are thought
  to occur at about the same rate as within the
  typical population
• There is a correlation between autism and
  dyspraxia
• Unusual prosody, rate of speech, and voice
  problems do occur
• There are no assessment tools specific to speech
  deficits for students with autism

12
Comments on Formal Assessment

• Keep in mind students with autism will often have
  better expressive than receptive language.
• Comprehension is often overestimated
• Higher functioning individuals will often do well
  on standardized tests, but struggle in everyday
  life
• Always augment standardized information with
  informal measures

13
Formal Assessment Lists

• http//www.behavior-consultant.com/aut-dx-devices.
  htm
• http//www.iidc.indiana.edu/irca/communication/CeD
  irSLP.html
• Asperger Syndrome and Adolescence Practical
  Solutions for School Success, 2001, by Brenda
  Smith Myles and Diane Adreon, published by Autism
  Asperger Publishing Company

14
What do you use?

• The Westby Play Scale! Its one of my faves.
  User friendly and parallels play and language
  side by side. In addition, it looks at Theory of
  Mind!
• Speech, Language Pathologist
• Source Assessment of Cognitive and Language
  Abilities through Play in Language Speech and
  Hearing in the Schools, Vol. 11, 154-168

15
What do you use?

• Id use the Test of Problem Solving, the Test of
  Pragmatic Language, and the Clinical Evaluation
  of Language Fundamentals. Also need language
  sampling and observation in multiple settings.
  Id need to be sure we had a history, all the
  medical information, and Id probably use the
  Childhood Autism Rating Scale or something
  similar.
• Speech, Language Pathologist

16
Informal Assessment

• Language Sample
• Apply SALT or some other method of looking at
  sentence structure, morphological development
  etc.
• Be aware this is not the primary information you
  want from a language sample

17
Language Sampling with the More Challenged Student

• Consider imaginative vs. constructive play
• Communication Temptations
• Observe in a social environment

18
Language Sample Questions Specific to Autism

• Did the students vocabulary seem appropriate for
  his age level? Decreased? Increased?
• Did the students language seem pedantic or
  little-professor like?
• Did you notice echolalia, perseverative speech or
  repetitive questions? Describe.
• Did you notice difficulty with figurative
  language, sarcasm, interpreting humor,
  interpreting idioms?
• Comment on the inflection, pitch and prosody of
  the students voice. Were those appropriate to
  age and topic?
• Did the student talk about a wide range of
  topics, or did he talk mostly about a special
  interest area?
• Could he transition easily from one topic to the
  next?
• Was the student able to use language for a
  variety of functions? Could he initiate,
  comment, ask and answer questions, sequence
  events?
• Did the student seem to know many facts about a
  particular subject?

19
Materials and Activities for the Language Sample

• Problem Solving
• Reciprocal Play
• Joke and Riddle Books
• Let the student pick a topic
• Barrier games
• Opportunity to ask questions, respond to sarcasm,
  indirect speech, figurative language

20
Assessing Functionally Nonverbal Students

• Think in terms of a system of communication
• Aided/Unaided
• High Tech/Low Tech/No Tech

21
Assessing Functionally Nonverbal Students

• The focus of assessment aligns wit the reasons we
  support the use of AAC-Participation
• Much of the assessment will occur in naturalistic
  environments
• There are no prerequisites for the use of AAC,
  but there are assessment questions which will
  assist in designing the most appropriate options
  for individuals

22
Assessing Functionally Nonverbal Students

• Ecological Assessment
• Assessment team consists of stakeholders
• Team identifies students environments and
  sub-environments
• Team identifies upcoming transitions
• Team creates detailed description of activities
  occurring in identified environments
• Team prioritizes activities
• Team looks for ways to improve students
  participation in identified activities

23
Assessing Functionally Nonverbal Students

• Additional Ecological Assessments
• McGill Action Planning System (MAPS)
• Futures Planning
• SETT

24
Assessing Functionally Nonverbal Students

• Specific Assessments
• Cognitive Skills
• Motor Abilities
• Sensory Functioning

25
Assessment and Literacy

• Emergent Reading-uneven development
• Conventional Reading-word reading is advanced
  compared to comprehension
• Skilled Readingmany do not get to this level,
  comprehension usually continues to be a problem,
  language problems often exist and interfere

26
FBA and FCT

• Individuals with severe communication deficits
  will often communicate with challenging behavior
• Our job is to determine the function or meaning
  of that behavior and provide a more appropriate
  alternative
• The first step is a Functional Behavior
  Assessment (FBA)

27
FBA Brief Review

• Informant
• Direct Observation
• Functional Analysis Manipulations
• Resource
• Functional Assessment and Program Development for
  Problem Behavior A Practical Handbook by
  ONeil, et al, published by Brooks/Cole 1997

28
FBA

• Functional Behavioral Analysis
• Assessment is on-going
• This is where you take data on your intervention
  and determine whether it is working or not
• Can be complex and involve multiple variables

29
Behaviors are Communication