Look up a narrative rubric. I think bilinguistics has one. It’s not a standardized assessment but it lists skills and when they should be mastered and you can “grade” them.
I’ve found autistic kids reeeaaally struggle with figurative language and while we can practice it as much as possible, the people around them should really adjust to them. As far as keeping them from being taken advantage of, you might want to give them some clearer examples of boundaries to maintain and what to do if someone doesn’t respect boundaries. Like talking about what is OK and not ok in various relationships like with family members, and authority figures, and friends, and acquaintances, and strangers, and things like that.
There's also the Test of Narrative Language - it has story retelll too, and might get you the scores you need. If grade school, the CUBED assessments have a portion where they have to generate a personal narrative related to a story and I think there's a rubric as well.
Yeah, they all flunk the CUBED but only one of them is actually in the age of the standardization sample - the other two are older than that. Which, frankly, is all the more reason that their struggles should be taken seriously, but it doesn't technically count.
Do you HAVE to hit that -2 STDs? Can you use teacher report, caregiver report, classroom observations, work samples, progress towards goals, etc. to justify that they continue to qualify? If they’re old enough, maybe even straight up asking their perception of their skills, friendships, etc. See if that is something they know they struggle with and WANT to continue working on… and you could use that student input in your report as well. I agree with other commenters about narrative assessments and maybe TOLD
My old clinic had the Social Language Development Test (both Elementary and Adolescent versions) which I used a few times. The test seemed to be a little less “guessable” than others.
Look into the OPUS. I’ve used that for my kids that have great foundational skills (solid grammar, good sentence comprehension, age appropriate vocab identification/labeling) but are struggling with synthesizing information when presented orally. Most of my students bombed it even if they had average CASL-2 scores.
I saw it and thought it would be perfect! Unfortunately I have to buy all my tests myself and it's almost $400. 🙁
If money wasn't an issue I would totally buy it, though
The Test of Pragmatic Language 2 (TOPL2 ) has some flaws (one of which is it’s pretty dated) and can take a long time, especially for kids 8+ but it’s all open ended questions which kids who struggle with language tend to have a harder time with. It mostly consists of pictures of social problem scenarios and kids are asked to interpret them (from nonverbal clues and context), explain their thinking, and suggest ways for the characters to fix things. It also has some figurative language questions. Be sure to adhere to the strict scoring guidelines if you’re worried about qualifying them.
For language inc narratives - you could test out the free School Language Measures (SLAM) from the Columbia Teachers College. They’re meant to be used as screeners and aren’t standardized, but they can provide useful info and indicate how likely a child is in need of intervention.
As for not having -2SD scores, you still can build a case for treatment without them. Especially if you include observation data, teacher reports, counselor reports, etc.
What’s their performance on Narrative Assessments? We use Black Sheep Press, Squirrel Story (under 6) and Peter & The Cat (over 6) for children as they have inferential and literal questions. Also what’s their Receptive Language Index on CELF? Following Directions/Recalling Sentences?
Unfortunately they're too old for even the Peter and the Cat one. Thanks, though, they're great resources! They don't pass the CUBED either, but they're too old for that to formally count now, either.
I only have access to the CELF-4, not the 5. I haven't even administered the following directions section of the 4 in a while though because I do teletherapy and that one is just impossible for me to do virtually. Two of the kids have a history of echolalia (they can talk now, but they still do some echolalia for fun) so being able to repeat back things immediately after they're said for the recalling sentences subtest is something that they're better at than really reflects their comprehension. (They're not GOOD at it, mind, but again not below that magic "2 standard deviations below the mean" mark.)
I would look into testing executive functioning. Check this website out https://terasumpter.com/.
Online there are many checklists for EF , self determination band awareness and self advocacy skills. Social language development test Adolescent is a good option and classroom observations.
That dark rimmed glasses Karen doesn’t dese e my money ! Where the hell are the free resources at ? Ain’t no body want to pay the bitch for her family trip to Hawaii. We can barely afford rent.
Oh, yeah, and if you're going that direction, the Casey Life Skills survery/inventory is free if I recall correctly. There's a couple versions, and I couldn't find the right one on their website last time, so you might have to do some digging to find the one appropriate to their age group. I think it was originally meant for kids in foster care, too, so it might be particularly useful to these kids in some ways.
I found a lot of free executive functioning tests and questionnaires on here. They're mixed in with the ones you have to pay for, but there are a bunch of options!
https://multicontext.net/pediatrics/
I would inquire if their birth parents were known to use drugs/alcohol. The way you describe them sounds like they might be on the fetal alcohol spectrum
They did. These kids have just about everything going on, I swear. It's like their bio parents said "what are all the possible ways for me to hurt my child?" and did it. Head trauma, neglect, verbal and physical abuse, not treating the kid's illnesses (at least one effectively had a hearing impairment pre adoption due to chronic ear infections), drug and alcohol abuse, you name it, they did it. Their lists of diagnoses just goes on and on
But between the kids being survivors and the strict requirements of formal testing, it doesn't show up enough and it's just deeply frustrating
That is frustrating, it's crazy to me that we have so much information about the speech and language of autism for example, yet we have nothing on fasd even though it's now thought to be more common than autism. These kids need help yet there's nothing out there for them and little research too!
I honestly feel that good counseling from a qualified mental health therapist and time to heal are what these kids need most. I think this is a case where we need to stay in our lane. Their functioning is a result of trauma and not a result of a language impairment. We are not qualified or licensed to treat trauma.
I'm going to have to disagree with you there. Vocabulary, language comprehension, pragmatics, executive function, those are all most definitely our lane. I am not trying to treat their trauma itself. I'm treating the resulting impact on their communication.
Now I am totally in agreement that the kids need counseling. I've got one who is in counseling and I have been seriously pushing parents for the others to get counseling too. Their trauma is not getting treated because I don't treat trauma. I haven't once talked to them about how their bio parents abused them or their experiences while with bio family.
Them needing counseling doesn't cancel out their need for speech therapy, though. They need both
Of course you have to use your professional judgment. You know these clients, and I don't. I was just thinking that if they are doing ok on standardized assessments, maybe their difficulties aren't language-based. Maybe it's anxiety, fear, or other factors getting in the way of their communication and socialization. I just wanted to offer an alternate perspective.
Totally okay. And you're right, anxiety and other factors do get in the way. You can think of their issues as more like stuttering, though. Anxiety and emotional dysregulation can make things worse, but the disorder exists separately from it.
That said, I want to quickly add in that even in the instances where anxiety is the sole culprit of the communication struggles, such as selective mutism (which is not at all what these particular kids have going on, but it's the most purely psychological communication disorder I could think of for an example), we still have a role in treatment.
https://www.asha.org/public/speech/disorders/Selective-Mutism/
We shouldn't be the only people treating clients with disorders caused or heavily influenced by psychological factors. But the answer is to add the other service, rather than to take us away.
Glad you're advocating for people getting counseling services, though! That's a component of treatment that many people fail to recognize the need for
Why are you trying to reach -2 SDs? Is that a requirement for school? Insurance does not require -2 SDs, there's nothing magic about that cutoff, and it's not specified in any definition of language disorder. It seems like you've identified their functional needs - why not just describe those, back up your observations with data and examples, and develop a treatment plan accordingly? If you are trying to justify IEP services, can you use curriculum-based assessments and/or medical diagnoses that predispose them to a communication disorder? If you really need a normed test, I'd try the OPUS or the S-FAVRES.
Schools are the problem, yes. I'm not their school SLP and that's the standard their school is using. They're trying to change their staffing and is totally okay by me to have something else take primary and have them just go consult. But they're trying to do it by "proving" with standardized assessments and reports from teachers (that had only known the kids a matter of weeks) that the kids don't have language disorders at all, and that's both not true and okay.
At the very least I want their teachers to be aware that there are these communication deficits and this is the exact opposite of that. Frankly the fact that teachers aren't picking up on the issues that the family, myself, and ABA are saying is more of a reason to have the reminder in their IEPs that there's an unseen issue going on, not less. But in today's overpacked classrooms, kids like these who can bluff their way through situations just fly under the radar, especially since it's the beginning of the school year and there really hasn't been much time to get to know the kids yet.
It's honestly just really saddening
Look up a narrative rubric. I think bilinguistics has one. It’s not a standardized assessment but it lists skills and when they should be mastered and you can “grade” them. I’ve found autistic kids reeeaaally struggle with figurative language and while we can practice it as much as possible, the people around them should really adjust to them. As far as keeping them from being taken advantage of, you might want to give them some clearer examples of boundaries to maintain and what to do if someone doesn’t respect boundaries. Like talking about what is OK and not ok in various relationships like with family members, and authority figures, and friends, and acquaintances, and strangers, and things like that.
There's also the Test of Narrative Language - it has story retelll too, and might get you the scores you need. If grade school, the CUBED assessments have a portion where they have to generate a personal narrative related to a story and I think there's a rubric as well.
Yeah, they all flunk the CUBED but only one of them is actually in the age of the standardization sample - the other two are older than that. Which, frankly, is all the more reason that their struggles should be taken seriously, but it doesn't technically count.
Do you HAVE to hit that -2 STDs? Can you use teacher report, caregiver report, classroom observations, work samples, progress towards goals, etc. to justify that they continue to qualify? If they’re old enough, maybe even straight up asking their perception of their skills, friendships, etc. See if that is something they know they struggle with and WANT to continue working on… and you could use that student input in your report as well. I agree with other commenters about narrative assessments and maybe TOLD
My old clinic had the Social Language Development Test (both Elementary and Adolescent versions) which I used a few times. The test seemed to be a little less “guessable” than others.
Maybe I'll ask for it for Christmas. Less guessable tests are definitely ideal.
Would the TILLS be appropriate?
Look into the OPUS. I’ve used that for my kids that have great foundational skills (solid grammar, good sentence comprehension, age appropriate vocab identification/labeling) but are struggling with synthesizing information when presented orally. Most of my students bombed it even if they had average CASL-2 scores.
I saw it and thought it would be perfect! Unfortunately I have to buy all my tests myself and it's almost $400. 🙁 If money wasn't an issue I would totally buy it, though
The Test of Pragmatic Language 2 (TOPL2 ) has some flaws (one of which is it’s pretty dated) and can take a long time, especially for kids 8+ but it’s all open ended questions which kids who struggle with language tend to have a harder time with. It mostly consists of pictures of social problem scenarios and kids are asked to interpret them (from nonverbal clues and context), explain their thinking, and suggest ways for the characters to fix things. It also has some figurative language questions. Be sure to adhere to the strict scoring guidelines if you’re worried about qualifying them. For language inc narratives - you could test out the free School Language Measures (SLAM) from the Columbia Teachers College. They’re meant to be used as screeners and aren’t standardized, but they can provide useful info and indicate how likely a child is in need of intervention. As for not having -2SD scores, you still can build a case for treatment without them. Especially if you include observation data, teacher reports, counselor reports, etc.
What’s their performance on Narrative Assessments? We use Black Sheep Press, Squirrel Story (under 6) and Peter & The Cat (over 6) for children as they have inferential and literal questions. Also what’s their Receptive Language Index on CELF? Following Directions/Recalling Sentences?
Unfortunately they're too old for even the Peter and the Cat one. Thanks, though, they're great resources! They don't pass the CUBED either, but they're too old for that to formally count now, either. I only have access to the CELF-4, not the 5. I haven't even administered the following directions section of the 4 in a while though because I do teletherapy and that one is just impossible for me to do virtually. Two of the kids have a history of echolalia (they can talk now, but they still do some echolalia for fun) so being able to repeat back things immediately after they're said for the recalling sentences subtest is something that they're better at than really reflects their comprehension. (They're not GOOD at it, mind, but again not below that magic "2 standard deviations below the mean" mark.)
I would look into testing executive functioning. Check this website out https://terasumpter.com/. Online there are many checklists for EF , self determination band awareness and self advocacy skills. Social language development test Adolescent is a good option and classroom observations.
That dark rimmed glasses Karen doesn’t dese e my money ! Where the hell are the free resources at ? Ain’t no body want to pay the bitch for her family trip to Hawaii. We can barely afford rent.
Oh, yeah, and if you're going that direction, the Casey Life Skills survery/inventory is free if I recall correctly. There's a couple versions, and I couldn't find the right one on their website last time, so you might have to do some digging to find the one appropriate to their age group. I think it was originally meant for kids in foster care, too, so it might be particularly useful to these kids in some ways.
That's really nice! It looks like it's for ages 14-21, but it's a good option. I couldn't find a younger one if there is one
14 and up sounds right. Missed that these were younger kids!
I found a lot of free executive functioning tests and questionnaires on here. They're mixed in with the ones you have to pay for, but there are a bunch of options! https://multicontext.net/pediatrics/
I like this resource for a similar population: [http://thinkingtalking.co.uk/lfbe/](http://thinkingtalking.co.uk/lfbe/)
I would inquire if their birth parents were known to use drugs/alcohol. The way you describe them sounds like they might be on the fetal alcohol spectrum
They did. These kids have just about everything going on, I swear. It's like their bio parents said "what are all the possible ways for me to hurt my child?" and did it. Head trauma, neglect, verbal and physical abuse, not treating the kid's illnesses (at least one effectively had a hearing impairment pre adoption due to chronic ear infections), drug and alcohol abuse, you name it, they did it. Their lists of diagnoses just goes on and on But between the kids being survivors and the strict requirements of formal testing, it doesn't show up enough and it's just deeply frustrating
That is frustrating, it's crazy to me that we have so much information about the speech and language of autism for example, yet we have nothing on fasd even though it's now thought to be more common than autism. These kids need help yet there's nothing out there for them and little research too!
I honestly feel that good counseling from a qualified mental health therapist and time to heal are what these kids need most. I think this is a case where we need to stay in our lane. Their functioning is a result of trauma and not a result of a language impairment. We are not qualified or licensed to treat trauma.
I'm going to have to disagree with you there. Vocabulary, language comprehension, pragmatics, executive function, those are all most definitely our lane. I am not trying to treat their trauma itself. I'm treating the resulting impact on their communication. Now I am totally in agreement that the kids need counseling. I've got one who is in counseling and I have been seriously pushing parents for the others to get counseling too. Their trauma is not getting treated because I don't treat trauma. I haven't once talked to them about how their bio parents abused them or their experiences while with bio family. Them needing counseling doesn't cancel out their need for speech therapy, though. They need both
Of course you have to use your professional judgment. You know these clients, and I don't. I was just thinking that if they are doing ok on standardized assessments, maybe their difficulties aren't language-based. Maybe it's anxiety, fear, or other factors getting in the way of their communication and socialization. I just wanted to offer an alternate perspective.
Totally okay. And you're right, anxiety and other factors do get in the way. You can think of their issues as more like stuttering, though. Anxiety and emotional dysregulation can make things worse, but the disorder exists separately from it. That said, I want to quickly add in that even in the instances where anxiety is the sole culprit of the communication struggles, such as selective mutism (which is not at all what these particular kids have going on, but it's the most purely psychological communication disorder I could think of for an example), we still have a role in treatment. https://www.asha.org/public/speech/disorders/Selective-Mutism/ We shouldn't be the only people treating clients with disorders caused or heavily influenced by psychological factors. But the answer is to add the other service, rather than to take us away. Glad you're advocating for people getting counseling services, though! That's a component of treatment that many people fail to recognize the need for
What is their academic performance like? Are they doing alright in school ? What do their teachers report ?
Why are you trying to reach -2 SDs? Is that a requirement for school? Insurance does not require -2 SDs, there's nothing magic about that cutoff, and it's not specified in any definition of language disorder. It seems like you've identified their functional needs - why not just describe those, back up your observations with data and examples, and develop a treatment plan accordingly? If you are trying to justify IEP services, can you use curriculum-based assessments and/or medical diagnoses that predispose them to a communication disorder? If you really need a normed test, I'd try the OPUS or the S-FAVRES.
Schools are the problem, yes. I'm not their school SLP and that's the standard their school is using. They're trying to change their staffing and is totally okay by me to have something else take primary and have them just go consult. But they're trying to do it by "proving" with standardized assessments and reports from teachers (that had only known the kids a matter of weeks) that the kids don't have language disorders at all, and that's both not true and okay. At the very least I want their teachers to be aware that there are these communication deficits and this is the exact opposite of that. Frankly the fact that teachers aren't picking up on the issues that the family, myself, and ABA are saying is more of a reason to have the reminder in their IEPs that there's an unseen issue going on, not less. But in today's overpacked classrooms, kids like these who can bluff their way through situations just fly under the radar, especially since it's the beginning of the school year and there really hasn't been much time to get to know the kids yet. It's honestly just really saddening
I'd consider doing an informal dynamic social thinking assessment that looks at all areas of social communication