Speech & Language Services for Students with Auditory Processing Disorders

1. Speech & Language Services for Students with Auditory Processing Disorders Sarah C. Hanson, M.A., CCC-SLP MSHA 2011Roundtable

2. Assessment:What Am I Looking For? • Occasionally, patients will come in for articulation evaluation • However, more often than not, the evaluation will be assessing one or more of the following: • Receptive language skills • Auditory memory • Organization of language skills • Language processing • Comprehension of written language • Verbal and/or written language expression • Comprehension/use of higher level language skills • Phonological awareness

3. Characteristics • Children struggling with language issues tend to be very different, but as you listen to each case history you will notice two main groups emerge • The first group is very easy to pick out! • Typical comments you may hear from parents

4. Case History: Things to Consider • Do the parents report that they feel like they’re re-teaching everything at home? • Does the child have a history of difficulty learning rote information such as ABCs, address, numbers? • Any significant medical history? • Have teachers complained about attention in school, but parents don’t feel it is an attention issue? • Are there friendship issues? • Do they find themselves having to repeat directions at home frequently? • Does their child tend to interpret things literally? Are they black and white? • Are they inconsistent? “Gets it” one day and not the next? • Parents may be frustrated because they can’t explain what’s wrong

5. Assessment Tools • Possible Evaluation Tools to Use When Assessing patients with possible Language Processing Issues • Clinical Evaluation of Language Fundamentals-4 (CELF-4) • Test of Auditory Processing Skills-3 (TAPS-3) • Test for Auditory Processing Disorders in Adolescents and Adults (SCAN-3:A) or in Children (SCAN-3C) • Lindamood Auditory Conceptualization Test-3 (LAC-3) • Gray Oral Reading Tests-4 (GORT-4) • The Word Test-2 (WORD-A) • Test for Auditory Comprehension of Language -3 (TACL-3) • Test of Language Competence-Expanded (TLC-E)

6. What do each of these assessment tools evaluate?

7. Evaluation • When you evaluate, it will be more important to watch how students respond and what types of errors they make rather than just the score alone • The TLC-E does a nice job of outlining behavioral observations to look out for with a checklist for each subtest

8. Adolescent Reading Theoretical Model Hock & Deshler, 2006 • Integration of word recognition, language comprehension, and executive processes cumulates in reading comprehension

9. The Process of Reading

10. Another Model Scarborough, 2001 (from Bashir presentation, ASHA convention, 2007)

11. Important Related Terms Executive Function (Phillips Keeley, 2003) Working Memory (Banotai, 2007) Metacognitive Strategies (Deshler, Hock & Catts, 2006)

12. Therapy: A Three Pronged Approach

13. Direct Skill Instruction • Where Do I Start?

14. Direct Skill Instruction • Therapy model with adolescents is like therapy with children or adults. • Content is driven by the results of evaluation • need to see how/why this is something they should do • how will this help me? • Bring in schoolwork as soon as you can. • You are not a homework helper, but you can’t assume they will generalize the skills you are teaching.

15. Direct Instruction Tasks

16. Direct Instruction Tasks

17. Direct Instruction Tasks

18. Direct Skill Instruction – Therapy Ideas • Hands-on experience • Objects • Visual aids • Personal experiences • Strategies for study skills

19. Compensatory Strategies • I uses these exact terms with them and I write it in a triangle – anytime we implement compensatory strategies, I label that is what we are doing. • Know what you don’t know or can’t do • Figure out a way to help yourself

20. Self-Advocacy How to get the help you need

21. Self-Advocacy • I teach a lot with color coding, visuals and formulas – anything to make language concrete • FORMULA: first say what part you DID hear, then say what part you’re missing or DIDN’T hear • This does 3 things: • 1. Lets the teacher know you were listening to at least some of what they were saying • 2. Breaks the cycle of and perception of “He’s just lazy” or “If he would try harder he could do it” • 3. Gives students a pattern to fill in so they don’t have to think so much

22. “The Formula” I KNOW ___________________ BUT I DON’T KNOW _____________

23. References American Speech-Language-Hearing Association. (2002). Knowledge and Skills Needed by Speech-Language Pathologists With Respect to Reading and Writing inn Children and Adolescents Knowledge and Skills. Available from www.asha.org/policy. American Speech-Language-Hearing Association. (2001). Roles and responsibilities of speech-language pathologists with respect to reading and writing in children and adolescents (position statement, executive summary of guidelines, technical report]. ASHA Supplement 21, 17-27. Rockville, MD: Author. Banotai, A. (2007, July 9). Working memory plays role in language assessment. Advance for Speech-Language Pathologists & Audiologists, 7-8. Deshler, D., Hock, M. & Catts, H. (2006). Enhancing outcomes for struggling adolescent readers. Perspectives, 32, 21-25. Eggleston, L. & Larson, L. (2007, June 18). Curriculum modifications for language impairments. Advance for Speech-Language Pathologists and Audiologists, 11. Ferre, J. (2007, Aug. 14). Understanding intervention for (C)APD: As easy as a-b-c. The ASHA Leader, 12, 20-22,34. Larson, V., McKinley, N., & Boley, D. (1993). Clinical forum: adolescent language service delivery models for adolescents with language disorders. Language, Speech, and Hearing Services in Schools, 51, 36-42. McKinley, N. & Larson, V. (1985). Neglected language-disordered adolescent: a delivery model. Language, Speech, and Hearing Services in Schools, 16, 2-15. Phillips Keeley, S. (2003). The source for executive function disorders, the. East Moline, IL: LinguiSystems. Pokorni, J., Worthington, C., & Jamison, P. (2004). Phonological awareness intervention comparison of Fast ForWord, Earobics, and LiPS. Journal of Educational Research, 97, 147-157. Shaywitz, S. (2005). Overcoming Dyslexia: A new and complete science-based program for reading problems at any level. Vintage. Zimmerman, S. (2007, May 7). Therapy tips: object description plan. Advance for Speech-Language Pathologists and Audiologists, 13.