Speak Out OCTOBER 2019 V3 DIGITAL EDITION

in practice

Conversations about DLD: Case example

• Classroom observation and report: Peter demonstrates significant difficulties in the classroom, i.e. shows limited knowledge of basic concepts, letters and numbers, demonstrates difficulties following instructions (copies his peers), gets frustrated (pushes peers), does not participate in story time , appears to be day-dreaming a lot, shows limited responding in class without substantial encouragement. • You ask Sarah Peter's Early Childhood Educator (ECE), to complete the CCC-2 (Bishop, 2013). Sarah also comments that Peter is still learning about peer-to-peer interaction and group-time expectations. The centre does not support a pre- literacy program. • A standardised language test that assesses both expressive and receptive skills to determine if Peter’s language skills are significantly below age expectations. o Peter obtains a Standard Score of 73 on the CELF-P2 for core language and for both receptive and expressive language; the data show him to have difficulties across a wide range of language domains (semantics, syntax and morphology in particular). The recalling sentences subtest score was very low (SS 3) • A spontaneous language sample in conversation and story retell conditions. Language sample analysis confirms the standardised results. o Conversation: low Mean Length of Utterance (MLU), low Number of Different Words (NDW), increased number of grammatical errors including difficulties with verb markers and articles/determiners. Moreover, low percentage of contingent responses.

You are a speech pathologist in private practice and you get a referral for a child (Peter) age 4;8. You talk to Peter's mum (Jane) over the phone prior to the first appointment. Jane tells you that Peter started using his first words at 24 months, started combining words at age 3, and is currently using simple sentences. Peter has been attending an early learning centre three days a week for the last 12 months and the Early Childhood Educator (ECE) advised Jane to talk to a speech pathologist because Peter’s language skills seemed delayed compared to his peers at the centre. Peter rarely uses long utterances (most are 2-3 words) and the ECE is concerned about his comprehension skills. Jane tells you she is not that concerned; Peter is her fourth and youngest child and the "baby" of the family. The family speaks Australian English as their first and only language. Assessment Based on recommendation 10 in Catalise paper 1 (Bishop et al., 2016): “Multiple sources of information should be combined in assessment, including interview/questionnaires with parents or caregivers, direct observation of the child, and standardised age- • A case history to obtain information about Peter’s medical history (including hearing) and his developmental milestones other than language. You ask if there is a family history of speech and language difficulties and seek more information about Peter’s current communication skills. o Peter is reported to have had "the usual number of colds" and overall, his development has generally been normed tests or criterion-based assessments.” Your assessment contains the following tasks:

in the normal range. In fact Jane says he was an early and fast walker. She noted that one older brother is having literacy support at school.

36

October 2019 www.speechpathologyaustralia.org.au

Speak Out