SLP’s Role For Social Language Assessment in ASD Learners
SLPS are a Critical Part of the Evaluation Team
(even if traditional receptive & expressive language skills seem intact prior to the evaluation)
Social Language Concerns – Key players are: SLP, Autism Resource Teacher, School Psychologist Possibly add:… OT, SLD Teacher, D/APE
Look at the MN ASD Criteria for Eligibility – Communication/Speech-Language is part of at least half of all behavioral indicators!
Core Feature 1: Qualitative impairment of reciprocal social interaction:
- limited use of facial expression towards others,
- gross impairment in ability to make friends,
- appears to prefer isolated or solitary activities,
- misinterprets others’ behaviors and social cues,
- significant vulnerability and safety issues due to social naiveté,
- does not show or bring things to others to indicate interest in activity,
- limited joint attention
- difficulty relating to people
Core Feature 2: Qualitative impairment in communication:
- not using finger to point or request,
- absence or delay of spoken language,
- inability to initiate or maintain conversation,
- odd production of speech (intonation, rhythm, rate)
- showing lack of spontaneous imitations of lack of varied imaginative play,
- limited understanding of nonverbal communication skills (gestures, facial expressions, tone of voice),
- using others’ hand or body as a tool,
- repetitive, idiosyncratic language
Core Feature 3: Restricted, repetitive, or stereotyped patterns of behavior, interest, and activities:
· repetitive hand or finger mannerisms,
- lack of true imaginative play vs. reenactment,
- demonstrating distress or resistance to change,
- over-reaction or under-reaction to sensory stimuli
- intense, focused preoccupation with a limited range of interests or conversation topics,
- rigid, rule-bound thinking,
- insistence on following routines or rituals.
ASHA’s Position on the SLP’s role:
- ASHA Position Paper: “Guidelines for Speech-Language Pathologists in Diagnosis, Assessment and Treatment of Autism Spectrum Disorders across the Life Span.” (2006) ASH
It is the position of the American Speech-Language-Hearing Association (ASHA) that speech-language pathologists play a critical role in screening, diagnosing, and enhancing the social communication development and quality of life of children, adolescents, and adults with autism spectrum disorders (ASD). The core features of ASD include impairments in reciprocal social interaction, impairments in verbal and nonverbal communication, and restricted range of interests and activities, which are due to neurobiological factors. There is great heterogeneity in this population, evident in a broad range of cognitive, social, communication, motor, and adaptive abilities. Integral to the diagnostic criteria, all individuals with ASD are challenged in the area of social communication. Thus, many individuals with ASD have difficulty acquiring the form and content of language and/or augmentative and alternative communication systems, and all have needs in acquiring appropriate social use of communication. Therefore, problems in use of language and communication are overarching because ASD is primarily a social communication disability. These challenges result in far reaching problems, including difficulties with joint attention, shared enjoyment, social reciprocity in nonverbal as well as verbal interactions, mutually satisfying play and peer interaction, comprehension of others’ intentions, and emotional regulation. Due to the nature of ASD, family members, peers, and other communication partners may encounter barriers in their efforts to communicate and interact with individuals with ASD. Therefore, the speech-language pathologist’s role is critical in supporting the individual, the environment, and the communication partner to maximize opportunities for interaction in order to overcome barriers that would lead to ever-decreasing opportunities and social isolation if left unmitigated.
……….Individuals with ASD should be eligible for speech-language pathology services due to the pervasive nature of the social communication impairment, regardless of age, cognitive abilities, or performance on standardized testing of formal language skills. As mandated by the Individuals with Disabilities Education Improvement Act of 2004 (Pub. L. 108-446), speech-language pathologists should avoid applying a prior criterion (e.g., discrepancies between cognitive abilities and communication functioning, chronological age, or diagnosis) and make individualized decisions on eligibility for services. Because formal assessment tools may not accurately detect problems in the social use of language and communication, eligibility may need to be based on clinical judgment and more informal, observational measures. (as cited in ASHA’s Position Statement, 2006)
Implications of Social Language Deficits
Source: Educational Relevance of the Communicative Disorders (Appendix F of the MN Dept of Education Special Education Policy Division Document entitled, Resources for Speech-Language Evaluations in Minnesota)
Three Areas of Impact:
Academic Impact
- Below average grades
- Inability to complete language-based activities versus non-language based activities
- Grades below ability level
ALSO consider:
· Difficulty participating in cooperative learning efforts such as science lab group work, literacy circles, elementary “center time”, independent partner work, or group assignments
· Difficulty interpreting social themes, character’s intentions/motivations in literature
· Difficulty understanding “author’s purpose” in literature
· Difficulty understanding audience point of view and a ‘reader’s perspective for written language endeavors
· Student may not clearly ask for help or clarification in lectures or regarding assignments
Social Impact
- Peers tease student about the communication problem
- Student demonstrates embarrassment or frustration regarding the communication problem
- Student demonstrates difficulty interpreting communicative intent
ALSO consider:
-
Difficulty understanding roles in a group discussion or project
-
Inappropriate responses to teachers or students
-
Difficulty interpreting non-verbal cues from teachers or peers
-
Difficulty gaining peer acceptance when participating in cooperative group learning efforts
Vocational Impact
- Inability to understand or follow oral/directions
- Inappropriate response to coworker/supervisor comments
- Unable to ask or answer questions in a coherent and concise manner.
ALSO Consider:
-
Violation of social boundaries with co-workers or customers
-
Difficulty adjusting styles of communication for customers versus supervisors versus co-workers, etc.
MN Criteria, Eligibility and S/L as a Related Service
- Use the Subpart 4 of the Language Disorder criteria in many cases. Informal assessment tasks, a criterion-referenced tool such as the Pragmatic Profile of the CELF-IV and interviews can substantiate educational need
- Document how the social language deficits impact the student socially in the school setting AND how it can impact the student in academic and classroom endeavors.
- Typically, a student will not have a primary disability area of S/L Impairment and only qualify with a Pragmatic deficit. In MOST CASES, the goal of the Social Language assessment is to document need under an umbrella heading such as Autism Spectrum Disorder (ASD), Other Heath Disabilities (OHD), etc.
- Use these practices to qualify a student for S/L as a RELATED service to Social Language needs the team identifies and targets.
This is a helpful resource provided by the St. Paul Public Schools. It helps guide team members through decision-making when considering the need for related services. It is cited in the September 2008 DRAFT of the Guide to Evaluation and Treatment Determination for Special Education Speech-Language Services in Minnesota’s Educational System, developed by the Minnesota Department of Education Division of Special Education Policy. (Draft date: 9/11/08 – not to be disseminated).
DETERMINING A STUDENT’S NEED FOR RELATED SERVICES
Primary consideration: Is the expertise of the related service provider necessary for the student to attain educational goals?
- Student must meet eligibility for special education
- Related service determined on a case by case basis
- Consider needs of the student
- Discuss rate of improved function
- Discuss educational goals and objectives and need for supplementary or complementary support service
- Consider changing demands of the student’s environment
- Consider expertise of educational staff
- Consider specific skills and knowledge unique to the related service provider
- It is a team decision, guided by the expertise and knowledge of the related service provider
In the case of students with Autism Spectrum Disorder as the primary disability classification, one can provide very compelling evidence that the Speech-Language Pathologist has unique expertise and skills related to the development of conversation skills and interpretation of non-verbal communication modes, to name just two areas of need. ASHA recognizes the treatment of Pragmatic needs as falling under the unique scope of expertise and practice of speech-language pathologists.
Teams may express ambiguity over which team member(s) write the goals/objectives for social language needs, and who carries the duty of measuring and reporting progress. The answer is clearly the TEAM. As mentioned initially in this paper, the SLP, autism resource specialist and in some cases the school psychologist should collectively work to gather regular data and measure progress. Examine the content of the objectives. Objectives that relate specifically to conversation skills or non-verbal communication skills may be most effectively measured by the SLP. Objectives related to handling peer conflicts, being socially flexible or understanding emotions may be most effectively measured by the autism resource person. Finally, objectives targeting the reduction of anxiety or addressing low self-esteem related to social failures may be most effectively measured by the school psychologist.
The draft of the SLP guide referenced earlier clarifies who writes the goals when a student has related service needs further.
Source: the September 2008 DRAFT of the Guide to Evaluation and Treatment Determination for Special Education Speech-Language Services in Minnesota’s Educational System, developed by the Minnesota Department of Education Division of Special Education Policy. (Draft date: 9/11/08 – not to be disseminated).
“Who writes the goals when a student has related service needs?
Related service providers support the goals that are developed by the IEP team. In the event that a speech-language pathologist’s services are required to support meaningful progress on the IEP, communicative needs should be reflected or embedded in the goals and objectives of the student. The goal and objectives should be developed in collaboration to insure that communication is not being address in isolated contexts but rather, opportunities to address increased communication skills are embedded across the school day. The service provision required to address these needs would be dependent upon the individual student. Embedded needs do not equate with a selected type of service delivery (i.e. indirect) nor does the existence of a communication goal indicate the need for direct service. Rather the determination of service delivery models should be based on the individual student’s needs in the educational and transition settings (for older students).”
