BILINGUAL SPEECH-LANGUAGE EVALUATION

Name: GM 

CA: 9 years; 7 months

Grade: 4th

Assessment Materials

• Parent Interview
• Teacher Interview/Questionnaire
• Language/Narrative Sample Analysis
• Informed Clinical Observations/Opinion
• Dynamic Assessment: Non-word repetition
• SLAM (School-age Language Assessment Measures): subway picture, language elicitation picture cards, understanding spoken stories

*In accordance with the New York State Education Department’s Associate Commissioner in the Office of Special Education, the Associate Commissioner of the Office of Bilingual Education and Foreign Language Studies, and IDEA 2004 (The Individuals with Disabilities Education Act) [20 U.S.C. 1414(3)], the assessment scores of culturally and linguistically diverse students should only be reported if:  a) the tests are valid for the purposes for which they are intended, and b)if the student is represented in the normative sample based upon their culture, linguistic and racial background.Furthermore, when interpreting evaluation results, care must be taken that issues of language differences are not confused with language disorders and that patterns of performance related to the student’s socio-cultural background, interrupted schooling, or lack of instruction, are not mistaken for signs of a disability. In lieu of standard scores, results were presented within the report in a descriptive, qualitative manner due to the absence of appropriate bilingual norms and the deviation from standard procedures to accommodate bilingual issues.

Reason for Referral

GM, a 9 year; 7-month old male, was seen for a bilingual (Spanish) speech and language evaluation at a local library on July 9, 2018. GM was referred for an evaluation to assess his current level of speech and language functioning and determine the need for intervention services. Parent reported concerns with GM’s fluency of speech as he has difficulty recalling words and expressing his ideas. Teacher did not report any concerns at the time of completing her teacher report as GM enrolled in her class at the end of the year. GM is currently enrolled in a 4^th grade co-teach classroom.

Background Information

GM is a friendly and cooperative 9 year old boy, who lives with his parents in the Bronx, NY. Spanish is the primary language in the household. A face-to-face interview was conducted in Spanish with Mr. M to obtain further background information. He served as a reliable informant. According to parental report, GM was born prematurely at around 7-8 months gestation. Medical history was unremarkable. Speech milestones were delayed as he began speaking “late” however father does not recall the exact age. Family history of speech and language disorders was denied.

Mr. M reported concerns with GM’s speech and language development. He stated that he is unable to read or write and his speech is disfluent at times due to difficulty recalling words and putting together his thoughts. Dad stated that he did not receive “quality” speech services in Ecuador. At times, he has difficulty following multi-step commands and his speech and language skills are “lower” than similar peers. Mr. Martinez reported a significant life change as GM and his parents immigrated to the U.S from Ecuador approximately 2 months ago.

A teacher report completed by GM’s classroom teacher, Ms. R, was reviewed. She highlighted that her observations were based on 3 weeks of working with GM. She also mentioned that GM’s grade level in reading and writing were not formally assessed as he enrolled in her class three weeks before the end of the school year. Ms. R stated that GM gets along with his peers and responds well to adults. He is very “well behaved and has great mannerisms”. An OT report revealed below average skills in writing or transcribing notes, sustaining visual focus to read and difficulty identifying personal information.

Please refer to Social-History report for any additional background information and medical history.

Language Background and Use

GM was born in Ecuador and immigrated to the United States approximately 2 months ago. He currently resides in a monolingual Spanish speaking home with his parents. They use Spanish 100% of the time at home. He is a sequential bilingual of English, as this is his first exposure to the language at age 9. He received schooling in Ecuador from Pre-K to 4^th grade. The highest level of education achieved by GM’s parents was reported to be college. Mr. Martinez reported that he considers GM’s speech and language development and skills to appear to be lower than his peers. GM communicates with his family in Spanish and his peers in Spanish as he has not yet acquired basic interpersonal communication skills in English. It usually takes 1-2 years for ELLs to acquire BICS and 5-7 years to acquire cognitive and academic language proficiency (CALP) similar to that of a native speaker.

During the evaluation, GM was assessed in Spanish to determine his proficiency in his home language as he did not respond to English. In Spanish, he demonstrated age appropriate basic interpersonal communication skills (BICS) and developing cognitive and academic language proficiency (CALP). Overall, GM presented as a developing bilingual with below average to average receptive and expressive language skills in Spanish. English proficiency cannot be determined at this time as he has only had exposure to the language for 2 months.

Evaluation

Hearing

GM had a pure-tone threshold hearing screening done along with his annual physical within the past year. He passed his hearing screening across all frequencies (250Hz, 500Hz, 1000Hz, 2000Hz, 3000Hz, 4000Hz, and 8000Hz) at 20dB.

Behavioral Observations

GM presented as a well-related and cooperative boy during one-on-one interactions. He maintained eye contact while conversing with the evaluator. GM both initiated discourse and responded to all of the evaluator’s questions and prompts. He also engaged in structured turn-taking appropriately with the evaluator. It was noted that GM often engaged in circumlocution when responding to questions and had difficulty with topic maintenance. GM displayed age-appropriate attention needed to complete all presented tasks.

Oral Peripheral Examination

Observation of the oral cavity revealed adequate structure of buccal, labial, mandibular, lingual, dentition and velar tissues for speech purposes. At rest, GM demonstrated a closed mouth posture and no drooling was observed. Strength and range of all articulators appeared to be within normal limits during observations.

Voice and Fluency

GM’s voice and fluency were assessed via clinical observation during the evaluation. Vocal parameters of intensity, quality, prosody and resonance appeared adequate for his age and gender. No disfluencies were reported or observed.

Articulation and Phonology

GM’s articulation was assessed through clinical observation during the evaluation and teacher/parental reports. Teacher and parental reports did not include any concerns in this domain. GM was noted to have difficulty producing the /r/ sound in all positions of words. (“opa” for ropa; “ten” for tren; “hemano” for hermano; “atoho” for atoro; “peo” for pero. The /r/ sound typically develops by age 8 and therefore his phonemic repertoire can be considered delayed. His overall intelligibility was judged to be fair to good in all contexts.

 Language

GM’s receptive and expressive language skills were assessed via parent and teacher interviews, informed clinical opinion, dynamic assessment, language/narrative sample analysis and School-Age Language Assessment Measures (SLAM). Overall, GM presented with receptive and expressive language skills that were in the moderately disordered range.

Receptive Language

GM demonstrated below average receptive language skills in Spanish through his ability to process visual information, make inferences, problem-solve and comprehend simple and complex wh-questions. He was presented with the “subway picture” which highlights a picture of a foot caught between train doors. Evaluator confirmed with Mr. Martinez that GM has had exposure to the subway prior to the task. GM was asked a series of follow-up questions about the picture scene; Que pasó?/What happened?- “Veo toda la persona sentada entonce dió una pequena patada y se atoró. /I see all the people sitting then gave a kick and got stuck.” In this example, we can see that GM was able to understand the gist of the question, however, his idea was slightly difficult to understand as he did not include information about who he was speaking about. He demonstrated below average skills in answering complex hypothetical questions such as How did this happen?- “porqué yo el tren estaba iendose muy rápido, imaginemos que habían juegos artificiales aquí y tengo que ir a mi casa, bueno, a la casa, pero el tren se está iendo y yo di una pequena patada para que el tren XXX una persona que quiera entrar/because I the train was going too fast, lets imagine that there were fireworks here and I need to go to my house, well, to the house, but the train is leaving and I gave a small kick so that the train XXX a person that wants to enter.” and What would you do if this happened to you?- “y si el conductor no se dió cuenta, lo intentaria sacar así y nada mas/and if the conductor didn’t realize, I would try to get it out and nothing else.” GM’s difficulty in answering simple and complex questions are indicative of a weak theory of mind and limited ability to problem solve and infer to make predictions.

GM demonstrated similar weaknesses with analyzing and sequencing picture cards and understanding hypothetical cause and effect in Spanish. He was unable to logically sequence a series of six picture cards even when provided with verbal cues. He appeared confused by the task and moved the cards around randomly. With regards to answering questions, when asked related wh-questions, he often stated “no recuerdo/I don’t remember” even with the visuals in front of him. When provided with verbal and visual cues he was able to answer questions such as: “Porqué el conejo saltó de la mochila/Why did the bunny jump out of the backpack?” GM responded, “Porqué vió la zanahoria/Because he saw the carrot.” He also used limited vocabulary in Spanish as evidenced by his use of non-specific demonstrative pronouns (i.e. ese/that, allá/over there, aquí/here).

GM was prompted to choose an age-appropriate book of interest in Spanish to assess his reading skills. He excitedly chose a book about owls. He was prompted to read the title however he remained silent. The evaluator provided him with initial phonemic cues and asked him for the sound letter correspondence for the each letter in the title. GM did not demonstrate the ability to decode nor understanding of the sounds each letter made as he often stated, “No recuerdo/I don’t remember.”

The Spanish non-word repetition task, first developed by Kohnert (2008), was used to assess the skills necessary for language learning- auditory processing, working memory, and organization of articulatory output. Unlike standardized language tests, non-word repetition tasks are unbiased by socioeconomic status, parent education level and do not test previous linguistic knowledge and skills. The task increases in complexity from 1- syllables (i.e. Ná ge; Be te cho dú pe). GM correctly repeated 30% of the non-words and had significant difficulty with those with 3-5 syllables. He often repeated each syllable as the evaluator was still reading even when instructed to wait until the entire word was read. Few of the errors were dialectal (i.e. v for b substitutions common is Spanish). His performance demonstrated significantly reduced processing skills and short-term/working memory functioning needed for language learning.

Expressive Language

GM presented with expressive language skills that were below average in Spanish. The ability to produce clear, cohesive thoughts and ideas using proper syntax, semantics and pragmatic skills via spoken language was assessed employing Bunny Goes to School language elicitation picture cards. One event cast narrative sample was elicited in Spanish.

This is the Spanish narrative GM produced:

“Primero, llegan a la escuela. después se sentaron y los ninos jugando con un conejito que XXX. Despues empezaron a darle comida y le dió su comida y la senorita estaba muy confundida y el conejito comenzó a saltar y saltar y saltar. Y llegó una persona y se lo llevó”

[“First, they arrive at school. Then they sat down and the kids playing with a bunny that XXX. Then, they started giving him food and they gave him his food and the lady was very confused and the bunny began to hop and hop and hop. And a person came and took him away.]

Macro and microstructure analysis of GM’s narrative highlights few strengths and significant weaknesses in his home language (L1). He was able to interpret the feelings of the lady in the pictures (“confundida/confused), include a setting (“escuela/school”) and some characters (“niños/kids”; “senorita/lady”; “conejito/bunny”). However, significant weaknesses can be noted in producing a clear and coherent story line. GM uses many run-on sentences and incomplete sentences/phrases throughout his narrative as he strings together ideas in random order. Minimal use of temporal conjunctions was noted as he frequently stated “Y/And.” He did not include any causal relationships (i.e. this happened because ____ ). There was no clear plot, plan/character motivation, internal response, resolution or consequence. GM engaged in circumlocution as he described each part of the picture scene separately but could not link each idea/thought to produce a coherent narrative.

Additionally, GM’s writing skills were assessed with a simple task of writing personal information such as his name, age and birthday using complete sentences. GM responded, “No se, es que no recuerdo/I don’t know, I just cant remember.” He was unable to write his first name because it was “muy complicado/too complicated” however he was able to write his middle name “Aron.” Similarly, he could not spell his last name even when the evaluator provided each letter verbally and later with a written model. His handwriting was difficult to read.

Summary/Impressions

GM, a 9 year; 7-month old male, was seen for a bilingual (Spanish) speech and language evaluation at a local library on July 9, 2018. GM was referred for an evaluation to assess his current level of speech and language functioning and determine the need for intervention services. Parent reported concerns with GM’s fluency of speech as he has difficulty recalling words and expressing his ideas. Teacher did not report any concerns at the time of completing her teacher report as GM enrolled in her class at the end of the year. GM is currently enrolled in a 4^th grade co-teach classroom.

GM presented as a well-related and cooperative boy during one-on-one interactions. He demonstrated age-appropriate attention for his age and participated fully in all presented tasks. It was noted that GM often engaged in circumlocution when responding to questions and had difficulty with topic maintenance.

GM is a sequential bilingual of English, as he recently immigrated from Ecuador approximately 2 months ago. This is his first exposure to English. He resides in a monolingual Spanish household with his parents where Spanish is spoken 100% of the time. Based on the results of this evaluation, GM presented with speech and language skills that were in the moderately disordered range. Receptive language was moderately disordered range. He presented difficulty with comprehension of visual and auditorily presented information impacting his ability to understand complex sentence structures, understand stories read aloud and respond to higher-level questions in Spanish. He also demonstrated weaknesses with responding to questions involving theory of mind and inferencing/problem-solving even when provided with visual support. Additionally, a nonword repetition task, a dynamic assessment tool that is less biased towards diverse populations, revealed significantly reduced processing skills and short-term/working memory functioning needed for language learning.

Expressive language skills were below average in Spanish. Significant weaknesses can be noted in producing a clear and coherent story line. GM uses many run-on and incomplete sentences/phrases throughout his narrative as he strings together ideas in random order. Minimal use of temporal conjunctions was noted. He did not include any causal relationships and there was no clear plot, plan/character motivation, internal response, resolution or consequence. GM engaged in circumlocution as he described each part of the picture scene separately but could not link each idea/thought to produce a coherent narrative.

Based on the results of this evaluation, GM’s receptive and expressive language skills in Spanish are in the moderately disordered range and demonstrate an adverse educational impact. Bilingual speech and language services are recommended.

The results of this evaluation will be reviewed in conjunction with other pertinent information conducted by the CSE to determine eligibility (or continued eligibility if it is a student already classified) for special education and/or related services. Specific recommendations will be made by the CSE after all pertinent information is presented.