We are continually impressed with the level of expertise and dedication that is evident in the emails we receive. I wanted to share this question and answer that came through about where to begin with new immigrant speech and language testing.
“It is instructive, makes me feel like I am not alone, and I know change is possible.”Good evening,
I was hoping to get some advice on how to proceed with a request for consultation we received at our Preschool Assessment Team.
The parent of a 4year 11month old girl visited our office with concerns regarding her daughter’s communication skills. The girl has been in the United States for 15 days. Previously, she was living in Mexico with her grandparents. Mother reported that the girl has been nonverbal all her life and communication is limited to pointing/gestures and some vowel sound production. Grandparents speak Mixteco, and the mother speaks Mixteco and Spanish.
The girl’s dominant language is unknown. Hearing acuity is questionable. A hearing screening was attempted in our office but the girl was unable to follow simple 1- step instructions in Spanish.
I would greatly appreciate any guidance you could recommend on how to proceed with this case.
I think that your use of the word consultation” versus “evaluation” is good here. There is a lot you can do to gather information to identify if this may head in the direction of a communication problem. There are several layers over this that will not allow a clear picture of communicative abilities:
- High mobility
- Recent immigration
- 2 home languages that are not English
On the other hand, her communication is extremely limited.
I would suggest you do a parent interview asking very direct questions about what she says or not. You want to get a “conceptual” language sample to get a feeling on her vocabulary. Conceptual, vs. Comparative means that if she has the word DOG in Spanish and MIXTECO that it counts as 1 concept.
As far as communication goes. Download the Apples to Apples Milestones from the same page. These are researched facts that are true of most languages. For example, mostly all 1-year olds have 50 words, mostly all 2-year olds make 2-word utterances. All children should be fully intelligible to their close family members by age 3. Her situation included.
Hope that gets you moving in the right direction.
Thank you so much for all the valuable suggestions. Since parents have limited social services/resources to address the hearing concerns, how would you address this issue? Would you proceed with the other parts of the assessment?
Thank you in advance,
But you have to establish hearing during testing. There is a good chance that she does have hearing issues based on how she is speaking.
Ask parents about history and number of ear infections. Also, ask about the latest ear infection.
Do a test during testing asking her to look. Clap behind her head and see if she turns.
You also need to do informal vision testing. Can she grab tiny objects with a pincer grip? Can she identify people in a photo on a phone? This will tell you that she can see the testing prompts which can be as small as 1×1 inch. You can also ask her to match small pictures at a distance. Show her a picture and give her four to choose from to see if she can select the match.
Then you need to write that up as part of your evaluation. Something like:
Current vision and hearing status is not available. CHILD’s vision and hearing were informally evaluated by… Vision and Hearing were deemed adequate for testing purposes. It is suggested that vision and hearing should be tested at the first available opportunity (also add this last sentence to the report summary.).
Too many kids go too long without this getting established. So, own it until the next professional (teacher, nurse, counselor) picks it up and keeps checking. I even met a family at a hospital once to translate for them when they were offered a free test.
Thank you for your suggestions on this case.
Have a great day.