Report from Speech and Language Therapist

Since my last meeting with Mrs Dunham and Becca at Rainbow three weeks ago, Becca reassessed Alex and here's the Progress Report dated 17 October 2008 which I would like to share with you. Most people feel that reports should be confidential but I would like to share this because it may help someone .... someday.

BACKGROUND

Alex was given a formal diagnosis of Autism Spectrum Disorder in May 2007 following a Multi Professional Assessment.

Alex started Rainbow Resources in May 2008. Since starting in Rainbow he has received regular group and 1:1 therapy from the Speech and Language Therapist (SALT). In addition he has had his functional communication reviewed regularly by the SALT and communication programmes have been integrated into everyday activities within the resource setting.

Information for this report has been gathered from observations in the Rainbow Resources and the nursery, formal and informal assessment and discussions with Alex's Parents and Education staff.

ATTENTION AND LISTENING:

Alex is able to sit and participate in circle time and listen to stories with minimal prompting from the staff. He is able to sit and wait his turn during group activities. He participates in activities with adult support to keep him engaged and focused. Alex responds to adult direction.

VERBAL COMPREHENSION (UNDERSTANDING):

Alex's comprehension was last formally assessed in January 2008 and was found to be mildly delayed for his age. Further informal assessment and observations have been carried out since this time to assess his functional communication.

Alex has demonstrated understanding of situation requests (i.e. put your snack box in your bag) and routines within the resources environment. His understanding is aided by gesture and signing. Alex is able to follow short instructions directed to him individually and directed to a group.

Alex recognises familiar objects and their uses. He is able to understand verbs and some conceptual vocabulary including colours. He is consistently able to follow 2 information carrying word level commands i.e. "make teddy sleep" and his 3 information carrying word level understanding is emerging. (Mummy's note: Alex is able to understand more than the SALT thinks he can. His speech is limited hence it's difficult to determine how much he understands)

EXPRESSIVE LANGUAGE:

Alex is communicative and gets his message across using a combination of verbal and non verbal communication. He is able to request, choose and comment verbally using single words or two word utterances, however his speech is frequently difficult to understand and his length of verbal utterance and use of grammar is delayed for his age. He supports his speech using a Picture Communication Book, gesture, signing, intonation and pointing.

Alex smiles and laughs to express enjoyment. He is able to request help and to refuse verbally. Alex is able to say "hello" and "goodbye" verbally.

Alex continues to copy adult's utterances with both immediate and delayed echolalia.

Alex's expressive language skills are delayed and disordered when compared to his peers.

PHONOLOGY (SPEECH SOUNDS):

Alex's phonology has been assessed using the Nuffield Dyspraxia Assessment. The assessment has highlighted that Alex has a severe phonological disorder with characteristics of dyspraxia.

Alex has difficulty articulating several consonant sounds and he uses only a limited number of vowel sounds. Alex struggled to accurately and consistently sequence consonant-vowels and his rate was observed to be very slow. When naming pictures with single words he was observed to make several delayed articulation errors including missing off the ends of words (i.e. "bed" was said as "beh") and reduplicating the first syllable of a word twice (i.e. "garden" was said as "gaga"?. In addition he demonstrated several disordered characteristics including the insertion of glottal stops and distortion of vowels when naming pictures with single words.

Alex demonstrated oral motor difficulties including being unable to imitate tongue movements and lip positions on request.

SOCIAL USE OF LANGUAGE:

Alex initiates interactions with adults. He is able to use his language for a variety of reasons including requesting items, commenting on what he sees/hears, ask questions and use social language. Alex is able to use names of familiar adults and himself.

Alex will use eye contact when he is talking to an adult. Alex finds it difficult to initiate interactions with his peers appropriately and requires adult support to do so. Alex's play is frequently repetitive and he generally plays alone or watches his peers. Recently Alex has become anxious when playing in the playground or in nursery and requires a high level of adult reassurance to do so. He seeks out adult interactions over peer interactions.

SUMMARY:

Alex has a formal diagnosis of Autism Spectrum Disorder. Alex's receptive language, expressive language and social interaction are delayed and disordered when compared to his peers. Alex has a severe phonological disorder with characteristics of dyspraxia.