Jocelyn had her 1-year speech therapy evaluation on Thursday. Lots of news to report.
Her expressive language is now age-appropriate. She scored 97. (Anywhere from 85-115 is considered “normal.") I am shocked and thrilled and a bit skeptical.
Her receptive language is still two standard deviations under normal. She scored 66 on the same scale where 85-115 is “normal.” I’m surprised that the discrepancy is so large.
This discrepancy indicates a disorder instead of a delay. With a delay, her scores would be expected to be much closer.
So, now the million-dollar question is… what disorder does she have? ADHD is still the most obvious possibility. Probably with some executive functioning issues. And now we can consider a possible auditory processing issue as well. My mommy-gut tells me that the root of her receptive language problems is an auditory processing disorder (APD) caused by her not being able to hear anything for 10 critical months when other kids were learning how to listen. (Luckily, APD is very treatable and most kids normalize just fine in elem school.)
And of course, the big autism worry… Receptive language being worse than expressive language is a red flag. But, there were more green flags on the evaluation. She showed good pretend play, good eye contact, and good interactions during the evaluation. So, the “Social Communication Disorder” dx coming in the 2013 should still be the closest she comes to a social-based problem, if she even qualifies for that when the time comes.
Her therapist showed us some of the receptive language questions she missed. She was in the ballpark for all the questions, but she was not able to fully understand or fully perform what the question was asking her to do. One question had a picture of a boy walking a dog and she was asked to “Point to the nose on the dog.” She pointed to the dog, and did not get credit. Another question had a picture of a boy in pajamas sitting on a bed holding a blanket, and she was asked to “Point to the blanket” and she said “Go night night!” She was also unable to answer some questions about the function of objects, like “What do you do with a cup?” She knows what to do with a cup, she knows what a cup is and she knows the word "drink," but she was unable to answer the question.
So, now we know where to focus our efforts. Receptive language. We think the developmental preschool she will be attending in the fall is the perfect intervention, and we are so glad she will have this opportunity. We are also going to keep her in private ST two times a week like she did all last year. Her strides this past year have been nothing short of amazing, and we are so, so proud of her and thankful for her progress.
Oh, and just to keep me on my toes, Elliott now needs to start speech therapy, feeding therapy, occupational therapy, and possibly physical therapy. He has zero words at 16 months, he does not have a pincer grasp yet, he will not feed himself, and he refuses to eat anything even close to crunchy. He will only eat soft foods from a spoon from an adult. He's also not walking independently yet, but he's super close (can take about 3 steps by himself at this point). So, here we go again down the early intervention path...