Got speech evaluation report. Sad :(

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Hi everyone,

My daughter had a speech assessment done a few months ago by a speech pathologist and we just got the report today. She got the assessment done as part of her ASD assessments (she was diagnosed with autism 2 weeks ago). I'd always known that she had a language delay but I didn't know just how bad it was. She is very chatty, can use sentences of unlimited length and sometimes we have back-and-forth conversations that make sense (note I said "sometimes" - because often the conversations don't make sense or don't stay on track!)
Yet the assessment rated her in the 0.5th percentile for language according to her age. (Yes, that number is 0.5! The 50th percentile being average, 60th percentile being above average, etc. and she got a percentile of 0.5! She was said to be in the 0.5th percentile for language overall, 0.5th for receptive, 0.4th for pragmatics and 0.1< percentile for expressive. What does a "0.1<" percentile mean? That no other 5-year-old has worse expressive skills than her? Huh? The only area she did marginally better in was "Word structure" where she got a score in the 16th percentile. That means she has some ability in understanding that words change structure, eg. "Sleep" can become "sleeps" "Slept" or "sleeping".

Right now I'm feeling sad and discouraged. How will she do in the future with such a severe language delay? How 'fixable' will it be with therapy? She's not having any therapy at the moment and I'm getting impatient about getting her into some... Long story but she hasn't had speech therapy for over a year. That's probably why she's fallen so far behind.

Did anyone else have an autie child with a bad language delay/impairment who managed to improve dramatically? Just looking for some encouragement, I guess.

I don't have a child but I wanted to mention that Stephen Shore was completely nonverbal until he was nine or ten years old and now he is a lecturer, educator, presenter. Your child has every possibility of developing into a verbal and effective adult!

Don't be too worried about the percentile scores. Young children's skills progress very rapidly, so such low percentile scores probably reflect only a year or two of delay.

What are your daughter's receptive skills? Does she follow verbal directions well or at all, or otherwise react in actions to things that you say?

I know how frightening those numbers must seem, but testing really only shows so much and a lot depends on other factors. Considering it a starting place for action, not a permanent sentence on your daughter's intelligence or abilities. She still has the ability to learn and develop.

it depends who administered the test, if it is a SP that knows her than it would be more serious but if it is someone who doesn't know her than low scores can happen from a variety of reasons. for example if she has a delay in processing or is easily distractable her results can be significantly lower.
my son got a lowest score on his language assessment but his SP and his teacher said that it was nothing. apparently it was some bogus test to determine if a child needs a spanish class (makes me really want to homeschool).
in any case i think one needs to prepare a child for the tests, i.e. know about the format they use and what is expected. for as people it makes sense to explain the process instead throwing a child in unexpected situation where they can be overwhelmed and confused.

Out of all the delays I think speech can be one of the better ones, but that's just one Mom's unscientific opinion. There is a lot that can be done about it and if she's speaking even a little bit the odds are very good that she'll be able to improve well. Children who don't speak at all are more likely to stay that way.

My son didn't speak until he was 5. He seemed to have his own unique language. He'd say stuff but it sure didn't sound like English or any other language we know. At around the age of 5 he started speech therapy with a really good speech pathologist at school and his improvement was dramatic. His first year in public school he was in full time special ed program and they assessed him with the lowest scores in every area they rate. The second year we moved and those records weren't sent to the new school. He went right into regular class and started speech. I didn't think he belonged in special ed and had tried to get him out so I was thrilled. When the old records arrived the new school was shocked that they'd assessed him that way (it was complete incompetence, he was obviosly bright just couldn't talk understandably). By the end of that school year he had resolved his speech problems nearly 100%. The next year they kept him in just to make sure he didn't regress and because his problem had been so severe in the first place. They also tested him for the gifted program, and he discovered calculus, which he really likes.

Now he's not only in the gifted program but they are looking at ways we can furthur accelerate his education because he needs more than he's getting. He is developing into a math prodigy, but also has astounding writing skills. Our state does standardized tests every year and he does very well in all areas,but this year he got a perfect score in language arts. He's also in the 99.9percentile for math reasoning on the WIAT-II and has several scores in the 99+range.

Yeah, sometimes kids who are really bright can't talk. My son's story is pretty extreme but I think there is a lot of reason to hope your daughters speech will improve and you'll find a very bright and exciting mind ready to communicate with you.

Try to focus on her strengths. My daughter sounds a lot like yours, she is also 5 but was diagnosed right before her 3rd birthday. She was kind of playing with a three year old last night and she managed to have enough conversation with her to play. Ill admit it was nice to see her playing. You daughter sounds like she is doing really well considering you just got the diagnosis and have just started therapy, Im sure you will be amazed at her progress over the next year. My daughter is still way behind a typical 5 year old in language and she still uses a lot of scripting and some of her own language. However, she can read, knows all the sounds of the letters, is amazing with numbers and puzzles and is beginning to be social with other children. I talked to an old friend about a year ago who has a son who is the same age as my daughter, I put her on the phone and she went through the whole alphabet including sounds. Now my friends son can carry on a conversation with her but was just learning his alphabet. She said to me after she got off the phone with me "Oh my gosh shes a genius". Everything evens out and our kids may lag behind in social skills and conversations but in a lot of ways they can be considered a genius .

Try not to let the scores upset you so much. My son is almost 5, and every speech evaluation he has comes in so much lower than what I know he is capable of . Every evaluation he does comes in lower than I know he is capable of. We participated in a study, and the evaluator came to our home. I sat there and watched her ask him all of this stuff that I knew my son knew how to do, and he just wouldn't do it. So I get this report that looks like he is barely functioning. I too get really sad when I read these reports, but I am trying to just look at what I am seeing in front of my eyes, and take those with a grain of salt.

I would try to get her into speech therapy as soon as you can. But, in the meantime, you can work with her too. I just talk to my son as much as I can. I ask questions and just try to redirect him back when he gets off topic. My son is almost 5, and he has been in speech therapy for almost 3 yrs. I am often baffled though because he can speak in 5 and 6 word sentences that make perfect sense that sound like a "normal" child, but he loves to make up words and talk nonsense and jibberish some of the time. I think I have shared on posts that he does the verbal stimming.

Just try to hang in there and keep working with her. I am just trying to have faith that one day all of this will just click and my son will start to do much better. I think your daughter will too-----

You didn't state what assessment it was that they used but it doesn't really matter. Our kids come with a wide variance between strengths and weaknesses. Try not to worry about those scores too much as others have pointed out. However, the scores are good because you know where the weaknesses are are and now you can have SLP works on those areas (you need to get on that immediately). My daughter also had a few "<.01%" in her scores. But she also had some 94% in other tests. Try not to focus on one set of tests, you need to look at a complete battery of tests to know the real picture. Also, for what it's worth my daughter has lousy speech/language/verbal scores but her nonverbal/spatial scores are superior. Perhaps math is your daughter's language as well?

Thanks everyone, for your replies.

I'm feeling better today. I know she has plenty of time to develop and it's just a matter of getting started on services.

I've heard of a number of auties like this and I always find that so amazing! It just goes to show that it's never too late to develop language. I think Temple Grandin was also non-verbal until she was 6? And she was said to be intellectually disabled but I think she proved them wrong in that regard. I've noticed that a lot of autie/aspie adults on here are very articulate with the way they write posts, as well.



She understands instructions if they're stated simply, and with just one or two instructions at a time. She seems to understand most of what I say when I'm conversing with her. Other times it will seem like she hasn't understood what I've just said, because she'll keep saying "Why?" or "What?" Sometimes she answers a question with an irrelevant answer but I don't know if it's because she really hasn't understood the question or if it's a pragmatics issue.



Thank you; that's a good idea. It's a starting place. And at least the report will show that she's severe enough to receive speech services from her school, because so far they've been denying that she's severe enough to need their help!



I'm beginning to think this might have something to do with it. The SP was someone she'd never met before and neither of us knew what test was going to be used or really what to expect. There's no way she could have been prepared. And she got distracted during the test and kept walking off or going on tangents with her talking, which probably skewed the results. In fact, I think she got the 0.1< percentile for expressive skills because she refused to co-operate with that part of the test altogether, getting her a score of 0!

Kiley, thank you for sharing your son's story. That is fantastic!! I really believe that many autistic people have brilliant minds, it's just a matter of knowing how to dig out that brilliance. Keep nurturing your son's gifts (which it definitely sounds like you are); I think he'll go far in life.

Lilolme - Wow, there you go. Kids with language delays are supposed to struggle with reading and writing, but your daughter is doing extremely well. I have seen this pattern in my family as well - a lot of late talkers who end up becoming writers and journalists. My daughter is in a mainstream kindergarten and they're learning the letters and their sounds (they don't start learning to actually read until first grade) and she seems to be doing really well with learning to identify and write the letters of the alphabet and their sounds and words that begin with those sounds. It's kind of weird, huh?



Thanks Angelbear. I've been using some techniques I picked up from speech therapists in the past to try and improve her language. I also make sure that I hold steady eye contact while talking to her and have found that she usually makes eye contact back. She only makes it with me, though, no one else! I definitely need to try to work on the redirecting back to the topic thing -- that's a biggie here!



Wow, that's great that she has superior abilities in other areas even if her speech scores have been coming out low. My daughter hasn't been tested on nonverbal/spatial stuff. I haven't seen any particular math ability yet -- it took her ages just to learn to count up to 20 without skipping or mixing up numbers! -- but she's only in kindergarten so it could emerge later. I mean, when I first started school I was dismal at reading and was in the lowest group for ability, but by 6th grade I had a reading age several years above my chronological age. I wasn't on the spectrum, but it does go to show that abilities can take awhile to emerge.