Model Eval-8.5-EnglishSpanish-ModerateLanguageDelay-HearingLoss.pdf
Ricky is an 8 year, 5 month old child who is strongly Spanish-Dominant. He exhibits behavioral issues and poor academic placements. In addition, he was recently diagnosed with hearing loss, but received no amplification.
Background History:
Ricky is in a general education third grade bilingual class. He has always been in bilingual classes, has never been held over, and has good attendance. He receives no support services and was referred for this initial evaluation. His hearing loss was only recently identified.
According to the mother and the teachers, Ricky is aggressive toward his peers and disrespectful to his teachers. He already has been suspended several times this year for bad behavior.
As a result of his bad behavior, Ricky has been transferred from class to class. In first grade, he had three different teachers. In second grade, he also had three different teachers. In third grade, he has had two different teachers. On the day of the evaluation, Ricky had just been transferred to a new class two days before.
According to the teacher from whom he had just been transferred, Ricky was extremely misbehaved. He would not sit down in class and would walk out of the room. His relationships with peers and adults were poor. He threatened to hit both the teacher and the other children with a chair. He would yell when he is frustrated and was generally, “out of control.” There was one boy in the class that Ricky picked on and challenged regularly.
When that same teacher was asked what his strengths were, she said that he loved to color and draw. This would calm him down and he could focus on this for as long as ten minutes. He would not concentrate on academic activities. The teacher estimated his academic skills as approximately at the first grade level in reading and math.
Ricky lives with his mother and two sisters, who are 10 years old and 3 months old. His parents separated only one year ago. Although separated, Ricky’s father sees him frequently.
His parents are Dominican. His mother came here 12 years ago and completed tenth grade here in New York. His father came here 11 years ago, and completed eleventh grade here. He makes hats in a factory. Ricky’s parents separated approximately one year ago.
According to the teacher and the special education supervisor, the parents are concerned, supportive, and very nice. The mother said that she had requested this referral due to Ricky’s poor behavior in school.
According to the mother, developmental milestones were within normal limits, although speech-language development was somewhat slow. His mother reported an unremarkable pregnancy and delivery. Reportedly, Ricky’s health has generally been good.
Language Background and Use:
Ricky is from an essentially monolingual Spanish home. He and his family speak the Cibaoan dialect of Spanish. His sister is in a monolingual English class, but uses only Spanish at home. In all areas, Ricky demonstrated strongly Spanish dominant language skills. (This is often true when a student who has a hearing loss is placed in a classroom where he receives no support through amplification or special services to learn English). Yet, in his bilingual class, the teacher used a great deal of English.
According to the teacher who taught the bilingual class he had just been transferred from, she taught English as a Second Language in the morning and Spanish when she taught math, social studies, and science. Although this might be a way for Ricky to learn English, it would be quite difficult to make the ESL instruction context-embedded given the size of the class (over thirty students). Without context-embedded ESL, Ricky would have great difficulty learning given his hearing loss and the size of the class. Moreover, the teacher said that the school looks to transfer the children to monolingual English classes by the third or fourth grade so a good amount of teaching that would be done in Spanish is taught in English.
Thus, his poor performance both behaviorally and academically may be related to the lack of teaching in Spanish in the class. The lack of amplification together with his limited English skills would make academic learning, and even understanding his teacher, extremely difficult.
Hearing:
Although Ricky has been in school since kindergarten, his hearing loss was only recently discovered. Ricky has a mild to within normal limits to severe sensorineural hearing loss in his right ear and a moderately severe to mild to moderately severe hearing sensorineural hearing loss in his left ear. His mother said no one else in the family has had a hearing loss.
The classroom size in both classes Ricky has attended in third grade is exceedingly large. His prior class had over thirty students. His current class has nearly that amount. Without amplification, it must be extremely difficult for Ricky to hear what was said in class.
An FM unit was used for this evaluation. He has no access to an FM unit or hearing aids in school or at home. The mother reported that when Ricky was younger, he had many middle ear infections. On the day of the evaluation, Ricky was on antibiotics to treat another ear infection.
Oral Peripheral Mechanism and Feeding:
Gross examination of the oral-peripheral speech mechanism revealed structures to be within normal limits in symmetry, size, shape, color, and function.
Fluency:
Vocal parameters for pitch, intensity, and quality were within normal limits for his age and gender.
Behavior
Ricky, a handsome well-dressed boy, was withdrawn and rarely smiled during the evaluation. He was compliant, but difficult to motivate. He did not appear challenged by what was put in front of him. Even the use of realistic-looking plastic bugs and dinosaurs as prizes hardly motivated him. Often, he seemed uninvolved in the presenting task. Several times during the evaluation, he and the evaluator did jumping jacks together to wake him up and to have some fun together. During these activities, he smiled slightly once or twice, but after sitting a few minutes, he returned to a quiet, withdrawn demeanor.
Articulation and Intelligibility:
A few minor cluster reductions were noted during the evaluation. These appeared to be secondary to his hearing loss. His mother reported that he cannot say some words and sounds like a baby. During the evaluation, however, this was minimal. Otherwise, Ricky’s overall articulation pattern indicated adequate mastery of most of the sounds of English and Spanish.
Language:
Assessment Materials:
- Woodcock Language Proficiency Battery-Revised-Spanish version (WLPB-R-Spanish)(Oral Language Cluster)*
- Clinical Evaluation of Language Fundamentals-3-Spanish (CELF-3-Spanish) (Selected portions)**
- Clinical Evaluation of Language Fundamentals-3 (CELF-3) (Selected portions)***
- Language sample narrative analysis
- Teacher interview
- Parent interview
- Classroom observation
- Clinical assessment
*Approximately 2,000 native Spanish-speaking subjects were chosen to develop the norms for each subtest in the WLPB-R-Spanish. The norms for this test were developed on a monolingual Spanish population, and no norms are available for a bilingual population.
**The norms for the CELF-3-Spanish are not appropriate for this population. Additionally, due to the faulty norming procedures used, many of the items on this test were significantly easier than the items on the CELF-3-English. As a result, a comparison of raw scores does not yield any information as to language proficiency.
***The standard scores for the CELF-3 are on a scale with a mean of 10 and a standard deviation of 3. This test is based on a monolingual English sample and no norms are available for a bilingual population.
NOTE: Testing materials are not available in standardized form for the bilingual and bicultural background of the student. Use of standard scores would be inaccurate and misleading so, the results reported are presented in a descriptive form. Raw scores are occasionally reported for gross comparisons of past and future performances of this particular student on this specific test.
Receptive Language:
On the Listening to Paragraphs subtest of the CELF-3-Spanish test, Ricky received a raw score of 5 out of 10, indicating performance in the low average range. This subtest assesses comprehension, recall, and interpretation of factual data presented in spoken paragraphs. Ricky recalled basic information in spoken paragraphs, recalled meaningful predictable elements, and made inferences about actions or states.
On the Sentence Structure subtest of the CELF-3-Spanish test, Ricky received a raw score of 13 out of 16, indicating average skills. This subtest assesses comprehension of structural rules at the sentence level.
On the Sentence Comprehension subtest of the WLPB-R-Spanish, Ricky received a raw score of 9 (a raw score of 21 would be expected for a monolingual Spanish speaker of Ricky’s age). This subtest measures the ability to comprehend a passage and supply the single word missing at the end of an oral cloze procedure. Ricky had difficulty making the connection between the first part and the cloze section. For example, for the stimuli, “Coffee with milk is for breakfast and rice soup is for _____,” Ricky said, “beber” (drink). He did not recognize the critical relationships.
On the Word Classes subtest of the CELF-3-Spanish test, Ricky had great difficulty making the connections between the words. This subtest assesses Ricky’s ability to categorize words by semantic class, opposites, and spatial or temporal features. More significantly, Ricky could not seem to understand what was being asked of him. For example, at times he gave only one word as an answer choice, at other times three words, and at other times the correct two words. Sometimes Ricky would repeat the answer he had just given even after this evaluator said that it was wrong. He had difficulty picking up the rather overt visual and verbal signals he was given to cue him to the correct answer. On several occasions, he provided a word from a previous stimulus. His performance on this subtest, and the Sentence Comprehension subtest described in the preceding paragraph, suggests that the student has severely limited understanding of the relationships between words. This difficulty in inferring subtle relationships may impact his development of appropriate relationships with peers and adults.
On the Sentence Structure subtest of the CELF-3-English test, Ricky demonstrated extremely limited skills in English. He received a raw score of only 5 out of 20. This subtest assesses comprehension of structural rules at the sentence level. His performance on this subtest indicates that Ricky will have an extremely difficult time learning any content areas in English. Moreover, he will have great difficulty even reviewing content areas in English. Given the amount of English used in his classroom, Ricky must understand significantly less than thirty percent of what is being said.
In the conversational context, as well as with the context-reduced and cognitively demanding language, Ricky understands most age-appropriate directions, questions, and statements in Spanish. His English skills are extremely immature because they are just emerging. When Ricky needed to analyze relationships and make inferences about relationships, his performance was extremely poor.
Expressive Language:
Ricky demonstrated moderately delayed vocabulary skills in Spanish. On the Picture Vocabulary subtest of the WLPB-R-Spanish, Ricky received a raw score of 21. Ricky identified helicopter, lock, and calculator, but not tennis racquet, mechanic, mushroom, or check. This subtest measures the ability to name familiar and unfamiliar pictured objects at the single-word level.
On the Recalling Sentences subtest of the CELF-3-Spanish test, Ricky received a standard score of 10, indicating severe delays in development of morpho-syntactical structures. This subtest assesses recall and reproduction of surface structure as a function of syntactic complexity. For example, Ricky repeated “¿Fue puesta la carta por correo?” as “¿Se fue las carta por correo?” and “Esta nota fue enviada por mi maestra” as “Esta mascota fue por mi maestra.” His difficulty in this subtest was probably related to the effects of his hearing loss in that he could not hear the fine details of morpho-syntactical structures even in Spanish. His performance on this subtest also indicates that he would have difficulty understanding grade-level instruction even in Spanish without amplification.
An area of strength was Ricky’s ability to organize, interpret, and integrate information and to express that information through language. He was able to follow a line of questioning. The following is illustrative of that delay, and was elicited when Ricky was presented with a picture of a shoe stuck vertically between two subway doors:
[“¿Qué pasó?”] El tren lo chocó el pie del hombre. [“¿Cómo pasó?”] El quería salir y el tren se lo chocó. [“¿Por qué esto nunca pasa contigo?”] Porque yo me meta. No pego de la puerta. [“¿Qué harías tú?”] Me ayuda. [“¿Quién?”] Alguna–Mí mami, mí papi.
This translates as:
[“What happened?”] The train hit the man’s foot. [“How did that happen?”] He wanted to go out and the train hit him. [“Why didn’t this happen to you?”] Because I get inside. I don’t hit the door. [“What would you do?”] Would help me. [“Who?”] Some–my mom, my dad. When the same picture was presented later and Ricky was asked in English about it, he said: He was walking out the door, and then the door closing. And then the feet got him. [“What do you do so this doesn’t happen to you?”] Because I see in the street.
Ricky demonstrated age-appropriate skills in a narrative task he was given. Ricky was asked to tell the story of the wordless picture book, A Boy, a Dog, and a Frog by Mercer Mayer. He told the story well using appropriate past tense markers throughout. When asked how the frog felt after the boy and the dog left him, Ricky said, “El sapo se quedó solo y triste” (“The frog remained alone and sad”). His understanding of the emotional state of the frog was interesting and indicative of good narrative skills. During the telling of this story was the one time Ricky seemed interested and involved in the evaluation.
In Spanish, Ricky used simple, but generally intact, syntactical structures. In English, Ricky demonstrated extremely immature syntactical structures since his English skills are just emerging.
Pragmatic language skills were delayed in his ability to provide relevant information and to attend to and focus on the presenting task. He did not initiate or extend topics well.
CONCLUSIONS
1. Ricky is strongly Spanish dominant, with extremely limited skills in English.
2. Ricky evidenced age-appropriate narrative skills, comprehension of paragraphs/stories, and the ability to organize, sequence, and verbalize information in a temporal and sequential manner. Moderate delays were evident in vocabulary skills, morpho-syntactical skills, and pragmatic skills. Severe delays were evident in his ability to make connections between words.
3. According to the mother, his teachers, and the special education supervisor, Ricky is aggressive toward his peers and disrespectful toward his teachers. He has been transferred to different classes two and three times in each school year because of his behavior problems.
Because he is strongly Spanish dominant, his poor performance both behaviorally and academically may be related to the lack of Spanish teaching in the class. Even with Spanish instruction, he would have difficulty learning with his hearing loss. The lack of amplification and appropriate education and therapeutic intervention have had a tremendous impact on language and learning to date. When in the adverse listening environment typically found in the classroom, such as the presence of competing noise, distance from the speaker, and loss of visual cues, the potential impact of such a hearing loss could be devastating to his educational, speech, and social development.
It remains unclear whether Ricky also has an emotional problem beyond that caused by the classroom language use issues and the hearing loss. (An additional factor is that his parents separated only one year ago). Until the language use and hearing issues are addressed, however, the nature of the emotional component to his language-based academic difficulties cannot be determined.
RECOMMENDATIONS
Bilingual speech-language therapy is recommended two times a week for thirty minutes in a group of up to 3 students.
Model Eval-8.5-BilingualEnglishSpanish-ModerateLanguageDelay-HearingLoss.pdf
