Talk of progress
POSTEDApril 23, 2004
“Who came to school today,” sings the class. “Matthew. Matthew. Who came to school today? Matthew did.”
A nearly four-year-old blonde boy gets up from the carpet to Velcro his name under the “Here” sign. “I am here.”
While most college students are sleeping at 9 a.m., Matthew is beginning his school day at the Preschool Learning Development Program (PLDP) located at the Callier Center’s Richardson campus.
His class of 10-12 children is not like any other at UTD – his peers range in age from three to five years old, and he has six clinicians instead of one professor.
Matthew has worked with the Callier Center’s speech and language pathologists to help him acquire the skills of putting his thoughts into words.
They have helped Matthew develop from speaking nothing more than “one and two word utterances” into an “eager, verbal” four-year-old in just over a year, according to Autumn Voss, one of Matthew’s clinicians.
<strong>’He just couldn’t express it'</strong>
At two-and-a-half years old, Matthew used only five words, according to his medical records. After turning three, his mother, Jeanmarie Geis, took him to the Callier Center.
“When he was around two, we noticed that he just wasn’t talking like the other kids his age,” Geis said. “That’s when we had him tested at the Callier Center.”
Stacy Reaves, program coordinator of PLDP and a certified speech-language pathologist, said that speech-language pathologists use both standardized and informal tests to properly diagnose a patient. They look at language samples to help determine whether the patient is at a linguistic level appropriate for their age.
“We look at whether they are able to answer questions or able to take conversational turns. We look at their sentence structure and where it needs to be,” Reaves said.
Matthew scored 69 and 104 on the expressive and auditory comprehension sections, respectively, of the “Preschool Language Scale-4” exam. The mean scores on the exam are both 100.
Matthew’s results categorized him as having a “severe expressive language delay.”
The goal, according to Reaves, is to have his scores on both exams within 10 points of each other, and to have them fall within the normal limit – a standard deviation of 15 points above and below the mean.
Reaves diagnosed Matthew with an expressive form of developmental language delay and a developmental articulation disorder.
<strong>Hard work pays off</strong>
Matthew began treatment at the Callier Center’s Dallas campus in the summer of 2003 with Reaves. He entered the Small Group Intervention for Language Emergence (SmILE) program and stayed for two semesters.
“We could see a big difference within three to four weeks,” Geis said.
After two semesters in the SmILE program, Matthew was tested again. He scored 105 and 107 on the expressive and auditory comprehension tests – Matthew had achieved his goals.
Although his scores improved, Matthew was recommended for the Preschool Learning Development Program (PLDP) classes at the Callier Center Richardson Campus to further encourage his verbal progress.
“While Matthew had acquired many new skills, he continued to exhibit delays in regard to his sentence length, use of grammatical features and functional use of words,” Reaves said.
<strong>A day in the life of…</strong>
Matthew is one of the first to enter the classroom. Before class starts, Matthew plays with toys, proudly showing Megan Eubank, his primary clinician, the snake he made.
As each child enters, Matthew announces, “Tim is here” or “Bobby is here.”
“He’s much more verbal than he was six weeks ago,” said Eubank, a UTD speech-language pathology graduate student.
During “circle time,” the clinicians and children sing about who came to class today as well as the days of the week. Matthew, the child who four weeks ago would rarely raise his hand now waves it to answer the questions saying “me, me, me.”
Then the children meet in small groups of two or three with a clinician to work on skills specific to their goals.
One week, the groups focused on food as their theme. Matthew’s small group placed different pictures of items into different categories. As positive reinforcement for a correct answer, the child pushed the button on the toy register. The dinging bell and the drawer popping out sent Matthew and his two playmates into a fit of giggles.
After small group, the children are ready to release some energy, so the class heads to the gym. During a game with a parachute, the kids and clinicians launched it up and down, letting the air catch underneath. Completely spontaneously, Matthew began a countdown from 10 to zero.
Reaves noted with excitement that Matthew counted backwards from 10 to zero, without prompting – a clear display of progress.
After snack time, the group moves to the rug where Matthew listens attentively to the story being read. During “Who is the Beast?,” the clinician talks to the children about animals in the jungle. Matthew raises his hand and in a sudden burst of energy pretends to be a monkey. He bounces back and forth in place and scratches under his arms making “ooh ooh” monkey noises.
“It’s refreshing to see him verbalize and communicate with his peers; whereas, in the beginning of the semester, he didn’t have as many words,” said Voss, communication disorders graduate student.
<strong>Really taking off</strong>
At the beginning of the program, Matthew was a parallel player – he would play with the same toys as other kids, but he would not play with the other kids, Reaves said. However, a progress summary prepared by Eubank and Reaves at the end of March noted Matthew had “increased his peer-to-peer interaction during all play activities.”
“He is really taking off,” Eubank said. “Matthew seeks out peers to join him in his play rather than playing alone.”
The clinicians also measure progress by an increase in Mean Length of Utterance (MLU). Originally, Matthew’s sentence length was 2.02 words per utterance placing him “severely below age level expectations.” However, the data presented in his most recent progress summary showed that Matthew “uses three word utterances in four out of five opportunities.”
“We’re seeing him, instead of using gestures to point at something he wants, actually use his words: ‘look at Matthew’ or ‘look what I did…look at me…Matthew is jumping,’ instead of pulling on our hands or pointing,” Eubank said.
The clinicians also work on the use of linking verbs, or auxiliary verbs, like “is,” “am” and “are.” The progress summary stated that initially Matthew formed combinations lacking such verbs, like ‘mommy going.’
“At the beginning it was one and two word utterances like ‘Me here,'” Voss said. “‘Say I am here’…you only have to tell him a couple of times and he has it.”
<strong>Ready for the next step</strong>
Matthew’s plans for the future look promising.
He will finish the spring semester in PLDP and continue in the six-week summer session. After completing the program, Geis said Matthew will be enrolled in St. Thomas Aquinas Catholic School for Pre-K 4 in the fall.
“I think the way we see him here, how he acts as far as how he requests. He wants to make choices, he wants to be a part of the group, he wants to do activities with us in the gym,” Voss said. “One can tell that he’s ready to make the next step.”
In recently released health discipline program rankings, The U.S. News & World Report named UTD 5th in audiology and 17th in speech-language pathology.
“Parents from all backgrounds sacrifice dearly to have their kids come here, and that is the beauty of the program and what all of us parents have in common. We want the best for our children, and that means the Callier Center,” Geis said.