Over the past term, I have been busy completing lots of formal assessment for my clients to evaluate their language skills. When completing an initial assessment, one of the main questions I get asked is, ‘will they ever catch up to their peers?’. During repeat assessments, a common question is ‘why haven’t their scores changed? They’re doing so much better!’
The answer to both of these questions lies in understanding the assessment process as well as typical language development. As a visual thinker, I’m going to use lots of graphs to help illustrate my answer.
When we picture typical language development, we imagine it to look something like this:
It’s likely a much less linear line, but for argument’s sake we’re going to pretend it is to illustrate the next few points. There is also a range of variation for what is considered ‘typical’ –but that is too much to include here.
For children with language delay, their language skills may be anywhere from months to years behind. We’ll use Johnny as our example, with language skills about 2 years behind when he was 3 years old. This means that at age 3, his language skills were the age equivalent of a 1 year old.
If Johnny were to ‘catch-up’ with his peers, his language would have to develop at an even faster rate than his typically developing peers. It would have to look something like this.
Sometimes, kids can respond so well to therapy that this super-fast development does actually happen. This sort of outcome is typically only seen where the child has a pure language delay, vs having other diagnoses that will impact on development, such as cognitive delays or sometimes autism.
This time, Johnny still has a two-year delay so when he is 3 years old, with language skills the equivalent of a one year old. Johnny starts therapy and his language starts to develop at the same pace as his typically developing peers. This means that Johnny may not catch up, but his progress is going great if he maintains the same gap. Here’s what it would look like.
On standardized scoring, Johnny’s scores may not change much as he’s still two years behind. If he measured in the 2nd percentile (meaning severe delay) on his initial assessment, he may continue to score in the 2nd percentile. This doesn’t mean that Johnny’s skills aren’t improving. On the contrary, Johnny started with a considerable delay and he’s working very hard to make sure that delay doesn’t get bigger. It’s a huge achievement to ‘maintain the gap’ and Johnny’s language is technically developing at the same pace, he just started a little later.
Sometimes, even with the best of therapy, schooling, and intervention at home, children may develop their language skills at a slower than expected pace. This can be frustrating, as standard scores may change from being something like the 10th percentile (mild delay), to 5th percentile (moderate delay), to 2nd percentile (severe delay) over time. It could look something like this on a chart:
This doesn’t mean that the child’s skills are getting worse, or that they are losing skills. Standardised scoring ranks the child against their typically developing peers and measures the distance between the two. So even if a child is developing new language skills, if this is at a slower pace, it will mean the gap between their skills and their typically developing peers will increase over time.
Here the important thing to remember is that the child IS actually developing new skills. There may be other factors that influence the speed of their learning, such as cognitive delays or diagnoses such as autism.
The take home message:
Don’t get discouraged by the standardized scores – what’s important is that your child is making slow but steady gains. It’s also useful to remember that formal assessments often don’t capture functional language skills, or subtle gains that may be evident in everyday life. Scores that stay the same or move to a lower level don’t necessarily mean your child isn’t making progress. Each child’s development is unique and the best measure of progress is against themselves.