pre-school screening--what does it involve?

blsdgalApril 18, 2006

My twin boys (will be four in June)will be screened next week. One of them clearly needs some speech therapy and so I decided to go ahead and just have both of them screened.

What exactly is involved in pre-school screening?

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There are a couple of different types of screening done where we live:
- Generic 'kindergarten readiness' screenings designed to helps parents decide whether to give a kid a little extra time to mature;
- Special needs assessments for children who may have a disability or require special services;
- And the general speech, vision and hearing screenings done for most kids at a few points in their elementary years.

What to expect depends entirely on the type of screening being done. Do you have any reason to suspect anything other than a "mild garden variety" speech impediment? And is this for their kindergarten year, or for pre-k? Programs vary state to state, but many school districts won't admit a child to pre-k or provide speech services unless the speech problem is pretty significant, or is combined with another area of weakness such as fine motor or social age-appropriateness. Other states are much more helpful, and I hope yours is one of those!

    Bookmark   April 18, 2006 at 8:20PM
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A word of caution- you know your children better than anyone, and tests are designed for EVERYONE. Observe the test- through a one-way mirror if you can- or at least familiarize yourself with it to make sure the person testing is not trying to fit a square peg in a round hole.

After 2 years of preschool, we had our son tested for school readiness (stupid on our part, but he had a November birthday and he never 'colored', had trouble sitting still and couldn't cut with scissors worth a darn, which was apparently an issue)and was told that he should wait a year and start kindergarten at 6 because he wasn't 'ready'. This is a kid who could make change when he was 3- no joke. We asked to see the testing materials and the answers and almost passed out.

When asked to draw a picture of a tree, he had drawn a 'stick' tree. It was explained to us that not finishing out the tree with leaves and color indicated some 'incompleteness' in his development. It was May, we'd had a tornado the week before, and there wasn't a leaf on a tree in our part of town- they all looked distressingly like the one he drew. Duh!

He was asked to identify some items by their function. He had given the grown-up term for several and been counted off. The only example I remember was "This is used to turn. It is a... " The answer was "It is a turner." DS said 'it is a spatula.' BZZZ! Wrong!

My favorite was the question where he was asked to 'name all the wild animals you can'. He proceeded to do exactly that. Jack the monkey. Michael the lion. Will the wildebeest...

I couldn't believe the director was so far inside the box that she could look me in the face and tell me DS was 'behind' and needed another year of preschool. Of course, we ignored her advice and sent him anyway.

I must be a small and petty person, as I nursed a silent grudge against her until last year when I sent her a news release from his high school detailing the 4 yr plus cash college scholarship offers he had received. It was liberating...

Conversely, DD2 had difficulties in school- tests came back within normal ranges but we knew there was something not right. They were taken in non-classroom settings and not an accurate assessment of her classroom performance. Turns out she has auditory discrimination issues, which the school was unwilling to accomodate. We've changed schools, but my point is, know HOW they are testing your children. If you see any red flags, or any results surprise you, get in there and ask questions.

    Bookmark   April 19, 2006 at 10:38AM
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Cute story Pecan, but the message is right on target.

I remember watching some of the testing done on my two sons (both with various LDs). They asked my younger son to name some pictures, and the pictures were so out of date he had no idea what they were -- a rotary dial phone, an iron (OK - this isn't out of date, but he hadn't seen me use one!), and a record player. They also asked him how to make a grilled cheese sandwich, which, since he can't tolerate either wheat or milk, he had never seen me make.

Watch the testing if at all possible. And if you have any concerns about your child's development, do some research into testing to be sure the tests they are proposing to do will determine if there's an issue that needs addressing.

    Bookmark   April 19, 2006 at 1:20PM
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If you're talking about speech issues, the screening process is easy. The child names pictures, the speech therapist watches and listens, and then determines the sounds/blends your child is challenged by. She will also help you determine whether this is a delay (he'll grow out of) or if he needs therapy.

Now, if it's a language issue (more of a processing thing then how to form the words), that's a little more complicated.

Our school district provides free therapy to preschoolers, but now that the school year is just about over you might need to go the private route. Still, your school system will screen for free. If your boys have another year of preschool, then you might get a full year of therapy inbefore kindergarten. Our school district has bi-weekly two hour sessions that looks like pre-school that focuses on the problems on the kids in the group. It's great. And free. Well, you're paying taxes, so it's not exactly free.....

    Bookmark   April 19, 2006 at 3:22PM
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I didn't reply till now, because it has been a long time since my kids were tested, so I don't remember a lot about the testing process. Both of my children had difficulty producing certain sounds correctly, and I was the one who requested the diagnostic testing and speech therapy.

When DD was age 5, her pediatrician referred me to an excellent speech therapist, who had a private practice in her home. It was pricey, but it didn't take very many sessions (maybe 2 months of weekly appts).

In the case of DS, we decided to take advantage of the public school system, although my son was attending a private kindergarten at the time; he was screened as cupofkindness describes, and we were given an IEP. He attended speech therapy sessions in the afternoons at a nearby elementary school. Speech therapy continued into a second year, when he was enrolled in public school, so he just went to a different classroom once or twice a week for his therapy sessions.

Speech therapy in the public school worked equally well (and at no expense to us), but it dragged out much longer because other children (usually two or three kids) shared the therapy sessions; my son received individualized attention, but for only part of the hour. I think he enjoyed the diversion of going to a different teacher and class. In both settings, the therapist used games, toys, and rewards (like stickers and small toys).


    Bookmark   April 19, 2006 at 5:25PM
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I am one who is very leery with screening for profit. Most preschools (private ones) hire private companies who do the screening, and those companies then provide subsequent services for those with diagnosed needs. In other words, if your kid needs therapy, you pay for it and they earn money. See a pattern?

You should know that public school systems provide special education services in all states by the age of THREE, and it's FREE. As is the testing. If your child needs speech therapy, your local school district can test for it and provide services for it and it shouldn't cost you a dime. Before you pay anyone to test and/or treat your child, give the district a call and ask about having your child tested there. Yes, your child can still attend any private preschool and receive testing and treatment from the district.

Note though that testing for special education (such as speech) and basic without-concern academic/development testing are two different things.

    Bookmark   April 19, 2006 at 5:57PM
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I agree with snookums re: private screening. Plus, the earlier you start (like to OP is doing) the more time you have until this becomes an issue with the child to solve the problem.

    Bookmark   April 19, 2006 at 6:12PM
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Good grief, Sweeby- rotary phone and record player? Are you sure it wasn't a trip down memory lane and a test for age-related memory loss?

    Bookmark   April 20, 2006 at 9:51AM
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It was really funny Pecan! If I hadn't seen it myself, I wouldn't have believed it. But it was part of a very standard, well-known speech test. Once I pointed it out to the speech therapist, she realized how inappropriate the pictures were, but apparently, no one had every done that before. It was a real eye-opener for the "cultural bias" issue...

While Snookums has a valid point about private testing having a financial incentive to find issues that require treatment, I'd like to point out that the flip side is also true. If the public schools do the testing, they have to remediate any needs they identify for free, so they have the opposite incentive...

    Bookmark   April 20, 2006 at 11:40AM
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Wow-interesting info--just what I wanted.

Thanks to all of you for taking the time to post so much info. Really opened my eyes and gave me lots of food for thought.

My boys were born a little early and they have late birthdays (June). So I would rather them be the oldest in their class rather than the youngest, so we will probably put them in school a little late. But, they will be attending pre-school this fall.

I do not think they they have any other problems or delays other than Brian and his speech. He has trouble with "K"--it always comes out "T". Can't seem to say the "th" sound either. Example--saying "Taffy" instead of "Kathy". When he gets excited, and talks too fast everything gets garbled.

I do know that they need to be around other kids and have the company of someone other than me--so maybe I should have done pre-school this semester. I even thought of finding a nice home based daycare for one day a week--just so they would be exposed to kids other than eachother.

Do you think I screwed up and should have had him in speech therapy sooner? I kept saying to myself that he would outgrow these things as his brother did.

The speech therapy is available through the school district so my family physician said that first we had to go through the screening--but I will be very watchful of how it is done. I do not need to have my boys labeled.

Again, thanks so much for the info. Thanks for letting me think outloud.

Any further info will also be appreciated.

    Bookmark   April 20, 2006 at 12:37PM
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blsdgal, that's the kind of speech problem my kids had, too. My DD would simply drop the "th" in some words, so, for example, "there" became "air." Consequently, people (especially the other kids in nursery school) would misunderstand her; I felt that this had the potential to be socially damaging, and that was the impetus for getting therapy instead of waiting for it to get better on its own--by age 5, that had not happened. She also couldn't pronounce certain combinations of consonants ("magnet" became "mag-a-net," "middle" became "mit-tel"), although that wasn't as hard to understand. Those problems were easily corrected; for the "th" sound, she just had to learn to put her tongue behind her teeth a certain way and make the vibration in her tongue (not sure I'm describing this correctly; it has been a long time). Anyway, it just took some practice (games) and reinforcement (small rewards), and the problem was GONE. My DS's problems were similar. I suspect it has something to do with the shape of the mouth and teeth (they both needed orthodontics as teenagers), rather than the clarity of the speech modeled by their parents.

I wouldn't worry much about the "labeling" for a speech problem. Once it has been resolved, there's no more problem; it's ancient history. It doesn't reflect on the child's intelligence or personality or upbringing, so there's no stigma. On the other hand, NOT getting it corrected can lead to frustration at being misunderstood and perhaps ridiculed by his peers. I don't think you "screwed up" at all, but I'd have the child's speech evaluated as soon as possible and then listen to the professional's recommendations on whether he'll grow out of it or need correction. BTW, I was allowed to be present in the room when my son was tested (we HAD a rotary phone and a phonograph, so recognition of those items wasn't a problem)! :-)


    Bookmark   April 20, 2006 at 1:34PM
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"I do not think they they have any other problems or delays other than Brian and his speech. He has trouble with "K"--it always comes out "T". Can't seem to say the "th" sound either. "

That's really very good news Blsdgal! That's a pretty simple phonological speech error called 'fronting', where a child takes a sound made in the back of the mouth and substitutes a simpler front-of-the-mouth placement. Can he say a 'K' sound at the end of a word, like 'book? Can he say words with a hard 'G' sound, like 'garden'? Or does that come out more like 'darden?' If he can make some 'throaty' sounds, then you've probably got a very minor issue that can be resolved very quickly.

You might try playing some invented games at home to see if it's something you can fix yourself in a few weeks. If he can say a 'K' at the end of a word, try to use that to 'bridge' into words with a K in the middle, then on into word combinations where the second word starts with a K sound -- like bookcase, look cool, like cake, big king! To work on an initial placement, try to think of a game where he has to say "Go, Go, Go, Go!" while you move a toy toward a target. After he's said a bunch of Go's and has a 'throaty' pattern well-set, have him try "Come back" to bring the toy back to the starting line. Keep it light, keep it fun, and be creative. It may not work, but it sure can't hurt anything.

Also, the 'th' sound is one of the later-devoloping sounds anyway, so he's probably not even delayed with that one.

(In case you're wondering where this comes from, my younger son has a speech condition where he had to be explicitly taught how to make every sound and every sound combination. We spent countless hours doing 'homework' along these lines to teach him his sounds.)

    Bookmark   April 20, 2006 at 4:18PM
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my daughter had speech therapy for her K, plus other sounds...but we started very early (by age 3) beacuse she pitched a huge fit every time we didn't understnd her. Poor thing was so frustrated that I didn't know she meant fish when she said tit...or tort for fork...she picked up all her sounds with a few weeks, except for the elusive k...finally, just shy of her year review--she got her k!

I foudn this link to an powerpoint presentation from Mass General from an online Language conference...lots of interesting data about when kids master different sounds...

Here is a link that might be useful: MGH power point pres

    Bookmark   April 20, 2006 at 6:33PM
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Thank you for all of the great info.

Brian in fact does say T instead of K (like Boot instead of Book), so maybe Sweeby his problem is minor. That was reassuring to read.

Thanks mtnester for the info you shared as well.

The link was interesting, although I didn't get to read the whole 107 pages.

The screening is tomorrow and I am glad to be a little more prepared.

Thanks again!

    Bookmark   April 25, 2006 at 7:44PM
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