How much assessment is enough?3 Replies
A child recently came to see me with a 30+ page Speech Pathology assessment report.
Before this assessment, she had already had a comprehensive cognitive and educational assessment by a Psychologist.
The only problems the Psychologist identified were weaker than average Working Memory (WM), Rapid Automatised Naming (RAN) and Phonemic Awareness (PA) plus limited knowledge of Grapheme-Phoneme Correspondences (GPCs, or what I prefer to call PGCs, because I work from sound to print).
Her verbal skills were otherwise in the high average range.
When I read the extensive case history in her Speech Pathology report, I scratched my head. There didn't seem to be much need for a Speech Pathology assessment.
The presenting problem was poor reading and spelling in the context of good oral language. Her literacy problems were readily explained by her problems with PA, PGCs, WM and RAN. There was nothing in the case history to suggest any other communication difficulties.
The child was given a comprehensive Speech Pathology workup: hearing, auditory processing, speech sounds, phonemic awareness, morphology, syntax, semantics, pragmatics, voice, fluency and even (to my surprise) learning style (Click here if you want to read a paper questioning the validity and educational relevance of learning styles). Perhaps there was a good reason for this, maybe the family specifically requested the most comprehensive assessment possible, and they were paying for it. I decided not to query this with the parent in case of unintended consequences.
The assessment concluded that all the child's communication skills were good, apart from slight memory and naming problems, but her reading and spelling skills were low, probably because of poor awareness of sounds in words and limited knowledge of sound-letter correspondences.
Well, yes, but we already knew that.
Occam's Razor, the law of parsimony, asserts the simplest credible explanation for something is probably the best.
When we already have a good explanation for a learner's failure to learn to read and spell, such as problems with PA, PGCs, WM and/or RAN, and no other problems are reported or observed, I'm not sure why children need to be put through lots of further testing. I'm not sure why parents or funding bodies should pay for this testing or for long, opaque reports about it.
What's needed, ASAP, is intervention targeting PA and PGCs, then once basic decoding and encoding is happening, building in work on vocabulary, comprehension and fluency.
Children's auditory memory matures over time, and rapid automatised naming is related to processing speed, so parents and teachers of kids with slower than average RAN need to know to give these kids a bit more time, and that this will probably make the process of learning to read a little harder.
These problems should be documented on the child's school file, in case the student needs to seek extra time or other special consideration during exams in the upper secondary school years. However, neither low WM or slow RAN mean learning literacy can't happen.
Don't bury the lead!
Learner-journalists are taught not to "bury the lead", or allow the main point of what they are writing to get lost in less important information.
Too often, parents bring professional reports to an initial session saying, "I don't really know what this means, or what to do next". The 30+ pager was one such report. The main information could have fitted into three or four pages, and been tied closely to a few specific recommendations, rather than having a swathe of general recommendations.
What children, parents and teachers need to know is why a child is having difficulties, and precisely what needs to be done about it.
Too much assessment, not enough intervention
I used to have a job driving all over the state doing language assessments, and writing reports about them.
It nearly drove me crazy, finding so many children with significant language and consequent literacy difficulties, and not being able to provide any of them with intervention.
I knew the chances of these children getting the intervention they needed were generally fairly slim, especially if they were from low socioeconomic groups, making private therapy difficult or impossible. Speech Pathologists in the government school system are as rare as hens' teeth, and most schools were then using Reading Recovery as the main literacy intervention, not the systematic, explicit synthetic phonics approaches more likely to assist such children.
I over-compensated by writing very detailed, specific recommendations, hoping that someone, ANYONE in the system would read my report and be able to follow them.
However, I'm sure many or perhaps most of those reports were put in filing cabinets and never acted upon, because of lack of staff time and/or relevant resources. If that's the case, they were kind of a waste of time, petrol and trees.
We're all taught in Speech Pathology courses that before we start intervention with a client, we should do an assessment and write a report. However, with time and resources so stretched in education (where's our Gonski money?!) and so many children having already done plenty of assessment which makes their areas of difficulty obvious, I often cut straight to the intervention chase. The longer intervention is postponed by further assessment and reporting, the further the child falls behind. And money that's been spent on assessment and reports can't be re-spent on intervention.