Isolated in the world

Today I assessed a little boy who was recently rescued from a refugee camp in Africa.  Here are portions of my assessment report (the name has been changed):

Background information:

Bobby is a 6 year, 2 month old male who currently attends 1^st grade at Pleasantville Elementary School.  He was referred to the IEP team in regards to his significantly delayed communication skills attributed to a significant bilateral hearing loss.  His father reports that Bobby has never completed a hearing assessment, but has an appointment scheduled in the near future.  For this reason, Bobby does not currently use any type of amplification. 

With the help of international missions, the family recently relocated to the area from a refugee camp where Bobby received minimal education with no training in a visual language.  His father reports that Bobby was delivered after a normal, full-term pregnancy and has not demonstrated a response to loud noise since he was very young.  Bobby knows some letters from the American Sign Language alphabet, but he does not understand the meaning.  The family uses gestures at home and reports frustration with communication for both the parents and Bobby. 

Relevant test behaviors:

Bobby came to the testing session with his dedicated assistant/interpreter and entered the testing room willingly.  He immediately attended to all the visual information on display around the room and showed interest in the computer that was set up.  All information from the SLP was provided in sign language and spoken language simultaneously; however, Bobby needed maximal prompting to attend to visually presented information.  Throughout the session, Bobby did not attempt any spoken language and did not provide any signs spontaneously.  He occasionally imitated signs/gestures and labeled three objects during play.  The only vocal output produced by Bobby was a humming sound likely produced for tactile stimulation and not related to communication with the adults in the room.  It was noted that Bobby had a very short attention span for tasks and attended to objects/manipulatives for a relatively longer time than pictures.  When offered a sticker at the end of a session as a reward, Bobby exhibited an adverse response by peeling it off his shirt and throwing it down.  He also reacted negatively to a cartoon drawing of a snake while playing picture bingo.

After the testing session, Bobby was observed by the SLP within the general education classroom during a whole group session with about 22 other students.  Bobby did not visually attend to the dedicated assistant/interpreter who modified/interpreted the information from the teacher, but followed a direction that was gestured by the teacher to sit down.  While the teacher was reading a story, Bobby looked around the room and did not attend to the task despite the presence of a dedicated assistant/interpreter.  When the teacher showed pictures to the students, Bobby's attention increased minimally and with maximal prompting from the dedicated assistant/interpreter, Bobby imitated signs to label the pictures.  

Summary:

It was found that Bobby exhibits receptive and expressive language skills that are within the below average range for that which is expected for his chronological age.  His verbal comprehension is the age equivalent of a child who is 1 year old or younger.  His expressive language is the age equivalent of a child who is 1 year, 3 months old or younger.  At this time, Bobby does not attempt to produce any spoken language.  

Bobby exhibits a delay in his ability to visually attend to objects/people which impacts his ability to receive information presented visually.  Considering his significant hearing loss, this could have detrimental effects on the development of his communication skills. 

 

This child has been informally assessed to have average or near-average cognitive abilities and is only behind in the area of communication....at this point.  These delays will also cause delays in learning basic concepts (colors, numbers, etc) and reading and writing....which will also cause delays in science and social studies....and so on and so forth.  

Despite the fact that this child has lived his life among thousands of other people in a refugee camp, he is isolated in the world.  He has not been given to key to communication through sign language and I can't wait to see how he develops once that door is open!