One of our areas of expertise is with language development and literacy. The best way to understand how we speak and comprehend words we hear to understanding written words is through linguistics.  Do not worry, as we will not bore you with any grammatical terms. Instead, let us take an evolutionary perspective. Dogs bark to alert their owners of impending danger, and dolphins produce high pitched sounds and clicks for survival purposes. These are communication forms of in-the-moment attempts alerting you of danger or of the animal’s immediate needs. Yet, to date, there’s no evidence that any other animal species demonstrate the ability to produce and understand grammar. Grammar is what makes us special: It provides us with the ability to discuss past and future events. It is a more sophisticated communication system compared to all other animals and previous human species. What evolved from linguistics is a written form of language called literacy. Schools are built around literacy. Speaking and understanding language have been around before we learned how to read and write. In fact, we do not need to be schooled to learn how to speak and understand our native language. On the other hand, literacy is taught explicitly and systematically and takes many years to learn how to master.

When seeking an evaluation to understand why your child is having difficulties with literacy, the top professionals to choose from are psychologists and speech language pathologists with literacy training. In New York State, licensed clinical psychologists evaluate learning and attentional differences. Next in line are licensed language pathologists who are experts in language (expressive and receptive language and its connection to literacy.) In New York State, language pathologists diagnose language disorders. Language disorders have many names such as developmental language disorder, and research calls it ‘specific language impairment’. Is dyslexia a form of a language disorder? At the research level, academics argue that dyslexia is a language disorder. Dyslexia literally means “bad language.” However, New York State defines dyslexia as a learning disorder which means in New York State, speech language pathologists cannot diagnose learning disorders (this is why psychologists are so vital to your child’s diagnosis). So, whenever your child is having difficulties with literacy, be cautious as teachers and non-licensed therapists cannot diagnose why your child is struggling with literacy. However, it is important that professionals recognize that your child is having learning issues, but it is best to work with a licensed professional who has expertise in this area of concern.

At Brooklyn Letters we offer a variety of language and literacy evaluations. Here’s more information for what we offer. We use assessment materials that are scientifically validated for identifying both language and literacy disorders. We know how to interpret these tests which are crucial for your child’s progress. We use an integrated approach which recognizes the connections between speaking, listening, reading and writing. Without putting these pieces together, it is nearly impossible to understand language learning and potential literacy issues. We also work closely with clinical psychologists who diagnose dyslexia. A full language and literacy evaluation provides you with a comprehensive profile of your child’s strengths and weaknesses and best positions your child for maximal progress.  We travel to you and can remotely evaluate your child within a week or two by one of our experienced licensed language pathologists/therapists.

Based on learning how your child is struggling, we act as detectives to thoroughly investigate your child’s spoken and written language skills at the word, sentence, and discourse levels. We explain how one area negatively impacted can spill over to other areas of literacy.  For example, if a child is struggling with reading, it could be due to difficulties at either the sound (phoneme), grammar (passive or complex sentences), vocabulary levels at various modalities involving listening (auditory, no text), written, and spoken levels. Poor listening comprehension is highly correlated with weak reading comprehension skills.

Based on the evaluation’s results, intervention goals are developed based on where your child is demonstrating weaknesses, such as phonemes, grammar, and vocabulary in connection to the modality levels (listening, speaking, comprehending text, writing).  Recommendations for modifications and accommodations for students with language and literacy disabilities are also provided for families and school staff.  These evaluations should not be a substitute for a comprehensive neuropsychological evaluation. We work closely with some of the top New York State neuropsychologists.  Neuropsychological evaluations are crucial for understanding learning and attentional differences and are more comprehensive than our evaluations. Neuropsychological evaluations dive deep into how attention, memory, cognitive, language, and social/emotional functioning can negatively impact learning. Our assessments can also provide you with invaluable information if you cannot afford a neuropsychological evaluation, you cannot wait months to receive the results of a neuropsychological evaluation, or if your child is suspected of having a language disorder.  On average it takes us two weeks to produce the report.  Our goal is to provide you with objective data to help you figure out your next steps to intervention or additional testing.

92523: Evaluation of Language Expression and Comprehension
95: is a modifier for telepractice, and the CPT code, e.g. 92507 or 92508 stays the same. CPT 95 is for reporting telepractice-related services e.g. synchronous telemedicine service rendered via real-time interactive audio and video telecommunication systems.
If insurance asks for a place code it’s (POS) 12 for home-based services and (POS) 11 for office-based services

F80.1: Expressive Language Disorder
F80.2: Mixed Expressive Receptive Language Disorder & Social Communication Disorder
F80.9: Language Disorder/Developmental Disorder of Speech and Language
F80.82: Social Pragmatic Communication Disorder
F80.89: Other Developmental Disorders of Speech and Language
R48.8: Language Deficits Related to an Organic or Medical Condition. Other Symbolic Dysfunctions, such as Auditory Processing Disorder, cognitive language disorders, and executive function impairment due to organic or neurological conditions.

315.2 Unspecified Specific Learning Disorder
F81.0 Specific Reading Disorder/Specific Learning Disability with Specific Impairment in Reading Comprehension
F81.1 Specific Impairments in Written Expression: Spelling, Clarity and Organization of Written Expression
*Please note that each State defines the definition of Learning Disorders and Language Disorders. The State’s definition might not be in accordance with the definition defined by the American Speech Hearing Association (ASHA).

A full language and literacy assessment for this age group can include a pre/emerging/early literacy assessment, an expressive (oral language), and a receptive (listening) assessment.

Early literacy skills assessment:  An early literacy assessment includes an analysis of your child’s phonemic (sound) awareness, letter (labeling the name of a letter) and word recognition, and decoding (how a child cracks the code) skills.  We go meta (awareness of language) and see how  your child manipulates sounds and words , identifies the individual sounds in a word and blends sounds together into words: these are essential skills for learning how to read and write.  Students who struggle to acquire these skills may be at risk for poor reading and spelling development. Another important ingredient is learning how your child is taught literacy, which can help us determine what type of literacy instruction your child will need.

Receptive language– We assess your child’s ability to comprehend spoken language by having him or her follow directions of increasing length and complexity, identify word relationships, and match pictures to the sentences spoken to them.

Expressive language– We assess your child’s ability to use language to formulate sentences, retell stories, formulate their own personal stories, and engage in a conversation. We compare your child’s quantity and quality of their vocabulary, grammar, and organization to peers. In addition, we analyze their length and complexity of the words and sentences they produce compared to peers. Lastly we analyze their pauses, revisions, repetitions, and overall expressive language fluency.

A full preschool-kindergarten language and literacy evaluation will take approximately 1.5-2 hours at your home and includes a 5-6 page report.  Shorter evaluations require less time and the reports are 1-3 pages long.

A full language and literacy evaluation for school age children can include:

Here are some of the skills we can cover during our evaluation: Vocabulary awareness, story retelling, spelling, listening comprehension, reading comprehension, decoding novel words that are not recognizable as real words, reading fluency, written expression, social communication, and short term and verbal working memory.

Phonemic Awareness:  We assess your child’s awareness of the individual sounds of words and his or her ability to manipulate them to create new words.

Decoding & Spelling:  We assess your child’s ability to read and spell unknown words in order to gather information about his or her knowledge of sound and letter patterns. Having a strong knowledge base about sound and letter patterns helps individuals become fluent readers and writers.

Listening & Reading Comprehension:  Individuals with language and literacy disorders may not have difficulty engaging in social conversations; however, they are more likely to have trouble navigating the complex academic language found in their classrooms. We assess your child’s ability to comprehend vocabulary words and complex sentences that are similar to those which he or she may encounter in the directions, discussions, and texts in their classrooms.

Oral expression and written language skills:  We assess your child’s ability to use language to communicate a coherent message when speaking and writing.  Students will be asked to retell a story and explain how to play a game or sport.  The evaluator analyzes the oral and written responses in order to determine the overall quality and organization, length, complexity, and grammaticality of the words and sentences and the number of different words used.

Social communication skills: We assess your child’s ability to understand a social situation which is important for reading comprehension.

A full school age language and literacy evaluation will take approximately 1.5-2.5 hours and could take place over two sessions depending on the child’s unique needs.  The full evaluation will include a 7-10 page report while other evaluations are 1-3 pages in length.