Communication Therapy Assessment

COMMUNICATION THERAPY ASSESSMENT

Name: File: Umby# Birthdate: Report Date: Age: Diagnosis: Session Dates: Parent(s) Legal Guardian: Case Coordinator: In attendance: Parent/Caregiver FSW OT PT Psych SCD SLP Other: Setting: Home Centre Preschool/Daycare Information Sources: File Review Parent Report Informal Observation Formal Assessment

Caregiver’s Concerns:

Summary of Skills: Receptive Language: (understanding) Expressive Language: (use of language) Non-verbal Communication: Speech Sounds: Pragmatics: (social use of language) Play Skills: Oral Motor Skills: Eating:

Communication:

Behaviour, Attention:

Other:

 The Centre for Child Development Child’s Name: (DOB: ) Communication Therapy Assessment Report Date:

Recommendations: Initial Intervention Plan: Frequency: Duration: Location: Child’s communication skills are at expected age level and no further follow-up is required. Referral for Communication Therapy Services will be closed. Child’s communication skills are nearly at expected age level. Parents agree to monitoring of child’s skills at this time with a review in _____ months. Parents to use teaching strategies as discussed and/or demonstrated. Parents to be notified of upcoming therapy groups. Enrollment in structured daycare/preschool/playground/community programs Child referred to: Occupational Therapy (OT) Physical Therapy (PT) Family Services (FS) Psychology (Psy) Supported Child Development (SCD) Fraser Health Authority Audiology Clinic Parent to talk with child’s physician regarding a referral to: Pediatrician Ear-Nose-Throat Specialist (ENT) Fraser Health Assessment Network (FHAN) Other:

Registered Speech-Language Pathologist 604-584-1361 Ext.

Original: Parents c.c.: SCD Consultant: Physician: Paediatrician: Main File

RS\\Shared\CT\Shimizu\2009\ page 2 The Centre for Child Development Child’s Name: (DOB: ) Communication Therapy Assessment Report Date:

CLINICAL INFORMATION

HOME LANGUAGE: English Comments: ATTENDS PRESCHOOL/DAYCARE: No Yes OTHER SERVICES INVOLVED: PERTINENT FAMILY/SOCIAL HISTORY: Comments: HEARING: Tested within normal limits Identified hearing loss Not yet assessed Comments: VISION: Tested within normal limits Identified vision challenge Not yet assessed No parental concern Comments: PERTINENT MEDICAL HISTORY Unremarkable Comments:

Clinical Observations: 

STRENGTHS: CHALLENGES:  

LONG-TERM GOAL:

: Short-Term Goal: : e e Status t t

a Activities and Strategies Who/What/When a New/Ongoing/Clo D D

t 1. sed w e e g i r v a

2. e Progress T R None/<50%/>50 3. %/ Achieved

ASSESSMENT RESULTS

These assessment results should be interpreted with caution. Environmental and/or physical factors may influence a child’s performance. Assessment results offer a “snapshot” of the child’s performance on a particular day.

It is of note that * is learning Punjabi and English concurrently. Standard scores may not apply since standardized assessments often do not include bilingual children in the normative sample and since the standardized measures used in this assessment were not administered in the standardized method (i.e. some test items were given to * in Punjabi or * was permitted to respond in Punjabi).

“Standard Score”: Average score is between 85 -115.

“Scaled Score”: Average score is between 7-13.

“Percentile”: does not mean percent correct. Average score is between 16th- 85th percentile.

GFTA – 2 (GOLDMAN – FRISTOE TEST OF ARTICULATION - 2) Assesses the clarity of a child’s speech production as s/he names coloured drawings. Date: Age at Time of Testing: Standard Score: Percentile Rank:

SPEECH SOUND INVENTORY Your child can produce the following sounds correctly:

p, b, m, w, t, d, n, l, k, g, ng, h, f, v, s, z, r, y, sh, ch, j, th (as in thumb), th (as in feather), zh (as in treasure)

SUBSTITUTIONS AND OMISSIONS Below is a list of sounds that your child has difficulty saying: Imitation of isolated sound Beginning of words Middle of words End of words p b m w f v t d n I r y th (as in thumb th (as in feather) s z sh zh (as in treasure) ch j k g ng

PHONOLOGICAL PROCESSES - Error patterns that your child is using: Assimilation: (e.g. gagon for wagon) Nasalization: (e.g. manana for banana) Cluster Reduction: (e.g. _tar for star) Postvocalic Devoicing: (e.g. bathtup for bathtub) Final Consonant Deletion: (e.g. du_ for duck) Prevocalic Voicing: (e.g. gup for cup) Fronting of /k/ And /g/: (e.g. tup for cup) Stopping: (e.g. hout for house) Gliding of /I/ and /r/: (e.g. white for light) Weak Syllable Deletion: (e.g. _jamas for pajamas) Initial Consonant Deletion: (e.g. _aif for knife) Other: Medial Consonant Deletion: (e.g. fi_ing for fishing)

THE ROSSETTI INFANT-TODDLER LANGUAGE SCALE Assesses understanding and expressive use of language through observation, elicitation and/or parent report. Date: Age at Time of Testing: 33-36 30-33 27-30 24-27 21-24 18-21 15-18 12-15 9-12 6-9 3-6 0-3 Months Interaction/ Pragmatics Gesture (used for Play (both Language Language Attachment (social use of communication) imaginative & Comprehension Expression communication) social/interactive) (understanding) (words & sentences)

*Grey area indicates there are no measured skills at this age level. Percent = percent of skills present.

MACARTHUR-BATES Communicative Development Inventory: Words and Gestures A vocabulary checklist used to determine what kind of words and gestures children know and use. Parents or caregivers fill in the information at home or during the session. Date: Age when checklist completed: Total Number of Words: Percentile: Receptive Vocabulary (understanding): Expressive Vocabulary (use):

MACARTHUR-BATES Communicative Development Inventory: Words and Sentences A checklist used to determine what kind of words and sentences children use. Parents or caregivers fill in the information at home or during the session. Date: Age when checklist completed: Total Number: Percentile: Receptive Vocabulary (understanding): Expressive Vocabulary (use):

PLS – 4 (PRESCHOOL LANGUAGE SCALE – 4)

Auditory Comprehension Section uses coloured pictures, blocks and objects to examine understanding of basic language concepts and language structure as well as the ability to follow directions.

Expressive Communication Section evaluates verbal language development including vocabulary, grammar and ability to define words.

Date: Age at Time of Testing: Standard Score Percentile Rank (confidence interval) (confidence interval) Auditory Comprehension (the language children understand) Expressive Communication (the language children use) Total Language Score (overall language ability)

PPVT– 4 FORM A/B (PEABODY PICTURE VOCABULARY TEST) Assesses understanding of single words. The child is asked to listen to a single word and then point to the one picture out of four pictures on each page that represents the word heard. Date: Age at Time of Testing: Standard Score: Percentile Rank:

EVT - 2 FORM A/B (EXPRESSIVE VOCABULARY TEST) Measures ability to name nouns, verbs and word categories (e.g. animals, fruit, clothing, etc.) Children are shown a picture and asked to name it. Date: Age at Time of Testing: Standard Score: Percentile Rank:

EOWPVT (EXPRESSIVE ONE-WORD PICTURE VOCABULARY TEST) Examines the words children use to name pictures. Date: Age at Time of Testing: Standard Score: Percentile Rank:

ROWPVT (RECEPTIVE ONE-WORD PICTURE VOCABULARY TEST) Examines understanding of words such as nouns, verbs and adjectives. The child is required to point to one of four pictures in response to “Show me ______.” Date: Age at Time of Testing: Standard Score: Percentile Rank:

PLAI-2 (PRESCHOOL LANGUAGE ASSESSMENT INSTRUMENT – 2ND EDITION) Assesses understanding of typical language used in a classroom situation and the ability to use language to respond appropriately. Using pictures in a book, children are asked questions and given directions that range from simple and concrete to more abstract. Date: Age at Time of Testing:

Levels of Language Abstraction Scaled Score Percentile Rank Descriptive Rating Matching Perception Selective Analysis of Perception Re-Ordering of Perception Reasoning About Perception

Modes of Response Scaled Score Percentile Rank Descriptive Rating Receptive Expressive Discourse Ability Score

BOEHM TEST OF BASIC CONCEPTS-2 Assesses a child’s understanding of basic concepts important for language development and later success in school. Through observation with a variety of toys, this tool examines the child’s use of verbal and non-verbal behaviours for the purpose of communication and social interaction. Date: Age at Time of Testing: Percentile: Performance Range:

Range Interpretation 1 Knows many concepts compared to peers. 2 Knows many concepts but lacks some key concepts. 3 Knowledge of concepts is extremely low compared to peers.

CELF-P2 (CLINICAL EVALUATION OF LANGUAGE FUNDAMENTALS – PRESCHOOL – 2ND EDITION) Assesses understanding and use of word meanings, word and sentence structure, and memory of verbal communication through the use of coloured pictures in a book. Date: Age at Time of Testing: Subtest Score Scaled Score Percentile Rank Sentence Structure Word Structure Expressive Vocabulary Concepts and Following Directions Recalling Sentences Basic Concepts (Ages 3-4) Word Classes – Receptive (Ages 4-6) Word Classes – Expressive (Age 4-6) Core Language Scores and Indexes Scaled Score Percentile Rank Core Language Receptive Language Expressive Language Language Structure Language Content

CSBS – DP (COMMUNICATION AND SYMBOLIC BEHAVIOUR SCALES – DEVELOPMENTAL PROFILE) Through observation with a variety of toys, this tool examines the child’s use of verbal and non-verbal behaviours for the purpose of communication and social interaction. Date: Age at Time of Testing: Cluster Scores Social Standard Score Percentile Rank Concern

Emotion and Eye Gaze Communication Gestures

Speech Sounds Words Symbolic Understanding Object Use Composite Scores Social Speech Symbolic

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