You are on page 1of 5


XX Romig



Date of
Date of Birth:

Stephanie L. Fowler, B.S


Kerry Ridall, M.S., CCC-SLP


Lori Romig
20 Breeze Knolls Drive
Catawissa, PA 17820

Developmental Language
Disorder (315.31)



XX received Speech and Language services at Southern Columbia Area Elementary School
during the 2014-2015 school year. XXs mother is interested in continuing services for the
XX is a 7 year old male. XX and his twin brother were born at 36 weeks gestational following a
high risk pregnancy. XX began receiving Speech and Language support services in November of
2014 at SCA targeting receptive and expressive language. The initial evaluation on November
11th, 2014 indicated a mixed language disorder. XX scored in the 0.5 percentile with a standard
score of 61 on the Core Language Composite Score on the Clinical Evaluation of Language
Fundamentals- Preschool (CELF-P2). He scored in the 0.1 percentile for the Receptive Language
Index with a standard score of 53 and 0.3 percentile rank for the Expressive Language Index
with a standard score of 59. XX exhibited difficulties with understanding spoken sentences and
directions. He presents with limited verbal expression. XX exhibited difficulty with all
phonological awareness tasks. XX was re-evaluated in April 2015 and was identified with an
intellectual disability. He achieved an overall IQ score of 62. XXs speech and language goals
for the current school based IEP target receptive language (categorization, following directions,
basic concepts), phonological awareness skills (identifying initial and final sounds in words), and
expressive language (identifying items as same and different and expressing why). XX
received services in the Life Skills classroom for portions of the school day.
Parent Interview and Questionnaire
During the parent interview XXs mother, Lori, reported that XX and his twin brother interacted
well together. Lori felt that XX offers up very little information because he is afraid of being
incorrect. She feels that he works well with other children. When asked if she felt her child had
made any improvements in communication over the past year, Lori reported that she
felt he was talking more, but that it takes him time to get warmed up to someone because he is
bashful. XXs mother indicated that her biggest concern for her sons communication is that

she wants him to be able to have a full conversation with her. She also reported that XX is
motivated by the use of the iPad and that he prefers manipulatives and hands-on activities.
Record Review
XX received Early Intervention services at the Susquehanna Valley Child Development
Center for three years prior to beginning kindergarten. Services through the Child Development
Center were discontinued as Mrs. Romig felt they were no longer necessary. XX passed a
hearing screening on 02/04/2015. XX achieved an overall IQ Score of 62 on the Wechsler
Intelligence Scale for Children- Fourth Edition (WISC-IV), as reported by the school
psychologist. It is reported that his verbal reasoning abilities as measured by the Verbal
Comprehension Index are within the Intellectual Disability range with a standard score of 57. He
achieved a standard score of 79, which is the 8th percentile, for nonverbal reasoning skills as
measured by the Perceptual Reasoning Index. XX received a standard score of 68, which is the
2nd percentile on the Processing Speed Index. On the Wechsler Individual Achievement TestThird Edition (WIAT-III) he achieved a standard score of 74 for Early Reading Skills. He
exhibited difficulty with rhyming, identifying initial and final phonemes, blending sounds to
form words, and matching pictures to simple words. XX achieved a standard score of 71 on the
composite score for Written Expression.
The Speech and Language report indicated that XX demonstrated slight improvement
when following simple directions containing location terms and identifying attributes through
pointing. He demonstrated an increase in his knowledge of the basic concepts same and
different after extensive focus and instruction. He benefits from repeated exposure to recentlytaught concepts. It was noted that over-teaching was required for all of the above goals. Due to
the significant decrease in complexity during teaching sessions, new goals were proposed to
target identifying initial and final phonemes, identifying items as the same and different and
expressing why, following directions containing location terms, categorization, and identifying
basic concepts. In the most recent probes for these goals, XX achieved 70% accuracy when
identifying basic concepts. He identified the initial and final phonemes in words with 60% and
20% accuracy, respectively. XX followed directions containing location terms with 60%
accuracy. XX required 3 clinician prompts to identify items as the same and express why and
required 4 clinician prompts to identify and explain why items were different. He required the
use of a carrier phrase and phrase completions to assist in this task. In the most recent probe, XX
categorized items with 90% accuracy. It is reported that during teaching sessions, XX required
multiple repetitions of concepts. His accuracy increased when verbal prompts, visual cues,
phrase completions, binary choice, and direct models are utilized.
Evaluation Completed at Bloomsburg University Speech, Language and Hearing Clinic on
June 26th, 2015 included the following:
Spontaneous Speech Sample/Story Retell
To obtain a spontaneous speech sample, XX was provided with sequencing cards as well as
provided a short narrative regarding the scenes depicted in the cards. XX was then prompted to
retell the story. The speech sample was then transcribed and analyzed through the SALT
program. XXs speech sample was compared to a database that contained 87 participants with an
age range of 6;7-7;7. It was noted that XX displayed significant difficulty with this task and
often responded with I dont know.

Standard Measures Report

The standard measures report indicated that XXs MLU in words and morphemes were 2.70 and
3.00, respectively. These MLUs are 4 standard deviations below the mean for both words and
morphemes. XX utilized 33 different words, which is 1.83 standard deviations below the mean.
His number of total words was 73, which is 1.47 standard deviations below his age matched
peers. XX was fully intelligible throughout the sample. His verbal facility and rate were within
the normal range when compared to the database.
Word Lists, Bound Morphemes, and Utterance Distribution Report
The results of this report indicated that XX utilized fewer conjunctions than his database peers.
He utilized two types, which falls 1.71 standard deviations below the mean. When producing the
ing morpheme, XX often produced this morpheme as /n/. However, this is an acceptable
dialectal difference. He utilized 8 negatives, which is 1.46 standard deviations above his peers.
This is likely due to the fact that a majority of XXs responses were I dont know. XX was in
the normal range for use of personal pronouns and bound morphemes.
Maze Summary
XX utilized fewer mazes than the database participants. This is likely attributed to the limited
output that XX provided during the sample. He was within the range of normal when compared
to age matched peers in regards to revisions, repetitions, and filled pauses.
Subordination Index
XX achieved an overall subordination index of 0.75, which is 3.41 standard deviations below the
mean. The subordination index analyzes the complexity of language based on the number of
clauses within a unit. XX produced 6 utterances that received a subordination index of 0. This is
6.86 standard deviations below the mean. XX failed to produce any utterances containing more
than one clause. This portion of the analysis falls 1.40 standard deviations below the database
Omissions and Error Codes Report
XX produced three word level errors. XX incorrectly utilize a for an when he said, He was
eatin a apple. He utilized incorrect verb conjugation when he said, He startin eat the apple.
Oral Mechanism Exam
The results of the oral mechanism exam were unremarkable. XX exhibited normal symmetry and
functional movements of the articulators (lips, tongue, and palate). Dentition was adequate. All
mechanisms functioned adequately for speech production.
Functional Communication Profile
XX displays distractibility and variable levels of difficulty attending to tasks presented as well as
signs of fatigue as the session progressed. XX presents with a moderately delayed response rate.
He exhibited a moderate to severe impairment in receptive language. XX understands limited
basic concepts. He responded to simple, direct language by answering questions and following
directions, but was unable to process more complex language. XX exhibited a severe expressive
language impairment. His verbal output was limited and often contained only 1 word or the
phrase I dont know. The communication profile indicated a mild deficit in pragmatic skills.
XX responds when spoken to, but refrains from initiating conversation. He engages in turn
taking, but keeps from continuing a conversation. He exhibited some articulation errors. He
produced /jlo/ as /llo/. XX also produced the // and // as the /f/ phoneme as well as
distortions with clusters. His motor, behavioral, voice, oral mechanism, and fluency abilities are

within the normal range. It should be noted that the Functional Communication Profile is a
subjective checklist.
Probes of Previous IEP Goals
Formal probes of XXs previous goals from his IEP at Southern Columbia Area School District
were conducted. XX was provided with various animals and asked to place them in the correct
category by where they would be found (e.g., zoo, house pet, farm). He achieved 60% accuracy
(6/10) on this task. XX was required to follow one-step directions containing location terms in
which he achieved 60% accuracy (6/10). XX identified initial and final sounds in words with
50% accuracy (5/10) and 10% accuracy (1/10) respectively. When asked to identify items as the
same or different, XX identified items as the same and expressed why with 70% accuracy
(7/10). He identified items as different and provided an explanation with 40% accuracy (4/10).
XX identified basic concepts with 80% accuracy (8/10).
XX was reluctance to participate in the beginning of the session. After he became comfortable
with the setting and rapport was established, XX actively participated in all assessment tasks. XX
demonstrated variable levels of attention throughout the assessment period. He utilized limited
verbal output and often repeated what was heard. XX worked very hard throughout the session..
XX demonstrates a severe receptive and expressive language delay. XXs accuracy increases
during activities when extensive prompting is utilized. He benefits from the use of visual cues,
verbal prompts, phrase completions, phonemic cues, a binary choice, and direct modeling. XX
exhibits difficulty when identifying final phonemes in words. He exhibits difficulty with
narrative retell. XX demonstrates success when identifying basic concepts. It is suggested that
XX continue speech and language services to target receptive and expressive language to
increase communication effectiveness.
Date: July 30, 2015
XX was originally evaluated on June 26, 2015 and has participated in four therapy sessions at
this time. Refer to daily log entries for further details. The following information is a summary of
data collected through diagnostic therapy sessions during the Summer 2015 session at
Bloomsburg University Speech, Language and Hearing Clinic.
XX demonstrated progress throughout the semester. He exhibited distractibility and fatigue
throughout therapy sessions. XX often responded to questions with I dont know when he was
not confident in his response. XXs off task behaviors included becoming preoccupied with
reinforcement materials that were provided. However, XX was easily redirected to the activity.
XX actively participated in all therapy activities.

The following objectives were met during the Summer 2015 semester:
XX will increase his expressive language by identifying items as the same or
different and express why during 70% of attempts across three therapy sessions.
XX will identify initial phonemes in words with 70% accuracy across two therapy
XX will follow one step directions containing location terms with 70% accuracy across
two therapy sessions.
XX has made progress throughout the Summer 2015 semester. He is currently identifying basic
concepts with an average of 60% accuracy. XX has increased his accuracy for identify
subordinate items in a category (60%). He has increased his ability to identify final phonemes in
words (54%). During these tasks, he benefits from the use of verbal prompts, visual cues, phrase
completions, phonemic cues, binary choice, and direct models.
# of Sessions Scheduled: 4
# of Sessions Attended: 4
% of Sessions Attended: 100%
It is recommended that XX receive speech and language therapy twice a week for fifty
minutes sessions at the Bloomsburg University Speech, Language and Hearing Clinic
during the Fall 2015 semester.
Therapy should target:
o Identifying items as the same and different and expressing why
o Identifying initial and final phonemes in words
o Identifying basic concepts (e.g., attributes, quantitative terms)
o Following one step directions containing location terms
o Identifying three items within a subordinate category
Stephanie L. Fowler, B.S.
Graduate Student Clinician

Kerry Ridall, M.S., CCC-SLP
Clinical Supervisor