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Appendix o Observation Assessment 2015
Appendix o Observation Assessment 2015
45min
Other _____
SERVICE PROVIDED TO: adult
30min
20min
adolescent
children
infant
SELECT INTERVENTION TYPE: speech
15 min
STUDENT ID
SETTING
SLP NAME
SLP SIGNATURE AND ASHA #
SELECT INTERVENTION AREA : feeding
articulation
AAC
voice
fluency
aural rehabilitation
language
combined
Answer the following questions using narrative style. Use an additional sheet of paper if necessary. Hand this
Form to the clinician delivering the service. Have the clinician sign the form and providing the ASHA account
number.
1. How was the patients case history taken?
3. Do you think all questions asked during the case history were adequate and appropriate given the patient situation?
4. Observe while the clinician provides directions to the patient before and during the assessment process. Which part of the
process cought your attention? Did the instructions seam clear and appropriate to the client situation?
5. What strategies did the clinician use to make sure the patient understood the formal test instructions?
6. Name and describe the formal measures used during the evaluation.
8. Which measures did the clinician took to safeguard the patient answers to avoid anxiety about his performance on the
test/procedure?
9.Observe what happens once the evaluation iscompleted. How does the clinician summarize the patients performance to
parents, family members or to the patient itself?
Prepared by:
Dr. Nydia Bou, Aug/2007, Rev May 2011, Rev. May/2014 Del Valle