Cabinet Logopedic Interscolar Nr.

2 Nr fisa____7______
Colegiul National J. Monnet , Ploiesti Data. __6.10. 2011__

FISA LOGOPEDICA DE EXAMINARE COMPLEXA

I. Date personale :
Numele si prenumele: __D.O.__________________________ Data nasterii:
_20.08.2005_______________
Domiciliul: _Ploiesti__________________ Strada _Dealu cu Piatra______________________Nr.__________
Blocul _______ Scara ________Etaj________ Apart.________Telefon______________________________
Gradinita / Scoala____51___________ Grupa / Clasa__preg._____ Ed./ Inv.___G.Maria_________________
Trimis de:_____revine in terapie____________________________________________________________
II. Date familiale :
Tatal : Vrsta :____34______Ocupatia :_tehnician________Locul de munca :_Proconstruct______________
Mama : Varsta : ___35___Ocupatia :__asistent medical____Locul de munca :___casnica_________________
Numarul membrilor familiei :__3___, Al catelea copil este :_____primul_____________________________
Relatii in familie :___bune, armonioase_________________________________________________________
Starea sanatatii membrilor familiei : __buna______________________________________________________
Tulburari de limbaj in familie :_____rudele pe cale paterna (frati, unchi)___________________________
III. Evolutia copilului:
Sarcina:____normala _________Nasterea:_ normala, la termen ___________________________________
Mersul nesustinut:__la 1 an_____Primele cuvinte:___9 luni______ Vorbirea in propozitii:_____la 3 ani_____
IV. Examen medical:
____impune investigatii neuropsihiatrice______________________________________________________
______________________________________________________________________________________
V. Examen psihologic:
Organizarea spatiala :_nu se orienteaza spatial___________________________________________________
Organizare temporala:_mai buna decat cea spatiala________________________________________________
Lateralitatea :mana__dreapta_____picior_drept_____ochi_stang_______ureche_stanga___________________
Lateralitate dominanta : _____incrucisata ________________________________________________________
Comportamentul in familie : _____atasat de mama_________________________________________________
Comportamentul in colectivitate :___usor agresiv__________________________________________________
Trasaturi de personalitate :__hiperkinezie, irascibilitate, uneori agresivitate____________________________
VI. Traseul educational (scolar) parcurs :
Gradinita :__nr. 51(al 2-lea an )_____________________________________________________________
Scoala :__________________________________________________________________________________
Logopedie :____CLI Nr 5, CLI Nr. 2_________________________________________________________
VII. Examen logopedic :
Aparitia tulburarilor de limbaj :_in ontogeneza____________________________________________________
Cauze posibile :__transmitere ereditara pe cale paterna_____________________________________________
__disfunctie psihica________________________________________________________________________
__hipoacuzie____________________________________________________________________________
Pronuntarea independenta a sunetelor :__recidiveaza pe vibranta R_________________________________
Pronuntarea dupa model a sunetelor:__deficiente de perceptie a sunetelor_____________________________
Pronuntarea silabelor:_apare uneori metateza, contopiri de sunete____________________________________
Sunete afectate:_R__________________________________________________________________________
Calitatea vocii:__buna_______________________________________________________________________
Motricitatea generala:___hiperkinezie__________________________________________________________
Motricitatea faciala:___buna_________________________________________________________________
Motricitatea linguala :__deficitara_____________________________________________________________
Conformatia aparatului fono-articulator :__fren lingual usor scurt____________________________________
Valul palatin :__usor adanc__________________________________________________________________
Dentitia :___de lapte_______________________________________________________________________
Respiratia :_normala_________________________________________________________________________
Auzul fonematic :___deficitar ______________________________________________________________
Ritmul si fluenta vorbirii :___uneori alert______________________________________________________
Scriere- Copiere : _____________________________________________________________________ _
- Dictare :__________________________________________________________________________
- Compunere :_______________________________________________________________________
Citire :___________________________________________________________________________________
Diagnostic
logopedic :__dislalie___________________________________________________________________
Indicatii privind activitatea de corectare :__continuarea terapiei logopedice_______________________
_________________________________________________________________________________________
VII. Alte date :
Durata terapiei logopedice : __________________________________________________________________
Incadrarea in colectiv dupa corectare sau ameliorare :__mult mai buna________________________________
Recomandari pentru familie :__sa repete acasa___________________________________________________
Prezentarea cazului la incheierea activitatii :_corectat___________________________________________
_________________________________________________________________________________________

SEMNATURA PROFESOR LOGOPED :

NUT CORINA