CLINIC NAME ES CASE NUMBER | PARENT(S) [eames NALUANON | ADDRESS EE CLINICIANS: Es Ea BES Laura Nygard, B.S. TELEPHONE EEE SUPERVISOR: es BIRTHDATE [ea Icb-10 CODE F80.0. F80.1 COMMUNICATION Phonological Disorder cPrcopt 92523 DIAGNOSIS: COMMUNICATION EVALUATION SUMMARY BACKGROUND AND RELATED INFORMATION RE is = female who was referred ET Spech-L on by her parents due to concerns over possible reading delays and difficulties producing (tag), /k! (cat) /6/ (hing) and if! (ship). She lives at home with her parents and 3 sili == BSS. and MBS According to parent report. her two oldest siblings exhibited similar speech errors. bu lly grew out of them. She is currently homeschooled by her mother and is in the first grade. III is teased by peers and siblings when speaking, due to her error sounds. She has not received speech-language services in the past. began babbling at § months and spoke her frst word at 8 months. Mrs. il reported that has been working on her reading skills for several years, and is struggling to make progress. They have been using the reading program ~All about Reading.” and fis currently at level one which works on sounding out words in isolation, sentences and passa reports that she enjoys reading, but gets frustrated when she is unable to sound outa word, She also enjoys when her mother reads to her, specifically when she reads the Harry Poiter books. AIEEE nother has no concerns about her reading comprehension skills Mrs. MMMM stated that she did not experience any complications during presnancy. AIM has not had any major illnesses or accidents, besides a resistant ear infection at $ months old. His worth noting that she was born with a “tongue-tie™ which was clipped during her frst week of TieASSESSMENT INFORMATION Observations: IERIE is an extremely: cooperative year-old who followed direetions well, and easily stayed on task. Speech: EEE completed the Goldman-Fristoe Test of Articulation. 3% edition (GFTA-3) t0 assess her articulation abilities during sounds-in-words and souncs-in-sentences tasks, She earned a standard score of 65 for sounds-in-words and a standard score of 88 for sounds-in-sentences. Standard scores on the GFTA ate based on an average of 100 with a standard deviation of 15, meaning that scores that fall within the 85-115 range are considered average or within normal limits, Her sounds in words score was outside of the normative range. IEE exhibited a phonological process called fronting, which is where a child replaces a sound made in the back of the mouth, with a sound made in the front of the mouth (ex. /U for /k/). This phonological process is not typically present in children past the age of 3:5 She also exhibited stopping, which is where the sound is quite literally stopped (ex: “pan” for “fan” ‘This phonological process is typically not seen in children past age S. The final phonological process = exhibited was depalatalization, This is where a child should be producing the sound at the location of the hard palate, but instead is producing it elsewhere. This phonological process is not typically present in children past age 5. Specific sounds in error during these processes are displayed below. ‘Target Sound I Errors Exhibited Examples from GFTA-3 TEI (eat) ——Tirtep) - igi (goal) Tid date) [7 [/ship) Jsh(sit) ids /Gudge) “Lisrsit) oO 7a (date) - isi(sit) Language: III completed the Comprehensive Test of Phonological Processing (CTOPP) to assess her phonologieal awareness sill in real-ord and non-word situations, The standard scores for each subtest are reported below. Standardization for this portion of the test had a mean of 10 with a standard deviation of 2. “Subtest - Elision Blending Words Non-word Repetition say Within normal limits Blending Non-words_| _ put these sounds together /v/, ‘ov. (p Within normal limit nenting Words say pig: say each sound inthe word — | — Within normal limits) ‘of the Sounds “Segmenting Non-words | say es: now tell me ea. thin nor nits] ‘The seores above indicate that scored within the «pica ange fora child her age on every ‘subtest but elision. where she scored 4 points below the average. Hlision is an omission of a sound or a eile from a word, For example. MMIII ws wea aay the word tn, then she wax ashe to au Soe mn tina tha Ws Po ansiory tees wrens bar, live md bending Aah icon eee eats eed petnciagped manga scorpion, tad i! Famag toe ec aad segmenting non-words were combined to form an alternate phonological awareness composite ‘These scores are based off a normal curve. with a mean of 100 and standard deviation of 15. Phonological awareness composite sore iva 94. and her aerate ph core nological awareness score is a 103.which both fall within normal limits. Due to parent concem about reading. further evaluation can be completed upon start of intervention A conversation based language sample was transcribed and analyzed using Sampling Utterances and Grammatical Analysis Revised (SUGAR). This analysis yields data that is compared to the normative ranges for the child’s age. The chart below shows the measures analyzed. the normative range and HR sor: ‘Measure ‘Normative Range ___Interpretation (Total Number of Words |~—(310-418) ~ [Below normal fimits Mean Length Utterance | (6.87-9.51) ——_ | Within normal limits Words Per Sentence (779.75) — | Below normal Clauses Per Sentence a - - Below normal limits In order for a child to pass the SUGAR analysis. they need to be within normal limits for 3 out of 4 of the above measures. Although, scored outside of normal limits on 3 out of 4 measures, she was exceptionally close to the being within range. Her language functioning should be continually monitored throughout therapy, with another language sample being taken in the Future Oral Mechanism Examinati n oral mechanism examination was performed. The structure and function of I oral mechanism appears to be adequate for speech production Literacy: Literacy was informally assessed during the parent/child intervie. A enjoys being read to, however she struggles with reading independently. EEE explained that it is challenging for her to sound out the words. Mrs. IMJ does not report any reading comprehension concerns. The CTOPP was used to assess some phonological processing shills important for reading. These results can be found in the language section of the report. Further assessment of literacy should be completed during intervention. Fluency: Over the course of a 60-minute evaluation. no dysfluencies were noted. Voice: SEE demonstrated age appropriate pitch and duration throughout the evaluation. It was worth noting that she demonstrated low intensity (spoke in a quict voice) throughout session. This could be attributed to shyness, and is not a concern at this time. Hearing: fell within normal limits on all measures of an audiological sereening completed at (he TT Audiology Clinic, IMPRESSION HERE was able to stay on task throughout the entirety of the diagnostic session and was able to follow directions during structured tasks. Overall, her language and social shills were a relative strength, Areas of relative weakness included phonological processing errors (fronting, stopping. and depalatalization.) which are occurring past the expected age. Speech sound errors have negatively impacted intelligibility and, reportedly. relationships with siblings. Phonological awareness deliits for elision (being able to restate a word minus @ given sound or spHlable) were also noted, which ean impact reading development. No formal reading assessment was completed. A language sample revealed lower scores on measures of total number of words used, words per sentence, and clauses per sentence. Mean length of utterance was a strength for