Communication Repair Assessment Report

Student Reagan Age: 13 years

The client was born with an infection that resulted in the administration of ototoxic medication.
As she was in the Philippines, there was no diagnosis of her hearing at the time. At 1:6 Rhegan
came to the U.S. and was diagnosed with bilateral, severe to profound sensorineural hearing loss.
At 3:0 she was fitted with hearing aids. Rhegan discontinued wearing it and was educated in a
self-contained classroom where the teachers and students used signed and spoken language.
Rhegan’s primary mode of communication was total communication. At the age of 4, Rhegan
received a unilateral cochlear implant and continued use of a hearing aid on the contralateral ear.
Rhegan has been since been educated in self-contained classrooms with teachers and children
who communicate via total communication. She received speech-language and itinerant support
services in school. In fourth grade, Rhegan discontinued use of her cochlear implant due to
reported discomfort, headaches and perception of loudness distortion. She uses her hearing aid
and an FM system in the classroom.

Communication Repair
Due to her hearing loss, Reagan suffers communication breakdowns when communication is too
fast, too low in volume or in a crowded area. The Script Inventory showed Reagan is adept at
using the Repetition technique, especially slow and clear repetition. However, of the 10 repair
strategies available, Reagan only utilized 6. She struggled especially with the Revision
techniques, only using alternate words once. On the SCRIPT Inventory, Reagan repairs were
classified as Repetition - 100%; Revision - 7%; Addition - 33%; Inappropriate - 40%; Nonverbal
- 20%.
When speaking, Reagan has multiple phonological processes she is either unaware of or makes
no attempt to repair, including Final Consonant Deletion, Medial Consonant Deletion, Devoicing
and Fronting. Her voicing is aprosodic, rushed and choppy with lexical stress errors.
She uses short, simple word and suffers from a lack of descriptive words. Reagan appears to be
at Brown's Stage IV for syntax and morphology.
When signing, Reagan consistently used the wrong sign for the intended word (i.e. used the sign
for "room" to mean "box" and "school" for "paper"). She does not follow either ASL or Signed
English syntax and leaves signs she does not know out of sentences.
It would appear as if either her immersion in total communication has left her adapt at neither
verbal communication or signing or she is struggling out of a total communication environment.
Recommendations
Reagan suffered from difficult circumstances given that her hearing was not identified or treated timely
and that her immersion in total communication does not appear to have provided her communication
repair strategies in either English or when signing. While she is adept at slow, clear and loud reputation
when prompted, her other repair strategies seem to be lacking due to her difficulties with syntax,
semantics and morphology.

Due to difficulty with Revision and her lack of vocabulary and difficulty with syntax and morphology, it is
recommended that Reagan being therapy sessions to use alternate words and grammar and to expand
her sentences into 2 sentences.

My objective recommendations are:

 R will alter a sentence's grammatical form 3 times in a conversation in a structured

therapy setting given verbal prompting for 3 consecutive sessions.
 R will use alternate words 3 times in a conversation in a structured therapy setting given
verbal prompting for 3 consecutive sessions.