Speech and language evaluation

Name of the child:

Date of birth:
Date of the evaluation:

Referral cause
Background information:
Personal informations and family background (age, siblings…)
Medical background (pregnancy, medications, surgeries, if parents are relatives)
Speech and motor development information (therapies before?)
Educational background
Linguistic background (L1 L2, native language, 2nd language… type of
stimulation)

Behavioral observations:
Eg.calm, cooperative, engaged in the activities, his attitude, shy social, aggressive,
if he shows interests, task refusal, interactive, incooperative, inappropriate
behaviors, hyperactive, excited, confident

Speech and language assessment:

Non-verbal communication skills

- Eye contact
- Visual pursuit or visual tracking
- Joint attention
- Vocal and gesture imitation
- Responding to sounds/name
 - Pointing
- Gestures
- Facial expressions
- Demand or request
- Sharing
Assessment : eg. play situation

Preverbal skills
Crying, vocalizations, onomatopee, babbling,

Oral language
Expressive skills
Free conversation
Praxis (facial muscles )
Articulation (assessment syllable repetition)
Phonology (words and non words repetition, mention the errors and analyze them, intelligible or
unintelligible)
Vocabulary (nouns verbs adjectives: frequent less frequent familiar non familiar)
Syntax (sentence structure, word order, sentence length and type)
Morphosyntax (verb tense, gender morpheme, nbr morpheme, negative form, prepositions,
pronouns)
Material : cards, play situation, books flash cards, pictures, sequential stories (all depends on the
kids level)

Receptive language skills

Vocab
Syntax ( questions, simple instructions, complex intructions..)
Morphosyntax
Assessment : pointing, choosing the good card

Pragmatics
Description (initiate conversation, same subject, requesting commanding, eye contat, sentence
structure, coherence, ideas, appropriate communication, )

Assessement: observing the child in different situations

Cognitive and perceptive skills

- Hand eye coordination
- Objects permanence
- Taking turns
- Auditory attention
- Visual attention
- Interests
- Type of play and level of symbolization (pretend play, symbolic play, exploration…)
- Problem solving
Assessment: Play situation

Summary and impressions:

Work plan

Recommendations:
Here are some recommendations that could help in class:

Speech and language report

Last name:
Name:
Date of birth:
Referral cause:
Date of the assessment:

Anamnesis:

Behavioral observations:

Speech and language assessment:

The assessment was based on,
Articulation:
Vocabulary:
Syntax:

Pragmatic skills:

Receptive language

Conclusion:

Speech and language pathologist