Speech-language and listening assessment summary report

(Not for forensic or medico-legal purposes)

Name & Surname Bumi Mkondweni

Date of Birth 24 April 2015
Grade R
School Hands On
Home language English
Language of Learning and Teaching English
Date of Initial Assessment 9 November 2022
Language(s) assessment was English
conducted in
Diagnosis Down Syndrome

1. Background Information

Bumi was referred for an assessment and speech therapy intervention by his
mum due to him being delayed with his speech and language acquisition.

Bumi was born via a caesarean section at 37 weeks, weighing 3,3kg.

Jaundice was reported during the neonatal period. Bumi was born with a
ventricular septal defect which was corrected with surgery.

According to his mum, Bumi is an incredibly social child who loves interacting
with people.

Bumi previously attended New England Pre-primary where his mum reports
seeing pleasing growth.
2. Communication functioning of the child

A play based assessment using both formal assessment instruments as well as

informal structured observations were used to obtain a general overview of
Bumi’s current level of functioning with regard to his current speech
production (articulation)-, listening- and language skills.

It is important to keep in mind that the formal assessment results are not
necessarily a direct reflection of Bumi’s everyday functioning in his natural
context. It is however an indication of level of functioning on a specific day
and within a specific context. It is used together with functional information
available to determine the need for treatment, obtain baseline data in order
to quantify progress and to ground outcome based service delivery.
2.1 Listening Skills

The CHRIB Listening Scale was used to assess Bumi’s listening skills. Bumi
responded consistently to speech and non-speech sounds, such as toys.
Bumi’s reaction to localization of sound is immediate and clear. Regarding his
listening behaviour, his responses are consistent and his overall listening
behaviour is good.
2.2 Language Comprehension

The Rossetti Infant-Toddler Language Scale (RITLS) was used to assess Bumi’s
comprehension skills. Bumi is able to follow 3-step commands, identify parts of
an object and responds to wh- questions.
2.3 Communication skills

Regulating the behaviour of another person:

Not observed

Social interaction:
Bumi willingly interacts with those around him. His interaction skills are age-
appropriate.

Shared communication / Joint attention

Bumi is able to maintain joint attention when the toys were those that
interested him. He particularly enjoyed the play dough, blocks and farm
animals.

Eye contact:
Bumi is able to make and maintain eye contact during his interactions.

Turn-taking:
Bumi is able to take turns appropriately while engaging in play. He is also able
to take turns when engaging in conversation.

List of gestures:
 Pointing
 Showing
 Waving
 Hugs
 Shakes head for ‘yes’ and ‘no’
 Slaps a palm in response to “give me five”
 Pretends to speak on the telephone
 Pretends to write or type

Gestural developmental level:

The RITLS was used to assess Bumi’s gestural development. His gestural
development is on a 24-27 month old level. This is the highest level assessed
by the tool. While Bumi is able to use gestures effectively, this should no longer
be one of his main ways of communicating.

Pragmatic developmental level:

The RITLS also assessed Bumi’s pragmatic skills. He is able to engage in adult-
like dialogue, use some words or sounds during play and when interacting
with people, he can take turns during conversation and during pretend play
and he can maintain eye contact.

Bumi is in the combining words stage of communicating. He is able to

combine words to make a sentence. His sentences had adult-like intonation.
His communication skills are delayed.

2.4 Oral-facial structure

No abnormalities were observed.
2.5 Oral-motor skills

Skills for voluntary movements:

Bumi’s oral-motor skills are not appropriate for speech purposes. He presents
with a decreased range of movement, as well as strength, which will affect
his ability to accurately articulate sounds. This is to be expected.

Skills for feeding:

Bumi is able to feed himself using his hands and a spoon. No concerns were
reported regarding Bumi’s dentition as he is able to bite and chew. No
concerns regarding feeding have been reported.

2.6 Speech sound development

Phonetic repertoire:
 Vowels: [i] [e] [ε] [α] [æ] [ǝ] [u] [o] [a] [œ]
 Diphthongs: [ow] [oo] [oy] [ou]
 Consonants:
 Plosives: [p] [b] [t] [d] [k] [g]
 Fricatives: [h] [j] [x] [w] [f] [l] [s] [ð] [Ɵ] [ʒ] [ʧ] [ʤ] [r]
 Nasals: [m] [n] [ŋ]

Syllable structure:
Bumi used vowels and consonants.

Phonological processes:
Final consonant deletion / cluster reduction / syllable reduction/
reduplication / backing / fronting / assimilation / distortion/diminunisation

Bumi’s speech sound development is currently delayed. He is able to imitate

all sounds immediately after they have been produced by the therapist but
he is often unable to retain this information for later use. The phonological
processes should have disappeared by now. His speech has phonological
processes and he uses his own made up words or sounds on occasion. This
may make his speech slightly difficult to understand by people outside of his
immediate environment.

2.7 Verbal expression

The RITLS was used to assess Bumi’s verbal expression. Bumi’s verbal expression
skills are severely delayed. Bumi is able to use some pronouns, ask
spontaneous questions and use negative statements. He is able to speak in
phrasess that have an adult-like intonation. Bumi is able to name colours and
various objects. However, he often relies on gestures and sounds when
naming objects or expressing himself. This is not age-appropriate as he should
be able to communicate using sentences.

Child’s imitation skills:

Bumi is able to imitate basic colours, body parts and clothing. He showed
willingness to learn.

Word class analysis: give examples

Nouns Verbs Descriptive Location Social words

words words
Horsie Eat Yellow In the box Hello
Box Cutting Pink Put away Good
Duckys Come Purple What’s in here
Circles Green
Red
Blue

Phrase structures:
 What’s that?
 Put away
 Run away
 I put it
 No, no

Sentences:
 I can do it
 It’s too hard
 The horsies run away
 I can make it
 That’s a circle
 Where’s the spoon?

2.8 Phonological awareness

Bumi’s phonological awareness is limited. Phonological awareness skills have
an important role in the development of literacy skills. Phonological skills are
required to enable a child to acquire reading skills. This should be monitored.
2.9 Emergent literacy skills

Bumi’s emergent literacy skills were assessed using the CHRIB Emergent
Literacy Development Checklist. Bumi is able to carry a book without any
assistance and he is able to switch between different activity books. He is
able to point at pictures in the book and had no difficulty paging through the
book from left to right. He is able to differentiate between pictures and print.
In terms of Bumi’s developmental sequence for writing, Bumi is able to
scribble and copy lines and circles. He could not however, copy a cross,
block, triangle or diamond shape.
Summary of Level 2: Communication functioning of the child

Bumi’s communication functioning is delayed. He mostly communicates using

sounds and gestures and this sometimes makes him difficult to understand. His
speech is also sometimes distorted due to his decreased range of movement
and strength in his oral musculature.
3. General development of the child
3.1 Sensory processing

Bumi did not present with any signs of a sensory processing disorder. Bumi is
able to adapt to the environment and remain calm for the duration of his
assessment. No visual acuity problems were observed during Bumi’s
assessment.
3.2 Perceptual-cognitive level

According to the Developmental Activities Screening Inventory (DASI) Bumi’s

perceptual-cognitive skills are on a 36-41 month old level. He is able to make
patterns, point to pictures and count.
3.3 Social-emotional level

Bumi’s social-emotional level is on 40-42 months according to the DAS, which

is delayed for his age.
3.4 Description of behaviour

Bumi enjoyed playing and communicating during the assessment. He was

initially shy but quickly overcame this as he began playing. He was very
attentive initially and showed intent during the assessment. Bumi quickly loses
interest in a task and becomes bored, losing focus. He is easily refocused
when the activity is adjusted. Bumi is a sociable child who happily engaged
with the therapist for the duration of the assessment.
3.5 Play

The RITLS was used to assess Bumi’s play skills. Bumi’s play skills are currently at
a 33-36 month old level which is slightly delayed.
3.6 Gross motor level
The DAS places Bumi’s gross motor development at a 37-39 month old level.
3.7 Fine motor level

According to the DAS, Bumi’s fine motor skills are at a level of 37-39 months
old.
3.8 Self-help skills
Bumi’s self-help skills were assessed using the DAS. His self-help skills are on a
49-51month old level.
Summary of level 3: General development of the child

Bumi currently does not present with any signs of sensory processing disorder.
His general development is considered to be slightly delayed.
Recommendations:

 It is recommended that Bumi continues receiving weekly intervention.

Conclusion:

Bumi’s speech, language and communication are currently delayed. He

enjoys interacting with others, although he gets frustrated at times when
people around him do not understand what he is trying to communicate. His
use of phonological processes and made up words may make his speech
somewhat difficult to understand and should be monitored. Bumi has come a
long way since I initially began seeing him. His concentration and ability to
concentrate during formal assessments has greatly improved. Bumi is a lovely
little boy and it was an absolute pleasure to assess him.
Please do not hesitate to contact me should you have any questions.

Kind regards,

Tamlyn Anderson (Speech Therapist)