SPEECH-LANGUAGE THERAPY REPORT

I. IDENTIFYING INFORMATION
Name:
XX XX

Dx:

Parents:
Address:

Date of Report:
Date of Birth:

Expressive Language,
CHARGE Syndrome (759.89)
07 /30/2015
08/30/2006

Clinician:
Supervisor:

Stephanie L. Fowler, B.S.

Kerry Ridall, M.S., CCC-SLP

Phone:

Stephanie XX
29 Levi Street
Bloomsburg, PA 17815
(570) 204-5484

II. REASON FOR SERVICES

XX is an 8 year, 9 month old female who is diagnosed with CHARGE Syndrome, which
includes a heart defect, choanal atresia, respiratory complications, and feeding difficulties
at birth. XX is bilaterally aided due to hearing loss. XX has been identified as having a
submucosal cleft and a bifid uvula. She currently utilizes some American Sign Language
as well as verbalizations, however, her functional communication is unreliable and
inconsistent at the independent level. XX was initially evaluated at the Bloomsburg
Speech, Language and Hearing Clinic on October 28, 2014. She received services in the
Spring 2015 semester that targeted articulation, receptive language, and pragmatics. XX
achieved her goal for producing /k/ in isolation as well as responding to yes/no questions.
She targeted word level correct productions for the /k,g,s/ phonemes, followed simple
one step directions, and maintained eye contact.
III. RESULTS OF PRE-TREATMENT ASSESSMENT
Oral Mechanism Exam
During the oral mechanism exam, a bifid uvula was noted. XX also displayed facial
drooping on the right side. She exhibited reduced tongue strength and reduced range of
motion for the tongue, as well. These findings will impact XXs articulation abilities. Due
to a diagnosed submucous cleft, XX will likely display difficulty producing pressure
consonants. Her productions will likely refrain from being clear and precise. Her clarity
of speech and intelligibility will be largely affected by these findings.
Skilled Clinical Assessment of Receptive Language
During a skilled clinical assessment of receptive language, XX responded to yes/no
questions with 70% accuracy (7/10 opportunities). XX utilized inconsistent responses
during this task. For example, when asked Is your name XX, she responded no. This
further indicates XXs delay in receptive language. When prompted to respond to the
questions, XX responded primarily through verbalizations and gestures in the form of
nodding or shaking her head.

Skilled Clinical Assessment of Expressive Language through Writing

When provided with a picture prompt and asked to write about the picture, XX exhibited
extreme difficulty with this task. She was able to write two words when attempting to
complete this task. She was provided with a picture of a cat in a fish tank. She wrote the
words cat and fish. XX requested assistance when attempting to spell the word
fish. She attempted to use more gestures and words than written communication
during the task. The results of this assessment task indicate a delay in XXs expressive
language through writing and through verbalizations.
Sound Inventory Probe
During a sound inventory probe, XX produced the /s/ phoneme in the initial position of
words with 25% accuracy (1/4 opportunities), the /k/ phoneme in the initial position of
words with 20% accuracy (1/5 opportunities), and the /g/ phoneme in the initial positon
of words with 40% accuracy (2/5 opportunities). She was unable to produce the /s/, /k/,
and /g/ phonemes in the final position of words. She consistently produced the word
go. XX substituted the /d/ for the /g/ phoneme in the initial position of a word on one
occasion. She consistently omitted final sounds in words. She was able to produce the
/s/, /k/, and /g/ phonemes in isolation.
Peabody Picture Vocabulary Test
The Peabody Picture Vocabulary Test 4th Edition (PPVT-4) was administered. XX scored
in the <.1 percentile on this assessment. She achieved a raw score of 59 and a standard
score of 51. The results of this assessment indicate that XX has a severe receptive
language delay with limited knowledge of vocabulary. This will impact her ability to
comprehend spoken messages. XX demonstrated difficulty attending to the assessment
when it was administered. This indicates reduced ability to attend.
IV. THERAPEUTIC OBJECTIVES
The Summer 2015 Semester Plan of Treatment focused on the goal areas of expressive
and receptive communication. For further details refer to the Summer 2015 Semester
Plan of Treatment.
V. THERAPY PROCEDURES
Goal Areas
Expressive Language
/s/, /k/, /g/, /d/ in the initial
position
/s/ in the final position
CVC word shapes
American Sign Language
Receptive Language
Responding to yes/no
questions
Following location
directions

VI. OBSERVABLE BEHAVIORS

Activities
Play Doh
Puzzles
Various Toys
(e.g., farm
animals, dolls,
kitchen set with
plastic food)
Games
Books

Facilitative Techniques
Milieu Teaching
Repetition
Wait Time
Sabotage
Model-Lead-Teach
Natural
Consequence
Think-Aloud
Technique

XX demonstrated consistent progress throughout the semester. XX demonstrated

distractibility during activities and became preoccupied in playing with the materials
provided. She often required multiple prompts to produce the desired vocalization or
sign. XXs off task behaviors also included leaving one activity to pursue another before
it was finished, however she was easily redirected to tasks. XX actively participated in all
therapy activities.
VII. CURRENT STATUS
The following objectives were met during the Summer 2015 semester.
XX will produce the /s/ phoneme in the final position of words with 60%
accuracy across three therapy sessions.
XX will produce the /g/ phoneme in the initial position of words with 60%
accuracy across three therapy sessions.
XX will increase her communicative effectiveness through spoken language by
producing CVC words with 60% accuracy.
XX will increase functional vocabulary through the use of American Sign
Language to 15 signs.
Progress has been made in the following objective areas in the Summer 2015 semester.
XX will produce the /s/ phoneme in the initial position of words with 60%
accuracy across three therapy sessions.
Current Status: 32%
XX will produce the /k/ phoneme in the initial position of words with 60%
accuracy across three therapy sessions.
Current Status: 20%
XX will produce the /d/ phoneme in the initial position of words with 60%
accuracy across three therapy sessions.
Current Status: 45%
XX will correctly follow one-step directions containing location terms in 4 out of
5 opportunities across three therapy sessions.
Current Status: 3 out of 5
XX will correctly answer yes/no questions through verbal output, gesture, or sign
with 80% accuracy across three therapy sessions.
Current Status: 67%
XX benefits from the use of visual cues, verbal prompts, phonemic cues, and direct
models to increase her accuracy for the objectives listed above. She increased her ability
to produce the CVC word shape. XX improved her articulation abilities for the /s/, /k/,
/g/, and /d/ phonemes in the initial position, as well as, /s/ in the final position. She
demonstrated progress in her ability to respond to yes/no questions and to follow
directions containing location terms.

VIII. RECOMMENDATIONS
1. It is recommended that XX receive speech and language therapy at Bloomsburg
University Speech, Language and Hearing Clinic for two fifty-minute sessions per
week during the Fall 2015 semester.
2. Therapy should continue to target:
o Producing CVC word shapes
o Producing the /s/, /k/, /g/, and /d/ phonemes in the initial position, and /s/
in the final position.
o Increasing receptive language skills by correctly answering yes/no
questions and following one-step directions containing location terms.
IX. SEMESTER DATA
# of Sessions Scheduled: 14
# of Sessions Attended: 10
% of Sessions Attended: 71%

__________________________
Stephanie L. Fowler, B.S.
Graduate Student Clinician

______________________________
Kerry Ridall, M.S., CCC-SLP
Clinical Supervisor