LANGUAGE SEVERITY RATING SCALE

Determination of Language Impairment

Student ___________________ School ________________ Grade _____ Date of Rating _______ DOB ________ Age ____ SLT _____________________

FORMAL ASSESSMENT
Comprehensive,
standardized 0 2 3 4
measure(s) and scores: Standard score* of 78 or >1.5 SD below test mean >2 SD below test mean >2.5 SD below test mean
above (standard score between (standard score between (standard score below 62) or
70-77) or 2nd - 6th 62-69) or 1st –2nd below 1st Percentile
Percentile Percentile
At least one of the following At least two of the following At least three of the following
INFORMAL ASSESSMENT areas are deficient areas are deficient areas are deficient
Check descriptive tools 0 2 3 4
used: Language skills are Check areas of weakness: Check areas of weakness: Check areas of weakness:
□ Language/communication within expected range. □ Sentence □ Sentence □ Sentence length/complexity
sample length/complexity length/complexity □ Word order/syntax
□ Checklist(s) □ Word order/syntax □ Word order/syntax □ Vocabulary/semantics
□ Observations □ Vocabulary/semantics □ Vocabulary/semantics □ Word finding
□ Other: _______________ □ Word finding □ Word finding □ Word form/morphology
□ Word form/morphology □ Word form/morphology □ Use of language/pragmatics
□ Use of □ Use of □ Auditory perception
language/pragmatics language/pragmatics
□ Auditory perception □ Auditory perception
FUNCTIONAL/ACADEMIC
LANGUAGE SKILLS 0 2 3 4
Functional/Academic The student performs effectivelyThe student needs more cues, The student does not perform
Language skills within most of the time with little or no
models, explanations, and checks
effectively
on
expected range. assistance required. progress most of the time, despite the provision
or assistance than the typical of general education
student modifications and supports
in class
Instructions: 1. Do not include regional or dialectal differences when scoring.
2. Circle score for the most appropriate description for each category: Formal (Standardized) Assessment and the Informal (Descriptive)
Assessment.
3. Compute the total score and record below.
4. Circle the total score on the bar/scale below to determine the severity rating.

0 2 3 4 5 6 7 8 9 10 11 12 TOTAL SCORE
__________
No Disability Mild Moderate Severe

Based on compilation of the assessment data, this student scores in the Mild, Moderate or Severe range for a Language Disability. ____Yes
____No
There is documentation/supporting evidence of adverse effects of the Language Disability on educational performance. ____Yes
____No
(BOTH STATEMENTS ABOVE MUST BE CHECKED YES)

*Determination of eligibility as a student with Speech and/or Language Impairment is made by the IEP team.
*Standard scores are based on a mean of 100 and a standard deviation of 15. The standard score can be a receptive, expressive or total language quotient.

SPEECH SOUND PRODUCTION SEVERITY RATING SCALE

Determination of Speech Impairment: Articulation

Student ________________________ School ________________________ Grade ______ Date of Rating _______ DOB _______ Age _________ SLT
__________________________

0 1 3 4
Sound Production No sound/phonological Sound errors/ phonological Sound errors/phonological Sound errors/phonological
process errors; errors processes less than one processes one to two years processes two or more years
consistent with normal year below age below age below age
development.
0 1 2 4
Stimulability Most errors stimulable in Most errors stimulable in at Although not correct, most No error sounds are
several contexts least one context errors approximate correct stimulable for correct
production production
0 0 3 4
Oral Motor Oral motor and/or Oral motor and/or Oral motor and/or Oral motor and/or sequencing
and/or sequencing adequate for sequencing difficulties are sequencing difficulties greatly interfere with speech
Motor Sequencing speech production minimal and do not interfere with speech production, use of cues,
contribute to speech production gestures or AD needed
production problems
0 2 4 6
Intelligibility Connected speech is Connected speech is Connected speech Connected speech mostly
intelligible intelligible; some errors sometimes unintelligible unintelligible; gestures/cues
noticeable; more than 80% when context is unknown; usually needed; less than 50%
intelligible 50-80% intelligible intelligible

Instructions: 1. Do not include regional or dialectal differences when scoring.

2. Circle the score for the most appropriate description for each of the four categories, i.e., Sound Production, Stimulability,
Oral Motor, Intelligibility.
3. Compute the total score and record below.
4. Circle the total score on the bar/scale below.

Note: Disability standards for Phonological Processing require ratings at the Moderate, Severe, or Profound Levels of Severity.

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Mild Moderate Severe to Profound
 TOTAL SCORE __________
Based on compilation of the assessment data, this student scores in the Mild, Moderate or Severe range for Speech Sound Production.
____Yes ____No
There is documentation/supporting evidence of adverse effects of the Speech Sound Production on educational performance. ____Yes
____No
(BOTH STATEMENTS ABOVE MUST BE CHECKED YES)
*Determination of eligibility as a student with a Speech and/or Language Impairment is made by IEP Team.

FLUENCY SEVERITY RATING SCALE

Determination of Speech Impairment: Fluency

Student ____________________ School ____________________ Grade ______ Date of Rating _______ DOB _______ Age _________ SLT ________________________

Forma/Informal 0 1
Assessment ___Frequency of dysfluency
is within normal limits for
age, sex and speaking
Frequency
situation and/or
___≤ 2 stuttered words per
minute and/or
___≤ 4 % stuttered words
0 1
___Speech flow and time
patterning are within
Descriptive Assessment normal limits.
Developmental dysfluencies
may be present
2 3
___Transitory dysfluencies ___Frequent dysfluent ___Habitual dysfluent
are observed in speaking behaviors are observed in behaviors are observed in
situations and/or many speaking situations majority of speaking
___3-4 stuttered words per and/or situations and/or
minute and/or ___5-9 stuttered words per ___More than 9 stuttered
___5% to 11% stuttered minute and/or words per minute and/or
words ___12% to 22% stuttered ___≥23% stuttered words
words
2 3
___Whole-word repetitions ___Whole-word repetitions ___Whole-word repetitions
___Part-word repetitions ___Part-word repetitions ___Part-word repetitions
and/or and/or and/or
___Prolongations are ___Prolongations are ___Prolongations are present.
present with no secondary present. Secondary Secondary symptoms
characteristics. Fluent symptoms, including predominant. Avoidance and
speech periods blocking avoidance and frustration behaviors are
predominate physical concomitants may observed.
be observed.
 0 1 2 3
___Speaking rate not ___Speaking rate affected to ___Speaking rate affected to ___Speaking rate affected to
affected mild degree. Rate moderate degree. Rate severe degree and distracting
Speaking Rate difference rarely notable to difference distracting to to listener/observer and/or
observer, listener and/or observer, listener and/or

___60-81 WSM 150-175 ___<59 WSM > 175 WSM

___82-99 WSM 125-150 WSM
WSM

Instructions: 1. Circle the score for the most appropriate description for each of these categories: Frequency, Descriptive Assessment,
Speaking Rate.
2. Compute the total score and record below.
3. Circle the total score on the rating bar/scale below.

2 3 4 5 6 7 8 9
WNL Mild Moderate Severe TOTAL SCORE __________

Based on compilation of the assessment data, this student scores in the Mild, Moderate or Severe range for Fluency disorder. ____Yes
____No
There is documentation/supporting evidence of adverse effects of the Fluency Disability on educational performance. ____Yes ____No
(BOTH STATEMENTS ABOVE MUST BE CHECKED YES)
*Determination of eligibility as a student with a Speech and/or Language Impairment is made by the IEP Team.

VOICE SEVERITY RATING SCALE

Determination of Speech Impairment: Voice
Student ______________________ School ________________________ Grade ______ Date of Rating _______ DOB _______ Age _________
SLT________________________

Pitch 0 1 3
Pitch is within normal limits. There is a noticeable difference There is a persistent, noticeable
which may be intermittent. inappropriate raising or
lowering of pitch for age and
sex.
 .

Intensity 0 1 3
Intensity is within normal limits. There is a noticeable difference in There is persistent, noticeable,
intensity which may be inappropriate increase or decrease
intermittent. in the intensity of speech or the
presence of aphonia.

0 1 3
Quality There is a noticeable difference in There is a noticeable difference in There is persistent, noticeable,
nasality which may be nasality which may be breathiness, glottaltry, harshness,
intermittent. intermittent. hoarseness, tenseness, stridency
or other abnormal quality.

Resonance 0 1 3
Nasality is within normal limits There is a noticeable difference in There is persistent, noticeable cul
nasality which may be de sac, hyper or hyponasality, or
intermittent. mixed nasality.
Instructions: 1. Do not include regional or dialectal differences when scoring.
2. Circle the score for the most appropriate description for each category, i.e., Pitch or Intensity.
3. Compute the total score and record below.
4. Circle the total score on the bar/scale below.

2 3 4 5 6 7 8 9 10 11 12
Mild Moderate to Severe
TOTAL
SCORE__________
Based on compilation of the assessment data, this student scores in the Mild, Moderate or Severe range Voice Disorder. ____Yes ____No
There is documentation/supporting evidence of adverse effects of the Voice disorder on educational performance. ____Yes ____No
(BOTH STATEMENTS ABOVE MUST BE CHECKED YES)
*Determination of eligibility as a student with a Speech and/or Language Impairment is made by the IEP Team.
 Mild 1 Service Delivery Unit
Minimum of 15 30 Minutes per
Week
Severity of Impairment minimally affects
Disorder the individual's ability to
communicate in school learning
and/or other social situations as
noted by at least one other
familiar listener, such as teacher,
parent, sibling, peer.
Articulation/ Intelligible over 80% of the
Phonology time in connected speech.
No more than 2 speech sound
errors outside developmental
guidelines. Students may be
stimulable for error sounds.
Language The student demonstrates a
deficit in receptive, expressive,
or pragmatic language as
measured by two or more
diagnostic
procedures/standardized tests.
Performance falls from 1 to 1.5
standard deviations below the
mean standard score.
Moderate 2 Service Delivery Severe 3 Service Delivery Units
Units Minimum of 31 60 Minutes Minimum of 61 90 Minutes per
per Week Week
Impairment interferes with the
individual's ability to
communicate in school learning
and/or other social situations as
noted by at least one other
familiar listener.
Intelligible 50-80% of the time
in connected speech.
Substitutions and distortions and
some omissions may be present.
There is limited stimulability for
the error phonemes.
The student demonstrates a
deficit in receptive, expressive or
pragmatic language as measured
by two or more diagnostic
procedures/standardized tests.
Performance falls from 1.5 to 2.5
standard deviations below the
mean standard score.
Impairment limits the individual's
ability to communicate
appropriately and respond in
school learning and/or social
situations. Environmental and/or
student concern is evident and
documented.
Intelligible 20 49% of the time in
connected speech. Deviations
may range from extensive
substitutions and many omissions
to extensive omissions. A limited
number of phoneme classes are
evidenced in a speech-language
sample. Consonant sequencing is
generally lacking.
Augmentative communication
systems may be warranted.
The student demonstrates a
deficit in receptive, expressive or
pragmatic language as measured
by two or more diagnostic
procedures/standardized tests (if
standardized tests can be
administered). Performance is
greater than 2.5 standard
deviations below the mean
standard score.
Augmentative communication
systems may be warranted.
Profound 5 Service Delivery
Units Minimum of 91 + Minutes
per Week
Impairment prevents the
individual from communicating
appropriately in school and/or
social situations.
Speech is unintelligible without
gestures and cues and/or
knowledge of the context.
Usually there are additional
pathological or physiological
problems, such as neuro-motor
deficits or structural deviations.
Augmentative communication
systems may be warranted.
The student demonstrates a
deficit in receptive, expressive or
pragmatic language which
prevents appropriate
communication in school and/or
social situations.
Augmentative communication
systems may be warranted.
 Fluency 2 4% atypical disfluencies
within a speech sample of at
least 100 words.
No tension to minimal tension.
Rate and/or Prosody
Minimal interference with
communication.
5 8% atypical disfluencies
within a speech sample of at least within a speech sample of at least
100 words.
Noticeable tension and/or
secondary characteristics are
present.
Rate and/or Prosody
Limits communication
9 12% atypical disfluencies
100 words. Excessive tension
and/or secondary characteristics
are present.
Rate and/or Prosody
Interferes with communication
More than 12% atypical
disfluencies within a speech
sample of at least 100 words.
Excessive tension and/or
secondary characteristics are
present.
Rate and/or Prosody
Prevents communication.

Voice Voice difference including
hoarseness, nasality, denasality,
pitch, or intensity inappropriate
for the student's age is of
minimal concern to parent,
teacher, student, or physician.
Medical referral may be
indicated
Voice difference is of concern to
parent, teacher, student, or
physician. Voice is not
appropriate for age and sex of the
student.
Medical referral may be
indicated.
Voice difference is of concern to
parent, teacher, student or
physician. Voice is distinctly
abnormal for age and sex of the
student.
Medical referral is indicated.
Speech is largely unintelligible
due to aphonia or severe
hypernasality. Extreme effort is
apparent in production of
speech.
Medical referral is indicated.

GUIDELINE FOR SPEECH-LANGUAGE ELIGIBILITY CRITERIA/MATRIX FOR SCHOOLS

Clinical judgment may necessitate modification of these guidelines.

By the age of 7 years, the student's phonetic inventory is completed and stabilized. (Hodson, 1991). Adverse impact on the student's educational
performance must be documented. If the collaborative consultation model of intervention is indicated at the meeting, the student receives one
additional service delivery unit."

Source: Illinois State Board of Education (1993). Speech-language impairment: A technical assistance manual
Reprinted by permission.