Kent State University

Speech and Hearing Clinic

Progress Note

CLIENT INITIALS: NS COVERED DATES OF SERVICE: 3/10/18, 3/17/18, 3/24/18,

4/14/18
INDIVIDUAL THERAPY SESSION: X GROUP THERAPY SESSION

SUBJECTIVE

DOS: 3/10/18 DOS: 3/17/18 DOS: 3/24/18 DOS: 4/14/18

NS was engaged NS was engaged throughout NS was engaged throughout NS was engaged and
throughout the session the session and was the session and was motivated throughout the
and was receptive to motivated by the activities motivated by selecting entire session.
feedback provided. He was provided. He was games to play in between
motivated by choosing the responsive to verbal cues each target.
games that were played and praise throughout
inbetween targets. activities.
LONG TERM GOALS:
 LTG 1: NS will accurately produce /z/ in all positions at word level in 80% of opportunities within a
structured activity with minimal support.
 LTG 2: NS will accurately and independently produce medial /l/ at conversational level in 85% of
opportunities.
 LTG 3: NS will accurately and independently produce vocalic /r/ at conversational level in 80% of
opportunities.
 LTG 4: NS will engage in eye contact with the clinician in order to initiate and maintain conversation in
75% of opportunities provided throughout the session with minimal visual supports.

SHORT TERM GOALS AS FOLLOWS

Objectives Methods 3/10/18 3/17/18 3/24/18 4/14/18
1a. NS will produce /z/ with adequate Modeling, verbal 1a) 1a) 1b) 1b)
voicing in isolation in 75% of cues, tactile cues, 6/13 (46%) with 4/12 (34%) 9/20 (45%) 10/24 (42%)
opportunities within a structured voicing warm ups, max support with max with max with max
support support support
activity with moderate support. facilitating contexts
1b. NS will produce /z/ with adequate
voicing at syllable level in 75% of
opportunities within a structured
activity with minimal support.

2a. NS will accurately produce medial Modeling, verbal 2a) 2a) 2a) 2a)
/l/ at sentence level in 80% of cues, use of 12/18 (67%) 14/17 (82%) 13/18 (72%) 13/16 (81%)
opportunities within a structured predeterminded with min with min with min with min
support support support support
activity with minimal support. sentences

3a. NS will accurately produce vocalic Modeling, verbal 3a) 3a) 3a) 3a)
/r/ at sentence level in 85% of cues, use of “or”: 12/15 “or”: 7/13 “or”: 9/13 “or”: 10/13
opportunities within a structured predeterminded (80%) with mod (54%) with (69%) with (77%) with
support min support min support min support
activity with minimal support. sentences, review of
“ar”: 7/9 (78%) “ar”: 8/12 “ar”: 10/15 “ar”: 12/16
accurate articulator with min (67%) with (67%) with (75%) with
placement support min support min support min support
 Kent State University
Speech and Hearing Clinic
Progress Note

CLIENT INITIALS: NS COVERED DATES OF SERVICE: 3/10/18, 3/17/18, 3/24/18,

4/14/18
INDIVIDUAL THERAPY SESSION: X GROUP THERAPY SESSION
4. NS will engage in eye contact with Review of the 4) 4) 4) 4)
the clinician in order to initiate and purpose and 8/14 (57%) with 14/17 (82%) 15/18 (83%) 18/23 (78%)
maintain conversation in 75% of importance of the min support with min with min with min
support support support
opportunities provided throughout skill, verbal cues,
the session with minimal visual visual cues
supports.
Time/Duration of Services/ 45 mins 45 mins 45 mins 45 mins
initials

DOS: 3/10/18 DOS: 3/17/18 DOS: 3/24/18 DOS:

A: Progress noted for the
production of /z/ in
isolation. NS seemed to
benefit from the use of
carrier phrases such as
“zipper, /z/, zipper” to
facilitate voicing. It was
noted that the vowel /i/ is
frequently produced with
the target. Due to this,
practice also focused on
syllables pairing /z/ with
additional vowels.
Difficulty was noted
elimitating the /i/ from
syllables, but
comprehension was noted
for the task and NS
frequently self corrected.
Progress noted for the
production of medial /l/
with verbal cues to slow
rate and achieve complete
contact of articulators.
Current levels of support
will remain for future
session.
Progress noted for the
production of both “or”
and “ar” within sentences.
NS was able to identify
accurate lip rounding for
each target with verbal
cues. He also seemed to
benefit from verbal cues to
slow his rate. Current
levels of support will
remain for future sessions.
Initiation and maintinence
of eye contact decreased
during this session. NS was
Accuracy decreased for
the production of /z/,
but it was noted that NS
did demonstrate
increased frustration
during this target. The
use of facilitating
contexts within carrier
phrases did seem
beneficial. Productions
focused additionally on
the production of /z/
within syllables. During
future sessions an
increase of visual
supports.
Progress was noted for
the production of medial
/l/ at sentence level.
Cues to slow his rate and
providing target
sentences 4 at a time
increased accuracy.
Current levels of support
will remain for future
sessions.
Accuracy decreased for
the production of vocalic
/r/, but it was noted that
the level of support
provided also decreased.
Productions of “or”
began with a review of
accurate lip rounding,
however difficulties were
still noted. NS
demonstrated
improvements with cues
to slow his rate and to
hold out each sound in
the target words as a
review. Current levels of
Increased accuracy noted Accuracy remained
for the production of /z/. consistent across this
NS seemed to benefit from session, with supports
“warm ups” of voiced continued from the
sounds, as well as carrier previous session. Voicing
phrases and visual was inconsistently
supports. These supports achieved at syllable level
will be continued within carrier phrases
thoughout the next that provided a
session. facilitating context. Use of
voicing warm ups were
Accuracy of medial /l/ used to attempt to shape
production slightly the targeted sound. NS
decreased compared to also benefited from visual
the previous session, but aids to assist in
it was noted that producing carrier
sentences did increase in phrases. These supports
difficulty. Improvments will continue within the
were noted with review of next session.
specific words and cues to
slow the rate of speech. Accuracy increased for
Current levels of support the production of /l/. NS
will remain for the next demonstrates increased
session. intelligability when cued
to reduce rate when
Increased accuracy was reading sentences and
noted for the production within conversation.
of vocalic /r/ targets. NS Based on progress,
demonstrated accurate lip current levels of support
rounding and was will continue next
sufficient at self session.
monitoring his rate of
speech. Current levels of Increased accuracy was
support will remain for noted for the production
the next session. of vocalic /r/ targets.
Review of accurate
Use of eye contact placements occurred, as
slipghtly increased during well as cues to reduce
this session, with NS rate. Due to progress,
showing increased self current levels of support
monitoring of the skill. will continue next
Visual cues continued to session.
be a beneficial way of
prompting. This goal will While accuracy slightly

CLIENT INITIALS: NS
4/14/18
INDIVIDUAL THERAPY SESSION: X
sometimes responsive to
visual cues and
demonstrated self
correcting behaviors, but
often did not demonstrate
the skill even with minimal
prompting. It was noted
that eye contact increased
during preferred activities
such as games, and
decreased during
articulation practice and
conversational questions
asked by the clinician.
Current levels of support
will remain for this goal,
but with increased
preteaching of the skill to
ensure the understanding
of cues.
P: Continue with current
Plan of Care.
See Addendum for
additional details.
Signatures/
DOS:
Student/
Emily Cavanaugh
Graduate Student
Clinic
Instructor
Ann Smith, M.A. CCC-
SLP
Kent State University
Speech and Hearing Clinic
Progress Note
COVERED DATES OF SERVICE: 3/10/18, 3/17/18, 3/24/18,
GROUP THERAPY SESSION
support will remain for continue with current decreased since the
future sessions. levels of support. previous session,
demonstration of the skill
Use of eye contact did remain consistent.
increased during this Use of a visual support
session, and it was noted was beneficial, and NS
that NS independently demonstrated multiple
initated eye contact instances of independent
multiple times initiation of eye contact.
throughout the session. Current levels of support
He continued to benefit will continue for future
from the use of a visual sessions.
support as an occasional
reminder. Current levels
of support will continue
in future sessions.
Continue with current Continue with current Continue with current
Plan of Care. Plan of Care. Plan of Care.
Update STG 1a.
See addendum for See addendum for See addendum for
additional details. additional details. additional details.
Emily Cavanaugh Emily Cavanaugh
Emily Cavanaugh
Graduate Student Graduate Student Graduate Student
Ann Smith, M.A. Ann Smith, M.A. CCC- Ann Smith, M.A. CCC-
CCC-SLP SLP SLP
 Kent State University
Speech and Hearing Clinic
Progress Note

CLIENT INITIALS: NS COVERED DATES OF SERVICE: 3/10/18, 3/17/18, 3/24/18,

4/14/18
INDIVIDUAL THERAPY SESSION: X GROUP THERAPY SESSION

Addendum:

3/10/18
Home practice was assigned for the production of /z/ using carrier phrases that proved successful during the
session.

3/17/18
NS’s performance and progress was discussed. He was assigned home practice for the production of /z/ at
syllable level.
Updated Goals:
STG 1b. NS will produce /z/ with adequate voicing at syllable level in 75% of opportunities within a structured
activity with minimal support.

3/24/18
NS’s perception of his progress was discussed, and home practice targets were verbally reviewed.

4/14/18
NS’s progress was reviewed and his perception of his performance was discussed. No home practice was
provided for the upcoming week.

Signitures/
DOS:
Student/Clinic
Instructor Emily Cavanaugh Emily Cavanaugh Emily Cavanaugh Emily Cavanaugh
Graduate Student Graduate Student Graduate Student Graduate Student

Ann Smith, M.A. Ann Smith, M.A. Ann Smith, M.A. CCC- Ann Smith, M.A. CCC-
CCC-SLP CCC-SLP SLP SLP
 Kent State University
Speech and Hearing Clinic
Progress Note

CLIENT INITIALS: NS COVERED DATES OF SERVICE: 3/10/18, 3/17/18, 3/24/18,

4/14/18
INDIVIDUAL THERAPY SESSION: X GROUP THERAPY SESSION

Date of Summary:
3/10/18 – 4/14/18

Overall, NS has demonstrated adequate progress throughout the previous four week period. Increased
comprehension and self monitoring skills has been noted for all current targets. Accuracy for the
production of /z/ has remained inconsistent across the session, even with the use of consistent
supports. While NS seems to benefit from the use of visual cues, voicing warm ups, and facilitating
contexts, voicing is difficult to achieve within this specific phoneme.
Increased accuracy has been noted for the production of medial /l/ over the span of four weeks, with
self monitoring skills regarding placement and rate improving. While productions remain somewhat
inconsistent, NS demonstrates increased intelligability within structured activities.
Increased accuracy has also been noted in the past two weeks for the production of vocalic /r/ targets,
“or” and “ar.” NS benefits from the review of accurate lip rounding prior to production practice, and
demonstrates increased intelligability with cues to decrease his rate.
Use of eye contact has demonstrated improvement throughout the past four weeks, with NS showing
increased self monitoring and independent initiation of eye contact within conversations. Use of visual
supports have been decreased successfully over time.
Based on client motivation, attendance, and performance so far, prognosis for continued success is
good.

_________________________________________________________ ________________________________________________________
Emily Cavanaugh Ann Smith, M.A. CCC-SLP
Student Clinician Clinical Instructor