The Speech Pathology and Audiology Experience:
A Clinic Portfolio by Courtney Bredenkamp
An Honors Thesis (HONRS 499)
by
Courtney L. Bredenkamp
-
Thesis Advisor
Mrs. Sue Heady
Ball State University
Muncie, Indiana
April 1998
Expected date of graduation: May 9, 1998
:)
Purpose of Thesis
,r "
r ."
This portfolio is designed to demonstrate growth and development during the
course of the Speech Pathology and Audiology clinical experiences, The portfolio
includes an introduction to the Ball State University Speech, Language, and Hearing
Clinic and reflections on the clinic I and clinic II experiences, focusing on the goals chosen
for each client and the methods and materials utilized to accomplish those goals, Samples
of reports used in the clinic experiences as well as academic achievements also are
included in this portfolio,
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-
-
Table of Contents
EDUCATION AND ACTIVITIES
Resume
Scholarships
Honoraries
CERTIFICATION
Practicum Hours
Transcript
DIAGNOSIS AND THERAPY
-
Clinic I
-Introduction
-Methods and Materials
-Reinforcement
-Personal Reaction
Clinic II
-Introduction
-Methods and Materials
-Reinforcement
-Behavior Management
-Personal Reaction
WRITING SAMPLES
Diagnostic Report
Individualized Education Plan
Progress Report
Lesson Plan
SOAP Notes
CLINIC EVALUATIONS
--
~EDUCATION
-
-
AND
ACTIVITIES
-
COURTNEY L. BREDENKAMP
CURRENT ADDRESS
PERMANENT ADDRESS
909 N. Linden, Apt. 206
Muncie, IN 47303
765/284-6701
OOc1bredenka
517 Sunset Drive
Noblesville, IN 46060
3171773-3892
CAREER O]UECTIVE
To obtain a speech language pathologist position in a hospital.
EDUCATION
May 1998
1994-1998
1994-1998
Bachelor's of Arts in Speech Pathology and Audiology
Ball State University, Muncie, Indiana
Concentration: Speech Pathology and Audiology
GPA: 3.695/4.0
Dean's List of College of Sciences and Humanities
Honors College Student
CLINICAL ]~XPERIENCE
January 1997-Apri11997
• Clinic 1 (Ball State University). Provided articulation therapy for a four year old
white male in the production of the r,l,j, and th sounds.
September 1997-December 1997
• Clinic 2 (Ball State University). Provided language therapy for a seven year old
white female in the usage of regular past tense verbs, associations, categorizations,
and following two-step oral directions.
January 1998-May 1998
• Clinic 3 (Ball State University). Provided aural rehabilitation therapy to a 67 year
old wt~te male in speechreading and auditory discrimination.
September 1997-December 1997
• School Experience (Muncie Community Schools). Observed, planned activities,
and participated in group articulation therapy.
WORK EXPERIENCE
-
September 1997-May 1998
Teacher's Aide
September 1995-May 1998
Child Care Supervisor
Seidel Family
May 1997-July 1997
Child Care Supervisor
Thomson Family
June 1994-August 1994
Teacher's Aide
First Presbyterian Preschool
..
Trinity Wesleyan Daycare
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ACTIVITIES
Member:
1994-1998
Chi Omega Social Sorority (Community Service Chair, President,
Sisterhood Chair)
Alpha Lambda Delta Freshmen Honor Society
1994
1995
Rho Lambda Greek Women's Honor Society
1994-1998
BSU Collegiate Bible Study
National Student Speech Hearing Language Association
1994-1998
Golden Key Honor Society
1997-1998
Homecoming Steering Committee Assistant
1998
Volumeer:
Adopt A School (Muncie Community School)
1995
Read Aloud (Muncie Community School)
1994-1998
1994-1998
Habitat for Humanity
1994-1998
Salvation Army
1994-1998
Boys and Girls Club of Muncie
1995-1998
March of Dimes
American Cancer Society
1996-1997
Community Care Center
1995-1998
UNICEF
1998
Fundraising for Riley Children's Hospital
1998
Fundraising for Prevent Blindness Indiana
1998
Project Read
1998
Adopted a Family
1994-1998
1995-1998
Student Voluntary Services
1995-1998
YMCA
HONORS AND AWARDS
1994-1998
Ball State University Presidential Scholarship Award
1994
Outstanding Freshman Award in Chi Omega Sorority
1995
Who's Who in American Colleges and Universities
1998
Exchange Club of Muncie Scholarship
1998
Outstanding Senior Award in Chi Omega Sorority
-
BAI-JIJ STATE UNI.VE"RSITY
designates
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In recognition of outstanding acadeTtlic achievemell t,
this certificate is issued
under the authority of the V.niversity 'Board of fJ'rustees
and upon the recommendations of
the Office of Schofarships and :Financiaf f2Lid and
tlie Office of .9ldmissions
C~~~A~
'Director qjScFrdarsfUps aruf rmaM'.flI.Uf
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This is to certify that
COURTNEY L. BREDENKAMP
has been named to the
University College Dean's List
for
Fall
semester 1994 .
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BALL STATE UNIVERSITY
The Dean
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BALL STATE UNIVERSITY
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CERTIFICATION
SUPERVISED CLINICAL OBSERVATION AND CLINICAL PRACTICUM RECORDS
Ball State University
SS#: 361-62-9611
Date: January 9, 1998
Name: Courtney Bredenkamp
Master's Degree:
Bachelor's Degree:
University: Ball State
Clinical Observation Hours Completed: 25
#22
Clinical Practicum Hours (Type)
SLP EVALUATION
I
IC~I
I
G
TOTAL
I
SLP TREATMENT
I
I
U
G
I
TOTAL~
19.25
19.25
1.75
a. Articulation
b. Fluency
0.00
b. Fluency
0.00
c. Voice
0.00
c. Voice
0.00
d. Dysphagia
0.00
d. Dyspha!:lia
0.00
1.75
Speech - Child
0.50
a. Articulation
0.00
b. Fluency
0.00
b. Fluency
0.00
c. Voice
0.00
c. Voice
0.00
d. Dysphagia
0.00
d. Dysphagia
0.00
0.50
Speech - Adult
2.75
Language - Child
0.00
Language - Adult
a. Articulation
1.75
Speech - Child
1.75
a. Articulation
.50
Speech - Adult
0.50
Language - Child
2.75
0.00
0.00
Language - Adult
19.25
0.00
0.00
0.00
19.25
0.00
24.75
24.75
0.00
I
a.
0.00
a.
0.00
b.
0.00
b.
0.00
,..aelated Disorders - Child
0.00
0.00
0.00
Related Disorders Child
I
0.00
0.00
0.00
I
a.
0.00
a.
0.00
b.
0.00
b.
0.00
Related Disorders Adult
I
I
SLP EVALUATION
TOTALS
0.00
0.00
5.00
0.00
U
G
0.00
Related Disorders Adult
G
TOTAL
Child
Adult
AUDIOLOGY
EVALUATION TOTALS
1-
I
I
I
,LP GRAND TOTAL
AUDIOLOGY GRAND
TOTAL
.25
0.25
IC~I
0.00
0.00
0.00
GGG
AUDIOLOGY
TREATMENT CAR)
~83
0.00
Treatment - Child
0.00
0.25
Treatment - Adult
0.00
Ampli., etc.-Child
0.00
Ampli., etc.-Adult
0.00
0.25
II
0.00
SLP TREATMENT
TOTALS
,
AUDIOLOGY
EVALUATION
0.00
49.00
AUDIOLOGY
TREATMENT TOTALS
0.00
0.00
I
II
~
0.00
SLP AND AUDIOLOGY
GRAND TOTAL
GGG
Ball State University
OFFICE OF THE REGISTRAR • MUNCIE, INDIANA 47306
DATE PRINTED: 04/15/98
PAGE 1
NOBlESVILLE HIGH sOt
NOBlESVILLE, IN
COURTNEY LYNN BREDENKArt'
STUDENT NlMJER 361-62-9611
-------~-------------------------------------------
BSU CREDITS
---------------------------------------------~----HRS CR/PT GR POO CR
DEPT CRS DESCRIPTION
------------~-------------------------------------~
FALL TERM 94-95
ENG 114 HONR COMP 2
3.0 12.000
GER 201 INTERMED 1
3.0 12.000
HIST 150 WESTERN CIV
3.0 9.000
HONRS 201 HUMANITIES 1
3.0 9.000
MATHS 125 MATH APPLlC
3.0 12.000
**** DEAN'S LIST ****
TERM
15.0 15.0 54.000 3.600
ACCUM
15.0 15.0 54.000 3.600
SPRING TERM 94-95
GER 202 INTERMED 2
3.0 12.000
HONRS 202 HUMANITIES 2 3.0 12.000
PEFWL 148 RHY AROBICS
2.0 8.000
SPAA 100 SURVEY SPAA
2.0 8.000
SPAA 101 CLIN PHONET
3.0 12.000
**** DEAN'S LIST ****
TERM
13.0 13.0 52.000 4.000
ACCUM
28.0 28.0 106.000 3.785
FALL TERM 95-96
ASTRO 100 ASTRONOMY
3.0 12.000
HONRS 203 HUMANITIES 3 3.0 12.000
PSYSC 100 GENERAL
3.0 12.000
SPAA 161 ANAT SP HR
3.0 9.000
SPAA 270 LAM3 DEVELOP
3.0 12.000
**** DEAN'S LIST ****
TERM
15.0 15.0 57.000 3.800
ACCUM
43.0 43.0 163.000 3.790
SPRING TERM 95-96
HEHS 275 CHILD DVLPMT
3.0 12.000
HONRS 189 SYW GLBL ST
3.0 9.000
HONRS 299 BIO HNRS SYM
3.0 9.000
SPAA 210 ARTIC DIS 1
3.0 12.000
SPCED 201 INT EXCEP CH
3.0 12.000
**** DEAN'S LIST ****
CONTINUED NEXT COLUMN:
L "OT RE~lRED
!ll\lSf.Ps~~*
~m'a'1'i:
ti.~~
I~!~srrr~t~s
paper lII"'W.~
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SCRIP-SAF~ot requ1re
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A
~
A
A
B
B
A
A
A
A
A
A
A
A
A
B
A
A
B
B
A
A
15.0 15.0 54.000 3.600
58.0 58.0 217.000 3.741
FALL TERM 96-97
HONRS 390 HOM COLLOO
2.0 8.000
PSYSC 241 ELEM STATlsr
3.0 8.001
SPAA 311 CLN PROC OBS
3.0 9.999
SPAA 312 INTRO OIAG
3.0 9.000
SPCH 210 FUND PUB COM
3.0 12.000
TERM
14.0 14.0 47.000 3.357
ACCUM
72.0 72.0 264.000 3.666
SPRING TERM 96-97
CS
104 MICRO LIT
3.0 9.000
ENG 392 WRITING EXAM
0.0 0.000
HONRS 199 HONOR SYMPQS
3.0 12.000
SPAA 319 SPAA CL PRAC
2.0 6.666
SPAA 360 SPCH ACOUST
3.0 11.001
SPAA 418 ORG SP DISOR
3.0 12.000
**** DEAN'S LIST ****
TERM
14.0 14.0 50.667 3.619
ACCUM
86.0 86.0 314.667 3.658
SUMMER TERM 96-97
SPAA 343 HEARING 1
3.0 11.001
TERM
3.0 3.0 11.001 3.667
ACCUM
89.0 89.0 325.668 3.659
FALL TERM 97-98
SNLNG 351 SIGN LANG 1
3.0 12.000
SpAA 319 SPAA CL PRAC
2.0 8.000
SPAA 344 HEARING 2
3.0 11.001
SPAA 361 NEURO ANAT
3.0 12.000
SPAA 371 LANG DIS 1
3.0 12.000
SpAA 420 SPAA SCHOOLS
2.0 0.000
**** DEAN'S LIST ****
TERM
14.0 16.0 55.001 3.928
ACCUM 103.0 105.0 380.669 3.695
TERM
ACCUM
BSU CURRENT REGISTRATION
A
6B+
B
A
ENG
SPAA
PSYSC
ENG
HONRS
-
B
CR
A
8+
AA
420
319
224
390F
499
SPRING TERM 97-98
3.0 U
SPAA CL PRAC
2.0 U
APP BHR ANLS
3.0 U
HONOR COllOO
2.0 U
HONORS PROJE
3.0 U
INTR LING SC
END OF TRANSCRIPT
**
OFFICIAL TRANSCRIPT alffAiNS 1 PAGE.
TRANSCRIPT ONlY VALID IF
UNIVERSITY SEAL AND SIGNATURE
OF REGISTRAR ARE AFFIXED
A-
A
A
AA
A
CR
--~------------------------------------------------
CUMULATIVE BSU
HR/AT HR/ER CR/PT GPA HR/TOT
UGRAD 103.0 105.0 380.669 3.695 116.0
GRAD
0.0 0.0
0.000 0.000
0.0
BSU ADVANCED STANDINl CREDIT
ENG
103 ENl COMP I
3.0
ADVANCED STANDING CREDIT
ESTABLISHED BY SAT TSWE AND
HIGH SCHOOL RANK
GER
101 BEGINNING 1
4.0
GER
102 BEGINNING 2
4.0
TOTAL CREDIT
11.0
CONTINUED NEXT COLUMN:
A BLACK AND WHITE TRANSCRIPT IS NOT f" ORIGINAL
TRANSCRlp·.... GUIDE ON BACK
IN ACCORDA~
VITH usc 438 (6) (4) (8) (THE FAMILY EDUCATIONAL RIGHTS AND PRIVACY ACT OF
OU ARE HEREBY NOTIFIED THAT THIS INFORMATION IS PROVIDED UPON THE CONc\
,THAT YOU,
YOUR AGENT::, ~ " EMPLOYEES, WILL NOT PERMIT ANY OTHER PARTY ACCESS TO THIS RECORD WITHO"" CONSENT OF THE STUDENT. ALTERATION OF THIS TRANSCRIPT MAY BE A CRIMINAL u.-.-ENSE.
1ft
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DIAGNOSIS AND
THERAPY
-
Introduction to Clinic
The Speech Pathology and Audiology program at Ball State University is
accredited as a training institution by the American Speech-Language and Hearing
Association (ASHA). Accreditation consists of a team of examiners from the Educational
Standards Board of ASHA who make a site visit every five years and reports which are
submitted annually to ASHA. The supervision requirements for the clinic are as follows:
faculty supervisor observes 50% of the diagnostic sessions and 25% of the therapy
sessions and conducts clinical and individual meetings with the student clinicians.
-
-
Introduction to Clinic 1
In the dinic 1 course, I conducted therapy sessions with a male client who was
4 years 8 months old. A diagnostic session was held at the beginning of the semester.
After the diagnostic testing was completed, I set goals for the semester of which included
the production of III initial words, Ijl initial words in sentences, Irl initial words, and Ie I
(ex: th as in thirteen) initial words in sentences. The goals are written behaviorally
because it provides a measurement for accountability. Progress was made with all of the
goals. At the end of the semester, the client was able to produce III initial in syllables
given a verbal model and verbal instructions (ex: "place your tongue behind your top
-
teeth). The client also was able to produce Irl initial in words given pictures. The client
met the Ijl initial words in sentences goal. At the end of the semester, the client was able
to produce lei initial words in sentences given a verbal model and pictures, too.
-
MethodslMaterials
1. Client will say III initial words with 90% accuracy given pictures.
At the beginning of the semester, we began therapy at the syllable level. I
presented the dient with a model (ex: la, Ii, etc.) and asked him to produce it. I also
provided him with verbal instructions (ex: told him the tongue position of Ill). The
method used was drill format in repetitions of five.
The materials chosen which interested the client included coloring 101 Dalmatians
stickers, picking a bunny to discover the hidden egg, and Go Fish.
2. Client will say Irl initial words with 90% accuracy given pictures.
At the beginning of the semester, we began therapy at the syllable level. I
presented the client with a model (ex: ra, ri, etc.) and asked him to produce it. I also
provided verbal instructions (ex: told him the lip position for Ir/). The method used was
drill format in repetitions of five.
The materials chosen which interested the client included an object box filled with
items that begin with Irl, Easter bingo, and Candyland.
3. Client will say Ijl initial words in sentences with 90% accuracy.
At the beginning of the semester, we began with Ijl initial words when given a
-
model (ex: yam) and pictures. Then, I dropped the model. Next, we worked on Ijl initial
words in sentences with a model (ex: Yes, I like yam). Finally, we dropped the model.
The method used was drill format in repetitions of five.
The materials chosen which interested the client included Spin for Spots, pictures
with a star on the back of one, and the "/jl game."
4. Client will say 181 initial words in sentences with 90% accuracy.
At the beginning of the semester, we began at the word level when given a model
(ex: Thumper) and a verbal instruction (ex: told him the tongue position of Ie I). Then,
we dropped the verbal instruction. Next, we dropped the model. The last step was
producing le/ initial words in a carrier phrase when given a model (ex: This is Thumper.)
and pictures. The method used was drill format.
-
The materials chosen which interested the client included an alphabet puzzle, a
fishing pole and fish, and Spot the Dog.
III Initial Words - tOt Dalmatians stickers
Irl Initial Words - Easter Bingo
Iii I mhal
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Words - ",/01
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/e/ Initial Words - Fishing
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Reinforcement
Verbal and tangible reinforcers were used for the client. The verbal reinforcement
of praise included "good work, nice sound, great job putting your tongue between your
teeth, and good listening." The tangible reinforcers included stickers, taking a tum at a
game, and a stamp added to the stamp chart. The reinforcement schedule was continuous
reinforcement (CRF) which is 1 reinforcer: 1 desired behavior.
-
-
Personal Reaction to Clinic 1
My experience in clinic 1 was very rewarding. I gained more experience working
with a child of age 4-5 years and I learned to plan activities that would be fun and
interesting to a boy (ex: fishing) with which I did not have prior experience. The
importance of planning an activity for each goal was learned, too, because the child's
interest needs to be kept in order to do work.
One V(~ry valuable lesson that I learned was the necessity for flexibility. The child
needs to be interested in an activity so that work on the goal can be done. So, the
clinician may need to redirect the child's attention ifhe/she becomes distracted. Being
-
flexible allows the clinician to do this without throwing off the schedule.
Anothl~r
lesson I learned was the importance of giving a child choices. I allowed
the client to choose the next activity in therapy because this meant that he would be more
interested. Allowing him to choose also provided him a say in how the therapy session
went. The choice he was given was which goal to would be next.
Introduction to Clinic 2
In the dinic 2 course, I worked with a female client who was 7 years 8 months old.
The first two sessions allowed me to give diagnostic tests to the client. From the results, I
was able to select the following language semester goals for the client: to say regular past
tense verbs in sentences, carry out 2-step oral directions, state associations among four
common items, and state labels of categories (from three categories). Language was the
focus of therapy because the client demonstrated the greatest need in language skills. We
made progress. in all of the goals throughout the semester. The client achieved the goal of
regular past tense verbs in sentences. At the end of the semester, the client was able to
carry out 2-st€::p oral directions when given objects and a request. The client also was able
to state associations among three common items and categories for common items (from
two categories) at the end of the semester.
-
MetbodslMaterials
1. Client will state regular past tense verbs in self-generated sentences with 90% accuracy
given pictures and a verbal request.
At the beginning of the semester, we began therapy at the word level in structured
sentences. I presented the client with a request (ex: Tell me what happened yesterday in
this picture.) and provided pictures. Then, we dropped the pictures. Next, we dropped
the structured sentences and I asked the client to produce her own sentences using the
pictures given (ex: He jumped rope.). The method used was drill format.
Materials were chosen which interested the client. The materials included pictures
of the verbs o(!curring in the present and the past, the book Courtney, and a Barbie doll.
2. Client will carry out 2-step oral directions with 90% accuracy given verbal stimuli and
objects.
At the beginning of the semester, we began therapy with I-step oral directions. I
presented the ,:lient with verbal requests (ex: Color the tail blue.) and objects (ex:
shapes). Then, we moved to the 2-step oral directions. I presented the client with verbal
requests (ex: First, put the blue pumpkin on the floor. Then, put the green pumpkin on
the chair.) and objects (ex: pumpkins). Next, we moved to paper and pencil activities. I
also presented the client with verbal requests (ex: First, write your name. Then, draw a
-
flower.). The method used was drill format.
The materials chosen which interested the client included shapes, crayons and
pictures to color, and holiday projects (ex: making a turkey and a Christmas tree).
3. Client will state categories from common items with 90% accuracy given pictures from
3 categories and a verbal request.
At the beginning of the semester, we began therapy with 1 category. I presented
the client with pictures and a verbal request (ex: Who is this?). Then, we moved to the 2
category level. I also provided pictures and a request. The method used was drill format.
The materials chosen which interested the client included a memory game using the
target pictures, Winnie-the-Pooh Memory, and a go fish game using the target pictures.
4. Client will state associations among 3 common items when shown pictures with
90% accuracy.
At the beginning of the semester, we began therapy at the level of associations
between 2 common items. I presented the client pictures and a verbal request (ex: Find
another pictur·e that goes with this one). Then, we moved to 3 common items. Again, I
presented pictures to the client and gave verbal requests. The method used was drill
format.
The materials chosen which interested the client included a memory game using the
target words, and the "associations game."
-
Regular Past Tense Verbs - Pictures of Verbs in Past and Present
-~?f-
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•
jumped
Jump
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talk
2 - Step Oral Directions - Turkey
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•
talked
State Categories from Common Items from 3 Categories - Memory Game
Using the Target Pictures
Associations among 3 Common Items - Association Game
Reinforcement
The reinforcers used were verbal and tangible. The verbal reinforcement of praise
included "great sentence, good working, nice job paying attention, and good work
listening." The tangible reinforcers used included stickers for a sticker chart, taking a tum
at a game, and prizes which are awarded upon completion of the sticker chart. The
reinforcement schedule used was continuous reinforcement (CRF) which is 1 reinforcer: 1
desired behavior.
-
-
.Behavior Management
I implemented a behavior modification program in clinic 2 because the client chose
not to work in therapy sometimes. When she did not want to work, she would say, "no"
or just refuse to work. Occasionally she chose to sit on the floor and look away from me.
She even tried to ignore my requests to work again. Thus, a program was needed so that
we could work on the semester goals established.
To begin the plan, I introduced a 101 Dalmatians stand-up dog. It was similar to
Colorforms bt:cause the spots on the dog could be removed or added as desired. I
explained to the client that our goal was to help the dog keep all of his spots. In order to
.-
do this, she ne:eded to follow certain established rules. When she did not follow a rule, a
spot was removed from the dog. I also explained to her that a sticker would be added to
the sticker chart if the dog had all of his spots at the end of an activity. This program
worked well because the client wanted to help the dog keep his spots and was motivated
to follow the rules. The established rules included listening with our ears, looking at the
activities with our eyes, and using our hands to do the activities.
When the client chose not to work, I removed a spot from the dog. If she still
chose not to work, I did the activity by myself which usually sparked her interest. I also
provided the client with opportunities to earn spots back by working on the activity and
following the rules.
-
Personal Reaction to Clinic 2
I leamed many new lessons in the clinic 2 experience. First, I learned the value of
a behavior modification program because the client liked to test my limits. She wanted to
see how much control she had in therapy. I needed a program which limited her behaviors
and allowed us to get more work accomplished in the sessions. Another lesson learned
was the importance of a positive atmosphere. I discovered that the client was more
willing to work on the activity when I was smiling and having fun, too. I also noted that
her attitude toward working was more enthusiastic when we were having fun. A third
lesson that I l(~arned was the benefits of a token economy. The client worked much harder
-
when her sticker chart was almost complete because she could anticipate the prize that she
would receive. Knowing the prize was close motivated her a lot.
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~{RITING
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SAMPLES
DIAGNOSTIC REPORT
CONFIDENTIAL
Name of Client:
Address:
-
Parent:
Phone:
Date of Evaluation:
Monday, September 8, 1997
Wednesday, September 10, 1997
Monday, September 15, 1997
Client's Date of Birth:
Chronological Age:
Referral Source:
Diagnostic Team:
Janet L. Bode, M.A., CCC-SLP
Diagnostic Supervisor
Courtney L. Bredenkamp
Undergraduate Clinician
Tests Administered:
Arizona Articulation Proficiency Scale-Second Edition (AAPS-2)
Carter-Buck Nonsense Syllable Test
Clinical Evaluation of Language Fundamentals-Third Edition (CELF-3)
Hearing Screening
Language Sample
Oral Speech Mechanism Screening Evaluation-Revised (OSMSE-R)
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Background Information:
_ a g , e . e a r s and.months, was seen at the Ball State University Speech,
Language, and Hearing Clinic on September 8, 10, and 15,~eech and
language evaluation. She was accompanied by her parent, _
exhibited normal development of speech and language. She
_
reported that _
indicated that_ speech problem was first noted at approximately 5 years of age. She
estimated the severity of her problem to be moderate-severe.
_
reported that ~ets frustrated when she is talking and cannot recall the
names of objects.
Behavioral Observations:
separated easily from her parent and accompanied the clinician to the testing area.
"'..........,'u attentive and cooperative throughout the testing. _
interacted with the
V'UJU"'''~'' by asking questions and giggling. She responded well to praise by smiling at the
clinician during testing.
_
ability to stay on task, cooperate during the session, and her responses to each task
created a favorable atmosphere for testing. The test results presented here were believed
to be a valid measure of her present level of communication abilities.
Test Results:
I. Articulation: The Arizona Articulation Proficiency Scale-Second Edition (AAPS-2)
was administered to assess'" production of individual speech sounds in words.
She made 11 errors on the picture subtest of the AAPS-2 which placed her articulation
skills in th~! fourth percentile. Her total score on the AAPS-2 was 90.0. This
represented an extremely low score on this test for a child of her age and sex.
_arti.culation was characterized by errors of substitution and omission. _
evidenced ltwo general patterns of misarticulation.
First~eleted word-final consonants in 29% of the stimulus words tested (e.g.,
omission of the 'Of' in "knife," "d" in "bir4," and "t" in "cal'').
Second,_substituted other sounds for several target sounds (e.g., "sh" for ')" in
'lumping," "sh" for ''th'' in ''thumb,'' and "f' for "th" in ''teeth'').
to_
The two error patterns discussed above contributed
misarticulations. _
demonstrated the most consistency on correct productions of speech sounds in wordinitial position.
phonetic inventory (repertoire of different ~h sounds) lacked various
did not consistently produce
the following speech sounds: ''th'' as in ''thumb'' and "g" as in "giraffe."
_
;= sounds that occur in the English language. _
The Carter-Buck Nonsense Syllable Test was completed to assess_ ability to
imitate speech sounds (i.e., stimulability) in syllables. Of the sounds that were not
produced during the administration of the Arizona Articulation Proficiency ScaleSecond Edition (AAPS-2),.evidenced the ability to imitate "g" as in "giraffe"
with 100% accuracy. "'did not imitate voiceless "th" as in "thumb" correctly in
any position or vocalic environment tested.
During connected speech, the intelligibility o~ conversation was approximately
80% as long as the context was known. Intelligibility decreased if the context was
unknown.
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II. Language: The y!mg~~!ill!!QTI~g!1£l=@g!~~~@!~:1.!lru:Q.J;&!!lli;m
(CELF-3) was administered to
receptive and expressive language skills .
. . Total Language Standard Score was 64 which placed her in the 1st percentile.
There was a 68% probability that her true score would fall in the 61-67 range of
standard seores. This represented a below average score relative to other children her
age. ~~earned a Receptive Language Standard Score of75 which placed her in the
5th percentile. She earned an Expressive Language Standard Score of 57 which
placed her in the 1st percentile. There was no significant difference between _
Receptive and Expressive Language Standard Scores. ~ encountered difficulty
understanding word structure rules which involved objective pronouns, possessive
nouns, possessive pronouns, regular and irregular past tense verbs, third person
singular, auxiliary + present progressive verbs, derivation of adjectives, regular and
irregular plural nouns, demonstrative pronouns, subjective pronouns, and reflexive
pronouns. . . also had trouble formulating compound and complex sentences,
identifYing classes, and was unable to recall and reproduce sentences with increasing
complexity. _
was unable to interpret oral directions which contained concepts
such as "closest" and "second."
A languag1e sample was gathered to asses~expressive language usage. This
sample was believed to be representative of_expressive language. _was
able to form simple sentences (e.g., "I don't remember her name."). She used ten of
Brown's 14 Morphemes. She demonstrated the use of prepositions (e.g., "Back in
the house."), articles (e.g., "See, one at ~ time."), plurals (e.g., "And say, 'We got
kittens. "'), irregular past tense verbs (e.g., "I forgot to do that one."), uncontractible
copula (e.g., "They say, 'Puppies are gone. "'), contractible copula (e.g., "That's all."),
present progressives (e.g., "They are thinking what that noise is."), possessives (e.g.,
"I don't remember her name."), regular past (e.g., "And they turned brown."), and
third person regular (e.g., "They put the other ones find the kitty.").
_
Mtean Length per Utterance (MLU), or the number of morphemes per
utterance, was 5.5 based on 51 utterances. This score demonstrated thattllll
use of morphemes per utterance was average for her age (Brown, 1973).
A Type-Token Ratio (TTR) was calculated to obtain a measure of vocabulary
Type-Token Ratio was .45. This score was average for a child
diversity. _
her age (Templin, 1957). This means that for approximately every two words
spoken, one word was different.
. w a s able to answer "wh" questions, and she used appropriate vocabulary for her
age. ~pragmatic skills appeared age appropriate. Although she had trouble
maintaming eye contact and would place her head on the table, she could take turns,
maintain a topic, "You got on it?" and answer the clinician's questions appropriately.
III. Voice and Fluency: Through informal assessment (a conversation in which.
talked about her school),_voice and fluency appeared to be age appropriate.
IY.Hearing: A hearing screening was administered to assess "ability to hear pure
tones. _responded appropriately to tones at 500, 1000, 2000, and 4000 Hz at
20 dB HL. Therefore, her hearing was assessed as normal.
Y. Oral Mechanism Examination: The Oral Speech Mechanism Screening ExaminationRevised (OSMSE-R) was administered to _ t o assess the structure and function
of her oral mechanism. The external oral structures were symmetrical and functional.
~levated, protruded, lateralized, and retracted her tongue with apparent ease.
Palatal structures were judged to be within normal limits although movement was
not observed (vertical or lateral) of the soft palate and pharynx when saying, "ah."
Lack of observation of movement may have been due to tester inexperience. The
oral structures appeared intact and no obvious abnormalities that would preclude
speech production were identified. Her deciduous teeth had gaps created by missing
teeth.
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Assessment of diadochokinesis revealed that _
rapid movement of articulators
was not correct and rhythmic. Her repetitions per second averaged 2, 1.6,2.5, and
l.3 for the syllables /pfl/, It AI, /k,..J, and IpAtAI. These rates were below average,
relative to the children on whom this test was normed. •was not able to produce
/pAtAkAI.
Summary:
_
age ~ears, emonths, received a speech and language evaluation at the Ball
State University Speech, Language, and Hearing Clinic on September 8, 10, and 15, 1997.
The results of this evaluation suggested a moderate articulation disorder. "'appeared
to have a severe receptive and expressive language disorder. Voice, fluen~aring, and
oral structures appeared to be within normal limits.
Recommendaltions:
1. It is recommended that. receive individual language therapy two times
weekly for 50 minute sessions.
2. Bec:ause"has a tendency to use present tense verbs in past tense situations,
one of the g~f therapy might focus on the production of regular past tense
verbs.
3. Bec:ause~as difficulties following oral directions, one of the goals of
therapy might focus on carrying out I-step oral directions.
4. Bec:ause_has difficulties with word associations, one of the goals of
therapy might focus on how words are associated.
5. Bec:ause _
has difficulties identifying items in categories, one of the goals
of therapy might focus on categorizing items.
Please do not hesitate to contact the clinic if we can provide additional information
regardingtllla communication skills.
Janet L. Bode, M.A., CCC-SLP
Diagnostic Supervisor
Courtney Bredenkamp
Undergraduate Clinician
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INDIVIDUALIZED EDUCATION PLAN (IEP)
Clinician: Courtney Bredenkamp
Supervisor: Mrs. Bode
Conference Date: December 8, 1997
IEP Effective Dates: September 8, 1997 to December 12, 1997
Number of Sessions/Cumulative Sessions: 26/97
-.
Current Level of Functioning:
_
articulation is characterized by errors of substitution and omission. Her
spontaneous speech is characterized by sentences of four to eight words and normal
vocabulary diversity. _has difficulty in the use of regular past tense verbs, following
oral directions, and in identIfying and stating associations and categories for common
items.
_~ voice, fluency, hearing and oral structures are within normal limits.
** See Diagnostic Report dated September 19, 1997 for further assessment information.
Semester Goals:
1. • will state regular past tense verbs in self-generated sentences with 90% accuracy
given pictures and verbal request.
_will
2.
objects.
carry out 2-step oral directions with 90% accuracy given verbal stimuli and
3. •
will state associations among three cornmon items with 90% accuracy when
shown plctures.
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4. •
will state categories for cornmon items with 90% accuracy given pictures from 3
categones and a verbal request.
4. _
will state associations among 3 common items when shown pictures with
90% aecuracy.
IV. SUMMARY OF PROGRESS
A. At the beginning of the semester,. said regular past tense verbs with 40%
accura,:y given pictures and verbal stimuli. At the end of the semester, she was
able to say regular past tense verbs in self-generated sentences with 92% accuracy
given pictures and a verbal request.
B. At the beginning of the semester, . w a s able to carry out 2-step oral directions
with 50% accuracy when given objects and a verbal request. At the end ofthe
semester, she was able to carry out 2-step oral directions with 83% accuracy given
objects and a verbal request.
C. At the beginning of the semester,. was able to state categories for common
items with 50% accuracy given pictures and a verbal request. At the end of the
semester, . .was able to state categories for common items from two categories
with 86% accuracy given pictures and a verbal request.
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D. At the beginning of the semester, •
was able to state associations between two
common items with 80% accuracy gIVen pictures and a verbal request. At the end
of the semester, _
was able to state associations among three common items
with 98% accuracy given pictures and a verbal request.
V. RECOMMENDATIONS
1. It is recommended that •
continue to receive individual speech and language
therapy and that she attend two 50-minute sessions per week.
2. It is re(:ommended that _
2-step oral directions.
therapy focus on improving her ability to carry out
WIIIII
3. It is re(:ommended that
therapy focus on improving her ability to state
categories for common items.
4. It is recommended that _
therapy focus on improving her ability to state
regular past tense verbs In sentences.
5. It is recommended that _
therapy focus on improving her ability to state
associations among common items.
--
6. A behavior modification program is recommended for ",to keep her on task.
Stickers given for attending were effective in increasing her attendance to tasks.
JANET L. BODE, M.A., CCC-SLP
CLINICAL SUPERVISOR
COURTNEY BREDENKAMP
UNDERGRADUATE CLINICIAN
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.-
Il\DIVIDUAL SPEECHILANGUAGE PROGRESS REPORT
CONFIDENTIAL
I. IDENTIFYING INFORMATION
A. Name of Client:
Address:
Telephone:
Date of Birth:
B. Date of Report: Monday, December 1, 1997
Time Period Covered: Fall Semester 1997
C. Number of Current Sessions: 26/26
Numb(~r of Cumulative Sessions: 26/97
D. Clinician: Courtney Bredenkamp
Supervisor: Mrs. Bode
II. BACKGROUND INFORMATION
A. - . age
years _
months, was seen for language therapy at the Ball
State Speech, Language, and Hearing Clinic for four semesters beginning spring
semester 1996.
B. Result:; of the current re-evaluation suggested a moderate articulation and a severe
language disorder. _exhibited errors involving regular past tense verbs,
following oral directions, word associations, and identifying items in categories.
~ hearing was adequate for speech as were voice, fluency, and the structures
and functions of her oral mechanism.
III. SUMMAH..Y OF GLOBAL GOALS
The following semester goals were established for _
1. _
will state regular past tense verbs in self-generated sentences with 90%
accura';;y given pictures and verbal request.
2.
.-a will carry out 2-step oral directions with 90% accuracy given verbal stimuli
~b.iects.
3. _
will state categories for common items with 90% accuracy given pictures
from 3 categories and a verbal request.
-
Therapy Recommendation:
_JC Direct Se:rvice
J~_ XlWeek
----- Consultation (See Comments)
Placement Justification:
50 M'mute S
'
----eSSlOns
----- Discontinue (See Comments)
_to
the Ball
The
referred
State Speech,
s of the Arizona Articulation
Proficiency Scale - Second Edition, analysis of a language sample, and results of the
Clinical Evaluation of Language Fundamentals - Third Edition indicated an articulation
and language disorder. _agreed with the recommendation for_placement in
therapy.
Concerns/Comments:
Materials: Real objects and pictures will be the primary stimulus items when available.
Evaluation: . . progress in therapy will be evaluated by percentage counts (90%
criterion to move to the next level) and clinician's observations.
Parent Commc~nts/ConcernslRecommendations:
-
IEP Conference Participants:
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Age~
Client
Problem
Clinician
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SOAP NOTES
11-3-97
Subjective:
Client attended very well today (no Dalmatian spots were lost on the dog)l
She did have to go to the bathroom during the middle of the session,
though, even though she went prior to therapy.
Objective:
1. Client will state regular past tense verbs with 90% accuracy given
pictures and a verbal request; 9110 = 90%t; error strategy: 111 = 100% (1
=
cue).
2. Client will state associations among 3 common items with 90%
accuracy given pictures and a verbal model; we did not get to this activity
because client had to use the bathroom which took up part of the therapy
time.
3. Client will follow 2-step oral directions with 90% accuracy given
objects and verbal instruction; 6/10 = 60%t; error strategy: 4/4 = 100%
(3
=
repeat, 1 = cue).
4. Client will state categories between 2 items with 90% accuracy given
pictures and a verbal request; 20124 = 83%t; error strategy: 4/4 = 100%
(2 = forced choice, 1 = cue, 1 = direct model).
Analysis:
Client's percentages all increased this session which may be in part due to
the client doing a better job of attending.
Plan:
-
1. See regular past tense verbs from 10-29-97 with materials and
procedures from 10-31-97.
2. See common categories from 10-29-97 except materials = pictures,
.-
stickers, and bean bags; and procedures = I will tell client to throw the
bean bag for a person (picture) and match the person to the item he/she
uses to do hislher job (picture) in her hand.
3. See 2-step oral directions from 10-29-97 except targets =
1. First, pick up the head. Then, put it on the table in front of you.
2. First, pick up a black ear. Then, put it on the head.
3. First, pick up a piece of tape. Then, tape the ear to the head.
4. First, pick up the body. Then, put it under the head.
5. First, pick up a piece of tape. Then, tape the body to the head.
6. First, pick up the other ear. Then, put it on the head.
-
7. First, ask me for a piece of tape. Then, tape the ear to the head.
8. First, pick up the tail. Then, put the tail on the body.
9. First, ask me for a piece of tape. Then, tape the tail to the body.
10. First, pick up the crayon. Then, write your name on the back
of the puppy.
and materials = shapes, tape, crayon, and stickers.
4. See associations from 10-31-97 except materials = pictures, stickers,
and monopoly (per request).
Subjective:
I used better verbal reinforcement variation (ex: "super job; great working;
good, Mary"). It was specific, too (ex: "super, Mary. That sentence was
great"). My reinforcement is consistent as it needs to be (both verbal and
.-
tangible). I am immediate in my reinforcement, too, so that she knows for
what she is being reinforced. I use my error strategies as indicated on my
lesson plan which work well with client. I do need to, however, keep her
working through the lessons so that we have time for all 4 activities.
-
..-
Conclusion
In condusion, this clinic portfolio contains evidence of my clinical experiences.
Included are essays about the clinical courses, a resume noting my education and
activities, honors and awards, evaluations, and samples of reports written in the clinical
courses. The information contained is important to my growth and development as a
student of Speech Pathology and Audiology.
-
..-
-
CL~[NIC
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EVALUATIONS