Speech-Language Initial Evaluation
(English/Spanish)
Name: JM
DOB: _______________
C.A.: 10 years, 2 months old
DOE: 01/25/2018, 01/29/2018
School: ____________
01/30/2018, 01/31/2018
Teacher: Mrs. _______
Grade: 4th / General Education
Clinician: Mayra Cruz-Vázquez M.S./CCC, TSSH-BE
Classroom Language: English
Bilingual Speech-Language Pathologist
Home Language: English/Spanish
Assessment Materials:
 Educational History
 Parental and Teacher interview
 Oral-motor examination
 Behavioral observations
 Clinical Evaluation of Language Fundamentals-4 (9-21) (Spanish)-subtests
 Clinical Evaluation of Language Fundamentals-5 (9-21) (English)-subtests
 The Listening Comprehension Test-2
 Clinical observations/Directed tasks
 Language Sample/Narrative Analysis
Reason for referral:
JM is a 10 years, 2 months old Hispanic male, of Honduran descent. He is a 4th grade student in
a monolingual General Education classroom, at ________. JM was referred for a Diagnostic
Evaluation due to overall academic concerns, and difficulties with communication skills.
Background history was obtained through a phone conversation with JM’s mother, Mrs. ______.
JM was evaluated at _______ school, in ______, New York.
Background history:
JM was the result of an uncomplicated, full-term pregnancy. He was born at Nassau Medical
Center, in East Meadow, and weighed 8 ½ lb. Developmental milestones were attained as
followed: sat down at 5 months, walked at 11 months, said his first words at 9-10 months of age.
Medical history was unremarkable. He only had one ear infection, at age three. At age 4, JM
fractured his left clavicle playing on the playground.
Language background and use:
JM lives at home with his parents, Mr. _____ and Mrs. ____, his older siblings (brother: age 24
and sister: age 18) and younger brother (20 months old). JM has another sister (age 22) who is
married with children and lives on her own. Mr. M and Mrs. Lopez were born and raised in
Honduras. Mr. _____ went up to 10thgrade and Mrs. _____ finished high school in Honduras.
Both parents came to this country in 1997, and are able to read and write in Spanish. Reportedly,
Spanish is the predominant language spoken by the parents. The older siblings use both
languages with JM. Mrs. _____ indicated that he stayed home with JM until it was time for him
to go to Kindergarten. Family history for speech-language delays is positive. One of JM’s
sisters (age 18) received speech-language therapy and counseling during upper elementary
grades.
Educational background:
According to school records, JM has been known to the ______ School District since September
2012, when he started full-day Kindergarten, at _________ School.
1
Name: JM
DOB: _______
A day after starting Kindergarten, JM was moved to the half-day Pre-Kindergarten at _____
because of his “late birthday and lack of prior school experience”. Ms. _____ said that JM cried
a lot and was not ready to be in school for the whole day. His preschool teacher (Mrs. _____)
referred him to the SSST due to difficulties understanding him. In September 2013, JM began
Kindergarten at a full-day, monolingual classroom (Mr. _____), at _______ School. His teacher
described him as a “friendly student who enjoys interacting with peers”. Nevertheless, there
were concerns regarding his distractibility and need for constant adult support. The results of a
speech-language screening indicated no need for speech-language evaluation. JM was referred to
the Committee on Special Education due to “slow academic progress”, “need for teacher
support” and difficulties staying on task. At the CSE meeting (05/02/2014), the committee
reviewed the psychological, educational and classroom report. No services were recommended.
The committee suggested continuation of building level interventions and progress monitoring.
The following year (09/2014), JM began 1st grade at ______ School. He continued in a
monolingual general education classroom (Ms. _____). In December, his classroom teacher
referred him to the SSST due to concerns about his difficulty “staying on task” unless constant
supervision was provided, frequent need for redirection, “disorganization and difficulty
following routines.” Modifications were made to facilitate completion of task and attention. JM
moved up to 2nd grade (September 2015), and after several months of classroom interventions,
his classroom teacher (Ms. _______) brought her concerns to the SSST. The concerns included
difficulties with his “fine motor skills, difficulty forming letters and numbers and difficulty being
understood (02/2016). On March 31, 2016, a speech-language screening was conducted and a
full speech-language evaluation was recommended due to concerns in the following areas:
auditory comprehension, expressive language and fluency. A meeting with Mr. __ was
scheduled to discuss the recommendations, but parent did not attend. No referral to the SSST
was made during 3rd grade. In September 2017, JM began his 4th year at _______ School. He is
described as a “quiet boy…who enjoys technology”. This year, JM has been receiving reading
intervention 5x a week. His classroom teacher, Mrs. ___, referred him to the SSST (11/17/2017)
due to academic and behavioral concerns. She indicated that JM has “difficulty comprehending
directions given to him” and that he “can be easily angered”. After meeting with both parents,
Mr. M and Ms. _____agreed for the school team to conduct diagnostic assessments to explore
academic, psychological, communication and fine motor skills.
When Ms. _____ was asked about JM’s school progress she said that JM does his homework but
needs constant reminders to complete his responsibilities. She encourages JM to ask for help
when he does not understand something. Ms. _____ frequently asks him to be careful with his
handwriting because the teacher will not understand what he writes. (“El hace su tarea pero sé
que es distraído, no es responsible…y su letra esta fea. Yo le digo a JM que él tiene que levantar
su mano si no entiende y necesita ayuda”).
Clinical assessment
Behavioral observations:
JM is a handsome, and compliant boy, who established eye contact spontaneously. He appeared
very comfortable in the testing room and waited for instructions. He was a pleasure to work with
during the entire assessment. JM was first addressed in Spanish as this evaluator explained the
purpose of the session. He responded in Spanish without hesitation or code switching.
2
Name: JM
DOB: _______
JM was assessed over the course of several sessions. He was engaged and participated
throughout all the tasks presented for intervals of 1-2 hours at the time. He used language to
make comments, ask and answer questions. JM seemed to understand the basic dynamics of
turn-taking skills as he waited to be asked or told what to do. However, he had consistent
difficulties maintaining the topic of his conversation, or clarifying his message when the
listener expressed confusion.
Visual skills appeared to be stronger than auditory-verbal abilities. JM was able to arrange 7step sequencing pictures in order of event but was unable to tell the story cohesively. When he
was asked to talk about a past event or to retell his favorite movie, JM narrated events without
introducing unknown elements to the listener. As his discourse became disorganized and
unclear, the evaluator would stop the narration and ask specific questions to clarify the message.
JM raised his voice and with increased emphasis repeated his response. He did not seem to
understand why was he being asked to clarify something he had already explained (lack of
awareness). Occasionally, JM required verbal prompting to remain focus throughout this
assessment. There were a few instances where he was observed using an electric sharpener next
to him. He would engage in this action without asking for permission or without the need for his
pencil to be sharpened. JM did not need verbal prompting to stop the action as he stopped using
the sharpener as soon as the evaluator looked at him.
JM was also observed in his classroom during whole group instruction. His seat is in front of the
smartboard. The seats are arranged in small groups of five students. JM’s teacher was delivering
graded math test when this evaluator arrived to the classroom and sat at the back of the room.
JM received his test, looked at his score and asked his teacher ‘why’ did he get the score he
attained. His teacher was still delivering tests to the class when JM asked the question. He kept
asking the question as the teacher passed by but did not receive a response. JM did not give up
and kept asking gently as his teacher finished delivering the tests. His teacher pointed out what
he had missed. After looking at his test, JM put it away on his backpack and returned to his desk
to get ready for a science lesson. Some students assisted in the distribution of materials needed
for the lesson as the teacher provided specific instructions for an experiment. JM was not
engaged and appeared self-directed. He played with his pencil while papers on his desk were
disorganized. Sometimes he asked aloud what to do with the materials provided (did not direct
his question to anyone in particular). JM did not follow the multi-step directions provided by the
teacher. He waited patiently to be told what to do. At one point, he was observed playing with a
tissue paper needed for the experiment. He broke the paper but did not ask for help. A student
assisted him in the experiment and JM did not acknowledge her assistance. As his teacher asked
a question to the class, he raised his hand and his teacher called on him to respond. He said: “I’m
pretty sure that when the plant grows the cotyledon is the leaf”. His teacher said: “Not really”
and proceeded to provide the correct response. JM did not seem upset. He turned to his papers
and continued looking at his seed. When time was over, the class was asked to get ready for
dismissal.
Hearing:
JM consistently, turned his head toward the source of sound, and stopped what he was doing
when environmental sounds were present, or when his name was called. According to Mrs.
____, JM has had one ear infection. No formal hearing test was reported.
3
Name: JM
DOB: _______
Oral-motor skills:
JM was able to move his tongue and lips upon verbal request for speech and non-speech tasks.
He evidences a slight under-bite. No deviation, asymmetry or drooling was observed. No feeding
difficulties were reported or observed during this assessment.
Articulation/Voice/Fluency:
Speech intelligibility at the word, phrase and sentence level is good, in both languages. Vocal
parameters (volume, resonance and quality) appear to be within age and gender expectations.
During spontaneous speech, JM evidenced repetition of single words at the beginning of phrases,
regardless of the language he used. In addition, he was observed to use a frequent interjection
(“right”) at the end of sentences, when he used English only. JM did not seem hesitant, tense or
unable to express his thoughts verbally. There were no signs of prolongations fixation of
sounds, avoidance behaviors or secondary behaviors (e.g. facial tension), which are signs of a
fluency disorder. JM’s repetitions or interjections appear to be related to language development
issues not a fluency disorder.
Linguistic abilities:
JM is a sequential language learner. He was exposed primarily to Spanish before he entered
school at the age of 4 years, 10 months. JM’s academic experience has been in English-only
classrooms. He continues to be exposed to Spanish (parents) and Spanish/English (siblings).
Language skills were assessed through clinical observations, directed tasks, language sample
analysis in Spanish and in English, the administration of individual subtest from the Clinical
Evaluation of Language Fundamentals-4 (CELF-4)* (9-21) in Spanish, the Clinical Evaluation of
Language Fundamentals-5 (CELF-5)* (9-21) in English and the administration of the Listening
Comprehension Test-2 (English)*.
The CELF-4 and CELF-5 are norm-referenced tests used for children ages 5-21. The tests
provide information about a child’s strengths and weaknesses across receptive and expressive
modalities, language content and language structure. Different subtests evaluate word meaning
and vocabulary (semantics), word and sentence structure (syntax and morphology), the rules of
oral language used in responding to and conveying messages (pragmatics), and recall and
retrieval of spoken language (memory). The Listening Comprehension Test-2 is a diagnostic test
of listening comprehension for elementary students age 6-0 through 11-11. The subtests assess a
student’s strengths and weaknesses in specific listening comprehension skill areas related to
classroom listening situation. The student responds to questions regarding: main idea, details,
reasoning, vocabulary and understanding messages. This test was normed in English speaking
students.
* Note: Testing materials are not available in standardized form for JM’s bilingual and
bicultural background. Use of standard scores would be misleading and inaccurate. Results
are presented in descriptive and qualitative form based upon tests administered, directed tasks
and clinical judgment.
4
Name: JM
DOB: _______
Receptive Language Skills
Auditory comprehension skills were assessed in Spanish and in English, in separate sessions. JM
seemed comfortable with either language. The following subtests were used to obtain
information regarding JM’s ability to follow commands, auditory comprehension of short
passages and comprehension of questions: Word Class (CELF-4 & CELF-5), Following
Directions (CELF-5) and the Listening Comprehension Test 2 (English). These materials were
modified to reduce bias and obtain accurate information about JM’s skills.
In the Word Classes 2-CELF-4 (Spanish), JM was given four words verbally and asked to
choose the two that related to each other (e.g. oscuro, caliente, suave, frio). The task required
the ability to recall list of words (auditory memory) and the ability to establish the relationship
between such concepts (semantics). The CELF-4 in Spanish assesses nouns within the following
categories: school concepts, sports, home, transportation materials and a couple of action words.
JM was able to associate a limited number of concepts within the following semantic categories:
home, school, clothing, and community. When the missed items were presented in English, JM
was able to respond correctly. In other words, he had the knowledge of the concept in English
but not in Spanish. The Word Classes 2-CELF-5 (English) used pictures for the first few items.
The student was asked to point to the two out of 3 or 4 pictures that belong together. After the
12th item, only list of 4 words were given verbally. The concepts presented are not a translation
of the CELF-4 (Spanish) but different types of categories. The words presented were a
combination of nouns, verbs and adjectives classified in semantic classes, location, composition,
synonyms, object function and opposites. JM evidenced strong auditory memory for discrete
details such as list of words. He was able to correctly choose the related concepts for most
categories except some synonyms and all antonyms. JM demonstrated knowledge of advance
concepts such as renovate/restore and quest/search but was unable to comprehend the nuances
of opposite concepts. His performance on this subtest suggests strong ability to recall isolated
words, and establish the relationship between nouns (concrete concepts) rather than verbs or
adjectives (more abstract concepts).
The Following Directions subtest from the CELF-5 (English only) requires the student to point
to shapes in response to an oral directive of increasing length and complexity. All familiar
shapes are presented in a variety of modifiers (e.g. colors: black/white, size: big/little or location:
first/second/third/fourth). For example, “Point to the big X, then point to the little triangle.”
This skill assesses short-term memory as well as procedural memory abilities. It relates to the
classroom with regards to comprehension, recall, and the ability to act upon spoken directions in
order to complete assignment. JM was able to follow 1-3 step commands with no orientation
(basically list of items). When commands included a specific order, JM was unable to follow the
sequence (e.g. fourth). In addition, he consistently had difficulty following direction with spatial
concepts (prepositions). Slower pace of presentation, repetition of the direction or presentation
in Spanish did not facilitate the comprehension of the command. His performance on this subtest
suggests a moderate difficulty following orally presented commands of increasing length and
complexity, in English. JM was attentive throughout the task.
5
Name: JM
DOB: _______
The Listening Comprehension Test-2 has five subtests. Short passages (3-6 sentences) related
to classroom situations were read aloud and specific questions were asked to assess the JM’s
ability to: 1) identify the main idea, 2) recall details, 3) make inferences, 4) provide a synonym
or a descriptive definition of a word heard and 5) understand short messages. The passages
were characterized by short declarative sentences with simple clauses. JM was told that there
were no pictures to look at. He was attentive to the task throughout the administration of the test.
JM consistently responded to questions on main idea, details and vocabulary. Once again, he
performed well in tasks where he had to recall isolated details, provide synonyms or define
words by using the context of a sentence. He was able to respond to ‘what’ and ‘where’
questions. However, JM was unable to respond to ‘why’ questions, to reason or make
inferences. His deficit comprehending abstract questions was consistent throughout this
assessment.
In a directed task, a longer passage (7 sentences) with complex sentences (e.g. indirect clauses,
prepositional phrases) was presented verbally and similar questions were asked. JM was unable
to respond to most of the questions. He was unable to indicate the main idea, understand a
sequence or make inferences. When pictures were provided for him to demonstrate
comprehension of sentences, JM’s performance was consistent. He was able to understand direct
statements but struggle to comprehend sentences with complex verb tenses, prepositional phrases
or clauses, regardless of the language used.
Based on JM’s responses to specific tasks that assessed his understanding of morphology
(grammar), syntactic structures (word order, questions), and semantic development (vocabulary),
receptive language skills appear to be in the moderate-to-severe range of impairment. He
presents deficits in specific areas of language. Areas of strengths: comprehension of nouns and
verbs, ability to establish relationships between concrete concepts, and auditory memory of
discrete information. Strength in these areas was evidenced in his ability to recall list of words,
establish relationships between nouns and some verbs, recall details, auditory comprehension of
‘what’ and ‘where’ questions about main idea, details, name synonyms and define nouns/verbs
using context clues. Weaknesses were evidenced in the following areas: poor comprehension
of specific linguistic concepts (sequential, and temporal-spatial concepts), and comprehension
of higher order thinking skills (e.g. ‘why’ and ‘how’ questions, difficulty making inferences and
cause/effect relationships). These weaknesses were consistent throughout this assessment,
regardless of the language used (Spanish or English). Deficits in the abovementioned areas
have a negative impact in JM’s ability to follow multi-step directions in the classroom,
organize information provided verbally, comprehend abstract and decontextualized
concepts and respond appropriately to classroom expectations. JM needs scaffolding
strategies and visual cues to support the development of age appropriate auditory comprehension
skills.
Expressive Language Skills
Expressive language abilities were assessed in both languages. JM was able to speak in Spanish
or English upon request. The following subtests were used to obtain information about JM’s
expressive language skills: Recalling Sentences (CELF-4 & CELF-5), Formulated Sentences
(CELF-4 & CELF-5) and Expressive Vocabulary (CELF-4). In addition, a language sample in
both languages was obtained and analyzed.
6
Name: JM
DOB: _______
In the Recalling Sentence subtest, JM was asked to repeat utterances including statements and
questions of various length and morphological complexity. His ability to repeat sentences in
English was superior to his ability to repeat sentences in Spanish. In Spanish, he was able to
repeat two active declarative sentences with a verb phrase and interrogation. In English, JM was
able to repeat an active declarative sentence with noun modification, an active interrogative with
negative and passive declarative with negative. He often finished the repetition of utterances
with: “don’t forget the period” after a sentence or “don’t forget a question mark” after a
question. He stopped making such comments after he was asked to just repeat the utterances.
However, JM had difficulty repeating complex sentences with subordinate clauses, relative
clauses or coordination (sequential concepts: such as then, before). JM often recalled the
beginning and the end of the sentence. JM usually omitted, substituted or distorted the middle
portion of the utterances. His performance in this subtest is consistent with deficits evidenced
throughout this assessment. JM’s ability to repeat sentences decreased as the level of word
(morphology-grammar) and sentences structure (syntax-word order) increased.
The Formulated Sentences subtest assesses the student’s ability to formulate complete,
semantically and grammatically correct spoken sentences when a given word (target) and
contextual constraints imposed by an illustration are provided. This task relates to the ability to
internalize the rules for forming simple, compound and complex sentences, and producing them
orally or applying them to written text. In Spanish, JM was able to put together 6-8 words
fluently. However, all the utterances were characterized by numerous grammatical errors such
as: lack of gender or number agreement between article + noun, or deficits in verb tensing.
These are some of JM’s utterances:
“La mujer ‘sta leyendo la diccionario” vs. el diccionario (gender agreement)
“Lo niños y la niñas stan jugando uno juego” vs. los niños y las niñas…un juego
(gender and number agreement)
“Los dos niño es jugando” vs. los dos niños estan jugando
(number agreement, verb tense)
In English, JM was able to put together 12+ words in grammatically correct sentences when
nouns, verbs, adjectives, some adverbs and some conjunctions were given. JM’s ability to
organize his thoughts to formulate grammatically correct sentences improved when the
illustration and the target word was concrete and easy to interpret. As the level of linguistic
complexity increased, his ability to formulate cohesive sentences decreased. He had difficulty
formulating sentences with conjunctive adverbs (e.g. instead), and coordinating and
subordinating conjunctions. These are some examples of his sentences:
“The kitty is putting her paw in the fishbowl so she can get the fish and she can eat it.”
“When the little girl fell of the bike, her pants ripped and she scrapped her knees.”
“There was a traffic police because he did not want any people ran over”
The errors evidenced in Spanish were grammatical errors, not present in English. JM was
exposed to Spanish primarily before entering school. It appears that the development of a second
language took place before the development of his first language (Spanish). Therefore,
grammatical errors in Spanish are consistent with lack of academic exposure to Spanish and not a
disorder. However, the errors noted in both languages were deficits in the appropriate
understanding and use of spatial/temporal concepts (semantics).
7
Name: JM
DOB: _______
The Expressive Vocabulary (CELF-4) subtest was used to assess word recall as he labeled nouns
in pictures. The illustrations used were from the Spanish version of the CELF-4. The CELF-5
does not have this subtest. JM was able to label 27 out of 29 items. All but one label was in
English. He labeled concepts such as arrow, tusks, fin, judge, and pyramid. As JM labeled
individual illustrations, he often went on to make comments about the pictures. For example,
watches- “an 1980 watch and a stop watch”, team- “playee…I’m pretty sure they won a soccer
match and I’m pretty sure they get their time”, arrow- “an arrow used to be different in 10,000
BC like we didn’t know how to make a table and…” (JM was referring to the movie “10,000
BC”, which he referred to without introducing the topic or explaining his idea).
Language Sample Analysis
Spontaneous language samples were obtained in Spanish and in English, in different days. The
following tasks were used to elicit a language sample: action pictures to tell a story (7-step
sequencing cards: students playing in the school playground---School-Age Language Assessment
Measure-SLAM), questions about the story, and open-ended questions to elicit conversation.
These are some of his utterances:
Stimulus
JM’s Utterances
Task: sequencing pictures
Language: Spanish
Analysis
De que se trata
esa historia?
(Student was asked to place the 7 cards in order of
events)
Spanish:
Deficits in:
Morphology (grammar),
semantics (lacks
vocabulary).
Si, que paso?
Es una historia de los dos niños esta siendo
mentirosos.
Esta siendo mentirosos
vs. son mentirosos
Loh loh niños staban jugahndo baseball
Y ehte niño se tiro la pelota muy duro
y se pego be bibrio y la maestro
staba como hummm y eh se fue para fuera con la
policia
y los dos niños se puso los guantes atras y se
puntodado la niña taba cuchando la musica y la
policia yyy la y la maestro y la niña se hizo eso relajo
(?)
se pego be bibrio vs. le
pego la pelota al vidrio
Que harias tu si
alguien te dice
que hiciste algo y
no fuiste tu?
(What would you
do if someone
says you did
something and it
wasn’t you?)
Yo pone enojado y yo diga “yo no hiso eso” yo sabe
quien hiso eso porque yo vido los dos ninos juando con
la pelota
porque no me gustan los mentirosos.
la maestro vs. el maestro
Los dos niños se puso
los guantes vs. se
pusieron
Yo pone vs. Me pongo
Yo diga vs. digo
Yo no hiso eso vs. no
hice eso
Yo vido los dos niños vs.
Yo vi a los dos niños
Grammatical errors in Spanish during spontaneous speech are consistent with grammatical errors
evidenced in during the administration of other assessment materials.
8
Name: JM
DOB: _______
Stimulus
Sequencing
pictures were
presented again on
a different day and
JM was asked to
tell the story in
English
JM’s Utterances
Task: sequencing pictures
Language: English
So there is like the kids are playing in the playground
And there were two boys playing baseball and the kid
in the red he threw the ball really hard and and and
he hit the window and the teacher saw it and he got
mad, right? and the police came so the two boys put
the mittens in their pocket so they would not get in
trouble and and they pointed at the girl listening to
music and and the police and the teacher saw she she
did it bu but she was only in the corner listening to
music.
Analysis
Sentences were more
organized.
Morphological markers
are appropriate.
Cohesive description of
the action using the
pictures as framework.
Stimulus
WH questions:
JM’s Utterances
(Responses to questions about sequencing story)
Analysis
What do you think
the teacher is
saying here?
I don’t know
but she shes just pointing at her and being mad
because he thought she she she did the damage.
Word choice- appropriate
context (e.g. damage,
expelled)
But he’s saying they’re expelled. Or suspended
because they got in trouble.
Why don’t the
teacher knows that
the boys were the
ones that did it?
So when the
teacher went to
the boys, the boys
pointed at the girl.
What do you think
the two girls
playing jump rope
should do?
If you were the
girl listening to
music, what
would you do?
They didn’t know? I’m pretty sure their eyes are
being sleek.
Clarity of the message is
compromised as he tries
to respond to a ‘why’
question.
Pretty sure their eyes are sleek (gesture)
Pretty sure he didn’t notice like but he should know
because he should seen the two boys playing baseball
with the mittens.
Yeah, so they framed her.
And and she got framed, right, for doing nothing.
She was JMust listening to music
because like she was too busy listening to music, right
and she was not focus on the police or the teacher.
They should help her
The girl listening to music because like
She she she saw … both the little girls they saw her
listening to music not playing with the ball so so so
she became sad, right, and they knew the two boys.
9
His discourse became
very unclear as JM used
pronouns and lacked
specific details. Who
became sad? And Why?
What would you
Say?
What would I say?
I would tell the truth because
What would I say?
What would you
say?
I would like…I did not do that
and I don’t know why people blaming
i stuff on other people
because they didn’t do that
and they just told the real evidence
and the boys were just telling the fake
evidence that she did it.
JM raised his voice and
seemed upset.
Learns vocabulary,
understands the general
meaning of the concept
but misses the nuances
of – when is it
appropriate to use this
word (pragmatic
judgment).
Fake evidence
Real evidence
During this assessment, JM was asked an open-ended question without visual constraints
(illustration) was used to assess his conversational skills.
JM’s Utterances
Stimulus
Who do you live with?
When you’re at home,
at night, and you go to
sleep, who also sleep in
your house?
What’s his name?
So he sleeps…? He
lives with you?
And when he doesn’t
sleep there, where does
he sleep?
Oh, oh, but he lives in
your house.
And how old is he?
Who watches him?
Ok. Does your mom
watch him? Sometimes?
Do you watch him?
It would be sometime soon mom, dad, or my
sister and my brother and sometimes my little
brother he just with somewhere else right,
Or with mom and dad
Or sometimes he’s at home they’re taken care of
my brother or my sister or my aunt.
Mom, dad, or sometimes my brother
Isaac!! My little one.
He sometimes sleeps inside the beeeed!!!
Ooooh!!!!
When he goes to sleep my mom always put him
inside the cuna!!! Inside the crib.
Yes!!
One month old, he’s a baby.
Sometimes is my brother or my sister
10
Analysis
Language is more
cohesive when is confined
to a visual framework.
Responses to open-ended
questions or description of
open-ended situations
become very
disorganized. He’s able
to label things, good noun
repertoire. He misses
nuances of language.
Difficulty understanding
abstract linguistic
concepts such as:
sometimes, always, some
where.
Pragmatics deficits: lack
of cohesive discourse,
disorganized thoughts,
unaware of lack of clarity
in his discourse. He gets
upset when he is not
understood.
Semantic deficits: large
vocabulary but has
difficulty understanding
the meaning and using
temporal-spatial and
sequential concepts. He
does not know how to use
Yeah
Yeah…but only in the weekends cause
if I got to go to school I can’t watch him
when I come back I can watch him.
prepositions, or
conJMunctions correctly.
Reportedly, his baby
brother is a year old, not a
month old.
Name: JM
DOB: _______
During the narration of a favorite movie, JM’s discourse was disorganized and unclear. He was
unable to maintain the topic of his narration, use sequential concepts appropriately of use
linguistic concepts (e.g. pronouns, prepositions, conjunctions) correctly to convey a clear
message. When questions were asked to clarify his narrative, JM would get upset, raise his voice
and appeared frustrated. He did not seem to understand why the listener was unable to follow his
narrative. This response was observed throughout this assessment.
JM’s responses to this assessment suggest that he is a bilingual child with a preference and
dominance for English. Linguistic deficits are not attributable to bilingualism.
Based upon assessment materials, directed tasks, and clinical judgment, JM presents a
moderate-to-severe impairment in expressive language abilities, even in his strongest
language, English. Areas of strengths are noted in the development of morphological skills and
recalling of discrete concepts. These strengths were evidenced in his ability to formulate
grammatically correct sentences when he had the constraint of an illustration as well as labeling
nouns in pictures. Weaknesses were identified in the formulation of cohesive sentences with
abstract concepts (temporal-spatial and sequential concepts), poor discourse skills, poor topic
maintenance, and lack of understanding nuances of linguistic concepts.
Difficulties
understanding such essential linguistic concepts have an impact in his ability to communicate
effectively. He has poor topic maintenance during spontaneous speech, off-topic responses, and
difficulties with sequential events in oral narratives and during spontaneous comments. He is
unable to clarify a verbal response unless scaffolding strategies are used to increase his
awareness and facilitate the development of semantic skills.
Writing:
An informal writing sample was obtained during this assessment. JM was asked to formulate a
sentence verbally using a target word (reading) and the constraint an illustration. He formulated
a 12+ grammatically correct sentence: “The big brother is doing his reading log and the little
brother is doing his picture and the sister is reading a book about history and the father is reading
a newspaper”. JM was then asked to write it down. He used his left hand and a quadruped
pencil grasp to write the following:
“the Big Brather is to doig his readiNg log ANd the little Brother iN draWing his picture
ANd the sister is readiNg A Book aBout historY ANd the father is readiNg
A NeW Paper”
JM evidenced difficulty with standards of English (appropriate use of lower and upper case
letters) as well as spelling errors. Reportedly, this is a typical writing sample seen in the
classroom.
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Name: JM M
DOB:
Summary:
JM is a 10 years, 2 months old Hispanic male, of Honduran descent. He is a 4th grade student in
a monolingual General Education classroom, at _______ school. JM was referred for a
Diagnostic Evaluation due to overall academic concerns, and difficulties with communication
skills. JM is a sequential language learner. He was exposed primarily to Spanish before he
entering school at the age of 4 years, 10 months. JM’s academic experience has been in Englishonly classrooms. He continues to be exposed to Spanish (parents) and Spanish/English (siblings)
at home. His responses to the assessment materials suggest that JM is a bilingual child who
prefers English to communicate. Linguistic deficits are not attributable to bilingualism.
JM is a handsome and kind boy who was attentive and compliant throughout this assessment. He
participated in all activities presented throughout several days. Based upon assessment
materials, directed tasks, and clinical judgment, JM presents moderate-to-severe deficits in
both areas of language: receptive and expressive language skills. Linguistic impairment is
characterized by deficits in semantics and pragmatics. Salient features of the language
deficits are: poor auditory comprehension of linguistic concepts, difficulty comprehending
cause/effect relationships, and poor comprehension of ‘why’ and ‘how’ questions, lack of
cohesive discourse, disorganized ideas, and lack of awareness of poor clarity in his discourse.
Visual skills appear to be a strong learning channel. Expressive language is more cohesive
when is confined to a visual framework. Responses to open-ended questions or description of
open-ended situations become very disorganized. He’s able to label things evidencing good
recalling skills and strong repertoire of nouns. He misses nuances of language because he has
difficulty understanding and using abstract linguistic concepts that describe time, space and
sequence of events. JM needs visual support, scaffolding strategies to facilitate comprehension
of linguistic concepts and simplification of commands that require order or events.
Speech sound production appears to be within normal limits in both languages. Fluency is
characterized by occasional repetition of whole words, particularly during tasks that require more
organization.
Speech and language therapy is strongly recommended for the 2018-2019 school year to address
the significant deficits in language skills.
Mayra Cruz-Vázquez M.S./CCC, TSSH-BE
Bilingual Speech-Language Pathologist
NYS License # 005301-1
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