Language Assessment Template

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INITIAL EVALUATION: LANGUAGE
Referral and Background
*BOY, age 11.5, is a fifth grader at Hassan Elementary School. *BOY’s classroom teacher, Ms.
Rosso referred *BOY for special education assessment. Ms. Rosso reported concerns about
*BOY’s communication skills in the area of language. Ms. Rosso performed two interventions in
the classroom over a 4-6 week period with no change to *BOY’s performance. There were no
other concerns reported by the team at the time of assessment planning. Currently, *BOY is in the
low reading group and receives additional support in the Targeted Service Program. During the
first quarter of this year, *BOY was sent to the Academic Study Room (ASR) five times to
complete homework assignments. *BOY’s first quarter grades for 5th grade were: Language ArtsD, Math-D, Social Studies-C, and Science-D.
*BOY’s mother, Ms. *BOY, reported *BOY had a normal birth and delivery and that *BOY
achieved most developmental milestones in an average pattern. *BOY has a history of ear
infections and speech therapy in early childhood. He lives at home with both parents and an older
sister.
Test Results
To determine *BOY’s present level of communication functioning in the area of LANGUAGE,
Sarah Peterson, Speech Language Pathologist administered the following tests: WORD TestElementary (WORD-E), Listening Comprehension Test-2 (LCT-2), and Test of Problem SolvingElementary, Revised (TOPS-ER). Additionally, a review of records (including subtest results from
intellectual and academic testing) and a Structured Language Sample & Conversational Analysis
Checklist were completed.
The PPVT-4 is a test of receptive language. It is designed to measure a student's understanding
of single word vocabulary. Vocabulary knowledge is a form of achievement-it represents the
words and word meanings that a person has learned both in and out of school. Understanding of
word meaning is important for extracting meaning from text, so students with limited vocabularies
often struggle to comprehend what they read in the classroom. In this test, a student is shown four
pictures and is asked to select one that most closely represents a target words’ meaning.
Composite standard scores ranging from 85-115 are considered average. *BOY obtained a
standard score of 61 (56-68), percentile of .5, and grade equivalent of pre-k to first grade. This
score fell in the EXTREMELY BELOW AVERAGE range for understanding SINGLE WORD
VOCABULARY as compared to *BOY’s same aged peers. Examples of words that *BOY missed
include…. *BOY may have difficulty understanding words and concepts presented at grade level.
*BOY may benefit from direct instruction in vocabulary for classroom units and from reading
assignments that are appropriate for his vocabulary level.
The WORD-E2 is a test of expressive vocabulary. It is designed to assess a student’s ability to
recognize and express critical semantic attributes. The more words a student understands, the
more likely he/she is to be a successful producer of language in both speaking and writing. In this
test, a student answers questions related to associations, synonyms, semantic absurdities,
antonyms, definitions, and flexible word use. Composite standard scores ranging from 85-115 are
considered average. *BOY obtained a standard score of 79 and percentile of 8. This score fell in
the MODERATELY BELOW AVERAGE range for EXPRESSIVE VOCABULARY SKILLS
compared to *BOY’s same aged peers. *BOY performed best on subtests that required him to
make associations between words (‘Tell me which word doesn’t belong and how are the others
alike?’); recognize and fix absurd statements (‘The plumber fixed the lights’); provide one-word
antonyms (‘What’s the opposite of hot?’); provide one-word synonyms (‘Tell me another word for
happy.’); explain the meaning of words (‘What is an island?’); and use words flexibly (‘What does
the word watch mean?’). *BOY struggled most with subtests that required him to… *BOY may
benefit from direct instruction related to attributes (class, function, color, shape, quality),
compare/contrast, vocabulary, paraphrasing, absurdities, and word retrieval.
The ASSET is a test of expressive and receptive language. It is used to measure a student’s
semantic and vocabulary skills through the use of familiar scenes and themes of everyday life like
‘around the house’ and ‘eating’. Students learn new information best with contextual instruction
that emphasizes experience, interaction, and learning through all of the senses. In this test, a
student is asked to point to and answer questions related to labels, categories, attributes,
functions, and definitions. Composite standard scores ranging from 85-115 are considered
average. *BOY obtained a standard score of 79 and percentile of 8. This score fell in the
MODERATELY BELOW AVEAGE range for SEMANTIC AND VOCABULARY SKILLS compared
to *BOY’s same aged peers. There was no significant difference between *BOY’s expressive
(standard score 34) and receptive (standard score 31) standard scores, which indicated that *BOY
understood as much as he said. *BOY performed best at tasks that required him to recognize
similarities among different objects (Show me some things you can string, What are these called:
1. 4. 7?); attach a purpose to an object (Show me something you can serve, What do you do with
a puzzle?); attach names to objects and actions (Show me the crayons, What is this called?),
distinguish critical elements of an object (Show me something that spins, What does paste feel
like?), and give clear definitions (Show me some things we can multiply and divide, This boy is
doing a somersault, what does somersault mean?) *BOY struggled most with tasks that required
him to…. *BOY may benefit from direct instruction to identify/label items from a story/unit, to
compare/contrast; to identify attributes and describe/define items; to re-tell stories,
The WABC is an expressive and receptive language test. It is used to measure a student’s
understanding and use of basic word opposites and related concepts. Basic concepts such as
colors, numbers, location words, and descriptive words are the building blocks that students need
to follow directions, engage in classroom routines, and provide descriptors. Understanding these
concepts is fundamental so that student’s can perform everyday tasks such as listening, speaking,
reading, writing, and arithmetic. In this test, a student is shown colorful storybook illustrations and
asked to point to objects and to name aloud an attribute, feature, or location associated with the
pictured entities. Composite standard scores ranging from 85-115 are considered average. *BOY
obtained a standard score of 93 and percentile of 31. This score fell in the MODERATELY
BELOW AVERAGE range for UNDERSTANDING AND USE OF BASIC CONCEPTS compared to
*BOY’s same age peers. *BOY’s understanding and use was well established for the following
semantic categories: color/shape, (e.g. ‘orange’) weight/volume (e.g. ‘heavy’ ‘deep’),
quantity/completeness (‘most’, ‘whole’) condition/quality (e.g. ‘rough’, ‘new’) and
sensation/emotion/evaluation (e.g. ‘hard’, ‘easy’). *BOY’s struggled more to understand and use
semantic categories for… *BOY may benefit from direct instruction to better understand and use
the concepts of ….
The TAPS-3 is a test of auditory skills. It assesses auditory skills that are necessary for the
development, use, and understanding of language commonly used in academic and everyday
activities, including auditory attention, basic phonemic skills, phonological segmentation, auditory
memory, and auditory cohesion. Auditory processing is simply what we do with what he hear.
When auditory signals are received, a person must attend to, analyze, store, and retrieve
information related to the signal. In this test, a student is asked to listen, repeat, and respond to a
variety of information presented. Composite standard scores ranging from 85-115 are considered
average. Subtest standard scores from 9-13 are considered average. *BOY obtained a composite
score of 73 (69-77) and subtest standard scores that ranged from 2-9: Phonologic (90), Memory
(81), and Cohesion (78). These scores fell in the range of LOW AVERAGE TO MODERATELY
BELOW AVERAGE range for AUDITORY SKILLS compared to *BOY’s same age peers. *BOY
performed best on tasks for a) basic phonologic skills like discriminating between sounds within
words, segmenting sounds into morphemes, and blending sounds into words. These skills are
important for understanding language and when learning to read; b) memory processes, including
sequencing. If a student cannot retain what has been heard and maintain it in correct sequence,
this student cannot process that information accurately. For example, students are often required
to retain and manipulate information before determining an answer, such as when learning to spell
or when learning arithmetic processes; c) auditory cohesion. This is a higher-order linguistic skill
that requires the student to understand exactly what was said and to use inference, deduction,
and abstraction to understand the meaning of a passage. The student is asked questions about a
passage that cannot be answered correctly using only the words presented in the passage and
must instead use more complex language constructions to answer the queries... Additionally,
*BOY demonstrated the following: poor listening skills; difficulty understanding spoken language in
the presence of back-ground noise or in areas with poor acoustics; poor auditory memory;
mumbling and indistinct articulation patterns; reading and spelling problems; and auditory
overload-difficulty screening out irrelevant auditory stimuli and, as a result, being overwhelmed by
auditory input. *BOY may benefit from direct instruction
The LCT-2 is a test of receptive language. It assesses a student’s strengths and weaknesses in
specific listening comprehension skill areas related to classroom listening situations. Listening is a
large part of learning in the classroom (50-75%) and is one of our primarily means of interacting
with others. Students must listen well in order to accurately follow directions, make inferences,
explain, participate in discussions, and to feel. In this test, a student listens to short paragraphs of
information and is asked to answer questions related to main idea, details, reasoning, vocabulary,
and understanding messages. Composite standard scores ranging from 85-115 are considered
average. *BOY obtained a standard score of 93 and percentile of 31. This score fell in the LOW
AVERAGE range for LISTENING COMPREHENSION SKILLS compared to *BOY’s same aged
peers. *BOY performed best on subtests that required him to listen to and identify the main idea of
short informational paragraphs (‘What am I talking about?’); to remember and answer questions
about details (‘Where was the party?’); to make inferences about information he heard (‘What
might Ray’s friends do to get ready for his party?’); to provide definitions to words used in
passages (‘What’s another word for gift?’); and to differentiate the most relevant from irrelevant
information in a passage. *BOY struggled most with subtests that required him to… *BOY may
benefit from direct instruction that…summarizes/outlines the main idea and details of a unit
beforehand 2) allows students to draw conclusions/reconstruct view points/ formulate solutions to
problems in a particular unit (e.g. In a science unit on photosynthesis, asking students to generate
a solution to the question, “What would happen if all green plants died?’); pre-teaches
vocabulary/concepts and uses concepts maps; and practices sorting out important from nonimportant details,
The SPELT-3 is an oral language test of morphology and syntax. It measures a student’s ability to
generate specific grammatical structures and complex sentence and question types. In this test, a
student is presented with photographs of everyday activities and asked to respond to statements
or questions. Composite standard scores ranging from 85-115 are considered average. *BOY
obtained a standard score of 72. This score fell in the MODERATELY BELOW AVERAGE range
for MORPHOLOGIC AND SYNTACTIC KNOWLEDGE compared to *BOY’s same aged peers.
*BOY demonstrated a mastery of the following grammatical structures: ….prepositional phrases
‘un/under’), plural nouns (addition of ‘s’ or ‘ez’), possessive marker ‘s (‘Mary’s’), pronouns (‘my’,
‘mine’,’ himself’), verb forms and tenses (‘walked’, ‘build/built’), present progressive verb
(‘walking’). *BOY also demonstrated mastery of complex sentence constructions that used…
conjunctions (‘and’, ‘because’), negatives (‘I don’t want to play’), complex sentences using clauses
(‘after it rained, it was wet’), passive voice (‘the ball got hit.’), and formulated questions (‘Where is
my shoe?’). *BOY struggled more with grammatical and sentence structures for:.. *BOY may
benefit from direct instruction for…
The TOPS-ER is a test of language-based problem solving and critical thinking. Language is the
foundation of critical thinking. Critical thinkers must be able to listen carefully; understand and
interpret what they see, hear, or read; and express their thoughts clearly to others. Difficulty in any
one of these language-based areas limits the ability to use good strategies to think and
communicate with others. In this test, a student is presented with 14 photographic pictures and
asked to answer questions about the information depicted. Questions focus on a broad range of
critical thinking skills including evaluating, determining word meaning from context, inferring,
generating solutions, and affective thinking. Composite standard scores ranging from 85-115 are
considered average. *BOY obtained a standard score of 72. This score fell in the MODERATELY
BELOW AVERAGE range for PROBLEM SOLVING and CRITICAL THINKING SKILLS compared
to *BOY’s same aged peers. *BOY performed best on questions that required him to.. evaluate
what was happening in a picture using context/visual clues (‘What do you think is happening with
the two boys in this picture?’); determine word meaning and use strategies to give a clear
definition without using vague words like ‘thing’, ‘it’ ‘stuff’ (‘BJ just enrolled in this school, what
does enrolled mean?’); infer information (What do you think is on his mind?); and generate
reasonable solutions to problems and identify consequences (‘Tell me two ways kids could help
him’). Additionally *BOY demonstrated …strategies for giving clear definitions; appeared to
process questions efficiently without misinterpretation’ didn’t perseverate answers across items;
understood another’s perspective—a prerequisite to persuading, explaining or role-playing.*BOY
struggled most with questions that… *BOY may benefit from direct instruction to…
The CELF-4 is a broad-based test of language that measures different expressive and receptive
language abilities. These include word meaning, word and sentence structure, and recall and
retrieval of spoken language. Core Language scores ranging from 85-115 are considered
average. Subtest standard scores from 9-13 are considered average. *BOY obtained a core
language score of 73 (69-77) and obtained subtest standard scores that ranged from 2-9 (see
below). These scores fell within the MODERATELY LOW range of EXPRESSIVE and
RECEPTIVE LANGUAGE SKILLS as compared to *BOY’s same aged peers. *BOY performed
best on subtests that that required him to… complete directions (e.g. “xxx’); to recall spoken
sentences (e.g. ‘If the rain doesn’t stop before noon, the field trip will have to be cancelled’); to
understand/explain relationships between words (e.g. ‘Listen to these words and tell me the two
words that go together best and why: school. Cake, street, teacher’ ‘); to interpret/create meaning
from spoken sentences (xxxx); to formulate complete and grammatically correct sentences using
given words (‘if, because’, ‘otherwise’); to label/identify/define people, objects and actions; to
listen, answer questions, and think critically about information presented in paragraphs; *BOY
struggled more to on subtests that… *BOY may benefit from direct instruction that…
Concepts and Directions
Recalling Sentences
Formulated Sentences
Word Classes
Core Language Score
2
7
4
9
73 (69-77)
The TOLD is a broad-based test that measures expressive and receptive language abilities.
These include listening, organizing, speaking, grammar, semantics, and general spoken
language. Composite standard scores ranging from 90-110 are considered average. *BOY
obtained the following composite standard scores: Listening (82), Organizing (62), Speaking (73),
Grammar (76), Semantics (75), Spoken Language (73). These scores fell within the
MODERATELY BELOW AVERAGE range of EXPRESSIVE AND RECEPTIVE LANGUAGE
SKILLS compared to *BOY’s same aged peers. *BOY performed best on subtests that that
required him to.. understand spoken language; relate incoming speech with various kinds of
memory and associative operations that are necessary for making oral responses; to
communicate thoughts orally; to construct words and sentences; to understand words. *BOY
struggled more to on subtests that… *BOY may benefit from direct instruction that…
A Social Language Assessment Checklist was completed to examine *BOY’s pragmatic skills
informally. Interpretation of verbal and nonverbal communication, knowledge of social scripts, and
understanding of implied social rules are required for school and non-school success. In this
checklist, an examiner looks for examples of 51 communication acts during a student’s language
sample and determines whether each act is used appropriately. The checklist is made up of four
sections: Conversation, Paralinguistic, Non-Verbals, and Social Rules/Etiquette. For
Conversation, *BOY demonstrated difficulties with conversational topic, turn taking, and
cohesion/clarity. For example,... For Paralinguistics, *BOY demonstrated difficulties in vocal
intensity, prosody, fluency, and intelligibility. For example,... For Non-Verbals, *BOY demonstrated
difficulty with gestures, eye contact, facial expression, and proxemics. For example,... For Social
Rules/Etiquette, *BOY was not aware of things going on around him during class time (e.g.
students lining up at door to go to the lunch) and *BOY frequently got up out of his seat to wander
the room at inappropriate times. Overall, the burden of communication will likely rest on the
shoulders of *BOY’s communication partner. This listener will often need to ask questions to
clarify *BOY’s thoughts; especially for wh-questions, as *BOY struggles to formulate these
question types. *BOY would benefit most from direct instruction that targets his use of
…conversational topics and turn taking.
A Structured Language Sample & Conversational Analysis Checklist was completed to examine
*BOY’s functional communication informally. In this checklist, an examiner looks for examples of
38 conversational skills and determines whether each skill was used appropriately. The checklist
is made up of two sections: Listening Skills and Speaking Skills. For Listening Skills, *BOY
appeared to struggle with attention and comprehension throughout the testing session. For
example, *BOY was observed to fidget in his seat and to frequently look around the room. He
responded ‘I don’t know’ to eight test questions. Restlessness appeared to increase for test
questions that were more lengthy and difficult. Unless prompted by the examiner, *BOY did not
ask for repetition or clarification of directions and questions-though *BOY’s test performance
appeared to increase on subtests that allowed repetition and provided practice trials. He did best
when information was repeated 1-2 times. For Speaking Skills, *BOY appeared to struggle to
convey his thoughts in an organized manner and to use grammar and vocabulary precisely. For
example, *BOY’s descriptions of pictures depicting the outdoors contained many false starts and
revisions. He was observed to formulate a thought and to revise it several times over within the
same breath. Descriptions contained many non-specific referents including ‘it’, this’ , and ‘like’.
Also, during a story re-tell task, *BOY related events in a fragmented and non-sequential manner.
He did not use terms like ‘first’, ‘second’, ‘finally’ or ‘then’ to help orientate his listener. The
examiner had to clarify the story’s order of events. *BOY willingly accompanied the examiner to
each test session and was pleasant and cooperative throughout the time together. *BOY’s use of
social language was judged as within normal limits, as he was observed to use appropriate
paralinguistics like eye contact, facial expression, and gesture. *BOY also initiated and maintained
conversation with the examiner about a variety of topics like.., No speech sound errors were noted
and *BOY’s voice was judged as within functional limits for fluency, pitch, prosody, quality and
loudness.
Results from current intellectual and academic testing were reviewed. On the Wechsler
Intelligence Test for Children-IV (WISC-IV), *BOY obtained a standard score of 72 for verbal
ability. This subtest…. On the Woodcock Johnson Tests of Achievement-III (WCJ-III), *BOY
obtained standard scores of 72 for written expression, 75 for reading comprehension, and 82 for
oral language/expression. These subtests…These scores fell within the below average range of
language functioning. *BOY struggled with language-rich subtests for intellect and academics.
Interpretation
Language learning is a gradual process that begins in infancy and continues through a child’s later
school years. Particular skills are present by general age ranges in most children, and these
developmental ‘milestones’ help specialists determine whether a child’s language is developing
normally. As school years progress, a greater emphasis is placed on a more complex use of
language and language competence is simply assumed. Older students and adolescents are
expected to possess an expanded vocabulary repertoire, to demonstrate advanced sentence
structures when speaking and writing, and to command an ability to use different language when
interacting socially with peers and adults. A child with who has problems with language may
demonstrate a marked slowness in the development of vocabulary and grammar necessary for
communicating effectively. This child may have poor speaking abilities, including problems using
word endings and sentence structure to ask questions. He/she may also experience difficulty
following directions, or varying language to fit a variety of social situations.
PLAAFP
*BOY’s communicative skills and interaction were judged as different. On tests of language, *BOY
obtained composite scores that ranged from low average to extremely below average compared
to his same age peers. *BOY struggled most to complete tasks that required him to make
associations between related words automatically and efficiently; to perceive relationships in word
meaning; to interpret and infer information; and to use functional communication in manner that
was coherent and concise. Additionally, *BOY obtained below average scores on language-rich
subtests for intellectual and academic measures in this assessment battery. *BOY performed
better on tasks that required him to... *BOY’s performance increased when practice trials were
provided, directions and test items were repeated, and responses to questions required short,
verbal output. *BOY’s articulation, fluency and voice were informally examined and judged as
appropriate. Overall, *BOY’s communication skills in the area of language were judged as
different.
Needs
*BOY has difficulty understanding and using LANGUAGE to convey his ideas in a coherent and
precise manner. Grade level work may be more challenging for *BOY. *BOY needs to improve his
skills related to …grammatical structures, self-expression, basic concepts, processing & listening,
association & vocabulary, social language, and language-based critical thinking in order to 1)
better understand and use language and 2) to meet Language Arts Benchmarks for …Vocabulary
Expansion, Comprehension, Literature, Spelling/Grammar/Usage, and Speaking/Listening.
Adaptations
Parents and teachers may help *BOY improve his language skills by: a) modeling correct
language when *BOY uses inappropriate grammatical structures. For example, if *BOY says ‘I
goed to the bathroom’ then respond by saying ‘Oh, you went to the bathroom’. Over emphasize
the target you wanted *BOY to use. This helps *BOY by letting him know you understood and
provides a model from which to learn b) pre-teaching new unit vocabulary c) using visual aides to
supplement lectures like pictures, diagrams, and graphic organizers d) breaking tasks in to small
steps e) writing out and sequencing directions for class projects and homework f) providing
reduced or alternate requirements for oral presentations, like a poster board or graphic organizer
to demonstrate learning g) providing examples of end-products of projects to be completed h)
increasing ‘wait time’ to 3-5 seconds before expecting *BOY to follow an instruction or to answer a
question i) having a peer take notes to share with *BOY j) Provide opportunity to respond orally
instead of written k) Provide opportunity to leave class for resource assistance l) Allow peer to
read materials m) Modified tests and assignments by limiting the number to be completed, reduce
multiple choice questions from 4 to 2, provide a word bank n) Allow special education staff to read
tests o) Preferential seating close to area of instruction p) 3) When absent or missing instruction,
assignments can be adapted, modified or exempt.
An educational handout about language with specific activities for at-home practice will be
provided to *BOY’s parents, and on-line games that support the development of language skills
also can be accessed for at-home practice using Ms. Peterson’s school website:
www.elkriver.k12.mn.us/webpages/sapeterson/
Criteria
 In order for a student to receive special education service, he/she must meet MN State
Criteria. *BOY DOES MEET CRITERIA for a communication disorder in the area of
LANGUAGE. *BOY scored two standard deviations below the mean on two tests
administered and *BOY’s communicative interaction was judged as different from what
would be expected given consideration to chronological age/developmental level/cognitive
level. Special education service for a communication disorder in the area of language is
recommended. Language support is typically provided in a small group setting, two times
per week, within a resource room at Hassan Elementary School. The specific days and
times of sessions are scheduled in conjunction with a student’s classroom
teacher/schedule.

In order for a student to receive special education service, he/she must meet MN State
Criteria. *BOY did not score two standard deviations below the mean on two tests
administered and *BOY’s communicative interaction was not judged as different from what
would be expected given consideration to his cognitive level. HOWEVER, *BOY did
demonstrate pervasive difficulty understanding and using language across measures in this
assessment test battery. Compared to *BOY’s same age peers, *BOY obtained composite
scores that ranged from low average to extremely below average on test of language, and
*BOY obtained below average scores on language-rich subtests for intellectual and
academic testing. As a result, grade level work be more challenging for *BOY and he may
struggle to meet academic benchmarks—especially those related to Language Arts,
including vocabulary expansion, comprehension, literature, spelling/grammar/usage, and
speaking/listening. Special education service for a communication disorder in the area of
LANGUAGE is recommended BASED ON NEED. This service is typically provided in a
small group setting, two times per week, within a resource room at Hassan Elementary
School. The specific days and times of sessions are scheduled in conjunction with a
student’s classroom teacher/schedule.

The child does NOT meet the state criteria… HOWEVER, since ...... met educational
criteria under the category of Developmental Delay, he/she only needed one test at -1.5 to
receive language services on a CONSULTATIVE basis. This means that the speech and
language clinician will be available to consult with the ECSE / classroom teacher to provide
ideas and strategies to support the learning of new language skills in the classroom
setting. These consultative services can continue until .... reaches the age of 7 or until the
educational team completes an evaluation to consider categorical K-12 special education
placement. At that time, ------ would need to meet the state criteria of two language tests at
-2.0 in order to receive language services.
*Be sure to include statement in ‘accommodation section’: SLP will assist student in
learning and/or maintaining new skills through consultation with service providers.
Be sure to include services as consultative from drop down menu and write a note to
document each observation in contact log and/or provide to case manager.

Treatment no longer results in measurable benefits. Jack demonstrates behavior that interferes with
improvement and participation in treatment (e.g. noncompliance, malingering). Efforts to address these
factors have not been successful. There does not appear to be any reasonable prognosis for improvement
with continued treatment. Reevaluation should be considered at a later date to determine whether the
student’s status has changed or whether new treatment options have become available.

Jack will be brought from home to Hassan Elementary to receive direct instruction in

Jack’s level of language skill is not commensurate with same aged peers and significantly affects his
performance in the academic setting. Based on need, Jack receives additional support in special education
for math and English classes. A small group setting, assignment monitoring, and help with work completion
are all required to increase Jack’s success in school as he would have difficulty reading and comprehending
the language used in general education materials.

The student requires extensive, direct instruction and/or supports in multiple settings to acquire, maintain, and
generalize academic and life skills to actively participate in school, work, home, and community environments.
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