Wayne County Public Schools
Exceptional Children Program
CONFIDENTIAL
Speech-Language / Communication Assessment
Student Name:
Date of Birth:
Chronological Age:
Grade:
School:
Teacher:
Date of Screening/Evaluation Request:
Date of Screening/Evaluation:
REFERRAL AND BACKGROUND INFORMATION:
This assessment was administered as part of the Wayne County Public Schools’
Exceptional Children Program referral for testing. The purpose of this assessment
is to screen and/or evaluate the student, as indicated based upon the information
provided by the IEP (Individualized Education Plan) team.
This student:
 Is undergoing speech/language screening/evaluation as part of a standard
assessment battery for an initial placement to the Exceptional Children program
 Is undergoing speech/language screening/evaluation as part of the reevaluation
process for the Exceptional Children program
According to information received from the IEP team, this student:
*Teacher/parent concerns
*Social / developmental history
*Student performance data can be inserted here or shared in the “educational
evaluation” if a speech only referral
STUDENT is in the ____ grade at SCHOOL NAME.
Social/Developmental
history completed by _____________ indicated ________. Referral for assessment
indicated _____.
Further information regarding this student may be found ____________________.
ASSESSMENT PROCEDURES: (specific tests administered are detailed in report)
 one-on-one assessment
formal measures
 arena assessment
informal measures/observations
The assessment took place over ___session(s).
The IEP team should review assessment results for consistency with the most current information available regarding student’s
communication skills in the educational setting. Should the IEP team feel these areas are of educational concern and require further
review, request for additional speech-language input is recommended.
GENERAL OBSERVATIONS AND IMPRESSIONS:
INFORMAL AND/OR FORMAL ASSESSMENT RESULTS AND
INTERPRETATIONS:
Voice/Resonance:
Conversational
Speech Sample
(Informal)
⌂ Subjectively judged as appropriate for age/gender; within
functional limits. No concerns reported. No further
assessment deemed necessary based on existing information.
⌂ Further assessment needed
Comments:
Fluency:
Conversational
Speech Sample
(Informal)
⌂ Subjectively judged as within functional limits. No
concerns reported. No further assessment deemed necessary
based on existing information.
⌂ Further assessment needed
Comments:
Articulation/(oral/
peripheral):
Conversational
Speech Sample
(Informal)
⌂ Subjective listening during conversational speech sample
revealed articulation within functional limits. Oral motor
structure and functions were judged to be adequate for
support of speech. Speech appeared intelligible. No
concerns reported. No further assessment deemed necessary
based on existing information.
⌂ Further assessment needed
Receptive,
Expressive, and
Social Language:
Conversational
Speech Sample
(Informal)
Comments:
⌂ Subjective listening and conversational speech sample
reveal adequate understanding and usage of language. No
concerns reported. No further assessment deemed necessary
based on existing information.
⌂ Further assessment needed
Comments:
The IEP team should review assessment results for consistency with the most current information available regarding student’s
communication skills in the educational setting. Should the IEP team feel these areas are of educational concern and require further
review, request for additional speech-language input is recommended.
Educational
Evaluation:
See psychological report for results of educational
evaluation.
OR
Teacher assessments indicate the following regarding
STUDENT’s educational /academic performance: (DIBELS,
student performance data etc.)
STUDENT is/is not performing on grade level
Summary:
Recommendations:
*Do not determine eligibility in report
*Do not make specific recommendations for service
-findings may SUGGEST that it APPEARS a student
MIGHT meet requirements but the TEAM determines
eligibility and for a related service, it is not about eligibility
but if the student needs the service to access their special ed
curriculum. Eligibility determination should not be in the
report
-The IEP team should consider…
-The IEP will review ….and determine which educational
setting the student’s needs can be best addressed in…
Evaluated by:
_________________________________________
SLP NAME
, MS CCC/SLP
Speech-Language Pathologist
Date:
__________________
The IEP team should review assessment results for consistency with the most current information available regarding student’s
communication skills in the educational setting. Should the IEP team feel these areas are of educational concern and require further
review, request for additional speech-language input is recommended.
*Evaluation is property of LEA, should be archived at least 5 years post service
*Evaluation should be kept in accessible location year round, included as part of IEP
documentation
TEST BLURBS to insert:
Goldman Fristoe Test of Articulation-2 (GFTA-2): The GFTA-2 is a systematic means
of assessing an individual’s articulation of the consonant sounds of Standard American
English in single words. The child is asked to name large colored pictures. The number
of errors on consonant sounds is compared to children of the same gender and age.
Initial errors
Medial errors
Final errors
Blends
GFTA: 2
Sounds-in-Words Score Summary
Standard Score:
*Standard scores from 85-115 are considered average. Standard scores on this test
should be interpreted with caution, because there is no consideration for the frequency of
occurrence of the error or age of acquisition of the phonemes.
Preschool Language Scale-5 (PLS-5): The PLS-5 is used to assess receptive and
expressive language skills in infants and young children. It can be used to help determine
if a child has a language delay or disorder. The Auditory Comprehension scale is used to
evaluate the scope of a child’s understanding of language. The Expressive
Communication scale is used to determine how well a child communicates with others.
PLS:5
Standard Score:
Auditory Comprehension:
Expressive Communication:
Total Language Score:
*Standard scores ranging from 85-115 are considered average.
The IEP team should review assessment results for consistency with the most current information available regarding student’s
communication skills in the educational setting. Should the IEP team feel these areas are of educational concern and require further
review, request for additional speech-language input is recommended.
Clinical Evaluation of Language Fundamentals-Preschool: 2 (CELF-P: 2): The
CELF-P: 2 is a clinical tool used to identify and diagnose language deficits in young
children. It assesses receptive (understanding) and expressive language abilities, in
addition to other areas of cognition and language. Subtest raw scores are converted to
standard scores, and are then combined to yield a composite language score.
Subtest standard scores ranging from 7-13 are considered average.
Composite scores ranging from 85-115 are considered average.
CELF-P: 2
Subtest Scaled Score
Sentence Structure
Word Structure
Expressive Vocabulary
Concepts and Following Directions
Recalling Sentences
Basic Concepts
Word Classes-Receptive
Word Classes-Expressive
Word Classes-Total
CORE LANGUAGE SCORE
RECEPTIVE LANGUAGE INDEX
SCORE
EXPRESSIVE LANGUAGE INDEX
SCORE
LANGUAGE CONTENT INDEX SCORE
LANGUAGE STRUCTURE INDEX
SCORE
Subtest standard scores ranging from 7-13 are considered average.
Composite scores ranging from 85-115 are considered average.
Bracken
The Bracken Basic Concepts Scale-Revised (BBCS-R) is a developmentally sensitive
measure of children’s basic concept acquisition and language skills. It assesses a child’s
receptive knowledge of 308 basic concepts in 11 distinct conceptual categories: colors,
letters, numbers/counting, sizes, comparisons, shapes, direction/position, self-/social
awareness, texture/materials, quantity, and time/sequence. The first six subtests compose
the School Readiness Composite (SRC). Standard scores are reported for the total test
The IEP team should review assessment results for consistency with the most current information available regarding student’s
communication skills in the educational setting. Should the IEP team feel these areas are of educational concern and require further
review, request for additional speech-language input is recommended.
and SRC. Standard scores have a mean of 100, with 85-115 considered the average
range.
Oral and Written Language Scales (OWLS): The OWLS assesses oral language skills.
The Listening Comprehension subtest examines listening and comprehension of spoken
language. The student is asked to respond by pointing to one of four pictures that
corresponds to the word or sentence given by the examiner.
The Oral Expression subtest examines the understanding and usage of spoken language.
Items are presented verbally and pictorially; responses are given verbally. The student is
asked to respond orally by answering a question, completing a sentence, or generating
one or more sentences.
OWLS
Subtest
Standard Score
Listening Comprehension
Oral Expression
Oral Language Composite
*Standard Scores between 85-115 are considered average.
The IEP team should review assessment results for consistency with the most current information available regarding student’s
communication skills in the educational setting. Should the IEP team feel these areas are of educational concern and require further
review, request for additional speech-language input is recommended.
Clinical Evaluation of Language Fundamentals-Fourth Edition (CELF-4):
The CELF-4 is an individually administered clinical tool used to evaluate for language
and communication disorders.
CELF-4
(ages 5-8)
Concepts and Following Directions
Word Structure
Recalling Sentences
Formulated Sentences
CORE LANGUAGE SCORE
Subtest Scaled Score=
Subtest Scaled Score=
Subtest Scaled Score=
Subtest Scaled Score=
Standard Score=
Concepts and Following Directions
Word Classes-Receptive
Sentence Structure
RECEPTIVE LANGUAGE SCORE
Subtest Scaled Score=
Subtest Scaled Score=
Subtest Scaled Score=
Standard Score=
Word Structure
Recalling Sentences
Formulated Sentences
EXPRESSIVE LANGUAGE SCORE
Subtest Scaled Score=
Subtest Scaled Score=
Subtest Scaled Score=
Standard Score=
*Scaled scores from 7-13 are considered average.
*Standard scores ranging from 85-115 are considered average
CELF-4
(ages 9-12)
Concepts and Following Directions
Recalling Sentences
Formulated Sentences
Word Classes-Total
CORE LANGUAGE SCORE
Subtest Scaled Score=
Subtest Scaled Score=
Subtest Scaled Score=
Subtest Scaled Score=
Standard Score=
Concepts and Following Directions
Word Classes – Receptive
RECEPTIVE LANGUAGE SCORE
Subtest Scaled Score=
Subtest Scaled Score=
Standard Score=
Recalling Sentences
Subtest Scaled Score=
Formulated Sentences
Subtest Scaled Score=
Word Classes-Expressive
Subtest Scaled Score=
EXPRESSIVE LANGUAGE SCORE
Standard Score=
*Scaled scores from 7-13 are considered average.
The IEP team should review assessment results for consistency with the most current information available regarding student’s
communication skills in the educational setting. Should the IEP team feel these areas are of educational concern and require further
review, request for additional speech-language input is recommended.
*Standard scores ranging from 85-115 are considered average
CELF-4
(ages 13-21)
Recalling Sentences
Formulated Sentences
Word Classes-Total
Word Definitions
CORE LANGUAGE SCORE
Subtest Scaled Score=
Subtest Scaled Score=
Subtest Scaled Score=
Subtest Scaled Score=
Standard Score=
Word Classes-Receptive
Understanding Spoken Paragraphs
Semantic Relationships
RECEPTIVE LANGUAGE SCORE
Subtest Scaled Score=
Subtest Scaled Score=
Subtest Scaled Score=
Standard Score=
Recalling Sentences
Subtest Scaled Score=
Formulated Sentences
Subtest Scaled Score=
Word Classes-Expressive
Subtest Scaled Score=
EXPRESSIVE LANGUAGE SCORE
Standard Score=
*Scaled scores from 7-13 are considered average.
*Standard scores ranging from 85-115 are considered average
The Test of Language Development-Primary: Fourth Edition (TOLD-P:4) is
designed to measure the various features and systems of language. It is comprised of six
subtests which are then used to generate composite quotients. Subtests scores from 7-13
are considered within the average range, while composite scores ranging from 85-115 are
considered average when compared to other children of the same chronological age.
Subtests:
Picture Vocabulary
Relational Vocabulary
Oral Vocabulary
Syntactic Understanding
Sentence Imitation
Morphological Completion
Scaled Scores:
Composites:
Listening
Organizing
Speaking
Grammar
Index Scores:
The IEP team should review assessment results for consistency with the most current information available regarding student’s
communication skills in the educational setting. Should the IEP team feel these areas are of educational concern and require further
review, request for additional speech-language input is recommended.
Semantics
Spoken Language
*subtest scores between 7-13 =average *composite quotients between 85-115=average
The Test of Language Development-Intermediate: Fourth Edition (TOLD-I:4) is
designed to measure the various features and systems of language. It is comprised of six
subtests which are then used to generate composite quotients. Subtests scores from 7-13
are considered within the average range, while composite scores ranging from 85-115 are
considered average when compared to other children of the same chronological age.
Subtests:
Sentence Combining
Picture Vocabulary
Word Ordering
Relational Vocabulary
Morphological Comprehension
Multiple Meanings
Scaled Scores:
Composites:
Index Scores:
Listening
Organizing
Speaking
Grammar
Semantics
Spoken Language
*subtest scores between 7-13 =average *composite quotients between 85-115=average
The Expressive One-Word Picture Vocabulary Test (EOWPVT) offers a quick and
reliable measure of an individual’s English speaking vocabulary, which is assessed by
asking the individual to name objects, actions, and concepts pictured in illustrations. The
EOWPVT is a standardized language assessment, with scores between 85-115 considered
average.
EOWPVT Standard Score:
*85-115 = average
The Receptive One-Word Picture Vocabulary Test (ROWPVT) offers a quick and
reliable measure of an individual’s understanding of English vocabulary, which is
assessed by asking the individual to select named objects, actions, and concepts pictured
in illustrations (given a choice of four). The ROWPVT is a standardized language
assessment, with scores between 85-115 considered average.
ROWVPT Standard Score:
*85-115= average
The Expressive One Word Picture Vocabulary Test: Spanish-Bilingual Edition
The IEP team should review assessment results for consistency with the most current information available regarding student’s
communication skills in the educational setting. Should the IEP team feel these areas are of educational concern and require further
review, request for additional speech-language input is recommended.
(EOWPVT: Spanish-Bilingual Edition) was designed to assess a student’s ability to
expressively identify a single object on the basis of a single concept. The examinee has
the option to respond in English or Spanish and instructions are provided in both
languages. The purpose of this assessment is to evaluate an individual’s overall
expressive vocabulary skills when given the opportunity to utilize both languages.
The Receptive One Word Picture Vocabulary Test: Spanish-Bilingual Edition
(ROWPVT: Spanish-Bilingual Edition) is an assessment referenced on typically
developing individuals who are proficient in both English and Spanish. The examinee
has the option to respond in English or Spanish and instructions are provided in both
languages. The child indicates from four possible choices the picture that represents a
word spoken by the examiner in English and/or Spanish. The purpose of this assessment
is to evaluate an individual’s overall receptive vocabulary skills when given the
opportunity to utilize both languages.
EOWPVT: Spanish-Bilingual Edition
Standard Score:
ROWVPT: Spanish Bilingual Edition
Standard Score:
Comprehensive Test of Phonological Processing (CTOPP): The CTOPP assesses
phonological awareness, phonological memory, and rapid naming. Composite scores are
reported as standard scores, with average ranging from 85-115.
CTOPP: (Ages 5-6)
SUBTESTS
Elision
Rapid Color Naming
Blending Words
Sound Matching
Rapid Object Naming
Memory For Digits
Nonword Repetition
Blending Nonwords (supplemental)
Composites:
Phonological Awareness
Phonological Memory
Subtest Standard Scores:
Standard Scores:
The IEP team should review assessment results for consistency with the most current information available regarding student’s
communication skills in the educational setting. Should the IEP team feel these areas are of educational concern and require further
review, request for additional speech-language input is recommended.
Rapid Naming
*85-115 = average
CASL
The Pragmatic Judgment subtest of the Comprehensive Assessment of Spoken
Language (CASL) is designed to measure the knowledge and use of pragmatic rules of
language by having the student judge the appropriateness of language used in a specific
situation or to actually respond with appropriate language for a given situation. This
subtest is norm referenced and standard scores ranging from 85-115 are considered
average.
SSI:3
The Stuttering Severity Instrument-Third Edition (SSI-3) assesses the three major
parameters of dysfluent speech including frequency, duration, and physical concomitants.
By adding the scores for the three parameters, a total overall score is obtained and
compared to others in similar age ranges.
Functional Communication Profile
The Functional Communication Profile is a comprehensive informal inventory of nine
major skill categories of communication and related aspects. The assessment allows the
speech-language pathologist to evaluate several possible means of oral as well as nonoral communication needed for daily living activities. Each skill area is rated on level of
impairment from normal to profound.
The IEP team should review assessment results for consistency with the most current information available regarding student’s
communication skills in the educational setting. Should the IEP team feel these areas are of educational concern and require further
review, request for additional speech-language input is recommended.