1

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.

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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.

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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 7-

step 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.

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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.

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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.

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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.

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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).

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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 Analysis

De que se trata

esa historia?

Si, que paso?

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?)

Task: sequencing pictures

Language: Spanish

(Student was asked to place the 7 cards in order of

events)

Es una historia de los dos niños esta siendo

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

(?)

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.

Spanish:

Deficits in:

Morphology (grammar),

semantics (lacks

vocabulary).

Esta siendo mentirosos

vs. son mentirosos

se pego be bibrio vs. le

pego la pelota al vidrio

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.

9

Name: JM

DOB: _______

Stimulus JM’s Utterances Analysis

Sequencing

pictures were

presented again on

a different day and

JM was asked to

tell the story in

English

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.

Sentences were more

organized.

Morphological markers

are appropriate.

Cohesive description of

the action using the

pictures as framework.

Stimulus JM’s Utterances Analysis

WH questions:

What do you think

the teacher is

saying here?

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?

(Responses to questions about sequencing story)

I don’t know

but she shes just pointing at her and being mad

because he thought she she she did the damage.

But he’s saying they’re expelled. Or suspended

because they got in trouble.

They didn’t know? I’m pretty sure their eyes are

being sleek.

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.

Word choice- appropriate

context (e.g. damage,

expelled)

Clarity of the message is

compromised as he tries

to respond to a ‘why’

question.

His discourse became

very unclear as JM used

pronouns and lacked

specific details. Who

became sad? And Why?

10

What would you

Say?

What would you

say?

What would I say?

I would tell the truth because

What would I 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.

Stimulus JM’s Utterances Analysis

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

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

11

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.

12

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 English-

only 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