Assessment Report
LANGUAGE AND SPEECH
ASSESSMENT REPORT FOR CHILDREN IN HEAD START
|Student Name: | |Date of Report: | |
|Date of Birth: | |Head Start Agency/Site: | |
|Age: | |Head Start Enrollment Date: | |
|Teacher: | |Date Signed Assessment Plan Received: | |
|Primary Language: | |Assessor: | |
|Translator: | |Assessment Date(s): | |
Reason for Referral
Indicate who initiated the referral, why and modifications attempted. Summarize Pre-Referral Intervention, if applicable, including information from the Pre-Referral Intervention Plan and Pre-Referral Intervention Tracking document.
Educationally Relevant Health, Developmental and/or Medical Findings
Information under this heading can be gathered from: parent interview, school/ nurse report and records. You must cite where your information came from and the date of report. Important information to include:
▪ Statement about developmental milestones, especially those that relate to communication: first words, 2 word phrases, sentences, etc.
▪ Medical diagnosis when relevant to communication difficulties, for example: syndromes, sensory disabilities, allergies, otitis media—be sure to identify how chronic and treatment to date; cleft palate—be sure to discuss whether the student is followed by team and any history of surgery or potential for future surgeries; etc.
▪ Statement regarding results of most recent hearing and vision screening
▪ General statement about health
Language Background
Include a brief statement describing the student’s primary language. Remember that the primary language means first language - not dominant language.
▪ Discuss language use in the home. Parents? Siblings? Primary caretakers? Others in home?
▪ Is student exposed to television and books? How much time per day? What language?
Parent Interview
Information under this heading should be gathered from parent interview. It may be conducted over the telephone, in person, or through a questionnaire. You must cite who your information came from and the date of report. Include under this heading responses to the following questions:
▪ What are your main concerns about your child’s current speech and language skills?
▪ When did you first become concerned with your child’s speech and language skills?
▪ What would you like your child to be doing one year from now?
▪ What are you doing at home to help develop your child’s speech and language skills?
▪ When a parent has relevant input that may conflict with your observations and/or assessment data, include a brief statement that begins with the words, “Parent reported…” It is an opportunity for the parent’s input on the student’s assessment report.
▪ If the parent is not able to be contacted please list parent contact methods and dates (should be at least 3 attempts via different methods).
Classroom Observation/Teacher Interview
Include description of classroom observation that addresses the activities, environment and child’s participation, as it relates to the reason for referral. Observation of child in at least 2 activities is recommended.
▪ Description of the classroom environment and how it affects the student’s ability to communicate
▪ Clarity of speech when communicating in the classroom, and ability to improve clarity when prompted by the teacher, aide or peers
▪ Attention to teacher during direct instruction. Do teacher prompts help student to attend?
▪ Ability to follow teacher directions. Does the student watch and imitate peer actions to follow classroom directions and routines?
▪ Length and appropriateness of response when responding to peers or teacher in the classroom. For example, is the response too long or too brief? Did the teacher need to scaffold a response? If so, did scaffolding result in more successful oral expression from the student?
▪ Ability to engage in appropriate verbal interaction with peers during cooperative learning groups
▪ Any other important behaviors observed such as: distractibility to noise or visual stimulus; constant or inappropriate body movements, etc.
▪ Teacher concerns related to speech and language use in the classroom during oral language activities
▪ How the student’s communication difficulties are impacting their ability to access and participate in classroom activities
For English Learners: What language(s) are used by the child, adults during this observation? Does the child appear to be transitioning through any of the English Learner processes such as the silent period, code switching, transfer, language loss? Add examples.
For English Learners: Per interview with teacher, describe what English learner strategies are used in the classroom.
Assessment Observations
Include description of evaluation environment and child’s level and style of engagement during process.
For English Learners: What language(s) are used by the child, adults during this session? Does the child appear to be transitioning through any of the English Learner processes such as the silent period, code switching, transfer, language loss? Add examples.
Tests and Validity of Assessments Utilized During the Assessment
| Teacher Interview | Classroom Observations | Review of Work Samples |
| Parent Interview | Clinical Observations | Standardized Assessments |
| Translator Name: | | Other: |
| Language: |
|Testing and assessment materials and procedures used for the purposes of assessment and placement of individuals with exceptional needs are |
|selected and administered so as to not be racially, culturally, or sexually discriminatory. Tests have been validated for the specific |
|purpose for which they are used and administered by trained personnel in accordance with the instructions of the producer.[34 C.F.R. |
|300.532(e)] |
Assessments and Assessment Results
Articulation/Phonology
If articulation/phonology is not an area of suspected disability and was not formally assessed, the following statement is required:
Based on informal assessment and observation, articulation is not related to the suspected area of disability. Include some brief descriptors of observed articulation skills that back up this statement.
If articulation/phonology is an area of suspected disability the following components must be included under this heading:
▪ Oral Peripheral Examination: An Oral Peripheral Examination is a visual inspection of the oral peripheral mechanism, including the lips, tongue, hard and soft structures of the palate, to determine if these mechanisms are adequate for speech production. The results of this exam indicate: fill in with appropriate data.
▪ Formal Articulation Test: Name the test, provide description of test, and results including:
o Standard Score and Percentile ranking, and statement that interprets test score results, such as average, below average, well-below average range, etc. DO NOT include age equivalents
o Description of sound errors or phonological processes exhibited on formal testing
o Be sure to discuss the student’s stimulability of correct sound production
▪ Speech Sample of Connected Speech: Include an intelligibility statement comparing sound production in single words, from formal articulation testing, to overall speech clarity in connected speech based on a spontaneous speech sample.
▪ Tie your articulation findings into a statement related to classroom performance. What does classroom teacher report about speech articulation skills and possible impact in the classroom?
NOTE: If formal tests were not completed and/or attempted a statement indicating the reason must be included.
English Learners
If the student is identified as an English Learner or is suspected of being an English learner and English articulation is NOT within normal developmental limits you MUST administer and report test results in both primary language and in English. Identify who served as translator for primary language articulation assessment if you were unable to perform the primary language assessment.
▪ If available, administer an articulation test in the primary language.
▪ If no primary language articulation test is available, you will need to make a general statement of sound production and speech clarity in the primary language based on interpreter feedback.
▪ Compare results of primary language articulation results to English articulation results. Are error patterns observed in both languages or only in one language?
▪ Based on all of the above formal and informal assessment procedures you must make a determination whether the student is demonstrating differences in English articulation skills due to dialectal transfer patterns from the primary language phonological system or is there an underlying phonological or articulation disorder demonstrated in both languages? Be sure you have “built the case” for your determination!
Language
If language is not an area of suspected disability and was not formally assessed, the following statement is required:
Based on informal assessment and observation, oral language is not related to the suspected area of disability. Include some brief descriptors of observed expressive language behaviors that back up this statement.
If language is an area of suspected disability the following components must be included under this heading:
Formal Test Results
▪ Administration of Standardized Language Tests
Per Title V regulations, each area of language disability must be demonstrated on two separate standardized tests. Name the tests, provide descriptions of tests, and results including:
o Standard Score, Percentile ranking, and a statement that interprets test score results, such as average, below average, well-below average range, etc. DO NOT include age equivalents.
o Description of language strengths and weaknesses demonstrated on formal testing using parent-friendly language.
o Give examples of some test responses that are representative of the student’s strengths and weaknesses
NOTE: If formal tests were not completed and/or attempted a statement indicating the reason must be included.
If assessments were completed but the student does not fit within the norming sample the following statement should be included: was administered to informally gather assessment data on language strengths and weaknesses. Test norms were not used as the student does not fall within the norming sample population. *Do not report any scores for students that do not fall within the norming sample.*
Informal Test Results
▪ Language Sample: A language sample measures an individual’s ability to produce language in natural contexts. A minimum of 50 utterances is required. Be sure to discuss the student’s abilities in the following areas:
o Semantic Usage - vocabulary, word relationships and word retrieval. Does the student use a lot of filler words or non-specific vocabulary?
o Grammatical Structures- length and complexity of utterance, word order, use of grammatical endings or forms, etc. Does the student repeat a very simple sentence form or use a variety of structures?
o Pragmatics- social use of language in conversation in a variety of communicative contexts with peers and adults
Provide several examples of utterances in this section that represent the student’s typical language use.
▪ Other informal procedures used during the evaluation may be inserted in this area if used including: informal language tasks, a summary of on-going therapy performance, dynamic assessment data, developmental checklists, parent or teacher interview, student report, etc.
Functional and Educational Language Skills (This section should be completed for non-verbal or low-verbal students)
▪ If formal tests were not administered you MUST include information describing the student’s overall receptive and expressive language skills based on informal measures.
▪ Tie your language findings into a statement related to classroom performance. How do language skills impact the student’s performance in the educational program? What does classroom teacher report about receptive, expressive and pragmatic language skills and possible impact in the classroom? Incorporate any information you have gathered from observations or teacher checklists.
▪ Include relevant information from a review of the student’s records, especially if the student is an English Learner or suspected English Learner, CST rankings, etc.
▪ Provide a statement that compares formal, informal language results and functional language skills. Do functional language skills match the formal and informal test results, or is there a discrepancy? Remember that this is a key factor in determining eligibility for LAS services!
English Learners
Always administer English language testing first. If English language test results are within the average range, you do not have to administer testing in the primary language. However, you must include a statement such as: Primary language assessment was not administered as the student performed within the average range on formal and informal English language testing. Student appears to be acquiring receptive and expressive English language skills within expected developmental sequence as a second language learner. Receptive and expressive English language skills are adequate to access educational program.
If student is an English Learner and performed below the average range in English you MUST administer and report test results in both the primary language and in English. Identify who served as translator for primary language assessment if you did not complete this portion of testing. Under the heading: Primary Language Assessment Results, include the following:
▪ Identify student’s primary language. Include a general statement of primary language use. For example, you could say, “Student reports he does not speak Spanish at school. He uses English at home with older siblings and mother, but does use Spanish exclusively with his grandmother, who lives with the family.”
▪ If available, administer language test(s) in the primary language. Be sure to identify the test as the Spanish version (e.g. CELF-4: Spanish Edition.) If normative data is available and are appropriate to LAUSD population, report standard scores and percentiles in primary language. If norms are deemed not appropriate for this student, or the LAUSD population, use a statement such as: was administered to informally gather assessment data on language strengths and weaknesses in the student’s primary language. Test norms were not used as the student does not fall within the norming sample population due to his English language acquisition status.
▪ If no primary language tests are available, you will need to use informal language assessments to gather primary language data, including information regarding following oral directions, sequencing events, retelling a story, maintaining a conversation, etc. Interpret results along language parameters: semantics, syntax and pragmatics. If you are not fluent in the primary language you will need to probe your translator for information regarding the student’s receptive and expressive language skills in the primary language.
▪ Compare the results of primary language assessment to English receptive and expressive language assessment results. Are error patterns observed in both languages or only observed in one language?
▪ Reiterate (from your classroom observation section) typical English Language Learning processes the student may be transitioning through, such as a silent period, code switching, transfer, language loss etc.)
▪ Based on all of the above formal and informal assessment procedures you must make a determination whether the student is demonstrating differences in English language use due to typical language acquisition patterns expected of students learning English as a second language (esp. BICs and CALPs) or if there is an underlying language learning disorder demonstrated in both languages? Be sure you have “built the case” for your determination!
Voice
If voice is not an area of suspected disability and was not formally assessed, the following statement is required:
Based on informal assessment and observation, voice is not related to the suspected area of disability. Include some brief descriptors of vocal parameters to back up this statement.
If this is an area of concern, the following components must be included in this section:
▪ Vocal Characteristics: Name the voice assessment protocol you used to determine vocal characteristics. Describe types of vocal assessment tasks administered and results using severity descriptors (e.g. mild, moderate, severe) for each of the parameters below:
o Intensity (volume)
o Pitch
o Quality
o Resonance
▪ Etiology-Current Physical Characteristics: Include in this section any physical factors influencing quality, resonance, or pitch and whether these factors are temporary (colds, short-term abuse), chronic (allergies, chronic abuse or misuse), or structural/sensory (nodules, palatal insufficiency, hearing impairment, etc) in nature.
o Include information received from physician regarding site, etiology and diagnosis of vocal pathology. Include statement of medical clearance for voice therapy if provided by physician. Be sure to name physician and location of practice.
Effect on Communication: Describe how the vocal pathology is affecting communication in the educational setting. Include any information obtained through classroom observation and/or teacher report.
Fluency (Stuttering)
If fluency is not an area of suspected disability and was not formally assessed, the following statement is required:
Based on informal assessment and observation, fluency is not related to the suspected area of disability. Include some brief descriptors of the student’s speech fluency to back up this statement.
If fluency is an area of suspected concern the following components must be included in this section:
▪ Administration of Descriptive Stuttering Assessment Instrument (e.g. SSI). Briefly describe format of test and results including:
o Description of dysfluent behaviors observed
o Description of secondary behaviors observed
o Describe severity of dysfluent behaviors observed per test guidelines
▪ Analysis of Speech Sample: Have student engage in a variety of speaking tasks such as picture labeling, asking and answering questions, conversation, oral reading, etc. and determine: frequency and duration of speech dysfluencies.
▪ Effect on Communication: Describe how stuttering behaviors are affecting communication in the educational setting. Include any information obtained through classroom observation and/or teacher report.
English Learner
Some students have a more severe level of severity in either their first language or in English. If the student is an ELL student, be sure to comment on the differences of stuttering severity when conversing in each language.
Validity of Assessment Findings
Including environmental, cultural, or economic factors on performance
| |The student was cooperative and the assessment results are a valid indicator of student performance. |
| |Assessment was administered in the student’s native language or other mode of communication to ensure that the measurement |
| |reflects the student’s ability rather than English language skills. |
| |Assessment results may have been affected by: |
Summary
Background:
▪ State current age, classroom and any pertinent medical diagnoses and educational information.
▪ Referral source and area of communication concern identified.
Strengths
▪ Information relevant to this performance area
▪ Baseline
▪ What the student can do
▪ Specific communication skills in all areas, including articulation, voice, fluency, receptive/expressive language, that have been mastered or fall within developmental expectations with or without accommodations
Needs
▪ What the student cannot do.
▪ Specific communication skills to ensure academic/social success
Impact of Disability
▪ Describe how the disability impacts the learning process
o Ex: Joan’s speech and language impairment in the areas of articulation makes it difficult for her to be understood in spontaneous speech and give oral reports.
o Ex: Joe’s expressive pragmatic language deficits make it difficult for him to engage in meaningful discussions with peers, take turns, and stay on topic.
Under no circumstances should there be accommodations/modifications or recommendations in the assessment report.
|Report Prepared By: | |
|Title of Assessor: | |
|Signature: |___________________________________ |
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related searches
- year 3 maths assessment pdf
- year 3 maths assessment papers
- common core kindergarten assessment test
- grammar assessment pdf
- special education assessment report tem
- assessment for learning vs assessment of learning
- nist risk assessment report template
- psychological assessment report template
- apa psychological assessment report template
- nist security assessment report template
- assessment report template word
- assessment report format