First Children, LLC

Preschool/Primary Program
Fanwood, NJ
Speech and language Therapy
Present Level of Academic Achievement and Functional Performance
Name: K. H.
D.O.B: 4/8/07
Report Date: 12/11/2015
K., an eight-year, eight-month-old male youngster, currently receives therapeutic speech
services three times weekly in an individual setting. Therapy focuses on promoting K.s prelinguistic skills; increasing production of assorted vocalizations to indicate expressions of
pleasure and displeasure; expanding utilization of signs, imitation, word approximations, and
functional lexicon; demonstrating active interest in an object, person, or activity; enhancing eye
contact and attention abilities; following simplistic directions; responding to affirmation and
negation; comprehending and identifying common objects and verbs; elaborating creative play
routines; monitoring his oral motor/feeding abilities; developing social interactions with
peers/staff within his home, academic, therapeutic, and public environments; and monitoring the
health of the student. Pertinent information has been collected by means of report, observation,
and data obtained from previous sessions.
K. demonstrates modest progress with regard to his receptive language abilities. He does
not routinely establish and maintain eye contact when greeting or engaging in conversations with
peers/staff for 5+ seconds. He demonstrates difficulty with comprehending and performing 1-2
step directives, as he often omits/transposes sequential steps within the task. Additionally, he
frequently requires hand-over-hand or light physical assistance to participate in tasks and
facilitate participation. He does not readily comprehend and identify common objects and verbs
from a field of two. He is unable to consistently respond appropriately to yes/no question
transformations, through verbalizations, gestures, signs, eye gaze, facial responses, and head
nods. He may interchange yes/no responses through use of head nods in response to simplistic
questions. K. has failed his annual hearing screening due to intolerance of the headphones and
inability to follow directions. However, at elevated loudness levels he presented with behavioral
responses including grimacing, whining, vocalizing, and fleeting eye contact. Additionally, he
has a visual deficit that he is expected to wear glasses for. He has not been observed to wear his
glasses at school this academic year, as he does not tolerate wearing them. He interacts with toys
and objects by bringing them closer to his face and will occasionally mouth them. All therapeutic
materials, objects and toys are placed in close vicinity as he has a visual deficit. His play skills
are developmentally delayed. K. still requires frequent modeling, cues, repetition, and prompts
(i.e. verbal, visual, and tactile), in order to elicit and maintain eye contact when engaging in
conversation with peers/staff or providing greetings/farewells; improve attention to tasks
presented; perform familiar 1-2 step commands; increase identification of assorted categorical
groups such as common objects, verbs, and foods; enhance comprehension and responses to
simplistic yes/no questions; and expand non-verbal communication to further enhance
communicative intent.

K. demonstrates fair progress with regard to his expressive language abilities. He does
not consistently engage in imitative sound play or speech when participating in a therapeutic
activity. He produces limited functional signs, word approximations, or single words when
conversing with peers/staff. Additionally, he produces a reduced amount of assorted
vocalizations to express pleasure, displeasure, wants, and needs. He presents with reduced active
interest in a presented object/person for 4+ minute intervals, utilizing vocalizations, facial
expressions, eye gaze, or change in body position, however he is making progress with this goal.
K.s verbal productions consist of whining, crying, grunting, cooing, moaning, squealing, or
shrieking. He infrequently produces the words yah, yes. His functional vocabulary and lexicon
is limited and he uses it modestly to greet, comment, or converse with peers and staff. He mainly
communicates intention through non-verbal means of communication including eye gaze, facial
expressions, gestures, and body language. Occasionally, he engages in self-stimulatory hand
movements during speech and feeding sessions. K. continues to require modeling, cues,
repetition, imitation, and prompts (i.e. verbal, visual, and tactile) in order to facilitate productions
of vocal play; promote assorted vocalizations to express intent; establish active interest in a
presented object/individual/task for 5+ minute intervals; enhance productions of 1-3 functional
signs, word approximations, or single words to converse with peers/staff; and elaborate nonverbal means of communication to promote socialization within his academic, therapeutic, home,
and public environments.
With regard to his oral motor functioning and feeding skills, K. demonstrates modest
progress. Progress of feeding goals is dependent on his mood, temperament, and health status
during each particular session. He will occasionally participate in self-feeding utilizing an
appropriate rate and bolus size, however he often requires monitoring to appropriately grade
amount of food and rate of intake. He inconsistently maintains labial closure around a spoon,
cup, or straw without any anterior spillage or excessive swallowing. He often does not maintain
his hands in a downward/relaxed position when edibles or liquids are presented without
aggressive or self-stimulatory behaviors observed. K. demonstrates difficulty utilizing
therapeutic equipment (i.e. utensils, scoop bowl, blue Nosey cup) for self-feeding. Therapy will
focus on holding a maroon spoon with hand-over-hand assistance for scooping an appropriate
amount of food and bringing it to his oral cavity. As the meal progresses, he may require less
assistance and grasp the spoon independently. However, he is able to utilize self-feeding using
his fingers to consume preferred foods (i.e. Cheese Doodles, pretzels, chicken nuggets, and
potato). He will whine and demonstrate strong resistance and refusal when presented with
disliked foods. When presented with foods he dislikes, he will seal his lips, turn his head away,
and refuse piece of food. He does not readily accept water with Thick-It (a thickening agent) in a
Nosey cup and requires hand-over-hand assistance to maintain appropriate bilateral grasp. He
will also bite lip of cup and present with moderate amounts of anterior spillage. K. enjoys a
limited array of favorite foods including: chicken nuggets, salty/cheesy snacks, and potato. He
does not readily accept new foods during his lunchtime meal and presents with gagging reflex
when provided with foods he has been overexposed to. Generally, he presents with reduced
attention to task, distractibility, and fleeting eye contact during feeding sessions. He is known to
appear calm, pleasant, and endearing.

It is strongly recommended by this therapist that K. continue to receive therapeutic

speech services three times weekly in an individual setting. Speech and language should
concentrate on developing pre-linguistic abilities; increasing receptive and expressive language
abilities to facilitate functional communication; eliciting spontaneous and elongated
verbalizations; enhancing use of non-verbal means of communication; following multiple
directions; promoting eye contact and attention abilities; improving oral motor/feeding skills;
monitoring the health of the student; and expanding socializations/interactions within his
academic, therapeutic, residential, and public environments.

____________________________________________
Gail A. Nahmias, M.A., CCC-SLP
Speech-Language Pathologist
License Number: 41YS00198800

____________________________________________
Mary Salama
Graduate Speech Clinician