Case Study 10/502

Case Study

Student: Ashley Age: 7 years, 4 months

Review of Previous Assessments: Ashley was previously assessed in when she was 5. The results of that evaluation indicated a moderate to severe delay in the areas of receptive language, expressive language, oral-motor control, and articulation. She has been receiving speech and language therapy for these deficits. Assessment Techniques: Informal observation and language sampling, as well as standardized instruments, were used to assess articulation, voice, fluency, pragmatic, receptive and expressive language skills. Standardized instruments used included the Clinical Evaluation of Language Fundamentals - 3, (CELF-3), the Test of Auditory Processing, (TAPS), Assessing Semantic Skills Through Everyday Themes, (ASSET), and The Assessment of Phonological Processes - Revised, (APP-R). Ashley appeared to be cooperating to the best of her ability during the testing session.

Test Standard Score CELF-3 Receptive Language 74 Expressive Language 74 Total Language 74 TAPS Auditory Number Memory - Forward 4 Auditory Number Memory - Reversed 4 Auditory Sentence Memory 6 Auditory Word Memory 4 Auditory Interpretation Directions 8 Auditory Word Discrimination 4 Auditory Processing 4 Auditory Quotient 63 ASSET Receptive Total 92 Expressive Total 110 Total Test 102

Articulation/Oral Motor Skills: The Assessment of Phonological Processes - Revised was administered to assess development of phonological processes. Ashley demonstrated a phonological deviancy score of 63 with a severity interval of profound. The phonological analysis indicated pattern deviations of consonant sequences, stridents, velars, liquid /l/ and liquid /r/.

A cursory oral-peripheral examination revealed that structure of the oral mechanism was intact and symmetrical. Function appeared limited for development of verbal communication skills. Ashley demonstrated difficulty in executing volitional movements of tongue elevation, both within and when protruding from the mouth, in moving the tongue up and down in the mouth, in protruding the tongue and moving it from side to side, and in touching the tongue to various locations on the hard and soft palate Fluency/Voice: Fluency of conversational speech and vocal quality, pitch, and loudness were observed to be appropriate for age and gender. Receptive Language: The CELF-3 receptive portion was administered to determine Ashley’s ability at understanding the language presented to her. Ashley achieved a standard score of 74. She was able to demonstrate understanding of the linguistic concepts of inclusion/exclusion (not, except, all), coordination (and) and conditional (instead of, until, when). She had difficulty with the concepts that were temporal (after, before) and quantitative (all, some, any one, all but one, first). She also demonstrated adequate understanding of sentence structure with the exception of indirect requests. In the area of following directions, Ashley had difficulty in following two and three step simple directions. The TAPS was administered to further measure auditory processing. Ashley received an auditory quotient of 63 with an age equivalency of <4-0. Ashley had difficulty in recalling numbers she heard, both forward and reversed. She had difficulty in recalling sentences and word strings. She also had difficulty in hearing the difference in sounds in minimal word pairs. The one area of relative strength that Ashley demonstrated was in interpretation of directions, where she scored within the average range. In this subtest, Ashley was asked to tell what she would do when given a series of directions, rather than actually following the directions as she was asked to do in the CELF-R, indicating that while she was able to recall the information she had been given, she had difficulty in acting on it. The ASSET was given to assess understanding of words and word relationships. Ashley achieved a standard score of 92. She demonstrated age appropriate understanding of identifying labels, categories, attributes, functions, and definitions. Expressive Language: The CELF-3 expressive portion was administered to determine Ashley’s ability at using language to express herself. Ashley achieved a standard score of 74. She was able to use age appropriate syntax when given credit for morphological structures affected by her articulation deficit. She did demonstrate difficulty in recalling sentences presented to her and in using specific vocabulary items in sentences.

The ASSET was given to assess Ashley’s ability at using words and word relationships. Ashley achieved a standard score of 110. She was able to state labels, categories, attributes, functions, and definitions. Pragmatics: In the functional use of language, Ashley was able to initiate and maintain a conversation appropriately, attend to listener needs by revising her statements when the listener could not understand her, and generally follow the rules of conversational exchange. Note: Clinical Evaluation of Language Fundamentals - 3, (CELF-3)

Mean 100, σ 15 Test of Auditory Processing, (TAPS) Subtest – mean 10, σ 3 Total test – mean 100, σ 15 Assessing Semantic Skills Through Everyday Themes, (ASSET) Mean 100, σ 15