Reason for referral:
John was observed to have challenges with his speech sound. He has undergone several assessments, and we've been working with him to improve his speech and language.
Background information:
John's teacher has been monitoring his learning and has noted potential signs of dyslexia. In school, John's performance in different subjects was recorded.
Summary of communication strengths, difficulties, and progress:
During the assessment, John was a bit reserved. We used various tests to gauge his understanding and use of language. He has some challenges, especially with more complex sentences and language tasks.
Understanding of language:
John faced challenges with multi-step instructions and complex sentence structures. This might mean he could struggle with understanding longer sentences in daily life.
Use of Language:
John has some difficulty formulating sentences. This is an area we will focus on to help him express himself better.
Clarification Skills:
It's essential for John to ask questions when he doesn't understand something. We will work on this skill with him.
Speech Sounds:
There are specific sounds John struggles with, which we aim to improve through targeted interventions.
Liaison with Parent:
You mentioned that John sometimes mixes up his sounds. We believe working on his speech sounds and reinforcing instructions will be beneficial for him.
Liaison with SENCO and Class Teacher:
The school's SENCo and class teacher have provided valuable insights. They note his progress in certain areas and challenges in others.
Summary:
John has some areas of strength and areas that need support. Our main focus will be on his expressive language and understanding. We'll provide targeted interventions to help him.
Classroom Strategies:
These strategies are designed to help John in a classroom setting.
Recommended Management / Agreed Actions:
We have a plan in place to support John, which includes regular reviews and interventions.
Reason for referral:
John was observed to have challenges with his speech sound. He has undergone several assessments, and we've been working with him to improve his speech and language.
Background information:
John's teacher has been monitoring his learning and has noted potential signs of dyslexia. In school, John's performance in different subjects was recorded.
Summary of communication strengths, difficulties, and progress:
During the assessment, John was a bit reserved. We used various tests to gauge his understanding and use of language. He has some challenges, especially with more complex sentences and language tasks.
Understanding of language:
John faced challenges with multi-step instructions and complex sentence structures. This might mean he could struggle with understanding longer sentences in daily life.
Use of Language:
John has some difficulty formulating sentences. This is an area we will focus on to help him express himself better.
Clarification Skills:
It's essential for John to ask questions when he doesn't understand something. We will work on this skill with him.
Speech Sounds:
There are specific sounds John struggles with, which we aim to improve through targeted interventions.
Liaison with Parent:
You mentioned that John sometimes mixes up his sounds. We believe working on his speech sounds and reinforcing instructions will be beneficial for him.
Liaison with SENCO and Class Teacher:
The school's SENCo and class teacher have provided valuable insights. They note his progress in certain areas and challenges in others.
Summary:
John has some areas of strength and areas that need support. Our main focus will be on his expressive language and understanding. We'll provide targeted interventions to help him.
Classroom Strategies:
These strategies are designed to help John in a classroom setting.
Recommended Management / Agreed Actions:
We have a plan in place to support John, which includes regular reviews and interventions.
Classroom Strategies:
Assessment scores:
Reason for referral:
Detailing John's history of referrals and interventions.
Background information:
Summary of John's school performance and potential dyslexia signs.
Summary of communication strengths, difficulties, and progress:
Detailed breakdown of John's assessment results, including percentile scores and implications.
Classroom Strategies:
Recommended Management and Agreed Actions:
A comprehensive plan detailing interventions, supporting resources, and review timelines.
SCHOOL VISIT SUMMARY REPORT CONFIDENTIAL
Name: John
Date of birth: 14.06.2018
Home Address:
School: Nursery
Date of visit: 02.07.23
Type of visit: Review Assessment
Liaison with: SENCO, Class Teacher and John's Mum
John was referred to the Preschool Speech and Language Therapy Service in April 2008 for difficulties with his speech sound production. John was first seen for assessment in July 2008 and was found to have reduced attention and listening and some speech sound difficulties. His understanding and use of language was not fully assessed at this point. Following assessment John was offered individual and group therapy blocks to develop his immature speech sound production. John was also referred to the Communication Team in September 2010 for assessment of his language skills when he started his Reception year at His Primary School. John was found to have “age appropriate language skills with grammatical delay”. A SLT development plan was provided for school staff to follow with John.
John was discharged from the SLT Community Clinic Service after no response to an offer of a review appointment.
Request for assessment was received from SENCO in June 2023.
SENCo has recently screened John for dyslexia and reported that there was a moderate possibility that John has dyslexia and classroom strategies have been put in place. School reported that John's National Curriculum levels were: Maths 2A, Writing 2B and Reading 3C
On assessment
John was withdrawn from class for 1:1 assessment in a quiet room for 50 minutes. John was very quiet during the session. When asked questions during informal conversation he responded in a very quiet voice not expanding on any questions asked responding with short phrase answers.
Understanding of language
The ‘Concepts and Following Directions’ subtest from the ‘Clinical Evaluation of Language Fundamentals (CELF) 4 UK’ was used to assess John's ability to follow particular language concepts in 1, 2, 3 and 4 step instructions. John scored on the 25th percentile which places his score in the low average range. A centile rank is used to compare John's performance with other children of the same age. A 25th centile score means that out of 100 children of the same age John would score the same or lower than 25 children and not as well as 75 children. John had difficulty with instructions containing 3 or more elements (e.g. point to the big apple, the little car, and the black shoe) and sentences that contain a modifier (e.g. before you point to the little black shoe and the big black shoe, point to the little white ball). He also had difficulties understanding particular
language concepts such as Inclusion/Exclusion (e.g. neither/nor, and), location (e.g. left), sequence (e.g. first, last, second, third), and temporal (e.g. before, after). Within the classroom this means that John may have difficulties understanding longer sentences. In order to support him with this, consider breaking down longer pieces of information into chunks so that John can process each piece of information at a time.
The ‘Understanding Spoken Paragraphs’ subtest from the ‘Clinical Evaluation of Language Fundamentals (CELF) 4 UK’ was used to evaluate John's ability to listen to spoken paragraphs of increasing length and complexity to answer questions about it by recalling and predicting information. John scored on the 37th percentile for this assessment which is a low average score. John had difficulty making inferences and predictions from the longer paragraphs read to him (e.g. “what was going to live in the animal house?”). To support John in the classroom, John would benefit from having the questions read/given to him beforehand so has an idea of what he is listening out for.
Both scores indicate that John's understanding of language is within the low average range which puts him in within normal limits.
Use of Language
The ‘Formulated Sentences’ subtest from the ‘Clinical Evaluation of Language Fundamentals (CELF) 4 UK’ assessed John's ability to formulate complete, semantically and grammatically correct spoken sentences of increasing length and complexity. John scored on the 2nd percentile which is a severely low score. On this assessment John was shown a picture and given a target word which he was asked to make up a sentence with. On occasion John used a sentence that was not meaningful (e.g. “As a consequence the boy answered the question”) or used a sentence that was not completely grammatically correct (e.g. “The last bone was longest”). John would benefit from having new vocabulary pre-taught to him, try to create opportunities for John to over learn the new vocabulary and use it in different situations.
John was quiet throughout the session and when he was engaged in free talk he appeared reluctant to talk preferring to nod or shake his head. When asked an open question he responded with one word or a short phrase when asked to expand or clarify. During liaison with class teacher commented that John does not enjoy participating in class discussions. John may have been reluctant to engage for a number of reasons including, a reduced vocabulary, an unfamiliar adult, difficulties describing or explaining, or that the contents of the assessment were not interesting to him. His targets will focus on expressive language and this area should be monitored in the coming academic year. John would benefit from a ‘talking partner’ a peer with good language skills who could model and support John by sharing verbal ways to answer questions.
John's expressive language skills are severely delayed which means his expressive language is developing below what would be expected for his age.
Clarification Skills
John did not ask for repetition of the question/instruction on any occasion or tell the adult when he was struggling to form a sentence. It is important that adults encourage John to identify when he has not understood.
Speech Sounds
John's speech sounds were assessed using the ‘CLEAR’ speech sound assessment. John experienced difficulties such as producing ‘s’ and ‘f’ sounds as ‘th’ word finally in single words, ‘and all his ‘s’ sounds within the ‘s’ blends (such as sm, sp, sk) are produced with a ‘slushy’ sound quality. We were unable to conduct an oro motor examination due to time and equipment restrictions. We would like to refer John to the SLT clinic service for further investigation.
Liaison with Parent
John's mum reported that he sometimes muddles up his sounds and sometimes he sounds fine. She felt that he does not take in instructions or information unless it has been repeated to him several times over and that it’s not uncommon for him to deny that he has been told to do something as he’s forgotten. She feels that John is aware of his speech sound errors and that he tries not to talk to unfamiliar adults because of this.
Liaison with SENCO and Class Teacher
School SENCo screened John for Dyslexia and found a moderate possibility that he has dyslexia and a weak auditory sequential memory. Class teacher reported that John had made progress in maths and reading but that his writing was still weak and he did not enjoy participating in class discussions, but that he is contributing more when working in groups.
John has significantly delayed expressive language which is impacting on his ability to express his thoughts and ideas confidently and his understanding of language is within the lower end of normal limits. School have identified that John has some difficulties with writing. John also has some speech sound difficulties, and he will be referred to the clinic service for support with this.
I will ask SALTA to work with John to develop his expressive language skills in the autumn term.
-Include John in paired/small group work
-Ensure you have John's attention before you begin talking
-Chunk longer pieces of information
-Give John additional time to express himself
-Pre-teach vocabulary
-Model language back to John if he makes an error
-Encourage John to give you more information
-Use the SLT programme for activity ideas
School based language programme to be delivered by TA
Supporting sample resources to be supplied by SLT
Progress to be reviewed termly at the planning meetings and annually via face to face contact with John
Follow up by SALTA Speech & Language Assistant
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