Case Study Student Ashley Age 7 years, 4 months

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

Case Study
Student: Cody Age: 5 years, 6 months
Cody was evaluated in October. Informal observation, student
interview, and
language sampling as well as standardized instruments were
used to assess
language form, content and use skills. Cody appeared to be
cooperating to the
best of his ability during the testing session. The results of this
evaluation are
therefore judged to be valid.
Form:
Articulation/Phonology:
The Assessment of Phonological Processes was administered to
measure
development of phonological skills. Cody received an average
phonological
process score of 27, with a phonological deviancy score of 37
and a severity
interval of moderate. Areas of concern included consonant
sequences, velars,
liquid /l/, and liquid /r/.
Oral Motor Skills:
A cursory oral - peripheral examination including the teeth,
tongue, and the hard
and soft palates revealed that structure of the oral mechanism
was intact and
symmetrical. Function of the oropharyngeal mechanism
appeared within normal
limits for development of verbal communication skills.

Morphology/Syntax:
Morphology and syntax skills were assessed informally. An
analysis of the
language sample indicated that Cody’s language included a
variety of linguistic
structures, indicating adequate development of syntax and
morphology.
Fluency/Voice:
Fluency of conversational speech and vocal quality, pitch,
loudness were
Content:
Semantics:
Understanding and use of words and word relationships was
assessed
informally. An analysis of the language sample indicated that
Cody’s language
included appropriate vocabulary, indicating adequate
development of semantic
skills.
Use:
Pragmatics:
In the functional use of language, Cody was able to initiate and
maintain a
conversation appropriately, attend to listener needs and
generally follow the rules
of conversational exchange

Note:
Mean 100, σ 15
Mean 100, σ 15
Case Study
Student: Jeannine Age: 13 years, 8 months
Review of Previous Assessments:
Jeannine has been receiving speech and language therapy since
she was two
years old. Speech and language difficulties have included
articulation, sentence
structure, semantics and pragmatics. Most recently, therapy has
concentrated
on semantics and pragmatic skills.
Informal observation and language sampling, as well as
standardized
instruments were used to assess articulation, voice, fluency,
pragmatic and
receptive and expressive language skills. Standardized
instruments used
included the Clinical Evaluation of Language Fundamentals -

Revised (CELF-3),
and The Adolescent WORD Test . Jeannine appeared to be
cooperating to the
best of her ability during the testing session. The results of this
evaluation are
therefore judged to be valid.
Test Standard Score
CELF-3 Receptive Language 50
Total Language 50
Adolescent WORD Test: 61
An informal observation of articulation skills indicated age
appropriate articulation
skills.
A cursory oral - peripheral examination revealed that structure
of the oral
within normal limits
for development of verbal communication skills.
Fluency/Voice:
loudness were
Receptive Language:
In the understanding of language, Jeannine was able to answer
simple questions
recalling details about a story she had heard. She had difficulty

in following
complex, three step directions, especially those involving serial
and left-right
orientation. She also experienced difficulty in understanding
comparative,
temporal, spatial and passive relationships.
Jeannine was able to construct sentences from segments. She
had difficulty in
defining words, giving multiple meanings of words, stating
synonyms and using
specific vocabulary in sentences. Syntax skills are appropriate.
Pragmatics:
In the functional use of language, Jeannine was able to initiate
and maintain a
conversation appropriately with the therapist. However, she
continues to
demonstrate difficulty in initiating and maintaining a
conversation with those
unfamiliar to her, maintaining appropriate volume, attending to
listener needs and
generally following the rules of conversational exchange.
Note:
Mean 100, σ 15

Mean 100, σ 15
Adolescent Word Test
Mean 100, σ 15
Case Study
Student: Jim Age: 11 years, 6 months
Assessment Techniques: Informal observation and language
sampling as well as
standardized instruments were used to assess articulation, voice,
fluency and
pragmatic and receptive and expressive language skills.
Standardized
instruments used included the Clinical Evaluation of Language
Fundamentals - 3
(CELF-3), The Test Of Problem Solving (TOPS), and The
Adolescent WORD
Test. Jim appeared to be cooperating to the best of his ability
during the testing
session.
Test Standard Score
CELF-R Receptive Language 87

Total Language 90
TOPS: 43
Adolescent WORD Test: 61
Interview with Student/Teachers:
Jim is a friendly young man who is very outgoing. He felt that
he was having
problems with his schoolwork and needs extra help. He finds
listening and
remembering what he hears to sometimes be difficult. His
teachers reported that
Jim has difficulty in following classroom directions, recalling
information he has
heard, understanding inferences, staying on topic. They also
stated that he has
a tendency to stay concrete and has difficulty in understanding
figurative
language and words with multiple meanings.
A cursory oral-peripheral examination revealed that structure of
the oral
for development of verbal communication skills. Jim
demonstrated age
appropriate articulation skills.
Fluency/Voice:
loudness were
observed to be appropriate for Jim’s age and gender.

Receptive Language:
Jim’s ability to process and understand oral communication
were assessed
utilizing the receptive portion of the CELF-3. Jim demonstrated
strength in
determining word classes. Jim experienced difficulty in the
ability to interpret,
recall and execute oral directions of increasing length and
complexity, and in
interpreting temporal, passive, and spatial relationships.
Jim’s ability to express needs and desires was assessed utilizing
the expressive
portion of the CELF-3. Jim was able to assemble sentences
from fragments and
to recall sentences. He had difficulty in producing sentences
containing given
words.
In the use of specific vocabulary Jim was able to give
definitions of words in his
vocabulary, but had difficulty in explaining brand names,
meanings of signs and
synonyms.
In explaining the causes and solutions of problem situations,
Jim demonstrated
age appropriate abilities.
Pragmatics:
In the functional use of language Jim was able to initiate
conversation
appropriately but had difficulty in maintaining the topic and did

not signal topic
change. He found it somewhat difficult to attend to listener
needs but was
generally able to follow other rules of conversational exchange.
Note:
Mean 100, σ 15
Mean 100, σ 15
Mean 100, σ 15
Case Study
Student: Michelle Age: 7 years, 2 months
Michelle was evaluated in English and in Korean through an
interpreter. Informal
observation and language sampling as well as standardized
instruments were
used to assess articulation, voice, fluency, pragmatic, receptive
and expressive

language skills. Michelle appeared to be cooperating to the best
of her ability
during the testing session. The results of this evaluation are
therefore judged to
be valid.
Test Standard Score
PPVT-3 English 41
Korean 65
EOWPVT: English 71
Korean bn
An informal articulation assessment indicated age appropriate
developmental
articulation errors.
A cursory oral - peripheral examination revealed that structure
of the oral
for development of verbal communication skills.
Fluency/Voice:
Fluency of conversational speech and vocal quality, pitch,
loudness were
Receptive Language:
The Receptive One Word Picture Vocabulary Test (ROWPVT),
which assesses
reception of vocabulary at the single word level, was
administered. Michelle

received a raw score of 34 with a standard score of 71 and an
age equivalent of
3 years, 4 months in English indicating a delay of 22 months in
relation to her
chronological age. When the same test was translated into
Korean Michelle
received a raw score of 22 with a standard score of >55 and an
age equivalent of
2 years, 4 months indicating a delay of 34 months in relation to
her chronological
age.
The Peabody Picture Vocabulary Test-Revised (PPVT-R) was
utilized to assess
expressive vocabulary at the single word level. In English,
Michelle received a
raw score of 13 with a standard score of 41 and an age
equivalent of 2 years, 5
months indicating a delay of 33 months in relation to her
chronological age. In
Korean, Michelle received a raw score of 29 with a standard
score of 65 and an
age equivalent of 3 years, 3 months indicating a delay of 23
months in relation to
her chronological age.
A language sample analysis revealed that in both English and
Korean Michelle
spoke in two to three word utterances consistently using only
present tense. Her
connected speech was usually disorganized, off topic and out of
sequence.
Semantically, Michelle named objects and pictures, used action

words and used
words to describe objects and people.
Pragmatics:
In the functional use of language Michelle was able to initiate
and but had
difficulty in maintaining a conversational appropriately. She
did not attend to
listener needs or generally follow the rules of conversational
exchange.
Note:
Mean 100, σ 15
Mean 100, σ 15
Mean 100, σ 15
The Receptive One Word Picture Vocabulary Test (ROWPVT)
Mean 100, σ 15
The Peabody Picture Vocabulary Test-Revised (PPVT-R)
Mean 100, σ 15

1
Case Study: Jeannine
Student Sample
November 23, 2018
SPE 502: Language Development and Challenges in Children
and Adolescents
National Louis University
Fall 2018
2
Jeannine
General Information:
This student’s name is Jeannine. She is 13 years and 8 months
old. She has received speech and

language therapy since she was two years old. Her difficulties
include articulation, sentence
structure, semantics and pragmatics. Jeannine was assessed
through informal observation and
language sampling. She was also assessed using standardized
instruments including the Clinical
Evaluation of Language Fundamentals- Revised (CELF-3), and
The Adolescent WORD Test.
These tests were used to assess Jeannine’s articulation, voice,
fluency, pragmatic and receptive
and expressive language skills. Jeannine appeared to be doing
the best she could on the exams.
The standard scores for her CELF-3 test are as follows:
Receptive Language: 50
Expressive Language: 59
Total Language: 50
Jeannine’s Adolescent WORD Test standard score resulted in a
61. Jeannine’s articulation and
oral motor skills were found to be age appropriate. Fluency of
speech and voice levels were
found to be appropriate for her age and gender. Jeannine is able
to answer simple comprehension
questions, but has difficulty following step-by-step directions.
Jeannine is able to construct
sentences, but has some difficulty in expressive language such
as defining words, giving multiple
meanings of words, choosing synonyms and using appropriate
vocabulary. Her syntax skills are
appropriate. Jeannine can initiate and maintain a conversation
with her therapist, whom she
knows well, but she cannot initiate and maintain a conversation
with anyone whom she is
unfamiliar with. Her pragmatic skills are lower in the areas of
volume control, attending to

listener needs and following general rules of conversation.
Impact on Academics & Recommended Interventions and
Technology
Jeannine’s scores indicated that she may have an intellectual
impairment. She seems to have the
most difficulty with semantics and pragmatics.
The impacts that semantics difficulties have on her reading
ability are: difficulty differentiating
between words with similar meaning, difficulty classifying
words into categories and
subcategories, difficulty using known words in new ways,
difficulty understanding figurative
language, difficulty identifying main points in a reading,
difficulty defining vocabulary,
difficulty with comprehension, inability to describe narratives.
The impacts on writing include: difficulty separating and using
subject and object pronouns,
difficulty using new words, difficulty using figurative language
in writing, difficulty with written
expression, and narrative writing capabilities are limited.
The impacts on spelling include: difficulty with homophones or
spelling words with similar
meanings.
3

The impacts on math include: difficulty following verbal or
written directions, difficulty
understanding math vocabulary/terms, and delayed computation
and expression.
The impacts Jeannine’s difficulties have on science are:
difficulty following verbal or written
directions, difficulty understanding science vocabulary,
difficulty using descriptive words,
difficulty participating in class or group discussions, and
difficulty memorizing science facts.
The impacts on social studies include: difficulty following
verbal or written directions, difficulty
understanding social studies vocabulary, difficulty participating
in class or group discussions.
The impacts on art include: difficulty following verbal or
understanding art vocabulary, difficulty with spatial terms, and
difficulty using descriptive
words.
The impacts on music include: difficulty following verbal or
understanding music vocabulary, and difficulty understanding
the order of music notes.
The impacts on PE include: difficulty with spatial terms,
difficulty communicating effectively
with a partner or team, and difficulty following verbal
directions.
My recommendations for intervention ideas to better help
Jeannine include:

• Tests should be read aloud
• Directions should be rephrased and broken down, repeated if
necessary
• Visuals should be named and classified into categories
• Sentence completion activities
• Use manipulatives for spatial/tactile learning
• Use word retrieval cues
• Practice symbolic play activities
• Ask student to show example of what a word means, find a
picture to show the word’s
meaning, or demonstrate the meaning with materials
Types of technology that would be beneficial for Jeannine
include:
• Use of graphic organizers and charts will help students to
categorize words and ideas
• Use of online dictionary and thesaurus
The impacts that pragmatic difficulties have on Jeannine’s
reading ability are: inadequate
reading comprehension, reduced ability to follow discourse in a
story, difficulty following
storylines, difficulty with volume control when reading in
groups, reduced comprehension of
figurative language/slang used in texts, and difficulty with
predicting and making inferences
based upon background knowledge and evidence in the text.
Impacts on writing include: difficulty writing using figurative
language forms, failure to provide
context to thoughts, difficulty writing dialogue, difficulty
constructing grammatically correct

sentences, and difficulties with use of symbolism, figurative
language, and theme.
4
Impacts on spelling include: difficulty spelling words and
pattern of difficulty in letter
formation, sequencing and spelling.
Impacts on math include: difficulty comprehending word/story
problems.
Impacts on science include: difficulty following written or oral
instruction, and difficulty
inferring based upon evidence and prior knowledge.
Impacts on social studies include: reduced reading
comprehension, difficulty explaining an
event/providing context for an event, and difficulty
understanding perspective from another time
period.
Impacts on art include: difficulty following oral directions,
difficulty following step-by-step
directions, difficulty describing artist’s intentions and/or
meaning behind artwork, difficulties
interpreting works of art based on their meanings and
symbolism, and disrupting creative
environment
Impacts on music include: reduced comprehension of lyric
meaning, difficulty following oral

instructions, difficulty with volume control when singing,
difficulties recognizing the tone,
mood, or voice in a musical piece, and challenges with
incorporating own emotions/expression
when given freedom to explore in music.
Impacts on PE include: may have trouble comprehending
indirect requests from teacher,
difficulty following oral instructions, and difficulty
communicating and working in teams.
My recommendations for intervention ideas to better help
Jeannine include:
• Structured therapy sessions that teach skills to communicate
with others in appropriate
ways
• ABA- Applied Behavior Analysis
• Visual reminders of appropriate ways to interact, respond and
communicate in specific
settings
• Social work activities
• Speech therapy
• Turn-taking activities
• Modeling
• Positive conversation incentive charts
Types of technology that would be beneficial for Jeannine
include:
• Visual conversation cards
• Augmentative and Alternative Communication (AAC)- devices

that provide
pictures/visuals/words to an individual to help communicate
5
• Video- based instruction or modeling- the student can record
themselves doing certain
skills and then watch the video later for reinforcement of
appropriate behaviors
• Visual volume control app that measures volume levels

Case Study Student Ashley Age 7 years, 4 months

Case Study Student Ashley Age 7 years, 4 months

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