ARKANSAS  COMMUNICATION  BOARD

Obtained from HomeSpeechHome, October 2017

This free document contains simple report shells/templates for over 90 speech-language diagnostic tests to use in writing assessment/evaluation reports.  Click here to view/download this document.  Go to www.Home-Speech-Home.com to find further information and apps that promote speech-language development. ​

Posted by Shelly Wier, November 2014

This two-page document lists the phonological and grammatical characteristics of African-American English Vernacular, which may be used to adjust scoring of speech and language assessments in a culturally relevant way.  Click here to view/download this document.

Obtained from ASHA Division 16 (School-Based Issues) listserv, March 22, 2001

This informal assessment protocol is designed for use by teachers and communication consultants who wish to foster better matches between teacher talk and child listening by analyzing current situations so that they may adjust the environment and provide individualized intervention when indicated.  Click here to view/download this document.

Obtained from http://csd.uncg.edu/

This rating scale is designed to evaluate cognitive, affective, linguistic, motor, and social (CALMS) components that are related to stuttering. It is recommended that clinicians base their clinical judgment on deriving a score for each item using scores and/or data from scales, tests, as well as documented evidence about the child being evaluated.  Click here to view/download this document.

Adapted by Shelly Wier, August, 2014

FREQUENTLY RECOMMENDED!

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This is an informal listening and speaking checklist that can be used to gather classroom-based or achievement data regarding speech and language skills.  It was originally published by Psychological Corporation in 1993.  Reconstructed and adapted by Shelly Wier, MS, CCC-SLP, August 2014.  Click here to view/download this document.

Modified from Clinical Connection, Summer 1988

This checklist provides a way for SLPs to quickly analyze a student's classroom environment -- from the teacher's presentation of information to the student's study skills.  Click here to view/download this document.

From the Sourcebook for Speech and Language Assessment, 1996

Language observations can be completed as the student describes pictures, tells stories, and in other situations.  Activities in which the student talks about action pictures can be helpful in assessing descriptive language skills and use of basic grammatical forms in the present tense. Click here to view/download this document.

Adapted by Shelly Wier, September 2000

These instructions are generic enough to apply to any observation, but are designed to accompany the Expressive Observation form below.  It includes tips to consider before, during and after observation sessions.  Click here to view/download this document.

Modified from Nelson, 1993

Use this document to help measure narrative skills more specifically, or to create a rubric for measuring progress on goals and objectives.  Click here to view/download this document.

Posted November 14, 2017

These templates were created/modified based on an example form used by the Bentonville school district.  They are provided in Word .doc format (rather than .pdf) so that they can be modified as needed for individual district use.  This is not a required addendum or report.  It's just an example of one way to summarize the data from the team's Existing Data Review.

Dismissal/EDR summary template - SLI primary

Dismissal/EDR summary template - SLI secondary

Additional guidance/instructions for dismissing students from speech-language therapy (especially for articulation/intelligibility) when no testing or additional data is needed and the student has achieved his/her 'terminal' goals... can be found on the News & Announcements page of this website.

Posted by Shelly Wier, August 2009

The SOAP format is a familiar form for writing progress notes.  The following documents, found online, provide an explanation of SOAP notations and sample notes documenting therapy sessions.  Click here to view/download the basic SOAP note.  Click here to view/download the problem-oriented SOAP note. 

Adapted by Shelly Wier, September 2000

Consider using this observation form to document developmental or basic language skills at any age.  It analyzes form and function according to the primitive, conventional, and symbolic behaviors demonstrated and the social and nonsocial intentions they communicate.  Click here to view/download this document.

From Singular Thomson Learning, 2000

The purpose of this evaluation is to determine how a student’s listening abilities are affected by noise, distance, and visual input.  It is designed to simulate the student’s listening ability in a situation that is more representative of his or her actual listening environment than the sound booth.  This protocol is based on a listening paradigm suggested by Ying (1990), and by Ross, Bracken, and Maxon (1992).  Click here to view/download this document.

Acquired from Donna Smiley, EARS Program

This single page form from Educational Audiology/Speech Pathology Resources for Schools (EARS) provides an easy means of tracking and documenting daily HA/FM checks.  Click here to view/download this document.

Acquired from Donna Smiley, EARS Program

This single page handout from Educational Audiology/Speech Pathology Resources for Schools (EARS) shows essential items for hearing aid maintenance and links to where to purchase them.  Click here to view/download this document.

Modified from Loeb, 1997

Use this document to help measure narrative skills more specifically, or to create a rubric for measuring progress on goals and objectives.  Click here to view/download this document.

Adapted from the SKI*HI Model Resource Manual

Use this form with young students with hearing impairment to assess auditory/listening skills ranging from Attending to Speech Use.  Click here to view/download this document.

Modified from Richards and Fahy, 2005

This is an observational worksheet that assesses attention, inhibition, initiation and persistence, goal selection, planning and organizing, flexibility, execution and goal attainment, and self-regulation.  Click here to view/download this document.

Posted by Shelly Wier, November 2014

The term intelligibility refers to the proportion of a speaker's output that a listener can readily understand.  In typical development, as children learn to talk, their comprehensibility to those around them steadily increases. This document from Carolyn Bowen's website provides a review of expected skills from a number of sources, and can be used to help document intelligibility of speech.  Click here to view/download this document.

From Clinical Connection, Winter 1988

The purpose of this nonstandardized, observational profile is to assist teachers in observing functional communication variables within the speaker, listener, content, and context.  It examines ongoing communication in a classroom setting utilizing a procedure developed by the SPERS model (Lasky, 1983, 1985).  The questionnaire asks about the signal and presentation, the environment, the response of the student, and the learning strategies used in the classroom.  Click here to view/download this document.

Early identification is the first step to helping young children with language delays improve their skills. This new, game-like, interactive, language screener, for 3-5-year-olds, measures children's skills in vocabulary, syntax, and process.  In about 15-20 minutes the child can complete it, with supervision from a teacher or paraprofessional, on any tablet, laptop, or desktop with touchscreen technology and Internet access.  Annual subscriptions cost $99.  Learn more at www.brookespublishing.com/quils.  Be sure to check out the Introductory video.

Posted by Shelly Wier, August 2009

Here's one I found online and modified.  As with all examples posted, you might need to tweak it to fit your needs.  Click here to view/download this document.

From the Stuttering Foundation of America

Teachers are an important part of a child’s environment. For children who stutter, a teacher’s understanding and support are critical in determining what the child’s experience with stuttering will be.  Click here to view/download this document.

Created by Shelly Wier, August 2014

FREQUENTLY RECOMMENDED!

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This is an informal checklist that can be used to gather classroom-based or achievement data regarding articulation skills/intelligibility, voice production, and fluency of speech.  It was created using content from a variety of similar tools used in other states.  Click here to view/download this document.

From Academic Therapy, 1983

This checklist for teachers can be used to begin gathering student information about word retrieval difficulties.  Click here to view/download this document.