Baby Rian's visit to Speech-Language Pathologist Part 2

Journal date: July 2011
Rian's Age: 3 years old and 10 months

This is the official result of the evaluation done by a Speech Language Pathologist of my baby Rian as I explained in my previous post: Baby Rian's visit to Speech language Pathologist Part 1

Demographic Data

Name of Patient: Czerina Kate Hernandez                                                Age: 3:10                        Sex: F
Medical Diagnosis: Speech Delay                                                             DOB: September 1, 2007
Address: Tinurik, Tanauan, Batangas


Clinical Impression

This is the case of Czerina Kate Hernandez, a 3 year old girl, who was seen to have Mixed Receptive and Expressive Language Delay with concomitant behavioral concerns as characterized by:

A. Behavior
       1. Poor attention span
       2. Poor impulse control
       3. Fair sitting span
       4. Fair compliance
       5. Presence of off-task behaviors

B. Delayed language skills

     1. Delayed inner language

•       Age-inappropriate skills seen in dimensions of symbolic play

     2. Delayed receptive language

•       Limited vocabulary and concepts (e.g. nouns, verbs)
•       Discriminating common objects used in activities of daily living, familiar and less familiar objects and people, animals, food, toys
•       Naming and discriminating action in pictures
•       Limited answering questions (e.g. yes/no, what regarding preference, object identity/function)
•       Limited following commands (e.g. routine commands; 1-2 step commands 2-4 critical elements)
•       Limited ability in integrative thinking skills (e.g. association, part-whole relationship)

    3. Delayed Expressive language

•      Limited ability to denote/code vocabulary and concepts (e.g. nouns, verbs) using gestures or 1-word utterances for the purpose of discourse-respond/commenting
•      Presence of jargons
•      Limited intent to communicate

Recommendations

Based from the evaluation and analysis of results acquired, the following are respectfully recommended:
      A. Regular one-on-one speech and language therapy once a week focusing on the following:
          1. Behavior management
              a. Increasing sitting span, attention span and compliance to structured tasks through positive    reinforcements and verbal prompts
              b. Increasing impulse control though close monitoring and verbal prompts
              c. Decreasing off-task behaviors through redirection, close monitoring and verbal prompts
          2. Improving language skills
              a. Facilitating age-appropriate play skills
              b. Increasing concepts and vocabulary through language stimulation techniques
              c. Improving auditory comprehension (e.g. answering, questions, following commands)
              d. Facilitating acquisition of integrative thinking skills
              e. Increasing specific gestures and 1-2 word utterances
      B. Referral to occupational therapy for further behavior management
      C. Discussion with family about results of evaluation and goals for intervention
      D. Caregiver education about the child’s present skills and condition, and language stimulation techniques  that can be facilitated at home
      E. Re-evaluation after six months to one year of continuous therapy to monitor the child’s progress.


Evaluated by Speech Pathologist: 
Kaycee L. Farol, SLP
Speech-Language Pathologist