Phonological Report Template

I. PRESENTING CONCERNS
A. FAMILY
 Speech production
 Impact on CHILD’s interaction with peers and adults


B. CHILD


C. TEACHER
 Speech production
 Impact on CHILD’s interaction with peers and adults


II. EVALUATION QUESTIONS

The following questions were considered in this evaluation process:

 Does CHILD have a Speech or Language Impairment?

 If so, does the impairment impact educational performance?

III. TESTING PROCEDURES

The school SLP described CHILD’s communication skills using performance assessment
technologies: interview, observation, ratings scales, checklists, behavioral sampling, and
standardized testing. The SLP performed the following evaluative tasks:
 Reviewed school and medical records
 Interviewed CHILD with the Speech Participation and Activity of Children (SPAA-C) to
determine the daily social/emotional impact of HIS/HER communication difficulties
 Asked CHILD to draw pictures of HIMSELF/HERSELF talking with someone, HIS/HER
family and doing something HE/SHE enjoys to further assess the social impact
 Interviewed CHILD’s family
 Analyzed the results of parent questionnaires (Speech Participation and
Activity of Children (SPAA-C) and Intelligibility in Context Scale (ICS))
 Interviewed CHILD’s teacher
 Analyzed the results of teacher questionnaires (Describing Speech Misarticulations)
 Collected and analyzed a structured conversation sample to assess CHILD’s expressive
language skills and to calculate CHILD’s overall intelligibility
 Administered a standardized articulation (sound production) test, Goldman-Fristoe Test of
Articulation-2
 Administered an independent single word sound probe of singleton consonants
 Administered an independent single word sound probe of consonant clusters (e.g., /fl-/)
 Administered an independent single word sound probe of multisyllabic words (e.g.,
“ambulance.”)
 Administered a stimulability (imitation) task of unknown sounds
 Analyzed the results of all sound production tasks to determine sound treatment targets

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IV. ARTICULATION ELIGIBILITY CRITERIA
California Code of Regulations establishes eligibility criteria for special education services in the
area of articulation development. The speech behaviors must significantly interfere with
communication, attract adverse attention and adversely affect educational performance. A child
must meet all three criteria in order to be eligible for an Individualized Education Program
(IEP).

V. DESCRIPTIVE ASSESSMENT
HEALTH AND DEVELOPMENTAL QUESTIONNAIRE
CHILD’s PARENT reported that HIS/HER primary concern is CHILD’s “______________________.”
Reportedly, CHILD is AWARE/NOT AWARE of HIS/HER speech difference and “realizes that
________________________.” PARENT described CHILD’s personality as “_____________________________.”
CHILD reportedly gets along well with HIS/HER SIBLING (Age _____), in addition to HIS/HER
friends at school and in the neighborhood. PARENT shared that CHILD attends XXX Preschool XXX
days a week and also participates in XXX.

PARENT provided information about CHILD’s health and developmental history. According to
HIS/HER report, SHE/HE stated that CHILD achieved all developmental milestones within the
typical range, including sitting, crawling, walking and toilet training. PARENT did not report any
issues during pregnancy or delivery. A history of ear infections was noted on the questionnaire.
PARENT reported that CHILD had 3-4 ear infections and all were treated with antibiotics. No other
health issues were noted.

PARENT reported that CHILD said HIS/HER first word at ______________, combined two words at
______________and used complete sentences at _________________. HE/SHE indicated that HE/SHE first
become concerned about CHILD’s communication at ________________ because “____________________.”

CHILD INTERVIEW
CHILD was interviewed about HIS/HER communication by completing the Speech Participation
and Activity of Children (SPAA-C; McLeod, 2004). CHILD was asked about HIS/HER family, friends,
interests, and talking. Following that, HE/SHE identified feelings about talking with different
people and in different situations by filling in faces that correspond to “happy,” “in the middle,”
“sad,” “another feeling” and “I don’t know.” During this task, CHILD indicated that
___________________.

In addition, CHILD was asked to draw three pictures: talking with someone, HIS/HER family and
doing something HE/SHE enjoys. After doing so, CHILD reported that “________________.” This
suggested that CHILD’s speech sound production ________________________________.

PARENT INTERVIEW
PARENT provided information about CHILD’s communication, self-help skills, school readiness,
gross motor skills, fine motor skills and sensory integration skills. Reportedly, CHILD understands
simple time concepts (before, after, yesterday), demonstrates problem-solving during play and
sequences two or more events. Furthermore, PARENT stated that CHILD communicates with long,
complex sentences, asks a range of questions (including why and how), tells stories with a
beginning and end and has an extensive vocabulary. She noted that CHILD enjoys playing alone,
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alongside peers, with peers and with adults. CHILD reportedly initiates with peers and familiar
adults and frequently engages in pretend play.

Additionally, PARENT shared that CHILD consistently demonstrates age-appropriate self-help

skills, such as washing/drying hands, dressing and feeding. Reportedly, CHILD has excellent gross
motor skills, fine motor skills and sensory integration skills: these are areas of strength.

TEACHER INPUT
TEACHER, CHILD’s classroom teacher, shared observations about CHILD’s classroom
performance. She indicated that CHILD demonstrates age-appropriate expressive language,
excellent social communication and age-appropriate play skills. TEACHER corroborated PARENT’s
report that CHILD _________________________.

TEACHER stated that HE/SHE is concerned about CHILD’s speech production. Furthermore,
TEACHER indicated that HE/SHE and other adults rarely understand CHILD’s speech when the
topic is unknown or in a noisy environment.

Reportedly, when adults do not understand, CHILD often repeats what HE/SHE said or shows the
person what HE/SHE means. Moreover, TEACHER stated that other children sometimes help
adults understand CHILD’s message.

Lastly, HE/SHE reported that CHILD sometimes participates during some small and whole group
activities. However, CHILD is reportedly reluctant to share what HE/SHE and HIS/HER family did
during weekly sharing time.

INTELLIGIBILITY IN CONVERSATION
Intelligibility refers to a person’s ability to be understood by others. PARENT completed the
Intelligibility in Context Scale (ICS, McLeod, Harrison & McCormack, 2012) in English. The ICS
includes seven items that require the parent to rate HIS/HER child’s intelligibility with different
communication partners (parents, immediate family, extended family, child’s friends,
acquaintances, child’s teachers and strangers) on a five-point scale (5 = always, 4 = usually, 3 =
sometimes, 2 = rarely, 1 = never). CHILD’s average total score was ____, which suggested that
HE/SHE is _____________________. HE/SHE was more likely to be understood by familiar adults and
children.

During the assessment, a conversation sample was elicited and recorded during play. The sample
was transcribed for analysis using the most reliable method identified by Flipsen (2006). The
following describes how CHILD’s intelligibility was calculated.

1. Counted the number of intelligible words (words that were easily understood); CHILD
produced ___ intelligible words
2. Counted the number of unintelligible words (words that were not easily understood);
CHILD produced ___ unintelligible words
3. Divided the number of unintelligible words by 1.25 because children generally produce
three one-syllable words for every one multisyllabic word

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4. The intelligible words were divided by the sum of the intelligible words (#1) and the result
of #3 (the adjusted number of unintelligible words)

Based on this calculation, CHILD’s speech intelligibility was __%. This corroborated the parent and
teacher reports. Overall, CHILD’s sound substitutions and omissions significantly impact HIS/HER
intelligibility and therefore HIS/HER classroom communication.

ADVERSE ATTENTION
There was evidence during the observation and from the parent and teacher questionnaires
(Speech Participation and Activity of Children (SPAA-C; McLeod, 2004) and Describing Speech
Misarticulations; Dunaway, 2004) that CHILD’s speech pattern attracts adverse attention. PARENT
reported that CHILD shies away from interactions with new people frequently because HE/SHE
anticipates that they will not understand HIS/HER speech. For example, when new people ask
CHILD HIS/HER name, CHILD often asks HIS/HER mother to respond on HIS/HER behalf.
Furthermore, PARENT reported that sometimes “children walk away or don’t play with HIS/HER
(CHILD) because they can’t understand HIS/HER.” CHILD’s teacher, TEACHER, shared that CHILD
sometimes demonstrates frustration when others do not understand HIS/HER message.
Furthermore, CHILD stated “_____________________.”

EDUCATIONAL PERFORMANCE
CHILD’s teacher, TEACHER, shared information about CHILD’s classroom performance. She
indicated that HIS/HER speech is ____________________ intelligible (depending upon the topic).
Currently, CHILD is BELOW/AT/ABOVE grade level in preacademic skills. However, HE/SHE
shared that CHILD’s conversational intelligibility significantly interferes with HIS/HER
interactions with peers and adults in the classroom.

PHONOLOGICAL ASSESSMENT AND ANALYSIS

The In-Depth Phonological Assessment (IPA; Taps Richard, 2012) was administered to examine
CHILD’s production of English sounds (singletons, consonant clusters and multisyllabic words) in
single words. The assessment probes will be utilized throughout treatment to monitor progress
over time.

Additionally, CHILD’s sound patterns were assessed during a conversation sample to determine if
HIS/HER speech sound patterns are consistent in single words and conversation.

During all tasks, CHILD produced vowels accurately. Therefore, HE/SHE demonstrated a complete
vowel inventory that does not require treatment. Below is an analysis of CHILD’s consonant
repertoire.

A child’s phonetic inventory consists of all the singleton sounds HE/SHE produced at least two
times in the sample. CHILD demonstrated mastery of many sounds in HIS/HER phonetic inventory
while other sounds are not fully mastered (though they are emerging). Below are the singleton
sounds in CHILD’s phonetic inventory as well as the sounds that are currently missing from
HIS/HER phonetic inventory.

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Singletons Phonetic Inventory Currently Missing from Phonetic Inventory

A child’s phonemic inventory consists of all the sounds HE/SHE used to signal a difference in
meaning at least two times in the sample. For example, if a child says “talk” and “walk,” HE/SHE is
using the /t/ and /w/ sounds to show that these two words have a different meaning. This
suggests that the child has a higher level of knowledge of these two sounds.

CHILD’s phonemic inventory was SIMILAR TO/DIFFERENT THAN HIS/HER phonetic inventory.
Below are the singleton sounds in CHILD’s phonemic inventory as well as the sounds that are
currently missing from HIS/HER phonemic inventory.

Singletons Phonemic Inventory Currently Missing from Phonemic Inventory

As noted earlier, CHILD did not use the following sounds in the assessment tasks: /f v th (voiced &
voiceless) l r/. These sounds were targeted during a dynamic stimulability (imitation) task. The
term stimulability refers to whether or not a child produces unknown sounds given support from
the SLP. The task required CHILD to attempt the missing sounds in isolation (e.g., “say /f/ by biting
lightly on your lip and pushing the air out”) and in syllables (“fee,” “eefee,” “eef,” etc.) given models
from the SLP.

Below are CHILD’s stimulable (sounds HE/SHE imitates with help) and nonstimulable (sounds
that were difficult to imitate) sounds. Research has demonstrated that teaching nonstimulable,
complex and later-developing sounds creates more rapid changes throughout a child’s sound
system.

Stimulable Sounds Nonstimulable Sounds

A child’s cluster inventory consists of all the consonant clusters HE/SHE produced at least two
times in the sample. /fl-/ as in “flap” and /str-/ as in “street” are two examples of consonant
clusters in English.

Below are the sounds in CHILD’s cluster inventory as well as the sounds that are currently missing
from HIS/HER cluster inventory. Children are given credit for any clusters they use in the sample,
even if they are not consonant clusters in English. For example, many children substitute “pway”
for “play.” /pw-/ does not occur in English; however, when a child produces /pw-/, that suggests
that HE/SHE knows something about clusters.

Clusters Inventory Missing from Clusters Inventory

Below are the patterns that emerged in CHILD’s sample as well as their frequency of occurrence.

 cluster reduction (e.g. “nake” for “snake”) frequent

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 gliding (e.g. “wide” for “ride”) frequent
 stopping (e.g. “tip” for “chip” and “map” for “math”) frequent (some /sh/, /ch/, /j/
produced correctly)
 substitution of /pw-/ and /bw-/ for some clusters (e.g., “pwab” for “crab”) occasional
 fronting (e.g., “tup” for “cup”) occasional (many /k/ and /g/ targets produced
correctly)
 initial consonant deletion (e.g., “eg” for “leg”) occasional

CHILD’s percentage consonants correct (PCC) was calculated for the singleton and cluster
samples. PCC corresponds to the percentage of consonants produced correctly in each word. For
example, when CHILD said “pwag” for “flag,” HE/SHE was given credit for 1/3 consonant sounds.
These measurements establish a baseline for later comparison during treatment.

Percentage Consonants Correct for Singletons Percentage Consonants Correct for Clusters

Lastly, CHILD produced multisyllabic words while looking at photographs. HIS/HER patterns on
the target words largely corresponded to the above patterns. Occasionally, HE/SHE deleted a
syllable as in “bupwy” for “butterfly.” Overall, HIS/HER percentage consonants correct for this
task was 45%.

These independent tasks corroborated PARENT’s and TEACHER’s reports about CHILD’s
difficulties with some singleton sounds and with consonant clusters. CHILD demonstrated a
moderate phonological disorder. She did not produce six singleton sounds (/f v th (voiced &
voiceless) l r/) and all consonant clusters in English. This significantly impacted HIS/HER overall
intelligibility.

ORAL PERIPHERAL EXAMINATION

The oral peripheral exam showed adequate lip pressure, tongue strength, tongue tip strength and
jaw stability. Difficulty was observed for jaw control and differentiation between the jaw and
tongue. These characteristics will be considered when speech sounds are taught. It should be
noted that research has suggested that non-speech oral-motor exercises (NSOMEs) do not impact
speech production (Lof, 2011). Therefore, NSOMEs are not recommended in the course of
treatment.

CHILDHOOD APRAXIA OF SPEECH (CAS)

Shriberg, Potter and Strand (2011) identified criteria for the identification of childhood apraxia of
speech (CAS). They stipulated that all children with CAS demonstrate vowel distortions. In
addition, children exhibit at least three of the following eleven characteristics across tasks:

1. Difficulty getting mouth ready to produce sounds

2. Moving through sounds (vowel to consonant, consonant to vowel or consonant to consonant)
3. Stress errors
4. Distorted substitutions
5. Breaking long words into individual syllables (rather than blending the syllables)
6. Groping
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7. Use of “uh” sound between sounds, such as “suh-am” for “Sam” or “wuh-in” for “win”
8. Voicing errors
9. Slow rate
10. Slow movement through words that feature different places of articulation, such as
“buttercup”
11. Increased difficulty with multisyllabic words

CHILD did not demonstrate any of the above characteristics. She presented with a full inventory of
vowels and there was no evidence of the other eleven possible CAS characteristics. Therefore,
CHILD’s speech production was not consistent with the profile of childhood apraxia of speech.

LANGUAGE SAMPLE
The language sample corroborated the teacher and parent reports. During an extended play
sample, HE/SHE communicated with complex sentences (average 6-7 words in length) and talked
about a range of topics.

Additionally, CHILD demonstrated age-appropriate understanding of language and various

concepts. Consequently, expressive and receptive language are areas of strength for CHILD. She
does not require support in these skills.

VOICE AND FLUENCY SKILLS

CHILD’s fluency and voice were also assessed during the phonological and language tasks. Both
were within normal limits.

VI. STANDARDIZED TESTING

SOUND PRODUCTION
CHILD’s speech production skills were assessed using the “Sounds in Words” subtest from the
Goldman Fristoe Test of Articulation –2 (GFTA-2). HE/SHE named pictures of common words that
targeted the singleton sounds and clusters of English. CHILD made ___ errors, which corresponded
to a standard score of __________. These scores fell below the average range for HIS/HER age group.
The results corroborated the findings from the independent sound task.

VII. STRENGTHS
 Receptive and expressive language skills
 Social communication
 Voice
 Fluency (speech smoothness)
 Preacademic skills

VIII. EXPLANATORY ANALYSIS/AREAS OF NEED





IX. INTERPRETIVE ANALYSIS

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The assessment revealed a phonological disorder, which significantly impacts CHILD’s classroom
performance. There was evidence that HE/SHE met all three articulation criteria for an IEP:
significant impact on intelligibility, adverse attention and educational impact. At this time, CHILD
meets eligibility requirements for speech/language intervention to target the areas of sound
production and its impact on CHILD’s participation in daily activities. It is recommended that
HE/SHE receive _______ minutes of therapy per week (____ hours of treatment per year).

X. STRATEGIES FOR SUPPORTING SOUND ACQUISITION AT HOME AND SCHOOL

As your child continues to develop his or HIS/HER speech, there are many things that you
can do during everyday conversation at home. The first five strategies are valuable for all children
who are developing sounds. It is suggested that parents and teachers select one intervention
technique to implement at a given time. The SLP will offer ongoing support and coaching to
ensure that CHILD receives the maximum benefit of these research-based strategies.

1. Provide extra models for your child. These are also called conversational recasts. During
conversation, you might hear your child make a substitution for a target sound, such as “wed” for
“red.” A conversational recast is saying the word again immediately for the child as a model for a
good production. This is not a correction, but rather an extra model that keeps the conversation
going. It is not necessary to emphasize the word or sound. It would go something like this:

Child: I want the wed one.

Parent: Red one. (Pause.) What are you going to draw?

It’s helpful to pause after providing the good model as well to allow your child to hear the
difference between his or HIS/HER production and your production. Researchers have found
conversational recasts to be effective in teaching new sounds, grammar and sentence structures.
When a child is provided with these cues over several weeks (10 – 20 weeks), he or HE/SHE may
start using the correct sound or structure naturally in conversation. Talking with your child about
his or HIS/HER day is a meaningful context for learning new skills and your patient modeling (not
correction) can enable him or HIS/HER to do so. There is no need to emphasize the word or draw
out the correct sound. A natural model is very powerful.

2. Provide a consistent hand signal to pair with a target sound. For instance, many
students respond well to the hand signal of running a finger down the entire arm to signify the /s/
sound. This visual cue can provide a subtle reminder for a child to use a sound in a variety of
situations. It is recommended that as many people as possible use this cue with your child,
including family members and teachers. In most cases, it is best for the child to select a hand signal
that is meaningful for him or HIS/HER. Your school’s speech-language pathologist can consult
with you if you have any questions.

3. Pause and model thinking about using good sounds. In turn, you can give your child
pause time to think about using good sounds. By giving your child more time to respond, you are
helping him or HIS/HER to develop more awareness of sound production.

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4. Model using “fixed-up-one” routines (Bowen & Cupples, 1999). All people make
speech errors when communicating. Therefore, it is important that children understand that we
all make errors and have to fix them. Bowen and Cupples have many helpful resources for parents
and teachers to model this practice at: http://www.speech-language-
therapy.com/index.php?option=com_content&view=article&id=72:fuo&catid=11:admin

5. Read books that feature unknown sounds. This is a wonderful opportunity to support
sound acquisition by modeling correct production of sounds during a meaningful activity. It also
provides a foundation for later literacy skills. A list of books for singleton sounds is available at:
http://consonantlyspeaking.com/sites/consonantlyspeaking.com/files/uploads/Books%20That
%20Work%20on%20Articulation.pdf.

6. Identify classroom activities during which CHILD needs support to participate. As

indicated in the report, CHILD’s speech significantly interferes with HIS/HER participation during
the weekly sharing time. When possible, parents may consider sending photographs of family
activities and sharing a quick note with the teacher and SLP about recent events. It may be
beneficial for CHILD to rehearse HIS/HER share topic with the SLP, teacher and/or parents for
increased confidence in the classroom.

7. Discuss the idea of overcoming obstacles. There was evidence that CHILD experiences
frustration and avoids interaction with others due to HIS/HER speech production. Therefore,
parents may consider reading the book, Cow That Went Oink (Most, 1990). It features two
characters, a cow and a pig, who collaborate to overcome their speech differences. They initially
experience teasing and frustration, but succeed in the end due to their perseverance. This book
may serve as a valuable source to help children with the social and emotional aspects of speech
sound disorders.

8. Discuss the impact of CHILD’s speech sound disorder on siblings. Research has
suggested that siblings of children with speech sound disorders may experience complicated
feelings (Barr, McLeod & Daniel, 2008). Therefore, it may be beneficial for siblings to have the
opportunity to discuss their feelings with parents about BROTHER/SISTER’s speech sound
challenges. This may enable siblings to support CHILD in an age-appropriate manner without
assuming too much responsibility for CHILD’s communication success. If needed, the SLP may
serve as a resource for siblings who have further questions about speech sound disorders or fun
activities that support their siblings during home practice.

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