Konuşma Terapisi Değerlendirmesi №____

1.İsim, soyisim :________________________________ Anne adı:_________________________

2.Doğum tarihi: ____________________
3.Yaş:____________________________
4.Başvurma sebebi: _____________________________________________________________________
5.Tıbbi bilgi: __________________________________________________________________________
Artikulyar motor:
1.Artikulyar aparatın anotomik yapısı:
 Dudaklar_______________________________________________________________________
 Dişler__________________________________________________________________________
 Dil____________________________________________________________________________
 Dilaltı bağ_____________________________________________________________________
 Damak_________________________________________________________________________
 Küçük dil_______________________________________________________________________
2.Dilde hareketlilik:____________________________________________________________________

3.Dudakda hareketlilik:_________________________________________________________________

4.Yanak kasında hareketlilik:_____________________________________________________________

5.Mimik kasda hareketlilik(tonusu, tempi):___________________________________________________

6.Göz kasında mimik hareketlilik :__________________________________________________________

7.Çenede hareketlilik:_________________________________________________________________

8.Ağız suyu:__________________________________________________________________________

9.İnce motor:___________________________________________________________________________

Nitq:
1.İmpressiv konuşma: ___________________________________________________________________

2.Ekspressiv konuşma:___________________________________________________________________

Fonematik Proseslər:
1.İşitmə:______________________________________________________________________________

2.Fonemik kavram:_____________________________________________________________________

3.Səslərin karıştırılması:__________________________________________________________________

4.Fonemik analiz:_______________________________________________________________________

5.Seslerin kelimede yeri (önde, ortada və sonda):______________________________________________

6.Kelimelerin hece yapısı:________________________________________________________________

7.Kelimelerin telaffuzu:__________________________________________________________________
8.Seslerin kontrölü:

P B T D S Z Ş J K G K Q Ğ H X Ç C L R Y M N V F

A I O U E Ə İ Ö Ü

9.Kelime hazinesi (iletişim becerileri):_____________________________________________________________

_________________________________________________________________________________________

10. Teneffüs köntrölü :_________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

11.Öngörülen tedavi süresi:____________________________________________________________________

Konuşma terapistinin adı, soyadı: _______________________ İmza:_____________________

Soruları cevaplayan kişi:____________________________ İmza:______________________

Tarih: ____/_________/20____