PLACE ON LETTERHEAD
SEMESTER SUMMARY REPORT
Name: Carmen Client
Date of Report: 4/20/15
Date of Birth: 01/011/1981 Age: 31
Diagnosis: Language/Aphasia
Address: 123 Valley Road
Anytown, AL 35758
Telephone: (256) 123-4567
Attended: 18
Absent: 5
Clinician: Susie Speech, B.S.
Supervisor: Cynthia Lewis, M.S.
CCC-SLP
This report will serve to summarize impressions and recommendations regarding Carmen Client who was enrolled in language therapy during the Spring Session, 2015. She attended individual therapy for two fifty-minute sessions weekly during this period.
RESULTS OF THERAPY
Long-Term Goal 1: The client will increase receptive language skills to 80% accuracy.
Short-Term Objective 1a: The client will follow one-step directions via verbal instructions with
80% accuracy.
Treatment: The client was presented with three objects, a ball, cup, and a pair of scissors. The
client was directed to repeat and then perform each one-step verbal instruction that was given by the clinician. The one-step directions included only three instructions; pick-up,
give-me, point to, or to touch one of the three objects. The clinician utilized repetitive cues,
written cues, and direct modeling.
Progress: During baselining, the client performed this task with 70% accuracy independently.
Currently, the client performs this task with 93% accuracy independently. Throughout the semester, the client would exhibit difficulty on following the correct action, but was able to identify the correct object for most, if not all of the time. For the majority of the semester, the client‘s level of performance was consistent at approximately 70% accuracy until the
clinician had the client repeat the instructions and provided an in-depth review of each action prior to beginning the procedure. The clinician has also noted that the client may have a 5-10 second delay upon hearing the instruction and performing the action. The client has achieved this objective with 80% accuracy independently for three consecutive sessions; therefore, this objective has been met, however, it is recommended that this goal be continued for the upcoming semester with the procedure to include several different instructions (other than the three included in this semester) to increase the client’s current repertoire of instructions, prior to increasing the level of difficulty to two-step directions.
Long-Term Goal 2: The client will demonstrate expressive language skills by naming common
Short-Term Objective 2a: The client will name common picture stimuli with 80% accuracy. Treatment: The clinician presented the client with 20 picture stimuli from the Super Duper Big
Noun flashcards and provided instructions to name each. Picture stimuli presented
represented common household objects (i.e., hammer, camera, laundry basket, etc.). For example, the clinician presented the client with a picture of an envelope, and then after the client had some time to observe, the clinician asked, “What is this?” Contextual, initial-phonemic, and written cues were given as needed.
Progress: This goal has been updated from naming pictures and objects to naming pictures
only. During baselining, this goal included two objectives that included naming the same objects and pictures (e.g. a picture of a hammer and an actual hammer). Due to the client’s consistency in naming both the object (hammer) and the picture stimulus (hammer) for three consecutive sessions, the objective for naming objects was discontinued. During baselining, the client performed this objective with 70% accuracy independently for picture stimuli. Once the client was able to name the first set of picture cards with 80% accuracy for three
consecutive sessions, a new set of common household item picture cards was introduced. Currently, the client performs this task with 82% accuracy independently and 100%
accuracy with cues. The client has achieved this objective with 80% accuracy independently for three consecutive sessions for 2 sets of 23 picture stimuli from the Super Duper Nouns set common household items category; therefore, this objective has been met for the stimuli presented; however, it is recommended that this goal be continued and increased to 90% accuracy for the upcoming semester in order to expand the client’s expressive language. Additionally, other categories that could be addressed from the Super Duper Noun cards include clothing and accessories, occupations, and transportation.
Long-Term Objective 3: The client will read monosyllabic words via written stimuli with 80%
accuracy.
Short-Term Objective 3a: The client will read monosyllabic words via written stimuli with 80%
accuracy.
Treatment: The clinician presented the client with flashcards containing one written
monosyllabic word. The client was instructed to read each card aloud. For example, the clinician presented the flashcard with the word, “does”, and asked the client, “What does this say?” Several of the monosyllabic words that the clinician implemented were from Fry’s High
Frequency Sight Words. Initial-phonemic cues were utilized during this procedure.
Progress: During baselining, the client performed this objective with 75% accuracy
independently. Once the client was able to name the first set of monosyllabic words with 80% accuracy for three consecutive sessions, a new set of monosyllabic words were
implemented. Currently, the client performs this task with 90% accuracy independently. The client has achieved this objective with 80% accuracy independently for three consecutive sessions; therefore, this objective has been met, however, it is recommended that this goal be continued for this upcoming semester to include additional monosyllabic words and the accuracy level increased to 90%. Additionally, other monosyllabic words that could be addressed for the upcoming semester may be adopted from Fry’s High Frequency Sight
Words.
Long-Term Objective 4: The client will increase orientation knowledge of time using a
calendar that spans from January 2015 – December 2015 by 80% accuracy.
Short-Term Objective 4a: The client will answer orientation questions regarding the day,
month, season, holiday, and year by using a calendar as a pictorial cue with 80% accuracy.
Treatment: The client was presented with a calendar containing the dates 1st- 31st. The
clinician counted the dates, one-by-one, in numerical order, and asked the client to repeat after the clinician, using the calendar as a pictorial cue. Next, the clinician asked the client to point to a specific calendar date ranging from the 1st – 12th. For example, the clinician asked,
“Can you point to the tenth?” Lastly, the clinician pointed to a random date, ranging from the 1st-12th, and asked, “What is this date?” Repetitive, initial-phonemic, and written cues were implemented in this procedure.
Progress: During baselining, the client’s orientation knowledge, specifically, identifying and
naming both calendar dates and numbers was at 0% accuracy independently. The clinician began with receptive and expressive tasks of targeting numbers that were specific to the numbers in a calendar month (i.e.1-31). Once the client mastered all the numbers, the clinician began targeting calendar dates (i.e. 1st-31st), beginning with the 1st-12th. Currently, the client is able to identify via pointing the 1st-12th with 92% accuracy independently and 100% accuracy with cues. Additionally, the client is able to name the dates 1st-12th with 79% accuracy independently and 100% with cues. The client has achieved 80% accuracy for the receptive portion of this task, targeting the dates 1st-12th, for three consecutive sessions; therefore this portion of the goal should be updated to include the remainder of the dates 13th-31st. Lastly, the client’s abilities for naming the dates the 1st-12th has not achieved 80% accuracy or higher for three consecutive sessions; therefore this portion of the goal should also be readdressed for the upcoming semester, as well as to include the remainder of the calendar dates.
Long-Term Objective 5: The client will complete homework assignments with 80% accuracy. Sort-Term Objective 5a: The client will complete homework assignments with 80% accuracy. Treatment: The client was presented with various flashcards and/or worksheets targeting each
objective.
Progress: The client turned in 20/20 homework assignments, achieving this task with 100%
accuracy. It is recommended that this goal continue to be addressed for the upcoming semester to promote maintenance and carryover of therapy objectives.
CLINICAL IMPRESSIONS
Carmen presents herself as a lovely, hard-working individual. The client worked diligently all semester with an upbeat and positive demeanor. Additionally, Carmen’s motivation to excel was evident in her timeliness and her prompt return of every homework assignment. Carmen was also extremely persistent during the therapy sessions, working meticulously through each task and procedure. The clinician utilized repetitive, written, initial-phonemic, semantic, and
articulatory placement cues for all objectives. Written cues prove to be the most beneficial for the client, whereas semantic cues prove to be the least. Carmen’s areas of strength include naming pictures, identifying via pointing to calendar dates, and reading monosyllabic words. The client’s areas of weakness include following directions and naming numbers. Carmen was able to master her short-term goal for following directions, but would greatly benefit to expand the directions to include additional instructions (other than point/tap/touch) and/or other objects to increase the level of difficulty for her receptive skills. Carmen has shown significant
improvements for naming objects via picture stimuli. Carmen has mastered close to 50 common household objects. Other categorical objects that may be addressed in the upcoming semester might include transportation, clothing and accessories, and/or food. Similarly, Carmen’s ability to read monosyllabic words has also shown improvement. She has mastered close to 70
monosyllabic sight words from Fry’s High Frequency Words. Carmen’s knowledge for calendar dates has shown promising results as well. Carmen has mastered the numbers 1-31 and the calendar dates 1st, 3rd, 5th, 6th, 7th, 8th, 11th and 12th. Occasionally, Carmen exhibited motoric difficulty when naming certain word-endings (/er/ would become /ers/) or calendar dates (6th, 26th). Written and articulatory placement cues were utilized to aid the client. Although Carmen mastered most of her short-term objectives, it would be most beneficial for her if all goals were readdressed in the upcoming semester and were increased in difficulty to further aid her overall
expressive and receptive communication. Carmen is a delightful individual to work with and worked fervently throughout this semester and will unquestionably continue this work ethic in the future. Carmen’s motivation has undoubtedly aided her in her improvements thus far.
RECOMMENDATIONS
It is recommended that Carmen Client be enrolled for language therapy two times a week for fifty-minute sessions, for the upcoming fall semester, 2015.
Student Clinician:
Date:
Clinical Supervisor:
Date:
Miscellaneous Examples:
Example of Difficulty Level Being Increased-Goal not Met
Short-Term Objective 1: The client will transcribe sentences used in conversational speech
when dictated by the clinician with 80% accuracy.
Treatment: The clinician addressed this objective by auditorially presenting the client with 10
job related e-mail messages. The client then typed the dictated responses (one sentence of 5-7 words) to each e-mail on a laptop computer.
Progress: The client began the semester performing at an accuracy level of 60% accuracy
independently and by mid-semester had met criterion levels for this objective for three consecutive sessions. Therefore, the difficulty level of the stimuli presented was raised from simple sentence forms to more lengthy complex sentences. By the end of the semester the client was performing at an accuracy level of 50% accuracy independently and 100% accuracy with written and question cues. With each written cue the clinician would show the client what she had said, written on a sheet of paper, in comparison to what the client transcribed so he could see the words he was leaving out of his response. The client has not received 80% accuracy on this goal for three consecutive sessions; therefore this goal has not been met and should be addressed for the upcoming semester.
Example of Difficulty Level Being Increased- Goal not Met
Short-Term Objective 2: The client will strengthen deductive reasoning skills by determining
causes for situations faced in daily life with 80% accuracy.
Treatment: The clinician addressed this objective by dictating a scenario to the client. The client
then provided one reason why the situation in the scenario may have occurred.
Progress: The client began the semester performing at an accuracy level of 95% accuracy.
Therefore, the clinician increased the level of difficulty and asked the client to supply 2 different reasons why the situation may have occurred. By the close of the semester the client was performing at an accuracy level of 85% accuracy independently and 100% accuracy with cues. However, he did not perform at an accuracy level of 80% independently for 3 consecutive sessions. Therefore, this goal was not met and should be continued for the upcoming semester. The clinician should also monitor the client’s progress to see if increasing the level of difficulty is warranted.
Example of Goal Being Met
Long-Term Goal 1: The client will eliminate deletion of final consonants at the conversational
level with 90% accuracy.
Short-Term Objective 1a: The client will produce the /t/ phoneme in the final position of words
in a) words, b) phrases, and c) sentences with 90% accuracy.
Treatment: The client was shown Super Duper articulation cards targeting the final /t/
phoneme. The client was asked to name the item on the card and was given the opportunity to play the game of his choice in between cards.
Progress: Upon collection of baseline data the client correctly produced 9/20 (45%) final /t/
phonemes in words. Phrases and sentences were not targeted due to the low
percentage of correct productions in words. During the final two sessions of treatment, the client produced 15/18 (83%) words in sentences correctly and 17/18 (94%) when provided a verbal cue. The client achieved the criterion of 90% accuracy for three consecutive sessions; therefore, this goal has been met. However, during conversational speech, the client often deletes final /t/.
Example of Decrease In Performance
**An Explanation Should be Provided for Any Decrease in Client Performance
Short-Term Objective 1b: The client will correctly use an idiom/figurative language in a
sentence as a means of conveying a message with 80% accuracy.
Treatment: The clinician provided a list of idioms/figurative language to the client and
instructed him to formulate sentences using each. When the client correctly formulated 2 sentences he was allowed to select 2 puzzle pieces.
Progress: During baselining, the client correctly used idioms in a sentence with 70% accuracy
independently. Currently, the client is able to use idioms in a sentence with 55% accuracy independently and 100% accuracy with verbal cues. This decrease in performance is likely due to the introduction of a new set of idioms. The client has not received 80% accuracy on this goal for three consecutive sessions; therefore this goal has not been met and should be addressed for the upcoming semester.
Long-Term Goal 3: The client will demonstrate knowledge of word families targeting long and
short vowel sounds with 90% accuracy.
Short-Term Objective 3a: The client will correctly spell word families of short vowel sounds
with 90% accuracy.
Treatment: The client was asked to spell words containing short vowel sounds derived from
different word families.
Progress: When therapy began the client was presented with monosyllabic words and was
performing this task with 100% accuracy independently. The goal was upgraded to include multi-syllabic words and the client is now performing with 80% accuracy. The client has not received 90% accuracy on this goal for three consecutive sessions; therefore this goal has not been met and should be addressed for the upcoming semester.
Example of Decrease In Performance
**An Explanation Should be Provided for Any Decrease in Client Performance
Short-Term Objective 1a: The client will express basic a) time/sequence/spatial, b) quantity,
and c) opposite concepts when given a field of two choices with 90% accuracy.
Treatment: The clinician presented the client with pictures or objects of basic concepts,
modeled the concept, and then asked the client to verbally express the correct concept. (i.e.- “Is the ball under the chair or on top of the chair?”)
Progress: During baselining the client performed this activity with 59% accuracy independently
and 100% accuracy with cues. The client is currently performing with 53% accuracy independently and 95% accuracy with cues, which is a 6% decrease in accuracy. This decrease maybe due to lack of attention and an increase in the number of basic concepts addressed during each session. The client has not achieved 90% accuracy for three
consecutive sessions; therefore this goal has not been met and should be addressed during the upcoming semester.
