Department of Human Services Speech-Language Pathology Program / Stanley Speech and Hearing Clinic P. O.

Box 13019, SFA Station Nacogdoches, Texas 75962 3019 O!!ice "936# $6% 1252 FA& ' "936# $6% 5%37 http:// !sfasu!edu ( )ai* ' speechclinic"sfasu!edu #$%&#'%(# PL&( NA+(, Client)s (ame -AT( OF B./T0, *anuary +, -../ A1(, +. years +. months PA/(NT"S#, *ohn 0 *ane Smith -.A1NOS.S, *ist diagnosis /(PO/T.N1 P(/.O-, 2an3a45 1, 2009 1/A-6AT( 78.N.7.AN, 1rad Clinician)s (ame S6P(/9.S.N1 S8P, Supervisor)s (ame STAT6S AT B(1.NN.N1 OF T/(AT+(NT P(/.O-: - narrative description of patient 2age, etc!3 - any pertinent medical history - hat happened - complicating or other pertinent issues - referred 4y 5555555 - seen at the clinic since 55555 - special issues addressed last semester, e!g!, voc reha4, family instruction - description of client6s level at start of semester and current level of communication - include enough information to rationali7e your choice of goals/o48ectives/tests - include a description of cueing hierarchy you ill 4e using in t9 - in this section include diagnostic test information if you did it early in semester %9ample: 'r! S! is a :; year old man ho suffered a series of left cere4rovascular accidents 2C<&3 in (ovem4er and Decem4er of +//;! &s a result, 'r! S! presents ith aphasia and apra9ia, as ell as right sided deficits of perception and function! =mmediately follo ing his C<&, he participated in speech-language therapy through >orgess 'edical Center and ?lsten Healthcare! #his is his first semester of therapy at this clinic! He currently lives at home ith his ife 'argaret, ho is a nurse and his full-time caregiver! 'r! S! demonstrates severely impaired comprehension s@ills, especially in deconte9tuali7ed tas@s such as pointing to pictures! He is a4le to complete the tas@ of pointing to pictures at A.B! His comprehension improves to C:B ith personally relevant material! He has difficulty attending to multiple stimuli during treatment tas@s and conversation! He uses a head nod/sha@e and ver4al utterance 2i!e! Dyes,E Dno,E Do@ayE3 to respond to Fuestions C.B of the timeG ho ever, these responses are not al ays accurate! 'r! S! can successfully use the Hritten Choice Communication Strategy 21arrett, +//I3 in hich responses are chosen from three or more options presented to him in ritten and ver4al form 4y the

conversation partner! & description of the Hritten Choice Communication Strategy is attached to this document! #hroughout the course of treatment, 'r! S! ill 4e provided ith cues to optimi7e his independence and success! #he levels of cueing ill 4e defined as follo s: 'inimal cue: Loo@ from clinician, repetition of Fuestion/stimulus 'oderate cue: Pointing, ritten cue from clinician, initial phoneme cue 'a9imum cue: Sentence completion, repetition/model provided, hand-over-hand assistance T/(AT+(NT P8AN, >egin 4y identifying one or t o long-term goals that ill encompass the semester! #hese L#1)s may not 4e measura4le right a ay! #hey serve as an indicator of hen treatment should 4e completed! =nclude short term goals under each long term goal! %9ample: 8T1:ST1, +! #he client ill use appropriate memory strategies to schedule and recall ee@ly activities and appointments! a! *ohn ill use meaningful gestures 2e!g!, pointing, sho ing relative si7e or shape3 in con8unction ith speech hen e9pressing an idea on C.B of conversational opportunities given ma9imal cues! ANT.7.PAT(- P/OB8(+S, =f the clinician does not anticipate pro4lem other than those included in the description of the client6s speech and language, this section is not relevant to the client and should 4e omitted! =f there are significant pro4lems anticipated, for e9ample, control of client 4ehavior or difficulty in o4taining caregiver support, they should 4e descri4ed in this portion of the report! P/O1NOS.S: professional description here 'a@e a statement predicting progress for the semester! #his should 4e 4ased on your 4est 8udgement in consultation ith your supervisor! Jor prognosis, use terms such as: e9cellent, good, fair, guarded! (xa);*e 1iven 'r! S!6s family support, his motivation to improve, the relatively recent onset of his impairments, and continued individual and group speech therapy, his prognosis for improved communication effectiveness is good! S.1NAT6/(S <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< (ame of Supervisor <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< (ame of clinician

Supervising Speech-Language Pathologist

1raduate Student Clinician

K#his report as completed 4y the a4ove named student clinician under the supervision of the supervisor hose name appears on this report!