Preschool Speech and Language Screening: Rapport: Attention Span: Response: Effort: Eye Contact
Preschool Speech and Language Screening: Rapport: Attention Span: Response: Effort: Eye Contact
Student:____________________________________ Date:________________
Date of Birth:________________ Examiner:_____________________________
Age:__________ Screening Site:_________________________
Behavioral Observations:
Rapport: Easily Attained ___ Slowly Attained ___ Poor Rapport ___
Attention Span: Appropriate ___ Short ___ Distractible ___
Response: Appropriate ___ Delayed ___ Impulsive ___
Effort: Good ___ Fair ___ Poor ___
Eye Contact: Appropriate ___ Inconsistent ___ Inappropriate ___
Summary of Screening
(Pass=>80% Borderline=50-80% Fail=<50%)
Area Screened Outcome
I. Personal Information Pass Borderline Fail
II. Basic Language Concepts Receptive:
● Body Parts _____
● Colors _____
● Prepositions _____
Expressive:
● Body Parts _____
● Colors _____
● Prepositions _____
Body Parts:
”
Receptive – “Point to your…
1 ½ -2 yrs= mouth, eye, nose, hair, hand, ear
2 ½ -3 ½ yrs= head, leg, stomach, knee, chin, back
4-5 yrs= elbow, shoulder
Colors:
Receptive – “Point to…”
3 yrs= red, blue, green, yellow
4 yrs= orange, purple
5 yrs= brown, black
Utterance Length:
Age MLU Milestone
12-26 1.0 -2.0 Uses one, two and three word utterances
months Uses intonation to ask yes/no questions
Uses limited wh - questions
27-30
months 2.0-2.5 Begins to use grammatical morphemes
Uses in and on
31-34
months 2.5-3.0 Increases in length due to use of auxilaries
Increases use of wh questions
Uses interrogative reversals
35-40
months 3.0-3.75 Uses object noun phrase complements
Uses indirect or embedded wh questions
Following Directions:
3 yrs (1 step) ____Give me the block.
4 yrs (2 step) ____Stomp your feet and then touch your nose.
5 yrs (3 step) ____Clap your hands, give me the block, point to the door.
V. Articulation:
Repeat the following:
3.0 years: all vowels (except vowel-r combinations)
3.5 years: pie, hop, bye, tub, mom, window, hi
4.5 years: no, fan, table, hat, do, hand, go, pig, cake, jump, yoyo
5.5 years: farm, knife
VI. Voice:
Pitch, Volume, Quality:
Appear adequate_________ Abnormalities_____________
VII. Fluency: