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Speech and Language Therapy

Assessment Report

Name Date of report

Julie Hall 17th August 2024

Date of birth Chronological age

16th August 2019 Four years and eleven months

Assessing therapist School

Laura Bradshaw Woodlands Primary

Assessment details

Date/s of assessment
17th August 2024

Standardized assessments
Comprehensive Assessment of Spoken Language – Second edition (CASL-2)

This report is private & confidential and should only be distributed/photocopied

with prior written parental consent.

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Background information

Reason for referral

Julie is a 4-year, 11-month-old girl enrolled in a full-time preschool program. She
was referred for evaluation of her speech and language skills because of her
parents’ concerns about her receptive and expressive language development.

Parental and teacher report

Julie’s parents report that she uses minimal expressive language and shows a
lack of understanding when she engages in conversations with friends and family
members. According to her developmental history, Julie displayed minimal
babbling and verbal imitation behavior as an infant. Her vocabulary is limited and
has been slow to progress during early childhood. Other developmental
milestones (e.g., basic personal hygiene, sleeping, eating, and walking) have
progressed normally, and her previous hearing screenings revealed that she
hears within normal limits. According to her preschool teachers, she does not
typically follow directions in new situations, and she hesitates to ask questions.
She rarely uses expressive language with her peers, such as imitative or parallel
play, in the structured academic and social setting of her preschool. Currently,
she can direct questions using one or two words or short multiword phrases. She
will respond with simple sentences when prompted.

General observations
It was a pleasure to work with Julie during the assessment. Her activity level
throughout the test was generally age appropriate. Her responses were generally
given promptly. She was administered the following CASL-2 tests: Receptive
Vocabulary, Expressive Vocabulary, Sentence Expression, and Sentence
Comprehension. All scores are based on a standard scale with a mean of 100 and

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a standard deviation of 15. The following describes Julie’s performance on the

CASL-2 tests.

Comprehensive Assessment of Spoken Language (CASL-2)

The CASL-2 is an assessment of spoken language that provides scores across four structural
language categories: Lexical/Semantic (knowledge and use of word and word
combinations), Syntactic (knowledge and use of grammar), Supralinguistic (knowledge and
use of language in which meaning is not directly available in content/inferencing), and
Pragmatic (knowledge of language that is appropriate across different situational contents
and the ability to modify language according to the social situation). The CASL-2 is comprised
of 14 subtests that can be administered and scored individually or combined to yield index
scores that represent broader areas of language function.

Lexical/semantic tests
The lexical/semantic language category assesses the child’s knowledge and use
of words and word combinations.

Overview of standard scores from lexical/semantic tests:

Test Standard score Percentile rank Descriptive range

Receptive vocabulary 57 0.2 Very low
Expressive vocabulary 74 4 Moderately low

Receptive vocabulary
The receptive vocabulary subtest measures comprehension of the meaning of a
spoken word, as shown by selection of the picture that best matches a word
spoken aloud by the examiner.

Julie obtained a standard score of 57, with a percentile rank of 0.2, on Receptive
Vocabulary. This score falls in the very low range and is greater than two standard
deviations below the mean (i.e., less than 70). Scores in this range represent

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areas of concern that should be addressed in intervention and goal planning. Her
score demonstrates a lack of specific word knowledge. Julie likely has not
mastered both the underlying concepts and perceptual relationships of the words
she answered incorrectly. She might also have difficulties with auditory
processing. If she cannot distinguish the subtle differences between sounds in
words, an auditory problem could explain her difficulty in processing what other
people are saying to her.

Strengths:

- Ability to attend to and understand the assessment task.

- item analysis indicated that almost all nouns that were tested were
identified correctly (e.g., house, bus, sun, animal, ball, light). This pattern
suggests that Julie can accurately identify multiple nouns across a range of
categories, such as transportation, dwelling/ habitat, domestic pets, and
weather). It is worth noting that nouns are more easily identified than
adjectives and verbs when represented in pictures.
-

Areas for development:

- Item analysis of Julie’s responses revealed a deficit in knowledge of verbs

and adjectives. Basic action words are typically developed at age three and
a half, for the activities a child has directly demonstrated (e.g., crawling,
walking, eating, sleeping).
- She correctly identified run but gave incorrect responses for sleeping,
talking, play, and jump, which are actions that she has performed and items
she would be expected to answer correctly, given that 90% of the
standardization sample of her age group successfully passed those items.
- Julie responded incorrectly to all adjectives describing size and number
(tall, small, one, many, big), but she correctly identified all color descriptors
(red, green, blue). This indicates that she is developing the concept of color
as expected for her age, but she lacks an understanding of the concept of
size that would be expected at her age.

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- Julie’s incorrect responses on the multiple-choice format of Receptive

Vocabulary appeared random, with no clear understanding of the features
of the word being tested (e.g., selecting the picture of the swimming dog
for sleeping or the picture of four pencils for one).

Expressive vocabulary
This subtest measures the child’s ability to express the word that best completes
a sentence that is spoken aloud by the examiner.

Julie scored below the average range on Expressive Vocabulary with a standard
score of 74, corresponding to a percentile rank of 4. Her score suggests that she
may lack specific word knowledge or that her word knowledge is imprecise. Her
performance may be related to difficulty in retrieval or difficulties in auditory
processing. It is important to note that the added contextual information given
by the stimulus sentence in each item seemed to help her performance compared
to the single words given in Receptive Vocabulary.

Strengths:

- Julie’s incorrect responses on Expressive Vocabulary suggest some

understanding of the word features (e.g., saying happy instead of laugh).
The additional context given by the sentences in Expressive Vocabulary
may have helped her to understand some features of the target word; this
could reflect difficulties in auditory processing.
- Julie has a basic understanding of simple sentences and pronouns as shown
by her responses on Sentence Comprehension and Sentence Expression.
She is also developing her knowledge of prepositional phrases, whereas her
knowledge of compound subjects, predicates, and negation is inconsistent,
demonstrated by her correct response to some of these items while missing
others that she would be expected to answer correctly given her age. Most
of her incorrect responses were in single words rather than phrases.

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- Relative strength in Expressive Vocabulary compared to Receptive

Vocabulary, suggesting that she can demonstrate greater knowledge when
more information is provided.

Areas for development:

- Expressive vocabulary development without cues/word retrieval.

- Support with concepts including size and other adjectives, as well as verbs.
- Individual word meanings may be most difficult for Julie to master when no
other contextual information is available to aid in determining meaning.

Syntactic tests
The syntactic tests assess the child’s knowledge and use of grammar.

Overview of standard scores from syntactic tests:

Test Standard Percentile rank Descriptive range

score
Sentence expression 71 3 Moderately low
Sentence comprehension 77 6 Moderately low

Sentence expression
This subtest measures the oral expression of accurate syntax, including
grammatical morphemes, sentence structure and word order.

Julie obtained a standard score of 71, corresponding to a percentile rank of 3, on

Sentence Expression. Her performance indicates a lack of specific syntactic
knowledge, suggesting that she has not not acquired specific syntactic structures
yet and is therefore unable to accurately express them.

Strengths:

- Julie may be a student who learns best when given as much context as
possible to support her learning. Further assessment should target her

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auditory processing skills to determine whether that is the cause of her

significant impairment in comprehension compared to her expression in the
Lexical/Semantic tests.

Sentence comprehension
This subtest measures understanding of the meaning of sentences as
demonstrated by the ability to select the picture that best matches a sentence
spoken aloud by the examiner.

Julie achieved a standard score of 77, corresponding to a percentile rank of 6.

Her score suggests a lack of syntactic knowledge for word order and sentence
types. She may not grasp the relation of sentence meanings when unfamiliar
word combinations are used.

Compared to her same-age peers, Julie shows the most deficits in Receptive
Vocabulary. Looking across her own performance, her Receptive Vocabulary
standard score is 17 points below her Expressive Vocabulary score, which
represents a statistically significant difference. This difference occurred in only
5% to 10% of her same-age peers in the standardization sample, which suggests
that this difference is clinically meaningful. Evaluating this difference is important
for supporting her observed difficulty in expressive vs. receptive abilities. Her
scores on Sentence Expression and Sentence Comprehension were not
significantly different from each other.

Summary

It was a pleasure to work with Julie during the assessment. She shows strengths
with her social communication and attention and listening skills. Results indicate
that she has language difficulties, particularly affecting her receptive and
expressive language which will impact her learning. Overall, she shows difficulty
in receptive and expressive language when compared to her same-age peers

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across both Lexical/ Semantic and Syntactic tasks. Her difficulty in understanding
and using vocabulary and in accurately constructing sentences inhibit her
communication and impact her performance in social and academic situations.
However, she shows relative strength in Expressive Vocabulary compared to
Receptive Vocabulary, suggesting that she can demonstrate greater knowledge
when more information is provided. It is recommended that she attends speech
and language therapy to support language development and that her progress is
reviewed. Additionally, it is recommended that classroom strategies be
implemented to facilitate her learning and full access to the curriculum.

Recommendations

Given Julie’s specific language needs she would benefit from direct intervention
from a speech and language therapist. Speech and language therapy aims to
develop the language abilities of the student to maximum potential and teach
strategies to reduce the impact of their difficulties.

Goals will specifically focus on the development of the following:

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The following information and strategies are aimed at supporting development of

speech and language skills in the classroom and home environment:

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Please do not hesitate to contact me if you have any questions.

Laura Bradshaw (Electronically signed)

Laura Bradshaw

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BSc Speech & Language Therapy

Speech & Language Therapist.

17th August 2024

Appendix 1 – Classroom observation

[insert your classroom observation here if carried out or delete as appropriate]

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