Katrina
M.
Newkirk,
MA,
CCC-SLP
Independent
Speech-Language
Pathologist
P.O.
Box
4571
Evansville,
IN
47724
newkirkslp@aol.com
FIRST
STEPS
EARLY
INTERVENTION
Initial
Note
SPEECH-LANGUAGE
PATHOLOGY
PROGRESS
REPORT
Interim
Progress
Quarterly
Summary
¨
Child's
Name:
Crystal
Allbritton
Report
Period:
10/19/01
to
01/11/02
DOB:
07/18/99
Date:
01/11/02
Initial
Evaluation:
10/07/00
Subjective:
Crystal,
a
30-month
old
female,
is
currently
receiving
individual
speech-language
therapy
through
the
Vanderburgh
County
First
Steps
Program.
Therapy
is
currently
provided
1x/wk.,
for
45-minute
sessions
within
her
home
and/or
day
care
environments
at
the
Goodwill
Family
Shelter.
As
of
the
end
of
January
2002,
Crystal's
therapy
location
will
be
switched
to
the
family's
new
apartment.
Crystal
presents
with
a
diagnosis
of
spinal
muscle
atrophy.
She
remains
generally
pleasant
and
cooperative
and
willingly
participates
in
therapy
activities.
Crystal
is
a
strong-willed
child
who
asserts
her
independence
during
therapy.
In
addition
to
speech-language
therapy,
Crystal
receives
developmental,
occupational,
and
physical
therapies
and
social
work
services
through
the
First
Steps
program.
Dietary
services
are
provided
to
Crystal's
family
through
St.
Mary's
Medical
Center.
Objective: Therapy is addressing an expressive language delay and is monitoring feeding/swallowing skills. Therapy objectives are addressed through structured language and play activities. The following progress has been made toward meeting current therapy goals:
1. Child to produce 10 different action words upon request. Goal partially achieved. Crystal continues to produce a few action words spontaneously; however, many of her productions remain approximations of the target word due to misarticulations. Crystal's vocabulary continues to consist of mostly nouns, though she is starting to use verbs occasionally in phrases. Continue goal.
2. Child to name at least 3 items within a variety of categories in order to expand expressive vocabulary. Goal achieved. Crystal has expanded her spontaneous expressive vocabulary to include the names of several items within various categories. Discontinue goal.
3. Child to imitate names of new objects/pictures 10x/session. Goal achieved. Within the past quarter, Crystal has started attempting to imitate the names of new objects/pictures more frequently. Per parent report, Crystal imitates words and phrases frequently during daily activities. Discontinue goal.
4. Child to produce first name and age upon request. Goal partially achieved. Crystal currently imitates her first name and age; however, she does not spontaneously answer questions requesting this information. Continue goal.
5. Child to produce 3-word phrases 10x/session. Goal achieved. Crystal has increased the length of her phrases and now produces spontaneous 3-word phrases frequently. Many of her phrases are difficult to understand due to multiple misarticulations, which affect her overall intelligibility. Discontinue goal.
6.
Child
to
execute
safe
and
efficient
swallow
of
various
textures
and
consistencies
without
evidence
of
aspiration.
Ongoing
goal.
Crystal
appears
to
continue
to
demonstrate
a
safe
and
efficient
swallow
of
a
variety
of
table
foods.
She
also
seems
to
tolerate
thin
liquids
from
an
Infa-Trainer
and/or
sipper
cup
without
excessive
coughing
or
choking.
When
Crystal
is
congested,
she
exhibits
more
difficulty
managing
thin
liquids.
Her
mother
reports
that
Crystal's
excessive
secretions
have
been
controlled
with
the
introduction
of
a
supplement
suggested
for
children
with
spinal
muscle
atrophy.
Suggestions
have
been
made
to
her
mother
and
day
care
providers
for
preventing
aspiration
(i.e.
upright
positioning,
cup
recommendations
to
reduce
flow
rate,
eliminating
drinking
from
a
water
bottle,
pacing
her
liquid
intake,
and
using
thickener
to
nectar
consistency
as
a
precaution).
Crystal
continues
to
demonstrate
a
weak
cough
and
has
a
limited
ability
to
cough
and
clear
due
to
hypotonia.
Due
to
the
degenerative
nature
of
her
diagnosis,
Crystal's
swallowing
skills
should
be
closely
monitored
and
addressed
as
necessary.
Continue
goal.
Assessment:
Crystal
continues
to
demonstrate
age
appropriate
language
comprehension
skills
and
slightly
delayed
expressive
language
skills
for
a
child
of
her
chronological
age.
According
to
her
performance
on
portions
of
the
Rossetti
Infant-Toddler
Language
Scale,
Crystal
demonstrates
language
comprehension
skills
scattered
within
the
30
to
33-month
level
and
language
expression
skills
scattered
within
the
24
to
27
&
27
to
30-month
levels.
During
the
past
quarter
of
speech-language
therapy,
Crystal
has
continued
to
make
significant
improvements
in
her
expressive
language
skills.
She
has
started
producing
phrases
frequently,
imitating
new
words
and
phrases,
producing
a
few
action
words,
and
repeating
her
first
name
and
age.
Though
Crystal's
expressive
language
skills
continue
to
improve,
her
speech
remains
difficult
to
understand
on
occasion
due
to
multiple
misarticulations.
Her
breath
support
remains
adequate
for
functional
communication
and
her
swallowing
skills
appear
safe
and
efficient
at
this
time.
Furthermore,
per
parent
report,
Crystal's
diet
has
been
supplemented
as
part
of
a
dietary
protocol
recommended
for
children
with
spinal
muscle
atrophy.
Plan: It is recommended that Crystal continue to receive individual speech-language therapy 1x/wk., for 45-minute sessions within her home environment. Current therapy will continue to focus on increasing Crystal's expressive language skills, facilitating improved articulation skills, and monitoring her feeding/swallowing skills. Therapy will focus on the following therapy goals: 1) Child to produce 10 different action words upon request. 2) Child to produce first name, age, and gender upon request. 3) Child to produce basic sentences to relate personal experiences. 4) Child to improve overall intelligibility by decreasing misarticulations. 5) Child to execute safe and efficient swallow of various textures and consistencies without evidence of aspiration. Please feel free to contact me should you have questions and/or concerns regarding this child's progress and/or therapy goals. Thank you.
Katrina M. Newkirk, MA, CCC-SLP