RESOURCE PACKET Assessment of Language Impairment

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LANGUAGE SEVERITY RATING SCALE Determination of Language Impairment Student _______________________ School ____________________ Grade ____ Date of Rating _________ DOB __________ Age ____ SLT __________________________ FORMAL ASSESSMENT Comprehensive, standardized measure(s) and scores: INFORMAL ASSESSMENT Check descriptive tools used: Language/communication sample Checklist(s) Observations Other: _______________ 0 Standard score* of 78 or above 0 Language skills are within expected range. 2 >1.5 SD below test mean (standard score between 70- 77) or 2 nd - 6 th Percentile At least one of the following areas are deficient 2 Check areas of weakness: Sentence length/complexity Word order/syntax Vocabulary/semantics Word finding Word form/morphology Use of language/pragmatics Auditory perception 3 >2 SD below test mean (standard score between 62- 69) or 1 st –2 nd Percentile At least two of the following areas are deficient 3 Check areas of weakness: Sentence length/complexity Word order/syntax Vocabulary/semantics Word finding Word form/morphology Use of language/pragmatics Auditory perception 4 >2.5 SD below test mean (standard score below 62) or below 1 st Percentile At least three of the following areas are deficient 4 Check areas of weakness: Sentence length/complexity Word order/syntax Vocabulary/semantics Word finding Word form/morphology Use of language/pragmatics Auditory perception FUNCTIONAL/ACADEMIC LANGUAGE SKILLS 0 Functional/Academic Language skills within expected range. 2 The student performs effectively most of the time with little or no assistance required. 3 4 The student needs more cues, modThe student does not perform effectiv explanations, and checks on progremost of the time, despite the provisio or assistance than the typical studeof general education modifications in class and supports Instructions: 1. Do not include regional or dialectal differences when scoring. 2. Circle score for the most appropriate description for each category: Formal (Standardized) Assessment and the Informal (Descriptive) Assessment. 3. Compute the total score and record below. 4. Circle the total score on the bar/scale below to determine the severity rating. 0 2 3 4 5 6 7 8 9 10 11 12 No Disability Mild Moderate Severe TOTAL SCORE __________ Based on compilation of the assessment data, this student scores in the Mild, Moderate or Severe range for a Language Disability. Yes No There is documentation/supporting evidence of adverse effects of the Language Disability on educational performance. Yes No (BOTH STATEMENTS ABOVE MUST BE CHECKED YES) *Standard scores are based on a mean of 100 and a standard deviation of 15. The standard score can be a receptive, expressive or total language quotient ED –4072 / Rev. 07.09 Language Impairment Resource Packet Department of Education
Functional Communication Severity Rating Scale Student ____________________________________ School _____________________________________ Date __________ SLT _______________________________ COMMUNICATIVE INTERACTIONS COMMUNICATIVE INTENTIONS COMMUNICATIVE METHODS COMPREHENSION OF LANGUAGE ADVERSE EFFECT ON EDUCATIONAL PERFORMANCE Social Emotional Academic Vocational No Disability (1) Mild (2) Moderate (3) Severe (4) Score = 0 Score = 2 Score = 3 Score = 4 Student successful in Student usually Student frequently Student not communicating successful in unsuccessful in successful in through initiation, communicating communicating communicating topic maintenance, through initiation, through initiation, through initiation, turn taking, topic maintenance, topic maintenance, topic maintenance, opening/closing turn taking, turn taking, turn taking, conversations opening/closing opening/closing opening/closing conversations conversations conversations Score = 0 Student successful in requesting objects/actions, commenting on objects/actions, etc. Score = 0 Student successful in using one or more modes of communication, (e.g., verbal, manual sign, AT system, pointing) Score = 0 Student successful in comprehending what others say, sign, show, etc. by demonstrating knowledge through action or speech Score = 0 Student’s communication skills are adequate for participation in educational settings Score = 2 Student usually successful in requesting objects/actions, commenting on objects/actions, etc. Score = 2 Student usually successful in using one or more modes of communication, (e.g., verbal, manual sign, AT system, pointing) Score = 2 Student usually successful in comprehending what others say, sign, show, etc. by demonstrating knowledge through action or speech Score = 2 Student’s communication skills are usually adequate for participation in educational settings Score = 3 Student frequently unsuccessful in requesting objects/actions, commenting on objects/actions, etc. Score = 3 Student frequently unsuccessful in using one or more modes of communication, (e.g., verbal, manual sign, AT system, pointing) Score = 3 Student frequently unsuccessful in comprehending what others say, sign, show, etc. by demonstrating knowledge through action or speech Score = 3 Student’s communication skills are frequently inadequate for participation in educational settings Score = 4 Student not successful in requesting objects/actions, commenting on objects/actions, etc. Score = 4 Student not successful in using one or more modes of communication, (e.g., verbal, manual sign, AT system, pointing) Score = 4 Student not successful in comprehending what others say, sign, show, etc. by demonstrating knowledge through action or speech Score = 4 Student’s communication skills are not adequate for participation in educational settings TOTAL SCORE 0 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Final Rating Comments_____________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ED –4072 / Rev. 07.09 Department of Education Language Impairment Resource Packet
Page 1: RESOURCE PACKET Assessment of Langu
Page 5 and 6: Examiners should not generalize fro
Page 7 and 8: To determine eligibility as a stude
Page 9 and 10: DETERMINING THE APPROPRIATE DISABIL
Page 11 and 12: Expressive Language The student: Ye
Page 13 and 14: Informal Language Assessment Checkl
Page 15 and 16: 19-24 MONTHS Speech and Language Sk
Page 17 and 18: Buttons clothes, washes face, and p
Page 19 and 20: AGE LANGUAGE SYMBOLIC PLAY CONSTRUC
Page 21 and 22: AGE LANGUAGE SYMBOLIC PLAY CONSTRUC
Page 23 and 24: Levels of Play Levels of Social Pla
Page 25 and 26: Early Identification of Language-Ba
Page 27 and 28: Determining the Type-Token Ratio Th
Page 29 and 30: Type-token Ratio for the Analysis o
Page 31 and 32: Functional Communication Checklist
Page 33 and 34: Page 3 of 3 NAME __________________
Page 35 and 36: Development of Narrative Skills 1.
Page 37 and 38: Story Structure Levels - Ordered fr
Page 39 and 40: Levels of Story Grammar Development
Page 41 and 42: Style of Narration Assessment NAME:
Page 43 and 44: Page 2 of 2 II. INTENTS (“why”)
Page 45 and 46: Issues and Challenges Generic Commu
Page 47 and 48: Functional Categories of Immediate
Page 49 and 50: Socioemotional Dimensions in Commun
Page 51 and 52: Evaluation of Classroom Listening B

RESOURCE PACKET Assessment of Language Impairment

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