RESOURCE PACKET Assessment of Language Impairment
RESOURCE PACKET Assessment of Language Impairment
RESOURCE PACKET Assessment of Language Impairment
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Evaluation <strong>of</strong> Classroom Listening Behavior*<br />
Student _____________Grade _____ School ______________Teacher ____________________<br />
Completed by _________________________________________ Date _________________<br />
Type <strong>of</strong> Amplification _____________________________________________________________<br />
Pre-Fitting ____________________________ Post-Fitting ___________________________<br />
1 3 5<br />
SELDOM SOMETIMES USUALLY<br />
The Student:<br />
_______1.<br />
_______2.<br />
_______3.<br />
_______4.<br />
_______5.<br />
_______6.<br />
_______7.<br />
_______8.<br />
_______9.<br />
______10.<br />
Responds when name is called at close distance (3-6 feet)<br />
Responds when name is called at a far distance (6-20 feet)<br />
Attends to a single oral direction<br />
Attends to a series <strong>of</strong> oral directions<br />
Attends to oral instruction<br />
Comprehends oral instruction in a one to one situation<br />
Comprehends oral instruction in a group situation<br />
Comprehends oral instruction in a quiet environment<br />
Comprehends oral instruction in a noisy environment<br />
Comprehends oral instruction without visual cues<br />
______/ 50 TOTAL SCORE<br />
*Source: “Evaluation <strong>of</strong> Classroom Listening Behavior” by L. VanDyke. 1985, Rocky Mountain Journal <strong>of</strong> Communication<br />
Disorders.<br />
ED –4072 / Rev. 07.09<br />
Department <strong>of</strong> Education<br />
<strong>Language</strong> <strong>Impairment</strong> Resource Packet
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