Sally A. Smith

000 Main Street

Snowtown, PA OOO00

D.O.B. 0/0/00

Foster parents: Betty and Bill Brown

This is a three year-2 month old girl who is seen for a speech and language evaluation at the request of Snowtown's County Children's Services. Mary Doe is the caseworker. It is felt that she is delayed in speech and language acquisition for her age. The history is quite involved. She was taken into a foster home at the age of 18 months. At that time, she was said to be deprived and almost in a catatonic state. She didn't talk at all and didn't smile. It took several weeks for the foster parents to get her to smile and at 23 months of age she said "mommy".

Up until the age of 18 months, it was felt that Sally was on a very poor diet. She was taken care of at times by a half sister. Her mother died when she was 13 months old. Informally, it has been ascertained that the mother's health was quite poor during pregnancy. The cause of death was a stroke so we might get some hint of some of the problems that she had from this. Evidently the home situation was terrible.

She has been seen at Snowtown Medical Center and they have stated that she has delayed bone age. However, according to the foster mother, she has been progressing nicely as of late. The foster mother seems to be quite quick to explain Sally's slowness as functional and is quite adamant about the fact that she is not retarded. At present, she is beginning to put words together. Her intelligibility is quite poor. Therefore, I could not obtain much in the way of an articulation sample. I was able to obtain a raw score on Form A of the Peabody Picture Vocabulary Test. This was 12, which converts to a mental age of 2-3, an intelligence quotient of 73 and a percentile score of 2. The reliability of these tests at the low end of the age spectrum is quite poor, and therefore the score is certainly no better than a ball park score. It is felt that Sally has not had any car infections and that she can hear well. The hearing screening that we did was essentially normal.

Certainly, from the history that we obtained, it seems as though we are dealing with a case of delayed speech and language acquisition that may certainly be explained in part or in its entirety by the very poor situation in which this child found herself for the first 18 months of her life during which the linguistic foundation should have been built. She will be attending a nursery program at Snowtown College and it would seem as though it would be most convenient for the parent if her speech therapy session could be plugged in to this. Therefore, I will be contacting Mrs. White of Snowtown College Speech Dept. to see if she will be able to work this out. If this is not possible then we could consider seeing Sally down here for speech therapy, but in view of the convenience of the college to the parents I would suggest that they try to work it in up there.

I would like to see Sally back hem in about six months for further speech evaluation.

cc: Mary Doe, SCCS (Snowtown's County Children's Services) Mrs. White, Speech Dept. Snowtown College