Speech and Language Screener Quick Take Along …

1 Speech and Language Screener Quick take Along Response Form(For use with the Speech and Language Screener Quick take Along Mini-Book #TA-160)Name: _____ Date of Screening: _____School: _____ DOB: _____Examiner: _____ Age: _____Reason for Screening: _____Primary Area(s) of Concern: Articulation Receptive Language Voice Fluency Expressive Language Other _____Action to take : None (age appropriate) Recheck in ____ months Consider RTI Refer for evaluation Continue S/L therapy Change/add goals Consider dismissal Other _____(9 is correct; - is an omission; X is a distortion; use the phonetic symbol for a substitution)I. ArticulationII. Early Skills (Colors, Shapes, Parts of the Body, and Number Concepts)III.

2 Simple Directions (Basic Concepts and Functions)IV. Complex DirectionsV. QuestionsV. Vocabulary (Synonyms, Antonyms, and Homonyms)AGE 3footpenbagfpbtngAGE 5 AGE 4 AGE 6 AGE 7mudUmjdknifegumngfmhaywebtapedayhwtdbpk ingk bookkshaveitchV vv cheesethis szleashjudgel smoothzoosealzsl teeththumb roserfur Colors: R Epurple red orange black green blue brown yellow Shapes: R Etriangle diamond star oval heart circle square rectangle Body: R Ehead eyes foot arm fingers elbow stomach chin Count 1 10 Number Concepts:3 apples 6 pennies biggest bottom same top below smallest right middle different beside What When Y/N Where Who Why ill large pretty Quick hot up asleep dark bark tie bat rock Y/N Who Where What When Why Where When Y/N Who What Why one we eat one in the kitchen one that grows one in the sky one found outside one used with paper one we eat with one that is a pet one we draw with one used with soupBasic Concepts:Personal:Give another word for.

3 Give the opposite of ..Give two meanings for ..General:Factual:Functions: the big car, then the little car the hat, then the dog the tree, then the book, then the chair the chair before the book either the dog or the hat the big car after the little car If you are a boy, the dog If you are a girl, the hat both cars before the chair the book and the tree after the hatVII. Categories (Attributes and Comparisons)VIII. GrammarIX. Phonological AwarenessX. Auditory MemoryXI. Story Retell and SequencingXIII. Speech SampleXII. Listening Comprehension and InferencingXIV. Social SkillsXV. Notes and Observations food tools flower bike dog, pig, bear table, bed, sofapants and shorts same differentdrum and piano same different sports jobsShow me all the.

4 Describe a ..Name the category ..Compare and Contrast ..Name three ..Adjectives: knife joke pillow ice elephant rock race car gluePlurals: cats books children blocks teeth men feet toys Pronouns: they/them I/me us/we she/her him/he me/my her/she them/theirVerbs: was/were is/are were/was do/does are/is have/has does/do are/amPast Tense: went finished talked built broke watched baked taught flash + light ru + ler ham + bur + ger cer + ti + fi + cate 4, 9 6, 2, 1 5, 7, 4, 3 6, 9, 5, 8, 1 Setting Characters voice fluency mouse talk goat car salt and _____ hammer and ___ a pair of _____ a cup of _____ bacon and ____ soap and _____ turn on the ____ brush your _____ yesterday pencil television fantastic corn, paint rabbit, pencil grass, chalk, ring folder, apple, camel initiating event sequence intelligibility sentence structure c + u + p ph + o + ne n + e + s + t c + l + ou + d cat mail nap fan Button your coat.

5 She ate the banana. The cat chased the mouse. My brother went to the store. flow problem relevant information topic maintenance solution conclusion nice - n tape - t stop - s drain - dAdd the syllables:Numbers:Identify the first sound:Auditory Closure and Associations:Clap the syllables:Words:Add the sounds:Give a rhyming word:Sentences: take away the sound: Who was having a birthday party? Why do you think Megan wasn t going? Where did Peyton live? Why did Amy wake up early on the morning of the party? What kind of decorations did Amy have? What did Amy ask her dad to help her with? When was the party supposed to begin? How long did Amy wait for her friends to arrive? Why do you think Peyton didn t answer the phone? Why do you think Amy s friends were at Peyton s house?

6 Student responds appropriately to greetings. Student works and plays cooperatively with others. Student initiates conversations with others. Student stays on topic during conversations. Student maintains eye contact with others. Student understands and responds to feelings appropriately . 2014, SUPER DUPER PUBLICATIONS, a division of Super Duper , Inc. All rights reserved. Permission is granted for the user to reproduce the material contained herein in limited form for classroom use only. Reproduction of this material for an entire school or school system is strictly prohibited. No part of this material may be reproduced (except as noted above), stored in a retrieval system, or transmitted in any form or by any means (mechanically, electronically, recording, web, etc.)

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