Imaginative Language Observation

X, age 3, was referred to the X Center by his pediatrician, Dr. X, for concerns with expressive language and intelligibility. The client received an evaluation on March 6, 2015 at the X Center. The results of the evaluation indicated a language delay, particularly, in the social communicative area. Therapy was recommended to target language and articulation. When the client was one day old, his mother reported that he suffered a seizure and had difficultly breathing. The client was hospitalized in the NICU for 12 days following these difficulties. The cause of the seizure is unknown and the client has not had any seizures since that time. The client is currently not taking any medications. The client’s mother speaks Spanish and English

The client demonstrated characteristics in stage VIII of Symbolic Play Scale Check List skills (Westby, 1980). Stage VIII is characterized by the child carrying out play activities of previous stages with different settings such as a doll house, barn or garage, using blocks and sandbox for imaginative play, uses one object to represent another, and uses a doll or puppet as participant in play. The client carried out activities at a play kitchen. The client used objects to represent other objects in play (i.e., pretended crayons were Coca-Cola). The client symbolically represented preparing and eating a meal during the group therapy session. The client prepared a meal with the kitchen and then sat down at the table with the clinician to eat dinner. The client interacted minimally with the other children during group therapy. When asked to participate in activities with other children, the client would respond, “no.” The client’s play skills were slightly below Stage IX according to Westby’s play scale for 3 ½ to 4 year olds. However, this could be due to the new environment. The client’s play skills will continue to be assessed throughout the

The client averaged 74% accuracy over the course of eleven sessions during large group. On February 17, 2016, the client did meet his goal of 90% accuracy during 10 turns at talk. A 10-minute speech sample from March 23, 2016 was recorded, transcribed, and analyzed. The clinician compared his speech sample to the initial speech sample recorded on February 1, 2016. The client demonstrated an increase in intelligibility. Only three percent of utterances (3/127) were not transcribed due to intelligibility. This was a 12% decrease from the initial sample. This allowed the client and the clinician to have a more meaningful