Speech Therapy Datasheet

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I. Patient Information

Patient Name:	[YOUR NAME]
Date of Birth:	October 13, 2045
Gender:	Female
Phone Number:	[YOUR COMPANY NUMBER]
Emergency Contact:	[YOUR EMERGENCY CONTACT]
Relationship to Patient:	Daughter
Emergency Contact Phone Number:	555-985-6543

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II. Medical History

A. Diagnosis

Primary Diagnosis:	Articulation Disorder
Secondary Diagnosis:	Phonological Disorder
Other Relevant Medical Conditions:	None

B. Previous Therapy History

Previous Speech Therapy Sessions:	12 sessions
Therapy Provider:	SpeechWorks Therapy Center
Duration of Previous Therapy:	6 months

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III. Treatment Plan

A. Goals

• Short-Term Goals:

  1. Improve clarity of /r/ and /l/ sounds.

  2. Increase vocabulary by 20 words.

  3. Demonstrate understanding of basic grammar concepts.

• Long-Term Goals:

  1. Achieve age-appropriate speech intelligibility.

  2. Expand expressive language skills to include complex sentences.

  3. Develop conversational turn-taking abilities.

B. Intervention Strategies

Speech Therapy Techniques:	Homework Assignments:
Articulation drills Language games and activities Visual aids and modeling	Practice saying target words daily for 10 minutes. Engage in storytelling with family members. Complete worksheets focusing on grammar concepts.

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IV. Progress Monitoring

A. Assessment Tools

• Baseline Assessment Results: Initial assessment conducted on February 1, 2050, indicated moderate difficulty with /r/ and /l/ sounds, limited vocabulary, and difficulty with basic sentence structure.

• Progress Notes: Regular progress notes indicate steady improvement in articulation skills and language development.

• Reassessment Results: Reassessment conducted on May 30, 2050, showed significant improvement in articulation and language skills.

B. Therapy Sessions Log

Date	Session Time	Session Focus	Progress Notes
March 5, 2050	9:00 AM - 10:00 AM	Articulation drills	The client demonstrated improved accuracy in producing /r/ and /l/ sounds. Homework assignments reviewed.
March 12, 2050	9:00 AM - 10:00 AM	Language games	The client engaged actively in language activities, demonstrating increased vocabulary usage.
March 19, 2050	9:00 AM - 10:00 AM	Grammar exercises	The client practiced using correct grammar structures in structured activities.

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V. Collaboration and Recommendations

• Collaborating Healthcare Professionals:

  • [PEDIATRICIAN'S NAME] - Pediatrician

  • [LANGUAGE PATHOLOGIST'S NAME] - School Speech-Language Pathologist

• Recommendations for Continued Therapy: Continue therapy sessions twice weekly to maintain progress and work towards long-term goals.

• Next Appointment: Scheduled for June 15, 2050.

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