Speech therapist speech card
SPEECH CARD (according to Fotekova)
FULL NAME. ________________________________________________________________________________________
Date of examination______________________________________________________________________________
Date of birth ______________________ Age __________________ Class ___________________________
Conclusion of the IPC ______________________________________________________________________________
Anamnesis_______________________________________________________________________________________
______________________________________________________________________________________________
Early speech development: word___________________________ phrase ____________________________________
Structure of the articulatory apparatus: lips, teeth, jaws, bite, palate, tongue.___________________________ Hearing ___________________________________________ Vision _______________________________________
Status: voice function__________________________________________________________________________
speech breathing_______________________________________________________________________________
prosodic components of speech____________________________________________________________________________
Series
 I. _
 Study of the sensorimotor level of speech. 1.Checking the state of phonemic perception. 
| ba – pa | pa - ba | B. | 
| Sasha | sha – sa | B. | 
| sha – zha – sha | zha - sha - zha | B. | 
| tsa - sa - tsa | sa - tsa - sa | B. | 
| ra-la-ra | la - ra - la | B. | 
Total per sample:__________
Score: 1 point – correct reproduction at the pace of presentation; 0.5 – the first term is reproduced correctly, the second is similar to the first (ba-pa - ba-pa); 0.25 – inaccurate reproduction of both members of the pair with rearrangement, replacement or omissions; 0 points – impossibility of performing the test.
2. Study of articulatory motor skills.
| "smile" | B. | Criteria: pace of execution, accuracy, symmetry, salivation, tremor, blueness. Total per sample:__________ | 
| "scapula" | B. | |
| "needle" | B. | |
| "pendulum" | B. | |
| "smile" - "pipe" | B. | 
Score: 1 point – correct execution; 0.5 – slow and tense execution; 0.25 – execution with errors (duration of searching for a pose, volume, synkinesis, hyperkinesis); 0 points – failure to perform movements.
3. Study of sound pronunciation.
| dog – mask – nose hay – cornflower – heights castle - goat winter – shop heron – sheep – finger | B. | fur coat - cat - reed beetle - knives pike – things – bream seagull - glasses - night | B. | |
| fish - cow - ax river - jam - door | B. | Lamp – milk – floor summer – wheel – salt | B. | |
| other sound groups | B. | Total per sample:__________ | ||
Score: 3 points – flawless pronunciation of all sounds of the group in any speech situations; 1.5 – one or more group sounds are not automated; 1 point – in any position only one sound of the group is distorted or replaced; 0 points – all or several sounds of the group are distorted or replaced.
4. Study of the formation of the sound-syllable structure of a word.
| tankman | B. | scuba diver | B. | |
| astronaut | B. | thermometer | B. | |
| pan | B. | Total per sample:__________ | ||
Words are presented before the first playback.
Score: 1 point – exact reproduction; 0.5 points – slow syllable reproduction; 0.25 points – distortion of the sound-syllable structure of the word; 0 points – no reproduction.
Total per episode (out of 30 points)
__________
Series
 II
 . A study of language analysis skills. 
| How many words are there in a sentence? | How many syllables are in a word... | ||||
| The day was warm. | B. | House | B. | ||
| A tall birch tree grew near the house. | B. | Pencil | B. | ||
| Determine the place of the sound in the word: | How many sounds are in a word? | ||||
| The first sound in the word roof | B. | Cancer | B. | ||
| The third sound in the word school | B. | Bag | B. | ||
| glass in the word | B. | Dictation | B. | ||
Total per sample:__________
The child is offered three attempts with stimulating assistance: “ Think again.
».
Score: 1 point – correct answer on the first attempt; 0.5 points – correct answer on the second attempt; 0.25 points – correct answer on the third attempt; 0 points – incorrect answer on the third attempt.
Total per episode (out of 10 points)
________
Series
 III .
 Study of the grammatical structure of speech. 1. Repetition of sentences. 
| The bird made a nest. | B. | 
| There were many red apples in the garden. | B. | 
| The children rolled balls of snow and made a snow woman. | B. | 
| Petya said that he would not go for a walk because it was cold. | B. | 
| Horses were grazing in the green meadow across the river. | B. | 
Total per sample:__________
Score: 1 point – correct and accurate reproduction; 0.5 points – skipping individual words; 0.25 – omission of parts of a sentence, distortion of the meaning and structure of a sentence, replacement with direct speech, the sentence is not completed; 0 points – no reproduction.
2. Verification of proposals.
Instructions
: I will name the sentence and if there are mistakes in them, try to correct them.
| The dog went into the booth. | B. | 
| A ship is sailing on the sea. | B. | 
| The house is drawn by a boy. | B. | 
| The bear sleeps well under the snow. | B. | 
| There was a deep hole above the large tree. | B. | 
Total per sample:__________
Score: 1 point – identification and correction of errors; 0.5 – correction of an error with minor inaccuracies (omission, rearrangement, replacement of words, violation of word order); 0.25 – an error was identified, but not corrected, or agrammatisms were corrected; 0 points – no error detected.
3. Compiling sentences from words presented in initial form
.
Instructions
: I will name the words, and you try to make a sentence out of them.
| boy, open, door | B. | 
| sit, titmouse, on, branch | B. | 
| pear, grandmother, granddaughter, give | B. | 
| Vitya, mow, grass, rabbits, for | B. | 
| Petya, buy, ball, red, mom | B. | 
Total per sample:__________
Score: 1 point – the sentence is written correctly; 0.5 – word order is broken; 0.25 – omissions, additions or substitutions of words, agrammatisms, minor semantic inaccuracies; 0 points – semantic inadequacy or refusal to complete the task.
4. Adding prepositions to a sentence
.
Instructions
: I will read the sentence, and you try to insert the word that is missing in it.
| The chick fell out... nest. | B. | 
| The buds have blossomed... in the trees. | B. | 
| Lena pours tea... cups. | B. | 
| The puppy hid... on the porch. | B. | 
| The dog is sitting... in a kennel. | B. | 
Total per sample:__________
Help: 1st – stimulating (“ Wrong, think again!
");
 2nd – in the form of a question to the missing preposition (“ Pours tea where
 ?”). 
Score: 1 point – correct answer; 0.5 – correct answer after stimulating assistance; 0.25 – correct answer after help of the second type; 0 points – help does not help.
5. Formation of plural nouns in the nominative and genitive case.
| One house, and if there are many of them, then these are houses. | One house, but many things? - houses. | ||||
| One table , and a lot is... | B. | One table , but a lot of things? — | B. | ||
| chair | B. | chair | B. | ||
| window | B. | window | B. | ||
| star | B. | star | B. | ||
| ear | B. | ear | B. | ||
Total per sample:__________
Score: 1 point – correct answer; 0.5 points – correct answer after stimulating assistance; 0.25 points – the form is formed incorrectly; 0 points – failure.
Total per episode (out of 30 points)
________
Series
 IV .
 Study of vocabulary and word formation skills. 1. Baby animals. 
Instructions:
the cat has kittens, and...
| goats | B. | Dogs | B. | 
| wolf | B. | Chicken | B. | 
| ducks | B. | Pigs | B. | 
| foxes | B. | Cows | B. | 
| lion | B. | Horses | B. | 
Total per sample:__________
2. Formation of adjectives from nouns.
2.1. Relative.
Instructions
: paper doll - paper.
| straw hat | B. | cranberry jelly | B. | 
| ice slide | B. | carrot salad | B. | 
| cherry jam | B. | mushroom soup | B. | 
| apple jam | B. | oak leaf | B. | 
| plum jam | B. | aspen leaf | B. | 
Total per sample:__________
2.2. High quality. 2.3. Possessive.
| If during the day heat , then the day | U dogs   | |||||
| freezing | B. | Cats | B. | |||
| Sun | B. | Wolf | B. | |||
| snow | B. | Leo | B. | |||
| wind | B. | Bear | B. | |||
| rain | B. | Foxes | B. | |||
Total per sample:__________
Score: 1 point – correct answer; 0.5 – correction itself or correct answer after stimulating assistance; 0.25 – incorrectly formed form; 0 points – failure.
Total for the episode
 (out of 30 points)
 ________
Series
 V. _ Study of connected speech. 
- Compiling a story based on a series of plot pictures “Snowman” (3 pictures).
Instructions:
Look at these pictures, try to put them in order and make up a story.
Child's story:
_____________________________________________________________________________
____________________________________________________________________________________________
_____________________________________________________________________________________________
Total per sample:__________
Criterion of semantic integrity
: 5 points – the story corresponds to the situation, has semantic links located in the correct sequence; 2.5 points – slight distortion of the situation, incorrect reproduction of cause-and-effect relationships, no connecting links; 1 point – missing semantic links, or the story is incomplete; 0 points – there is no description of the situation.
Criterion for lexical and grammatical formatting of statements
: 5 points – the story is grammatically correct with adequate use of lexical means; 2.5 points – database of agrammatisms, but there is a stereotypical design, isolated cases of word search or inaccurate word usage; 1 point – agrammatism, inadequate use of lexical means; 0 points – the story is not formalized.
Criterion for completing a task independently:
5 points – independently laid out pictures and composed a story; 2.5 points – pictures are laid out with stimulating help, the story is composed independently; 1 point – laying out pictures and writing a story based on leading questions; 0 points - the task is not available even with help.
2. Retelling the text you listened to.
Instructions:
Now I’m posting a short story, remember and retell it.
A child's story
:_____________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________
Total per sample:_________
Criterion of semantic integrity
: 5 points all main semantic links are reproduced; 2.5 points – minor reduction, no connecting links; 1 point – the retelling is incomplete, there are significant abbreviations or distortion of meaning, inclusion of extraneous information; 0 points retelling not available.
Criterion for lexical and grammatical formatting of statements
: 5 points – the retelling is compiled without violating lexical and grammatical norms; 2.5 – without agrammatisms, but there is a stereotypic design of the statement, a search for words, and some close verbal substitutions; 1 - agrammatisms, repetitions, inadequate verbal substitutions, inadequate use of words; 0 points - retelling is not available.
Criterion for completing a task independently
: 5 points – independent retelling after the first presentation; 2.5 points – retelling after minimal help (1-2 questions) or after re-reading; 1 point – retelling the questions; 0 points – retelling is not available even for questions.
Total for the episode
 (out of 30 points )
 __________
Total for the entire test (out of 130 points))__________
Study of the reading process.
Character of reading______________________________________________________________________________
Reading method________________________________________________________________________________
Reading Comprehension________________________________________________________________________________
Research into the writing process.
- Cheating
- Number of mistakes__________________________________________________________________
- Nature of errors__________________________________________________________________________
-  Letter from dictation-  Number of mistakes__________________________________________________________________
 
- Nature of errors__________________________________________________________________________
______________________________________________________________________________________
CONCLUSION
_______________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Recommendations
_______________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
SPEECH PROFILE
_________________________
| № | Norm | Number of points | Success rate in % | 
| Series I. Study of the sensorimotor level of speech | |||
| Phonemic perception | |||
| Articulatory motor skills | |||
| Sound pronunciation | |||
| Sound-syllabic word structure | |||
| Series II. Language skills research analysis | |||
| Series III. Study of grammatical structure | |||
| Series IV. Exploring Vocabulary and Skills word formation | |||
| Series V. Study of coherent speech | |||
| Score for the entire test | 






