SEDGWICK COUNTY AREA EDUCATIONAL SERVICES INTERLOCAL COOPERATIVE #618
SPEECH/LANGUAGE SERVICES
CLASSROOM PERFORMANCE DATA
STUDENT:
TEACHER:
GR:
Please observe the above named student in your class and answer the following questions. Your observations will help to
determine if this child's communication problem is affecting his/her educational/social performance.
What is the primary area of concern? (Please circle)
Articulation
Language
Auditory Skills
Voice Fluency
1.
Is the student aware of his/her communication problem?
Yes
No
2.
Does this student avoid speaking in class?
Yes
No
3.
Does this student seem frustrated when trying to speak?
Yes
No
4.
Do peers tease this student about his/her communication problem?
Yes
No
5.
Do you feel comfortable when you communicate with this student?
Yes
No
6.
Does this student's speech problem distract you sometimes from what he/she is saying?
Yes
No
7.
Does this student have a lot of pronunciation/enunciation errors?
Yes
No
8.
Do most of this student's mispronunciations during reading occur on the articulation error
sounds?
Yes
No
9.
Do you ever hear this student correct his articulation errors by himself/herself?
Yes
No
10.
Does this student make errors in writing (spelling) on the same sound symbols that he
makes the verbal errors on in articulation?
Yes
No
11.
Is this student usually able to follow your oral directions?
Yes
No
12.
Does this student have difficulty remembering general information?
Yes
No
13.
Is this student able to listen to a story and interpret the meaning?
Yes
No
14.
Is this student's grammar (syntax) adequate for his/her age?
Yes
No
15.
Is this student's vocabulary limited for his/her age?
Yes
No
16.
Does this student have difficulty in completing simple sentences or story endings (orally)?
Yes
No
17.
Does this student have trouble in finding or understanding the humor in funny stories?
Yes
No
18.
Does this student lack the ability to ask questions when he/she does not understand what
was being said?
Yes
No
19.
Is this student hesitant to initiate speech?
Yes
No
20.
Does this student use non specific pronouns like "it", "this" and "stuff" when the listener
has no way of knowing to what the child is referring?
Yes
No
21.
Does this student have a problem picking or maintaining a topic, switching topics, or taking
turns during conversation?
Yes
No
22.
Does this student's voice quality make it difficult to understand the content of his/her
verbal message?
Yes
No
23.
Does this student lose his/her voice during or by the end of the day?
Yes
No
24.
Does this student use an unusually loud voice or shout a great deal?
Yes
No
25.
Does this student have difficulty with the fluency (hesitations or prolongations) of
his/her speech?
Yes
No
26.
Have you heard anyone make fun of or call him/her a stutterer?
Yes
No
27.
Comments:
ESC-310 (06/09)
Classroom Teacher's Signature
Date