Speech-Language History
Child's Full Name
Your answer
Please describe your child's communication difficulties:
Your answer
Has your child previously received treatment?
If yes when and where:
Your answer
Is your child aware or frustrated/anxious about these difficulties?
How does your child prefer to communicate?
Your answer
Please share an example of a typical sentence said by your child.
Your answer
What is the total number of words your child has in their vocabulary?
Please Identify those behaviors your child demonstrates consistently
Please list any speech errors your child may use (i.e. says /w/ for /r/, can't say /th/)
Your answer
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