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DATE OF EVALUATION: ___11/30/2012___________

I. BACKGROUND INFORMATION
Pam was evaluated for an expressive and receptive language assessment
assignment for the class CD 656 (Diagnostics) from San Francisco State
University. She is 13:5 years old. Pam has no reported language concerns and has
had no formal language evaluation. The evaluation was conducted at Pams family
home where she lives with her father L. Cruz, a self-employed businessman, her
mother M. R. Cruz a Dentist, and her 10-year-old brother S. Cruz.
Pam is polyglot in English, Spanish and Tagalog who can understand Tagalog
fluently but will respond in English. She does not have a history of language delays,
nor any speech issues as observed by her caregiver. Her receptive language has
never been questioned nor has her expressive language ability. Pam primarily
speaks English and has been taking Spanish at St. Catherine of Siena School since the
third grade as part of her curriculum requirements. She is verbally expressive and is
equally receptive to instructions and requests as reported by Mr. Cruz.
Pams primary language at home is English. Both Mr. and Mrs. Cruz primarily
speak English, and they are fluent in Tagalog and Spanish. The Cruz family has been
a polyglot at least one generation before, with Mr. Cruzs mother able to speak,
French, Spanish, Japanese, English and several dialectal variants of Tagalog. The
paternal grandfather is a bilingual, in English and Tagalog. Pams Grandparents
primarily speak to her in English.
Mr. Cruz reported that Pam was a breech baby; however, during labor Pam
turned and had a cephalic presentation. Pam was on the small side her father said
but very healthy. Her mother had uterine fibroid during the pregnancy; a possible
SAN FRANCISCO STATE UNIVERSITY Client: Pam
1600 Holloway Ave. Birth Date:06/23/1999
San Francisco, CA 94132 Age: 13-5
Phone: 415-338-1001 Phone: Confidential
Fax: 415-338-0916 Address: Confidential
Referral: (Class project CD 656)

SPEECH and LANGUAGE EVALUATION REPORT
BY:__________________________________________ _______________________________________
Jesse Blanca, Student Clinician
(Tester/ Interviewer)
Flo Kimmerling Ed.M., M.S., CCC
Clinic Supervisor
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cause to Pams hindered growth. Pams father is unaware of an Apgar score.
At 6 months old, Pam contracted a fever of 103 and began convulsing. After her
eyes rolled up into her head, she was taken to the hospital. It looked worse that it
really was Mr. Cruz said. Pams aunt, a pediatrician and her mother waded the
fever out at the hospital. After the fever, no other major medical issues aroused. Pam
hit all developmental milestones early. There was no feeding difficulty and she was
cooing before the 2nd month. Before her 1st birthday, she was walking. Although
her father could not recall her first word, or her first sentences, he could recall that
his daughter Pam engaged in joint laughter, seemingly soliciting from those around
her and began eliciting smiles a few weeks after birth. She was feeding herself
around the 20th month and was painting her own nails by 29 months old. Both of
Pams parents read to her and she began to read on her own well before Pre K. Her
father stated that they primarily used Baby Einstein videos for an hour each day.
Pams vision and hearing are checked every semester as a school requirement and
she has had consistent 20/20 vision and normal hearing. Presently she is not on any
prescriptive medication, only vitamins and cold medicine.
Pam is in the 7
th
grade at St. Catherine of Siena, a private school in Burlingame.
Mr. Cruz reported Pam is 1
st
honor student with a straight A record, likes math but
loves the arts, especially drawing. She has never been behind schoolwork and has
never been truant. Her father added We use to threaten them (their children) that
if they dont behave they cant go to school. Her brother goes to Serendipity School
Elementary in Belmont and is an A, and B average student.
After school Pam and her brother immediately work on homework. After
schoolwork and dinner the family plays video games together, Mr. Cruz says he is a
proponent of video games. When Pams mother was pregnant, both parents played
Halo together; something that Mr. Cruz believes has had some influence in Pam.
Pam goes to bed around 10pm each night. She is up by 7am; her father said she gets
an average of 7 to 8 hours of quality sleep. Mr. Cruz states that breakfast is very
important to the family and that the children are conscientious about their diet, no
fats and moderate on soda consumption. Mr. Cruz believes that these elements gave
Pam the ability to do well in school, she has never complained of being tired or
lacking energy during her school day.
Throughout the interview, Pams father expressed his gratitude for having a
daughter like her. Mr. Cruz said that Pam is very sociable, has many friends and she
is a balanced communicator. She loves to read but currently, her father cannot recall
who is Pams author of choice.

II. ASSESSMENT PROCEDURES AND RESULTS
Pam was administered two standardized and norm-referenced assessments. The
Test of Adolescent and Adult Language Fourth Edition (TOAL 4), for 12-0 to 24-11.
This test quantifies Pams abilities in both expressive and receptive languages
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established on ethnically sensitive population sample. Age, gender, income,
educational attainment, and regional differences are normative Sample categories.
The second test was the Peabody Picture Vocabulary Test, Fourth Edition, (PPVT 4)
another test for receptive and expressive language skills. The PPVT4 is a test for
ages 2:6 to 90+ years old and it is normed only with English speaking population.
Pam was assessed for 1.30 hours at her family home, after school. This was a last
minute assessment in order to meet a deadline and was facilitated by a friend of the
family who is acquainted with the examiner. Pam was very cooperative, composed,
and did not appear to be nervous. She sat quietly next to the examiner and waited
for instructions. As Pam listened carefully, her behavior was responsive and
enthusiastic.
Both the TOAL 4 and PPVT 4 have raw scores, which are the tally of points earned
for the test/subtests. The two tests represent the raw score as a percentile rank,
standard score and age equivalents based on population samples. Age equivalent is
measured against typically developing age ranges with similar performance.
Standard score represents all of the scores in an equal distribution of weight,
along with a mean/average. The standard score performance is either at mean
(absolute average or middle or 0), or n points above or below mean, for example 1+
above mean or -1 below mean. In percentile rank, the raw score is represented as
to where the Child is situated in a numeric line of 100 aged peers. For example 60
th

percentile means the child is 59 higher on the peer range and 40 lower on the peer
range. Normative score, such as percentile rank and standard scores are used to
illustrate how a childs performance compares to a age-matched peer group.
Therefore performance can be above or below relative peer group inconsequential
to chronological age. Furthermore, standard scores have an equal incremental point
difference, meaning result interpretation could be different if compared to
percentile rank, which does not use this. PPVT 4 does not have a subtest. The TOAL
has 6 subtests, which yields a composite score.
Test 1: Test of Adolescent and Adult Language, Fourth Edition (TOAL 4)
The TOAL 4 is a valid measure of spoken and written language for ages 12-0 to
24-11. It features both receptive and expressive modes in 6 core subtests. It
measures spoken and written languages encompassing semantics, grammar,
morphology and graphology (study of handwriting). Two modes divide the subtest
into receptive and expressive systems of language, Spoken and Written. In Spoken
Mode, the subtest Word Opposites (WO) and Spoken Analogies (SA) test for
semantics, while Word Derivation (WD) tests for grammar. In Written Mode the
subtests are Word Similarities (WS) a test for semantics, Sentence Combining (SC) a
test for grammar, and Orthographic Usage (OU) a test for graphology.

Scoring the TOAL 4 begins with the raw score for each subtest, which is converted
into percentile rank, then into a scaled score (standard score) and finally into a
descriptive rating, for each subtest. Percentile rank and scaled scores are two
normed referenced scores. Scaled score have a 10:3 distribution, which is the mean
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of 10 and a standard deviation of 3. Composite scores have a 100:15 distribution, a
mean of 100 and a standard deviation of 15. The highest subtest scaled score range
is 17 20 with a descriptive rating of Very Superior with a composite score of 130
or above. The lowest score range of 1 -3 is given the descriptive rating of Very
Poor with a composite score of 70 or below. Average range is 8 12 with a
composite score equivalent of 90 -110. Basal and ceiling for all subtests are simple;
all subtests begin at 1 and progress until 3 consecutive errors are produced,
establishing the ceiling.


Table 1.
There are three composite scores that are presented as indexes that have a mean
of 100 and a standard deviation of 15. These indexes are divided into Spoken
Language (SL) index, Written Language (WL) index, and General Language (GL)
index. Contrasting SL with WL provides patterns that reflect diagnostic, and is the
most useful scores on the TOAL -4 and is the basis for four psychometric clinical
groups.
Composite Score:

Subtest Scaled Score
Table 2.
Psychometric Clinical Groups:
Group 1: SL and WL combined indexes that are 90 and above is considered
average or above average. This means if there are academic issues, it is most likely
not linguistic.
Group 2: A combined score below 90 for SL & WL indexes are sub average and
could mean it is a language issue. Causes for sub average language performance
could be experiential depravity, delayed cognitive development, autism, pervasive
language disorder or insufficient experience with the English language.
Subtest Abbr. Raw
Score
Percentile
Rank
Scaled
Score
Descriptive Rating
Word Opposites WO 21 95% 15 Superior
Word Derivation WD 15 63% 11 Average
Spoken Analogies SA 11 50% 10 Average
Word Similarities WS 18 91% 14 Above Average
Sentence Combining SC 29 99% 19 Very Superior
*eval

Orthographic Usage OU 33 95% 15 Superior
Composites WO WD SA WS SC OU Sum
of SS
%
Rank
Descriptive
Rating
Composite
Index
Difference
Spoken
Language
15 11 10 34 79% Superior 121
Written
Language
14 19 15 48 99% Very
Superior
138 17
General
Language
15 11 10 14 12 15 75 87% Above
Average
117
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Group 3: An SL index that is 90 or above and with a WL index score of 89 or
lower could indicate a higher proficiency in spoken language than written
language. Often attributed to dyslexia, dysgraphia, attention disorder, vision,
and traumatic brain injury.
Group 4: An SL index of 89 or below with a WL index of 90 or above means a
higher proficiency in written language than spoken language. Many bilingual
English Language Learners (ELL) exhibit this, also oral-motor problems, severe
articulation difficulty, cleft palate, dysarthria and traumatic brain injury.
Clinical Group
Table 3.
SL index is quantified by combining WO, WD and the SA subtest. The result is
a measure of expressive vocal language. WL index is the combination of WS, SC,
and OU subtest, the result of which is a measure of literacy skills, such as
vocabulary, grammar, reading, writing, spelling and punctuation skills.
Core Subtest:
Word Opposites subtest quantifies the childs knowledge of antonyms, a key
feature in vocabulary. Pam was read aloud a series of words where she answered
with a word that had the opposite meaning. These 34 words are written in a column
with an adjacent column of correct responses. For each correct answer, 1 point is
scored on the third column. The test is terminated after the last stimulus word is
read or there are three consecutive wrong answers. Pam did not produce the correct
antonyms for the 24th word, deceit, the 25th concur and the 26th opaque
which terminated the test. She also missed the 19th word seldom, the 21st word
deliberate and 22nd inferior, missing 6 out of 26 stimulus. Pam had a great
momentum, answering without hesitation from stimulus 1 through the 24th. She
scored 21 on Word Opposites, which placed her in the 95 percentile rank which
equates to the descriptive rating of Superior.
Word Derivations subtest quantifies the persons ability in complex derivational
affixes in root words, along with morphology a key skill in generating new words.
Pam is given a keyword, for example eat, then two sentences; The boy got hungry
looking at his friends lunch His friend was _________. The correct answer is
Group 1 Group 2 Group 3 Group 4
Characteristics Average or Above
in both SL and WL
Below Average in
both SL and WL
Average or above
in SL and below
average in WL
Average or above
in WL and below
average in SL

Psychometrics
TOAL- 4
Composite

SL 108 (121) 80 100 85
WL 107 (138) 79 84 99
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eating. Pam had a potential total of 51 points for this subtest; three consecutive
wrong answers terminate the test. Pam was unable to continue past the 22nd task.
Pam did not provide the correct word derivation for: 8th word glory, the correct
response was glorious Pam gave gloried as her response. Pam did not guess
when she was unsure and made an effort for the more difficult task, responding Im
not sure four times out of seven wrongs. Beginning with the 12th word mortal,
the correct response was immortal, she said Im not sure;14th word was
intense, the correct response was intensify, she said Im not sure; 18th word
was capital, the correct answer was capitalistic, she said Im not sure; 20th
word was mercy, the correct answer was merciless or unmerciful, she responded
with merciful; 21st word was intent, the correct answer was unintentional, she
responded with intensive, and 22nd word was wise, the correct answer was
unwise, she responded with Im not sure terminating the test. Pam got 15 out of
22 tasks correct, a Word Derivation raw score of 15 and percentile rank of 63, giving
her the descriptive rating of Average.
Spoken Analogies quantify the knowledge of analogies that directly relates to
vocabulary. A partial analogous sentence, with a missing word at the end is read by
the student clinician; Pam is to fill in the missing word. For example Mother is to
Father as daughter is to _____________ ; answer, Son. There were a possible 26
analogies in this subtest, Pam reached the 19
th
analogy before the test was stopped.
She missed a total of 8 out of 19. Her first wrong answer was question 7; Dog is to
mammal as snake is to _________, the answer was reptile. Pam did not guess on
question 7. Her second incorrect answer was on question 10. Girl is to feminine as
boy is to _________, the correct answer was masculine, she responded with male.
No attempt at guessing by Pam on the following wrong answers for questions 12,
13, 15, 17, 18 and the 19
th
question. SA is an inference task, simply, if two or more
things agree with a portion of the sentence, then its highly probable that the next
portion of that sentence can agree with the missing element. If cat and feline
agree, then dog and canine agree as well. As a child gets older linguistic
competence is built upon the fundamental foundation of inference. A cognitive skill
that requires a firm grasp of analogical reasoning. On this subtest, a pattern appears.
Pam does not gamble with her answers, if she is not firm with the answer, she
simply answered with Im not sure. Pam had a raw score of 11, which translates to
a percentile rank of 50, and a scaled score of 10, and descriptive rating of Average.
Word Similarities quantify synonyms, which relate to semantic ability and play a
major role in orthographic or printed/written language. Pam was read a stimulus
word and had to answer with a similar word. For example, similar word to Mug,
answer Cup. WS can also be used to probe for reading comprehension,
vocabulary, semantics and long-term memory for lexical access. WS has a potential
of 40 correct responses, Pam got 18 out of 31. Pam missed stimulus 14, Astonish
(surprise; amazed; shock; astound potential answers.), 18 Novice (beginner;
learner; rookie) she said not sure. Stimulus 19, Barter (trade; exchange) was also
missed, again she answered not sure. The final three consecutive missed stimulus
were; 29, Pandemonium (uproar; turmoil; chaos; clamor; din), 30, Rotund (round;
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sufficient; fat; hefty) and finally 31, Suffice (enough; sufficient) which terminated the
subtest. Pam received a raw score 18, which translated to 91 percentile rank and a
scaled score of 14, this gave her a descriptive rating of Above Average.
Sentence Combining quantifies syntactic ability, grammar knowledge, and
pragmatic skills. Pam was asked to combine simple short sentences into one
grammatically correct written sentence. Key features used to tease out proper
answers is the proficiency in adjective re-sequencing and be able to embed phrases
in the new sentence. This subtest is strict on grammar in accordance to the rules of
informal standard English, which the level of English is often used by educated
persons in letters of correspondence. Simply no awkward or confusing sentences,
spelling errors and punctuations; capitalizations are not counted as errors.
Extensive use of coordinating conjunctions are strict, over use of and, but, and
or can yield no points. For example on task 20, she needed to combine the
sentences; The dance., Where they would dance the lights would be bright., The
lights would flash.. The critical phrases that needed to be carried over were, They
would dance and bright lights would be flashing where they danced. Pam
answered with; They should dance where the flashing lights would be bright.
Pam received a mark of 1 because she correctly changed tenses and did not use the
word and.
For task 15 she combined the sentences; We heard static on the radio., We
feared a thunderstorm., We decided not to go out in the boat., For this, she could
only use and once. We heard static on the radio from the thunderstorm and
decided not to go out in the boat. Pams response was; We decided not to go out in
the boat because we heard static on the radio, and we thought it was thunderstorm.
She constructed a well versed and complicated sentence that met all the
requirements. Pam had a raw score of 29, that translated into a percentile rank of
99, a standard score of 19, and a descriptive rating of Very Superior.
Orthographic Usage quantifies orthographic conventions, such as spelling,
punctuations as well as vocabulary. Pam is given a series of sentences with
punctuation and spelling errors, she is tasked to correct them. Orthographically, the
English language is sectioned into five skills; letter knowledge, spelling, punctuation,
abbreviations, and special symbols. The TOAL 4 concentrates on spelling and
punctuation. Pam had a total of 47 sentences to correct; she got 33 correct for a raw
score of 33. Her percentile rank is 95 and a scaled score of 15 which had the
descriptive rating of Superior.
Pams performance in Spoken Language gave her a composite index of 121, and in
Written Language 138. Both composite indexes are above 108 (SL), 107 (WL)
Table 3.

placing Pam in Group 1. The composite group 1 is based on psychometric data taken
from a Sample of people who are linguistically proficient for both spoken and
written language. They are typically college-educated parents, predominantly
females, high percentage of European American who speak English, low percentage
of people with disability and low percentage of minorities. Ethnic demographic is
predominantly White (88%), females (55%), college-educated parent (27%),
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smallest-percentage of non-Whites (13%), Hispanic (8%), and a person identified
with a disability (12%).
Test 2: Peabody Picture Vocabulary Test, Fourth Edition
A child's ability to understand a wide range of words and their meaning is an
essential measure of vocabulary depth and a precursor to literacy. The Peabody
Picture Vocabulary Test, Fourth Edition is a quick norm-reference vocabulary test
that requires no reading. Individually administered with no time limits, it is normed
for ages 2:6 to 90+. PPVT 4 measures comprehension of the spoken Standard
English language, vocabulary acquisition, instructions (receptive), difficulties in
reading, and screening instrument for verbal development.
Pam was read a stimulus word by the examiner, while a four picture page layout
is presented. She answered by pointing to one of the four images in the picture.
There are 228 items in the PPVT4, grouped into 19 sets of 12 items each. Arrange so
that the test becomes progressively difficult because of this Pam begins at her
appropriate age range which is not from the beginning of the test. She responded
well to vocabulary instructions. No errors in the first set establishes the basal which
has 12 words, the ceiling (end of test) is eight or more error in a set.
PPVT -4 SCORE SUMMARY
(table 4)

The PPVT 4 has three normed scores,
Standard Score
i
, Percentile Rank
ii
, and
Stanine
iii
with no Composite Score. The two
non- normed scores are, Raw score and
Growth Scale Value. Scoring begins with the
Raw score, which is simply the tally from the
test. Standard scores are normative scores
which mean it is compared to others in her
chronological age. Percentile rank is the rank
performance value in a group. For example a
percentile rank of 64 mean 64% of that group
performed as well as the child. The Stanine
score is a normalized one digit score, from 1
to 9, and represents a range within that
number. A stanine score of six includes the
63
rd
and 75
th
percentile rank. Stanine is often used as cutoff scores when more
accuracy is needed.
Pam began at her chronological age set, set 11 and did not have any errors until
set 14, which included the words; primate, valve, parallelogram, and consuming.
Her second error was on set 15, missing the words; pentagon, and perpendicular.
Her third error was on set 16 with the words; cultivate, wedge, maritime, and
incarcerating. Ceiling was established on set 17, producing 8 errors in a row on the
words; incandescent, confiding, mercantile, upholstery, filtration, replenishing,
Raw Score 183
Standard Score
i
105
Confidence Interval 90%

Percentile
ii
66

Normal Curve Equivalent 58
Stanine
iii
6
Growth Scale Value
(GSV)
199

Age Equivalent 14:8
Grade Equivalent 8.8

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trajectory, and perusing. Set 17 was not part of the score tally, Pams potential
score was 192, where she missed 9, giving her the raw score of 183.

figure 1.
Pams raw score of 183 gave her a standard score 105 and a percentile rank of 66.
She is in the 6
th
stanine
figure 1
, and when combined with her percentile rank of 66,
places her in the high average range. Pams GSV score is 199, which can be used to
track change of PPVT -4 performance, over time. The PPVT -4 also provides an age
equivalent and grade equivalent. Pams equivalent age is 14:8, and her grade
equivalent is 8.8
table 4
.

III. IMPRESSION
Pam was attentive and paid close attention to instructions from the student
clinician. She had a good rapport with no tension throughout the entire assessment.
For every test prompt, her composure was alert and relaxed. Her approach once the
testing began was deliberate, very keen in giving precise answers on the Word
Opposites, Word Derivation and Spoken Analogies. If Pam was sure about an
answer, she would not guess, and always responded with not sure. On the subtest
WO, not sure of her answers, Pam guessed 1 time out of 6 errors. Overall Pam
produced results commensurate to her socioeconomic Sample, Group 1,
table 3.
as
described in the TOAL 4. She is average or above average in Spoken Language and
superior in Written Language. Her age equivalent on the PPVT -4 is one above her
chronological age and grade equivalent indicates performance 1 grade above her
current grade, placing her on the high average range. Both results from the TOAL 4
and PPVT 4 indicate she is academically proficient in all the critical written literacy
skills; grammar, punctuation, spelling, orthography, and syntax. Her performance on
TOAL 4 subtest Sentence Combining was very superior, with limited use of
conjunctions like and, or but, which is a challenging task, when no other
instruction is given. SC is based on informal standard English, which is privy to
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convention of how written English is used in certain population groups. Pams
performance on SC subtest could have been better based on her performance on the
Orthographic Usage subtest and PPVT -4.
Her Spoken Language composites are not as high as the Written Language, yet
overall she is above average. Vocabulary performance is on the high average to
above average as indicated by contrasting PPVT score with TOAL 4 WO and WS.
There is a 17-point difference between SL and WL on the TOAL -4, yet both scores
are above the average composite score, no language issues could be expected. Pam
has no reading difficulties, good verbal development, she is ahead of her age range
and her linguistic potential is good.
The large difference between Pams Spoken Language and Written language could
be attributed to her being multilingual. Multilingual people are often tasked more
than monolinguals, acquiring multiple systems at the same time. Silent period is a
common phenomena (ASHA) that occur, also interference (L1 to L2), and code
switching are all normal phenomena for multilingual.
IV. RECOMENDATION
In the long term, her language background could have cognitive-linguistic
benefits. Multilingual speakers often outperform monolingual speakers in meta-
linguistic skills. She might benefit from the following;
A. Pam could practice both Spanish and Tagalog outside of the classroom and
home. This could potentially increase her Spoken Language skill.
B. More word exposure in general in any context, or form, such as language
exposure through play.