Local speech therapy & myofunctional therapy practice in New Jersey since 1982

As an infant, did your child babble and play with sounds?

When did your child speak his/her first word?

When did s/he begin to use 2-word phrases?

Does s/he use speech:

Always

Occasionally

Never

Does s/he prefer to use gestures? If so, give examples:

Which option(s) best describes the manner in which your child currently communicates:

5+ word sentences

2-4 word phrases

Single words

Sounds

Body language

Examples of child’s speech

How well can your child be understood by parents: (Use %)

How well can your child be understood by siblings: (Use %)

How well can your child be understood by friends: (Use %)

How well can your child be understood by strangers: (Use %)

Describe your child’s auditory behavior (hearing speech and environmental sounds, following directions, etc.)

Has speech/language been tested? By whom and when?

Has your child received speech therapy in the past?

Yes

If yes, where/when? What were they working on?

Have you seen any improvements or changes in your child’s speech/language over the past 6 months?

Has your child received any other evaluation or therapy? (e.g. physical therapy, counseling, occupational therapy, vision etc)?

Has vision been tested? By whom and when?

Has hearing been tested? By whom and when?

Thanks for registering to our event. See you there!

LOCATION:

667 Shunpike Road,

Suite 1A
Chatham, NJ 07928

EMAIL:

CALL:

Tel: 973-635-5757

SOCIAL MEDIA

Facebook @chathamspeechandmyo;

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