Clinical Scenario
Jane is a speech-language pathologist (SLP) in a rural school district in the Midwestern United States. She has 15 years of clinical experience, 13 of those working in the public school setting. Jane provides services to children in the school district’s special education preschool and two elementary school buildings, and almost half of her caseload consists of students with phonological disorders.
Ben is a preschooler with a severe phonological disorder. Jane worked with Ben the previous school year and has developed growing concerns about his progress. Jane was expecting Ben to be further in his treatment program, given his motivation during therapy sessions and the additional practice he gets at home working with his mom. In a recent evaluation where she obtained his percentage of consonants correct (PCC), Jane discovered that, compared to his baseline PCC level, Ben had made minimal progress with his overall speech production skills. To ensure she had not overlooked any other explanation for his lack of improvement, Jane administered communication, cognitive, and academic assessments. Review of this information revealed no concomitant developmental issues or additional impairments that could be affecting his speech sound development.
Adding to her concern was her realization that this would be Ben’s last year of preschool before moving on to kindergarten. With only nine months left to work with him, Jane felt compelled to re-evaluate Ben’s existing treatment program and consider ways to deliver his therapy as effectively and efficiently as possible.