Report ID: 17654
GENERAL
Georgia
Client Name: Evaluation
Pagano 5/15/2013
Date:
Client's Report
Georgie Shore Lake
Name: Clinic:
Services
Report Date: 6/11/2013
ABOUT THE COMMUNICATION MATRIX
The Communication Matrix is a communication skills assessment designed for the parent and
professional to evaluate communication in individuals with disabilities. The Communication Matrix is
unique in measuring all possible communicative behaviors in non speaking individuals and
accommodates any type of communicative behavior, including augmentative and alternative forms of
communication, pre-symbolic communication and typical forms of communication such as speech
and writing. The measure covers seven levels of communication occurring during the earliest stages
of communication seen in typically developing individuals. Completed profiles allow parents and
professionals to directly compare the information they have across settings to provide a
comprehensive portrait of an individual’s communication skills. The Communication Matrix is available
in print and as an online service. Complete information about this assessment is available at
[Link]
PERSONAL INFORMATION
Age: 6 years 3 months Primary Diagnosis: CHARGE Syndrome
EDUCATIONAL INFORMATION
School / Program: Lakeside Elementary Grade: 1
PREVIOUS COMMUNICATION ASSESSMENTS
Previous Date: 9/9/2012
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PREVIOUS COMMUNICATION MATRIX PROFILE
MatrixID = 69142
A1 A2 A3
I
Pre- Expresses Expresses Comfort Expresses Interest
Intentional Discomfort in Other People
Behavior
Key: = Surpassed
I I I
B1 B2 B3 B4
= Not Used
II Protests Continues an Action Obtains More of Something Attracts Attention
Intentional
Behavior
II II II II = Emerging
C1 C2 C3 C4 C5 C6 C8 C9
III Refuses Requests Requests Requests Makes Requests Requests Shows
Unconventional or More of a New More of Choices a New Attention Affection
= Mastered
Communication Rejects an Action Action an Object Object
Something
III III III III III III III III
C10 C11 C12 C13 C14 C15
IV Refuses Requests Requests Requests Makes Requests Requests Shows Greets Offers Direct Polite Answers Asks
Conventional or More of a New More of Choices a New Attention Affection People Things Your Social "Yes" Questions
Communication Rejects an Action Action an Object Object or Attention Forms and "No"
Something Shares
IV IV IV IV IV IV IV IV IV IV IV IV IV IV
C7 C16 C17
V Refuses Requests Requests Requests Makes Requests Requests Requests Shows Greets Offers Direct Polite Answers Asks Names Makes
Concrete or More of a New More of Choices a New Objects Attention Affection People Things Your Social "Yes" Questions Things Comments
Symbols Rejects an Action Action an Object Object that are or Attention Forms and "No" or
Something Shares People
V V V V V V V V V V V V V V V V V
VI Refuses Requests Requests Requests Makes Requests Requests Requests Shows Greets Offers Direct Polite Answers Asks Names Makes
Abstract or More of a New More of Choices a New Objects Attention Affection People Things Your Social "Yes" Questions Things Comments
Symbols Rejects an Action Action an Object Object that are or Attention Forms and "No" or
Something Shares People
VI VI VI VI VI VI VI VI VI VI VI VI VI VI VI VI VI
Refuses Requests Requests Requests Makes Requests Requests Requests Shows Greets Offers Direct Polite Answers Asks Names Makes
VII
or More of a New More of Choices a New Objects Attention Affection People Things Your Social "Yes" Questions Things Comments
Language
Rejects an Action Action an Object Object that are or Attention Forms and "No" or
Something Shares People
VII VII VII VII VII VII VII VII VII VII VII VII VII VII VII VII VII
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CURRENT COMMUNICATION MATRIX PROFILE
MatrixID = 69143
A1 A2 A3
I
Pre- Expresses Expresses Comfort Expresses Interest
Intentional Discomfort in Other People
Behavior
Key: = Surpassed
I I I
B1 B2 B3 B4
= Not Used
II Protests Continues an Action Obtains More of Something Attracts Attention
Intentional
Behavior
II II II II = Emerging
C1 C2 C3 C4 C5 C6 C8 C9
III Refuses Requests Requests Requests Makes Requests Requests Shows
Unconventional or More of a New More of Choices a New Attention Affection
= Mastered
Communication Rejects an Action Action an Object Object
Something
III III III III III III III III
C10 C11 C12 C13 C14 C15
IV Refuses Requests Requests Requests Makes Requests Requests Shows Greets Offers Direct Polite Answers Asks
Conventional or More of a New More of Choices a New Attention Affection People Things Your Social "Yes" Questions
Communication Rejects an Action Action an Object Object or Attention Forms and "No"
Something Shares
IV IV IV IV IV IV IV IV IV IV IV IV IV IV
C7 C16 C17
V Refuses Requests Requests Requests Makes Requests Requests Requests Shows Greets Offers Direct Polite Answers Asks Names Makes
Concrete or More of a New More of Choices a New Objects Attention Affection People Things Your Social "Yes" Questions Things Comments
Symbols Rejects an Action Action an Object Object that are or Attention Forms and "No" or
Something Shares People
V V V V V V V V V V V V V V V V V
VI Refuses Requests Requests Requests Makes Requests Requests Requests Shows Greets Offers Direct Polite Answers Asks Names Makes
Abstract or More of a New More of Choices a New Objects Attention Affection People Things Your Social "Yes" Questions Things Comments
Symbols Rejects an Action Action an Object Object that are or Attention Forms and "No" or
Something Shares People
VI VI VI VI VI VI VI VI VI VI VI VI VI VI VI VI VI
Refuses Requests Requests Requests Makes Requests Requests Requests Shows Greets Offers Direct Polite Answers Asks Names Makes
VII
or More of a New More of Choices a New Objects Attention Affection People Things Your Social "Yes" Questions Things Comments
Language
Rejects an Action Action an Object Object that are or Attention Forms and "No" or
Something Shares People
VII VII VII VII VII VII VII VII VII VII VII VII VII VII VII VII VII
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CURRENT COMMUNICATION SKILLS LIST
C1. Refuses or Rejects Something
Skill Behavior Mastery
scream, whine Mastered
frown, grimace Mastered
pushes away object or person Mastered
specific vocalizations ("uh-uh") Emerging
rejects object symbol representing
Emerging
unwanted item
C2. Requests More of an Action
Skill Behavior Mastery
leg movements (kick) Mastered
takes your hand Mastered
holds hands up or out to you (for "up") Mastered
indicates object symbol representing
Emerging
desired action
3-dimensional symbols for snack, PE,sensory play
C3. Requests a New Action
Skill Behavior Mastery
indicates object symbol representing
Emerging
desired action
C4. Requests More of an Object
Skill Behavior Mastery
reaches toward or taps object Emerging
guides your hand to or pulls you over to
Mastered
desired item
indicates object symbol representing
Mastered
desired item
C5. Makes Choices
Skill Behavior Mastery
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reaches toward, touches or taps desired
Emerging
item (without taking it)
indicates object symbol representing
Emerging
desired item
C6. Requests a New Object
Skill Behavior Mastery
guides your hand to or pulls you over to
Emerging
desired item
Not sure if understands purpose of switch or if can hear the message.
C8. Requests Attention
Skill Behavior Mastery
activates switch or "calling device" Emerging
coo, squeal Mastered
touches you Mastered
C9. Shows Affection
Skill Behavior Mastery
coo, squeal Mastered
smile Mastered
touches you Mastered
hugs, kisses, pats you Mastered
C10. Greets People
Skill Behavior Mastery
waves "hi" or "bye" Mastered
C11. Offers Things or Shares
Skill Behavior Mastery
gives or shows something to you Emerging
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PRIMARY LEVEL AT WHICH CLIENT IS OPERATING
Unconventional pre-symbolic behaviors are used intentionally to
communicate. Communicative behaviors are “pre-symbolic”
because they do not involve any sort of symbol; they are
Level III. Unconventional
"unconventional" because they are not socially acceptable for us to
Communication
use as we grow older. Communicative behaviors include body
movements, vocalizations, facial expressions and simple gestures
(such as tugging on people).
PERCENTAGE OF MESSAGES EXPRESSED AT EACH LEVEL
l Level 1: 100%
l Level 2: 100%
l Level 3: 87.5%
l Level 4: 35.7%
l Level 5: 29.4%
l Level 6: 0%
l Level 7: 0%
CATEGORIES OF BEHAVIOR USED TO COMMUNICATE
l Early Sounds
l Facial Expressions
l Simple Gestures
l Conventional Gestures & Vocals
l Concrete Symbols
l Body Movements
OTHER IMPRESSIONS OR OBSERVATIONS
Georgie has become increasingly sociable this year.
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SUMMARY OF PROGRESS SINCE LAST ASSESSMENT
is operating on the same level as s/he was
This evaluation shows that client previously, but has gained some new skills at a
higher level
l C3. Requests a New Action
New messages either emerging or mastered l C6. Request a New Object
since last assessment l C11. Offers Things or Shares
New types of communicative behavior l Concrete Symbols
Georgie is making progress in the use of
Additional observations to describe client's
tangible symbols for favorite activities and toys.
progress more thoroughly
She is less frustrated.
Quantitative estimate of change (points
11
gained since last assessment - MAX 160)
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RECOMMENDATIONS
LEVEL 1
LEVEL 2
LEVEL 3
LEVEL 4
LEVEL 5
l Description of Level V
¡ Symbols represent, or stand for, something else. At Level V, individuals use “concrete"
symbols that physically resemble what they represent. They look like, feel like, move like
or sound like whatever they represent. Concrete symbols include pictures, objects (such
as a shoelace to represent "shoe"), "iconic" gestures (such as patting a chair to say "sit
down") and sounds (such as making a buzzing sound to mean “bee”). Most individuals
skip this stage and go directly to Level VI. But for some individuals, concrete symbols
may be the only type of symbol that makes sense to them; for others they may serve as
a bridge to using abstract symbols. Typically developing children use concrete symbols in
conjunction with gestures and words, but not as a separate stage.
l General Goals For Level V
¡ Increase the number of different symbols (vocabulary) in the symbol mode that the client
currently uses.
¡ Expand the use of concrete symbols to new contexts, partners, materials and settings.
Intents to Target and Specific Suggestions
C2. Requests More of an l Choose a motivating activity, for example:
Action bubbles, balloons, swinging, tickle, taking a
bath, taking a walk, reading books, singing a
song at circle time, or action toys or electronic
musical devices that Georgie needs your
assistance to activate. Every once in a while,
stop the action or turn off the device. Don’t
start it again until Georgie uses the targeted
concrete symbol to ask for more of the action.
Continue to provide opportunities for {him/her}
to make requests throughout the activity.
C2. Specific Level 5 3-D symbols for major activities of day, especially
behaviors to target preferred activities.
C2. Other Suggestions Use 3-D activity symbols to "announce" new
activities before you begin them (to give Georgie a
chance to learn what the symbols mean).
C3. Request a New Action l Since Georgie has a sensory impairment, it’s
important to use a variety of sensory
modalities. Instead of changing the activity
quickly, tell {him/her} ahead of time verbally
and tactilely. This allows {him/her} the chance
to anticipate a change and communicate to you
that {s/he} wants something new.
C3. Specific Level 5 Independently head to appropriate area when given
behaviors to target a symbol for an activity.
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C5. Specific Level 5 Touching or giving correct 3-D symbol after you
behaviors to target have determined what Georgie really wants at the
moment. If desire is not clear, pair symbols for
preferred items with symbols for non-preferred
items.
C5. Makes Choices l Present Georgie a choice of one favorite item
and one that {s/he} dislikes. Don’t give
{him/her} the desired item until {s/he} shows
you which one {s/he} wants, using the
appropriate concrete symbol. Offer choices
throughout the day and during a variety of
activities like snack, dressing routines, bath
time, songs or book reading.
Monitoring Progress
Touching/giving appropriate symbol after activity
is stopped, when she wants more of an item, or
Type of data:(e.g. pointing
to make a choice. Demonstrate comprehension of
to desired object, using
a 3-D symbol by going to correct activity area or
manual sign to request help)
by selecting appropriate item when given a
symbol for it.
How to measure behavior
(e.g., frequency of behavior,
Level of assistance
accuracy, independence,
level of assistance)
How often to take data
(e.g., once a week at snack, 1 X per week in each major activity
every day at circle time)
Who will take the data Rose and Sean
Criterion for success (e.g.
Independently touches/gives correct symbol to
points to desired object to
ask for more or independently demonstrates
verbal cue of "What do you
comprehension of symbols in 3/4 opportunities
want" at least 75% of the
when give choice of at least 2 symbols at a time.
time)
LEVEL 6
LEVEL 7
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