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Intake Form

Child Intake 

This intake form can be given to parents before or during an evaluation to obtain a comprehensive case history for preschool and school aged children who stutter

 Community Centered Stuttering Assessments 

These clinical assessments are completed by various listeners in order to provide a comprehensive overview of a child's communication in various contexts.

CCSA-Child

Children ages 8-17 are encouraged to complete the survey

CCSA-Parent

Both parents are encouraged to complete the survey separately
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CCSA-Teacher

The child's primary teachers are encouraged to complete the survey separately 

CCSA-SLP

The child's speech-language pathologist(s) are encouraged to complete the survey separately 

Sample Reports and Goals

Sample Report - Preschool

Sample report for a preschooler who will require a direct treatment approach

Sample Report - School Age/Adolescent

Sample report for a school age/adolescent

Sample Goals - Preschool

Includes sample goals for indirect and direct treatment approaches for young children

Sample Goals - School Age/Adolescent

Includes sample goals to target knowledge of stuttering, physical tension and secondary behaviors, amount of stuttering, and overall communication