DATA INTRARII IN GRADINITA: _______________________________ b4u10uo
DATA INCEPERII CORECTARII: _______________________________
I.DATE GENERALE:
Numele si prenumele____________________________data nasterii__________ domiciliul_____________str.__________________nr.___et.____ap.___tel.___________
II.ANAMNEZA FAMILIALA:
TATA_____________________varsta___________studii_________________________ locul de munca_______________________________functia_______________________
MAMA____________________varsta___________studii_________________________ locul de munca_______________________________functia_______________________
TIPUL DE FAMILIE______________________________________________________
STRUCTURA FAMILIEI_____________________________RANGUL_____________
BOLI___________________________________________________________________________________________________________________________________________________________________________________________________________________
ATITUDINEA PARINTILOR FATA DE LIMBAJUL COPIILOR__________________
________________________________________________________________________
STIMULAREA SOCIALA SI LINGVISTICA__________________________________
________________________________________________________________________
III.ANAMNEZA PERSONALA
Sarcina____________________nastere___________________apgar_____greutate_____boli____________________________________________________________________________________________________________________________________________ tratamente_______________________________________________________________ alimentatia_______________________________ridica capul_______merge sustinut____
_________merge independent_____________controlul sfincterian__________________
IV.EXAMENE MEDICALE
PEDIATRIE_____________________________________________________________
O.R.L.FONIATRIE_______________________________________________________
OFTALMOLOGIE________________________________________________________
STOMATOLOGIE________________________________________________________
NEURO-PSIHIATRIE_____________________________________________________
ENDOCRINOLOGIE______________________________________________________
V. EXAMENE PSIHOLOGICE
INTELECT______________________________________________________________
MEMORIA______________________________________________________________
ATENTIA_______________________________________________________________
AFECTIVITATEA________________________________________________________
SCHEMA CORPORALA___________________________________________________
ORGANIZAREA SPATIALA_______________________________________________
ORGANIZAREA TEMPORALA____________________________________________
LATERALITATEA:mana___________picior__________ochi_______ureche_________
COMPORTAMENTUL____________________________________________________________________________________________________________________________
VI. ALTE PARTICULARITATI
________________________________________________________________________
VII. EVOLUTIA VORBIRII
Ganguritul________lalatiunea__________primul cuvant___________prima
propozitie__
______ritmul vorbirii_________limba materna___________________limba mediului
inconjurator_________________________________atitudinea copilului fata
de voirbire_
________________________________________________________________________
VIII. EXAMEN ANATOMO-FUNCTIONAL AL APARATULUI FONO-ARTICULAR
1.Malformatii____________________________________________________________
2.Sistemul labio-comisural__________________________________________________
3.Maxilar________________________________________________________________
4.Limba_________________________________________________________________
5.Palatul dur_____________________________________________________________
6.Palatul moale___________________________________________________________
7.Uvula_________________________________________________________________
8.Sistemul nazal__________________________________________________________
9.Deglutitia______________________________________________________________
10.Respiratia_____________________________________________________________
11.Intelegerea vorbirii interlocutorului-acuitatea auditiva__________________________
________________________________________________________________________
12.Recunoasterea si reproducerea sunetelor perechi______________________________ sunete izolate________________silabe ,cuvinte_________________________________
13.Autocontrolul auditiv_______________________confuzii______________________
________________________________________________________________________
IX. EXAMENUL VORBIRII ARTICULATE
PROFILUL LOGOPEDIC AL VOCALELOR
I.EMISE________________________________________________________________
II.NECONSOLIDATE_____________________________________________________
III.INLOCUITE__________________________________________________________
IV.OMISE_______________________________________________________________
V.DEFORMATE_________________________________________________________
VI.NEEMISE____________________________________________________________
X. EXAMENUL LIMBAJULUI
VARSTA PSIHOLOGICA A LIMBAJULUI-VPL_______________________________
VORBIREA REFLECTATA________________________________________________
VORBIREA INDEPENDENTA_____________________________________________
SUNETELE AFECTATE___________________________________________________
STRUCTURA GRAMATICALA____________________________________________
XI. DIAGNOSTIC LOGOPEDIC INITIAL____________________________
ACTUAL___________________________
FINAL_____________________________
XII. PROGNOZA__________________________________________________
XIII.OBIECTIVELE TERAPIEI LOGOPEDICE_______________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
