Cabinet Logopedic Interscolar Nr. 2 Nr fisa____7______

Colegiul National « J. Monnet «, Ploiesti Data. __6.10. 2011__

FISA LOGOPEDICA DE EXAMINARE COMPLEXA

I. Date personale :

Numele si prenumele: __D.O.__________________________ Data nasterii:

_20.08.2005_______________

Domiciliul: _Ploiesti__________________ Strada _Dealu cu Piatra______________________Nr.__________

Blocul _______ Scara ________Etaj________ Apart.________Telefon______________________________

Gradinita / Scoala____51___________ Grupa / Clasa__preg._____ Ed./ Inv.___G.Maria_________________

Trimis de:_____revine in terapie____________________________________________________________

II. Date familiale :

Tatal : Vârsta :____34______Ocupatia :_tehnician________Locul de munca :_Proconstruct______________

Mama : Varsta : ___35___Ocupatia :__asistent medical____Locul de munca :___casnica_________________

Numarul membrilor familiei :__3___, Al catelea copil este :_____primul_____________________________

Relatii in familie :___bune, armonioase_________________________________________________________

Starea sanatatii membrilor familiei : __buna______________________________________________________

Tulburari de limbaj in familie :_____rudele pe cale paterna (frati, unchi)___________________________

III. Evolutia copilului:

Sarcina:____normala _________Nasterea:_ normala, la termen ___________________________________

Mersul nesustinut:__la 1 an_____Primele cuvinte:___9 luni______ Vorbirea in propozitii:_____la 3 ani_____

IV. Examen medical:

____impune investigatii neuropsihiatrice______________________________________________________

______________________________________________________________________________________

V. Examen psihologic:

Organizarea spatiala :_nu se orienteaza spatial___________________________________________________

Organizare temporala:_mai buna decat cea spatiala________________________________________________

Lateralitatea :mana__dreapta_____picior_drept_____ochi_stang_______ureche_stanga___________________

Lateralitate dominanta : _____incrucisata ________________________________________________________

Comportamentul in familie : _____atasat de mama_________________________________________________

Comportamentul in colectivitate :___usor agresiv__________________________________________________

Trasaturi de personalitate :__hiperkinezie, irascibilitate, uneori agresivitate____________________________

VI. Traseul educational (scolar) parcurs :

Gradinita :__nr. 51(al 2-lea an )_____________________________________________________________

Scoala :__________________________________________________________________________________

Logopedie :____CLI Nr 5, CLI Nr. 2_________________________________________________________

VII. Examen logopedic :

Aparitia tulburarilor de limbaj :_in ontogeneza____________________________________________________

Cauze posibile :__transmitere ereditara pe cale paterna_____________________________________________

__disfunctie psihica________________________________________________________________________

__hipoacuzie____________________________________________________________________________

Pronuntarea independenta a sunetelor :__recidiveaza pe vibranta R_________________________________

Pronuntarea dupa model a sunetelor:__deficiente de perceptie a sunetelor_____________________________

Pronuntarea silabelor:_apare uneori metateza, contopiri de sunete____________________________________

Sunete afectate:_R__________________________________________________________________________

Calitatea vocii:__buna_______________________________________________________________________

Motricitatea generala:___hiperkinezie__________________________________________________________

Motricitatea faciala:___buna_________________________________________________________________

Motricitatea linguala :__deficitara_____________________________________________________________

Conformatia aparatului fono-articulator :__fren lingual usor scurt____________________________________

Valul palatin :__usor adanc__________________________________________________________________

Dentitia :___de lapte_______________________________________________________________________

Respiratia :_normala_________________________________________________________________________

Auzul fonematic :___deficitar ______________________________________________________________

Ritmul si fluenta vorbirii :___uneori alert______________________________________________________

Scriere- Copiere : _____________________________________________________________________ _

- Dictare :__________________________________________________________________________

- Compunere :_______________________________________________________________________

Citire :___________________________________________________________________________________

Diagnostic

logopedic :__dislalie___________________________________________________________________

Indicatii privind activitatea de corectare :__continuarea terapiei logopedice_______________________

_________________________________________________________________________________________

VII. Alte date :

Durata terapiei logopedice : __________________________________________________________________

Incadrarea in colectiv dupa corectare sau ameliorare :__mult mai buna________________________________

Recomandari pentru familie :__sa repete acasa___________________________________________________

Prezentarea cazului la incheierea activitatii :_corectat___________________________________________

_________________________________________________________________________________________

SEMNATURA PROFESOR LOGOPED :

NUT CORINA