FI DE EXAMINARE LOGOPEDIC

Nr. fiei_______________
Datele examinatorului____________

Numele examinatorului________

I. DATE GENERALE
1.1 Personale
Numele de familie_________________prenumele_______________________________
nscut n anul__________luna_______ziua_____domiciliul_______________________
instituia________________________________________________________________
1.2. Familiale
numele prinilor
naionalitatea
vrsta
studii ocupaia locul de munc
tata _________
___________ _____
_____ ______
____________
mama________
___________ _____
_____ ______
____________
1.3. Motivul examinrii
Trimis de ____________________________________________________________
Cu ce acuze este trimis__________________________________________________
II. ANAMNEZA
2.1. Familial
Structura familiei_________________________________________________________
Al ctelea copil este______starea de sntate a membrilor familiei__________________
Persoane cu tulburri de limbaj n familie______________________________________
Relaiile n familie : a. ntre prini____________________________________________
b. fa de copil____________________________________________________________
c. atitudinea fa de defectul de pronunie al copilului_____________________________
Dac sunt stngaci sau ambidextri n familie____________________________________
Condiiile materiale, igenice, educative ale familiei_______________________________
2.2. Personal
Sarcina__________________________________________________________________
Naterea : la termen_____________la _____luni;greutatea_________________________
Tulburri psihice__________________________________________________________
2.3.Date asupra auzului i limbajului
Gnguritul_______________________________________________________________
Evoluia vorbirii lalaiunea
4
6
8
10
1
pimul cuvnt
8
10
12
14
1
prima propoziie 14
16
18
20
2
Ritmul vorbirii___________________________________________________________
Limba matern i cea a mediului nconjurtor___________________________________
_______________________________________________________________________
_
nelegera vorbirii persoanelor din jur_________________________________________
_______________________________________________________________________
_

nsuirea unei limbi strine__________________________________________________

nsuirea scrierii i a citirii__________________________________________________
Cnd a aprut tulburarea de limbaj____________________________________________
Cauza real sau presupus__________________________________________________
Dac a beneficiat de tratament logopedic_______________________________________
_______________________________________________________________________
_
III.EXAMENUL SOMATIC I FUNCIONAL
3.1.Aspectul somatic
Conformaia capului_______________________________________________________
_______________________________________________________________________
_______________________________________________________________________
__
Mecanisme periferice ale vorbirii_____________________________________________
Cavitatea bucal_________________vlul palatin_______________________________
______________________limba_____________________________________________
buzele_________________maxilarele_________________________________________
dantura__________________________________________________________________
3.2.Motricitatea
Mersul__________________________________________________________________
Coordonarea general a micrilor____________________________________________
Lateralitatea______________________________________________________________
Motricitatea limbii________________________________________________________
Motricitatea mimico-facial_________________________________________________
Motricitatea buzelor_______________________________________________________
Motricitatea vlului palatin_________________________________________________
Ritmul acustico-motor_____________________________________________________
3.3.Respiraia
Diferenierea dintre respiraia oral i cea nazal_________________________________
Tipul de respiraie_________________________________________________________
3.4.Funcia auditiv
Atenia auditiv___________________________________________________________
Memoria auditiv_________________________________________________________
Capacitatea de difereniere fonematic_________________________________________
Auzul muzical____________________________________________________________
3.5.Funcia fonatorie
Intensitatea vocii__________________________________________________________
Calitatea vocii____________________________________________________________
Mutaia vocii_____________________________________________________________
IV.LIMBAJUL ORAL I SCRIS
4.1.Pronunia sunetelor i a cuvintelor
Reproducerea fonemelor pe baz de auz_______________________________________
Reproducerea fonemelor pe baz de citire______________________________________

Micri articulatorii defectuoase______________________________________________

Micri asociate__________________________________________________________
Omisiuni de sunete________________________________________________________
Confundarea sunetelor_____________________________________________________
Estomparea terminaiei cuvintelor____________________________________________
4.2.Ritmul i fluena vorbirii
Fluena__________________________________________________________________
Ritmul vorbirii___________________________________________________________
Poticniri la sunete_______________________silabe_____________________________
_____cuvinte_____________________________________________________________
Repetri de sunete______________________silabe______________________________
_____cuvinte_____________________________________________________________
Spasme articulatorii i muchii afectai________________________________________
Calitateavorbirii:independent_______________________________________________
reflectat________________________________________________________________
Calitatea citirii:independente:________________________________________________
reflectat_____________________________________________________________
Diverse fobii_____________________________________________________________
Micri concomitente______________________________________________________
Vorbirea n diferite situaii__________________________________________________
Blbiala n cnt i la instrumente____________________________________________
Blbiala n scris__________________________________________________________
4.3.Scrierea i citirea
Copiere_________________________________________________________________
Dictare__________________________________________________________________
Compunere______________________________________________________________
Structura grafic__________________________________________________________
Structura logic___________________________________________________________
Citire___________________________________________________________________
V. DIAGNOSTICUL TULBURRILOR DE LIMBAJ
5.1.Caracterizarea limbajului i a persoanei examinate
Vorbirea________________________________________________________________
Scrisul__________________________________________________________________
Cititul__________________________________________________________________
Succesul colar___________________________________________________________
Conduita________________________________________________________________
5.2.Cauzele i diagnosticul
Cauze presupuse__________________________________________________________
Cauze confirmate_________________________________________________________
Diagnosticul iniial________________________________________________________
Evoluia diagnosticului_____________________________________________________
Diagnosticul final_________________________________________________________

LUNA
Octombrie
Noiembrie
Decembrie
Ianuarie
Februarie
Martie
Aprilie
Mai

IV. Evidena frecvenei la leciile logopedice

ZIUA

IV.Observaii asaupra desfurrii procesului de corectaremetodele,procedeele,exerciiile folosite n diferite faze ale corectrii,rezultatele
pariale,materialul intuitiv,auxiliar folosit,impediomentele corectrii,ajutorul primit
din partea prinilor,medicilor de specialitate,cadrelor didactice:recidive sau
greuti survenite n timpul tratamentului logopedic.