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Speech Pathology

Read the following information.

Free OET Writing Sample Test with Answer Subtest Speech Pathology #9

Task: Child with Severe Language Delay

Case Notes:

  • Patient: Master Ethan Wright, 4 yrs

  • Referral Source: Pediatrician

  • Presenting Concerns:

    • Limited expressive vocabulary (?50 words), mostly nouns, very few verbs or functional words

    • Minimal use of two-word phrases, rarely attempts sentences

    • Difficulty following multi-step instructions, struggles to answer “why” or “how” questions

    • Frustration during play ? frequent tantrums, withdrawal from peers

    • Limited imaginative play and reduced symbolic play skills

  • Developmental History: Full-term birth, no perinatal complications, typical gross and fine motor milestones

  • Medical History: No hearing loss, normal vision, no neurological disorders

  • Family History: Older sibling had a mild speech delay (resolved by age 5)

  • Social: Attends preschool, teacher reports low participation in group activities, avoids speaking in front of peers

  • Examination: Oral motor structures intact, age-appropriate motor skills

  • Referral Request: Full speech and language assessment, intervention plan for expressive and receptive language, parental guidance

To: Speech Pathology Department

Dear Speech Pathologist,

I am referring Master Ethan Wright, a 4-year-old boy, for a comprehensive assessment and management of suspected expressive and receptive language delays.

Ethan’s parents and preschool teacher report significant difficulties with verbal expression. He uses approximately 50 words, primarily nouns, and rarely combines words into phrases or sentences. He struggles to follow instructions that involve more than one step and has difficulty answering questions that require an explanation of “why” or “how.” Observations during play show frustration, frequent tantrums, and withdrawal from peer interaction. His symbolic and imaginative play skills appear to be limited, which impacts his social and cognitive engagement.

His birth and developmental history are unremarkable. An oral motor examination is routine, and there are no concerns regarding hearing or neurological function. Family history is notable for an older sibling with an intellectual disability, which resolved naturally. Teachers note that Ethan participates minimally in group activities and rarely speaks spontaneously at preschool.

We would appreciate a detailed assessment of his receptive and expressive language abilities, as well as recommendations for targeted therapy and strategies for home and school support. Parental education and guidance on daily language stimulation activities will also be beneficial in facilitating progress in communication and social skills.

Thank you for your evaluation and management of Ethan’s needs.

Yours sincerely,
Paediatrician

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