Patient Name: Angel

Patient Information:

Patient ID: 9972
Patient First Name: Angel
Patient Date of Birth: 01-31-2019
Gender: male
Assigned Office: NB1 east side
Primary Care Physician: Jose, Prieto
Patient Status: Active

Primary Attendance / Assigned Therapists:

ST - Speech Therapy:
FD - Feeding Therapy:
OT - Occupational Therapy:
PT - Physical Therapy:

Patient Primary Authorizations:

Auth. IDStatusStart DateEnd DateInsuranceST-UnitsFD-UnitsOT-UnitsPT-Units

Speech and Language Evaluation:

IDDateTypeEvaluation Diagnosis
2638302-25-2026Speech Initial EvaluationF84.0, F80.2
Speech Background History: Angel is a 7-year-old male referred for a speech and language evaluation due to concerns regarding expressive language development and difficulty engaging in reciprocal conversation. Per parent report, pregnancy and birth were complicated by a hemorrhage during delivery, and Angel required oxygen support at birth due to low blood sugar levels. Angel has been diagnosed with Autism Spectrum Disorder (Level 1) and Attention-Deficit/Hyperactivity Disorder (ADHD). Developmentally, mother reported that gross motor milestones such as walking and crawling were achieved within expected timeframes; however, communication skills emerged later than expected. Angel continues to demonstrate delays in language development and functional communication. Parent also reported that Angel is currently still being potty trained, which has impacted participation in school settings. Angel previously attended school but was withdrawn due to difficulties related to toileting and behavioral regulation. Family circumstances included a temporary relocation to Ciudad Juárez, which may have impacted access to consistent services. Mother reported that Angel has also been recommended for feeding therapy due to sensory-related feeding challenges. Socially, Angel attempts to interact with peers but has difficulty establishing and maintaining friendships. Primary parental concerns include limited conversational skills, difficulty initiating and maintaining back-and-forth communication, and challenges with expressive language during social interactions.
Speech Medical History:
Speech Medications:
Speech Behavioral Observations:
Speech Communication Strengths: Easily separated from Parents, Interactive, Responds to greetings,
Speech Communication Weaknesses: Delayed echolalia, Diminished vocabulary, Poor vocabulary, Unable to follow commands,
Speech Background Summary:
Speech Diagnosis/Impressions: Based on standardized assessment results, clinical observation, and parent report, Angel presents with a severe mixed receptive-expressive language disorder. Standardized scores fall in the 1st percentile, indicating language abilities significantly below those expected for his age. Angel demonstrates difficulty understanding higher-level language concepts including descriptive language, spatial concepts, inferencing, and negative sentence structures. Expressively, Angel demonstrates limited spontaneous language generation and relies heavily on echolalic or scripted language forms consistent with characteristics of Gestalt Language Processing. While these language patterns serve communicative intent, they limit Angel’s ability to generate flexible and functional language needed for conversation, academic learning, and social participation. Angel also demonstrated difficulty sustaining attention to structured language tasks and required frequent redirection during the evaluation, which further impacts his ability to process and respond to spoken language. Parent report indicates ongoing difficulty with conversational engagement and reciprocal communication, which affects his ability to develop peer relationships and participate successfully in social interactions. Due to the severity of Angel’s receptive and expressive language deficits, skilled speech-language therapy is medically necessary to address foundational language comprehension, support development of flexible language generation, and improve conversational communication skills. Without intervention, Angel remains at risk for continued language delays, reduced academic participation, difficulty establishing and maintaining peer relationships, and ongoing communication barriers across environments
Speech Diagnosis/Impressions: Based on standardized assessment results, clinical observation, and parent report, Angel presents with a severe mixed receptive-expressive language disorder. Standardized scores fall in the 1st percentile, indicating language abilities significantly below those expected for his age. Angel demonstrates difficulty understanding higher-level language concepts including descriptive language, spatial concepts, inferencing, and negative sentence structures. Expressively, Angel demonstrates limited spontaneous language generation and relies heavily on echolalic or scripted language forms consistent with characteristics of Gestalt Language Processing. While these language patterns serve communicative intent, they limit Angel’s ability to generate flexible and functional language needed for conversation, academic learning, and social participation. Angel also demonstrated difficulty sustaining attention to structured language tasks and required frequent redirection during the evaluation, which further impacts his ability to process and respond to spoken language. Parent report indicates ongoing difficulty with conversational engagement and reciprocal communication, which affects his ability to develop peer relationships and participate successfully in social interactions. Due to the severity of Angel’s receptive and expressive language deficits, skilled speech-language therapy is medically necessary to address foundational language comprehension, support development of flexible language generation, and improve conversational communication skills. Without intervention, Angel remains at risk for continued language delays, reduced academic participation, difficulty establishing and maintaining peer relationships, and ongoing communication barriers across environments
Speech Recommendations: Speech Therapy: 2 time(s) a Week for 30 to 45 minute sessions

Speech and Language Plan of Care:

IDPlan of Care
58754
Plan Date: 02-25-2026
Speech Assessment Summary: Based on standardized assessment results, clinical observation, and parent report, Angel presents with a severe mixed receptive-expressive language disorder. Standardized scores fall in the 1st percentile, indicating language abilities significantly below those expected for his age. Angel demonstrates difficulty understanding higher-level language concepts including descriptive language, spatial concepts, inferencing, and negative sentence structures. Expressively, Angel demonstrates limited spontaneous language generation and relies heavily on echolalic or scripted language forms consistent with characteristics of Gestalt Language Processing. While these language patterns serve communicative intent, they limit Angel’s ability to generate flexible and functional language needed for conversation, academic learning, and social participation. Angel also demonstrated difficulty sustaining attention to structured language tasks and required frequent redirection during the evaluation, which further impacts his ability to process and respond to spoken language. Parent report indicates ongoing difficulty with conversational engagement and reciprocal communication, which affects his ability to develop peer relationships and participate successfully in social interactions. Due to the severity of Angel’s receptive and expressive language deficits, skilled speech-language therapy is medically necessary to address foundational language comprehension, support development of flexible language generation, and improve conversational communication skills. Without intervention, Angel remains at risk for continued language delays, reduced academic participation, difficulty establishing and maintaining peer relationships, and ongoing communication barriers across environments
Speech Rehabilitation Potential: Good. with consistent Speech Therapy and parental support
Speech and Language Long Term Goals:
CategoryGoal Description
Home Management Intervention ProgramWhen counseled by the clinician, parents will incorporate the home management intervention program as a daily and weekly activity to transfer skills learned in therapy into the home environment. Home management training will optimize patients functional communication tasks in the home.
Receptive LanguageWithin 12 months, Angel will improve receptive language skills in order to understand age-appropriate directions, questions, and language concepts during functional communication tasks.
Expressive LanguageWithin 12 months, Angel will improve expressive language skills by increasing flexible language use and reducing reliance on scripted language to communicate wants, needs, and ideas.
Speech and Language Short Term Goals:
CategoryGoal Description
Expressive LanguageWithin 6 months, Angel will produce novel 3–4 word utterances to comment, request, or describe during structured tasks with 60% accuracy across three consecutive sessions.
Expressive LanguageWithin 6 months, Angel will answer simple questions verbally during structured communication tasks with 60% accuracy across three consecutive sessions.
Play/SocializationWithin 6 months, Angel will maintain attention to structured communication tasks for at least 5 minutes in 3 out of 5 trials with minimal redirection across three consecutive sessions
Receptive LanguageWithin 6 months, Angel will demonstrate understanding of descriptive concepts (e.g., big/small, hot/cold, clean/dirty) with 60% accuracy across three consecutive therapy sessions
Receptive LanguageWithin 6 months, Angel will demonstrate understanding of spatial concepts (e.g., in, on, under, next to) with 60% accuracy across three consecutive therapy sessions.
Play/SocializationWithin 6 months, Angel will participate in back-and-forth conversational exchanges for at least 3 conversational turns in 3 out of 5 opportunities with minimal cues.

Completed Appointments:

IDPlan of Care
Appt-IDServiceStart-DateEnd-DateTherapistLocationStatus
89291292523: Artic & Language Eval02-25-2026 01:30 PM02-25-2026 02:15 PMStephanie EscobarNB1 east sideCompleted

Paient Notes:

DatePosted ByDescription
03-26-2026Shekinah Velasquezreceived signatures, missing THsteps. faxed request to PCP.
03-18-2026Shekinah VelasquezST paperwork sent to PCP via fax. Pending signatures & THsteps.

Paient Messages Admin:

DatePosted ByMessage
02-12-2026 04:26 PMJulie MoraPlease fillout the form https://patient.newbeginnings-elp.com/Registration/default.aspx?sid=2632
02-13-2026 02:29 PMJulie MoraPatient Registration: When you are ready to pick up where you left off, click this link https://patient.newbeginnings-elp.com/Registration/step2.aspx?sid=2632
02-13-2026 02:37 PMShekinah VelasquezÁngel has been added to our Speech & Language Therapy wait list. To send us a message at any time, just respond here. To check the status of the wait list, click this link https://patient.newbeginnings-elp.com/Schedule/waitlist_status.aspx?pid=9972&type=1&wid=568
02-13-2026 02:37 PMShekinah VelasquezÁngel has been added to our Feeding Therapy wait list. To send us a message at any time, just respond here. To check the status of the wait list, click this link https://patient.newbeginnings-elp.com/Schedule/waitlist_status.aspx?pid=9972&type=2&wid=569
02-13-2026 02:38 PMShekinah VelasquezÁngel has been added to our Occupational Therapy wait list. To send us a message at any time, just respond here. To check the status of the wait list, click this link https://patient.newbeginnings-elp.com/Schedule/waitlist_status.aspx?pid=9972&type=3&wid=570
02-13-2026 02:38 PMShekinah VelasquezÁngel has been added to our Physical Therapy wait list. To send us a message at any time, just respond here. To check the status of the wait list, click this link https://patient.newbeginnings-elp.com/Schedule/waitlist_status.aspx?pid=9972&type=4&wid=571
02-17-2026 11:58 AMJulie MoraJulie DELETED Patient from Feeding Services
02-17-2026 11:58 AMJulie MoraJulie DELETED Patient from Physical Services
02-18-2026 02:24 PMJulie MoraJulie DELETED Patient from Physical Wait List
02-19-2026 05:14 PMJulie MoraJulie DELETED Patient from Feeding Wait List
03-09-2026 07:23 PMStephen TulliusPlease join us for the next New Beginnings free Parent Training: Sensory Play. In this session learn how to create safe, engaging sensory experiences that help hypersensitive children regulate their responses to touch, sound, and movement. Register here: https://patient.newbeginnings-elp.com/trainings/default.aspx?id=20&pid=9972
03-11-2026 05:41 PMStephen TulliusHello, for anybody who would like to attend our Sensory Play parent training today but can't, we will be attempting a webinar version. You can register to see it online at https://webinar.getresponse.com/JvvC9/sensory-play/

Paient Messages Therapist:

DatePosted ByMessage
02-24-2026 10:18 AMStephanie EscobarHello I am Stephanie Escobar the SLP who will be working with Angel. The front office notified me you guys need a different time for tomorrow. The earliest time I have available tomorrow is 1:30, would that work for you guys? :)
02-24-2026 10:20 AMÁngel CastanedaÁngel (Prim) Replied: Buenos días Stephanie, cuánto duraría la cita? Tengo una cita prenatal a las 3:30 con mi doctora
02-24-2026 10:35 AMStephanie EscobarDe 30-45 minutos so terminaos para las 2:10-2:15?
02-24-2026 10:36 AMÁngel CastanedaÁngel (Prim) Replied: Okay si está muy bien ☺️
02-24-2026 11:03 AMStephanie Escobarokay nos vemos manana gracias! si me puede responder con estas pregunatas 1️⃣ ¿Hubo alguna complicación durante el embarazo o el parto?
2️⃣ ¿Ha tenido enfermedades importantes o accidentes desde su último chequeo? ¿Tiene algún diagnóstico médico (por ejemplo: autismo, TDAH, síndrome de Down, etc.)?
3️⃣ ¿Los hitos del desarrollo se alcanzaron dentro de lo esperado o hubo retrasos?
4️⃣ ¿Tiene problemas para dormir o respirar?

¿Duerme entre 8–10 horas?

¿Se despierta varias veces durante la noche?

¿Ronca?

¿Duerme con la boca abierta o cerrada?

5️⃣ ¿Toma algún medicamento actualmente?
6️⃣ ¿Asiste a la escuela, guardería o preescolar?
7️⃣ ¿Tiene problemas de visión o audición?
8️⃣ En pocas palabras, ¿cuáles son sus preocupaciones principales sobre el habla y lenguaje de Angel? También, ¿cuáles considera que son sus fortalezas?
9️⃣ ¿Cuándo comenzaron estas preocupaciones?
🔟 ¿Tiene historial de terapias previas (habla, terapia ocupacional, terapia física, consejería, etc.)?

Muchas gracias por su tiempo. Quedo atenta a su respuesta.
02-24-2026 11:24 AMÁngel CastanedaÁngel (Prim) Replied: •si
Tuve hemorragia, ángel no tenía azúcar en la sangre y le faltaba oxígeno
•no
Autismo etapa 1 y TDAH
•hubo retraso del habla, no sabe limpiarse en el baño, no sabe bañarse, no le gusta comer verduras, frutas, carnes, sólo come sopa
•unas veces duerme más rápido q otros días, y otras veces no puede dormir
•si
•2 beses máximo para ir al baño solamente
•aveces
•boca abierta
•no
•no, acabamos de agarrar una casa en el paso Tx y apenas voy a inscribirlo en la escuela
•no
•me preocupa que no me puede contar sus cosas, no me sabe decir si alguien le hace algo o si se golpeó, pero si viene y me dice q alguien le pegó pero no sabe decirme cómo
• desde que tenía 1 año
• si, ahí con ustedes estuvo teniendo terapias de lo mismo que le van a dar ahora pero lo saqué por q en la escuela en la que iba se las ofrecieron
02-24-2026 02:20 PMStephanie Escobarmuchas gracias!!
02-24-2026 02:29 PMÁngel CastanedaÁngel (Prim) Replied: A usted ☺️
02-24-2026 06:30 PMStephanie EscobarHola, esto es solo un recordatorio de que Ángel tiene una cita programada para una evaluación de terapia de habla y lenguaje manana a las 01:30 PM. Nos vemos pronto! - New Beginnings 🙂
02-24-2026 06:31 PMÁngel CastanedaÁngel (Prim) Replied: Si gracias ☺️
02-25-2026 07:56 AMStephanie EscobarHola, esto es solo un recordatorio de que Ángel tiene una cita programada para una evaluación de terapia de habla y lenguaje hoy a las 01:30 PM. Nos vemos pronto! - New Beginnings 🙂
02-25-2026 08:02 AMÁngel CastanedaÁngel (Prim) Replied: Si gracias ☺️
02-25-2026 01:15 PMStephanie EscobarÁngel Castaneda : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=892912