Table 1.

Initial Case Assessments

Assessment parameter	Case 1: “Ellen”	Case 2: “Sarah”	Case 3: “Karen”
Neuro/cognition	Somewhat impaired, cognitively intact with limited sustained attention	Fluctuating, from alert, anxious, cognition intact to somnolent, requiring maximal tactile/auditory stimulation to attend	Intact, alert and oriented, cognition fully intact
Oral-motor	Nonfunctional, few attempts to mouth words, poor articulation, unintelligible	Moderately functional, few attempts to mouth words, imprecise articulation	Functional, but minimal attempts to mouth words
Upper extremities	Compromised, left hemiparesis and left neglect, moderately limited right upper arm control, unable to write	Moderately compromised, deconditioned, tremulous, elbow support needed for pointing, difficulty grasping writing instrument, poor legibility	Functional, gross/fine motor skills intact; able to write, type, point
Head control	Adequate, but head-nods unclear at times	Adequate, but head-nods unclear at times	Intact, clear, consistent head-nods
Sensory	Intact	Sight compromised, glasses available but ill-fitting (able to read 24 pt font with glasses on)	Sight compromised, unimpaired when glasses on
Breath support for phonation/speaking valve trials	Initially poor phonation with speaking valve, overall intelligibility <25% in conversation	N/A—No speaking valve trials due to deconditioning and medical acuity	Vocal quality poor: 2/10
Language/literacy	English/literate	English/literate	English/literate
Primary communication method/preference before SLP intervention	Gestures—unclear and imprecise, often misinterpreted	None noted—spiral notebook was tied to bedrail, but out of patient's reach	Writing—notebook filled with patient's writing at bedside; legible
Communication needs	Immediate medical needs, meaning of gestures	Immediate medical needs, requests for family	Novel messages