Table 1.

Functional outcome measures.

Functional level	Auditory	Expressive language	Receptive language
1	The child does not respond to sound, neither environmental sounds nor spoken language.	The child attempts to speak, but vocalizations are not meaningful to familiar or unfamiliar communication partners at any time.	The child is alert but unable to follow simple directions or respond to yes/no questions, even with prompts.
2	The child has developed an awareness of sound used within a close proximity.	The child attempts to speak, although few attempts are accurate or appropriate. The communication partner must assume responsibility for structuring the communication exchange and, with consistent and maximal prompting, the child can only occasionally produce automatic and/or imitative words and phrases, which are rarely meaningful in context.	With consistent cues and prompts, the child is able to follow simple verbal directions, respond to simple yes/no questions in context, and respond to simple words or phrases related to the child's needs.
3	The child demonstrates consistent discrimination of prosodic and suprasegmental aspects of spoken language during informal and formal learning interactions within educational, vocational, and social situations.	The communication partner must assume responsibility for structuring the communication exchange. With consistent and moderate prompting, the child can produce words and phrases that are appropriate and meaningful in context.	The child usually responds accurately to simple yes/no questions. The child is able to follow verbal simple directions out of context with prompting. Accurate comprehension of more complex verbal directions is minimal.
4	The child demonstrates inconsistent closed-set word and short phrases identification during informal and formal interactions within educational, vocational, and social situations.	The child is successfully able to initiate communication using spoken language in simple, structured conversations in routine daily activities with familiar communication partners. The child usually requires moderate prompting but is able to demonstrate simple sentences.	The child consistently responds accurately to yes/no questions and occasionally follows simple directions without prompts. Moderate verbal contextual support is needed to understand complex verbal sentences. The child is able to understand limited conversations about routine daily activities with familiar communication partners through audition.
5	The child is successfully able to identify words varying in vowel and consonant content during informal and formal interactions within educational, vocational, and social situations.	The child is successfully able to initiate communication using spoken language in structured conversations with both familiar and unfamiliar communication partners. The child occasionally requires minimal prompting to frame more complex sentences in messages.	The child is able to understand spoken communication in structured conversations with both familiar and unfamiliar communication partners. The child occasionally requires minimal prompting to understand more complex sentences. The child occasionally initiates the use of compensatory strategies when encountering difficulty.
6	The child is successfully able to follow conversations of an undisclosed topic during informal and formal interactions within educational, vocational, and social situations.	The child is successfully able to communicate in most activities, but some limitations in spoken language are still apparent in educational, vocational, or social activities. The child rarely requires minimal prompting to frame complex sentences.	The child is able to understand verbal communication in most activities, but some limitations in comprehension are still apparent in educational, vocational, or social activities. The child rarely requires minimal prompting to understand complex sentences. The child usually uses compensatory strategies when encountering difficulty.
7	The child is successfully able to process information while listening with competing stimuli during informal and formal interactions within educational, vocational, and social situations.	The child is able to successfully and independently participate in educational, vocational, and social activities, which are not limited by spoken language skills.	The child is able to independently participate in educational, vocational, and social activities, which are not limited by spoken language comprehension. When difficulty with comprehension occurs, the child consistently uses a compensatory strategy.