10. Case Studies

Student Information

Name: Max
Age: 14
Grade: 8th
Diagnosis: Max has a medical diagnosis of dysarthria, a speech disorder caused by muscular problems which make it difficult to articulate thoughts and ideas verbally and can sometimes cause difficulties with breathing (American Speech-Language-Hearing Association, n.d.). Max is eligible for special education services under the category Other Health Impairment. He receives Speech-Language services as a related service. Max struggles with forming sentences and expressing himself clearly in conversation and written communication.

Max is highly motivated to communicate and wants to actively participate in classroom discussions.
He has a solidly average IQ score (Standard Score = 103), demonstrating age-expected cognitive abilities on all tasks that do not require verbal communication.
Max has average language comprehension skills.
He utilizes age and grade expected vocabulary in written assignments, though the medical condition that contributes to his dysarthria, also results in fine motor fatigue. His handwriting becomes increasingly illegible as he becomes tired.
Max has a supportive group of friends inside and outside of the classroom.
Max requires assistance with expressing himself verbally.
He struggles with initiating and maintaining conversations in all environments.
Max needs tools that can help him communicate effectively to express his thoughts and feelings.

Max attends middle school where he receives support from a speech therapist and special education teacher in the general education classrooms.
Adults in the environment are generally supportive, actively including Max in group discussions by providing additional wait time after asking him a question. In some cases, teachers give Max advanced notice of questions or topics so he has additional time to prepare his thoughts.
Max experiences the most frustration with communication in his English/Language Arts and History classes, which frequently use Socratic Seminars. Although Math can also be frustrating, the class is more lecture based and there are far fewer expectations of spontaneous verbal responses.
Max feels self-conscious about his communication difficulties, particularly in social situations or when presenting in front of the class.
Max socializes with peers of the same age/grade in class, during class transitions, at lunch, and during extra-curricular activities including basketball and photography club.

The English Standards of Learning require oral presentations in eighth grade in addition to participation in group discussions. Specific expectations include:
- Giving formal and informal multimodal presentations individually or as part of a group.
- Using effective verbal and nonverbal communication skills to deliver multimodal presentations.
- Using language and vocabulary aligned with audience, topic, and purpose.
Max needs to efficiently and clearly express his wants and needs (e.g., order lunch, request a pain reliever for a headache, etc.), as well as request help in both academic and non-academic contexts in school and the community,
Max requires support in initiating and maintaining conversations in social interactions, as well as academic contexts.

Augmentative and Alternative Communication (AAC) Devices:
- Speech-generating devices (SGDs): These devices can help Max communicate by generating spoken language from text or symbols.
- Picture communication boards: Visual aids with images representing words or phrases can assist Max in expressing himself when verbal communication is challenging.