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FISA LOGOPEDICA GRADINITA
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DATA INTRARII IN GRADINITA: _______________________________ b4u10uo
DATA INCEPERII CORECTARII: _______________________________

I.DATE GENERALE:

Numele si prenumele____________________________data nasterii__________ domiciliul_____________str.__________________nr.___et.____ap.___tel.___________

II.ANAMNEZA FAMILIALA:
TATA_____________________varsta___________studii_________________________ locul de munca_______________________________functia_______________________
MAMA____________________varsta___________studii_________________________ locul de munca_______________________________functia_______________________
TIPUL DE FAMILIE______________________________________________________
STRUCTURA FAMILIEI_____________________________RANGUL_____________
BOLI___________________________________________________________________________________________________________________________________________________________________________________________________________________
ATITUDINEA PARINTILOR FATA DE LIMBAJUL COPIILOR__________________
________________________________________________________________________
STIMULAREA SOCIALA SI LINGVISTICA__________________________________
________________________________________________________________________

III.ANAMNEZA PERSONALA

Sarcina____________________nastere___________________apgar_____greutate_____boli____________________________________________________________________________________________________________________________________________ tratamente_______________________________________________________________ alimentatia_______________________________ridica capul_______merge sustinut____
_________merge independent_____________controlul sfincterian__________________

IV.EXAMENE MEDICALE

PEDIATRIE_____________________________________________________________
O.R.L.FONIATRIE_______________________________________________________
OFTALMOLOGIE________________________________________________________
STOMATOLOGIE________________________________________________________
NEURO-PSIHIATRIE_____________________________________________________
ENDOCRINOLOGIE______________________________________________________




V. EXAMENE PSIHOLOGICE

INTELECT______________________________________________________________
MEMORIA______________________________________________________________
ATENTIA_______________________________________________________________
AFECTIVITATEA________________________________________________________
SCHEMA CORPORALA___________________________________________________
ORGANIZAREA SPATIALA_______________________________________________
ORGANIZAREA TEMPORALA____________________________________________
LATERALITATEA:mana___________picior__________ochi_______ureche_________
COMPORTAMENTUL____________________________________________________________________________________________________________________________

VI. ALTE PARTICULARITATI

________________________________________________________________________

VII. EVOLUTIA VORBIRII

Ganguritul________lalatiunea__________primul cuvant___________prima propozitie__
______ritmul vorbirii_________limba materna___________________limba mediului inconjurator_________________________________atitudinea copilului fata de voirbire_
________________________________________________________________________

VIII. EXAMEN ANATOMO-FUNCTIONAL AL APARATULUI FONO-ARTICULAR

1.Malformatii____________________________________________________________
2.Sistemul labio-comisural__________________________________________________
3.Maxilar________________________________________________________________
4.Limba_________________________________________________________________
5.Palatul dur_____________________________________________________________
6.Palatul moale___________________________________________________________
7.Uvula_________________________________________________________________
8.Sistemul nazal__________________________________________________________
9.Deglutitia______________________________________________________________
10.Respiratia_____________________________________________________________
11.Intelegerea vorbirii interlocutorului-acuitatea auditiva__________________________
________________________________________________________________________
12.Recunoasterea si reproducerea sunetelor perechi______________________________ sunete izolate________________silabe ,cuvinte_________________________________
13.Autocontrolul auditiv_______________________confuzii______________________
________________________________________________________________________

IX. EXAMENUL VORBIRII ARTICULATE

PROFILUL LOGOPEDIC AL VOCALELOR

I.EMISE________________________________________________________________
II.NECONSOLIDATE_____________________________________________________
III.INLOCUITE__________________________________________________________
IV.OMISE_______________________________________________________________
V.DEFORMATE_________________________________________________________
VI.NEEMISE____________________________________________________________

X. EXAMENUL LIMBAJULUI

VARSTA PSIHOLOGICA A LIMBAJULUI-VPL_______________________________
VORBIREA REFLECTATA________________________________________________
VORBIREA INDEPENDENTA_____________________________________________
SUNETELE AFECTATE___________________________________________________
STRUCTURA GRAMATICALA____________________________________________

XI. DIAGNOSTIC LOGOPEDIC INITIAL____________________________
ACTUAL___________________________
FINAL_____________________________

XII. PROGNOZA__________________________________________________

XIII.OBIECTIVELE TERAPIEI LOGOPEDICE_______________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


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