The task
Assume that today's date is 20 November 2026. Toby's final session at your service is on 4 December 2026.
You are a paediatric speech pathologist at a community health service in Melbourne. Using the information in the case notes, write a letter to Ms Rebecca Alavi, Senior Paediatric Speech Pathologist, asking her to continue therapy for Toby after his family moves to Brisbane. Address the letter to Ms Rebecca Alavi, Senior Paediatric Speech Pathologist, Children's Community Health Service, 40 Wharf Street, Brisbane QLD 4000. In your answer: expand the relevant notes into complete sentences; do not use note form; use letter format. The body of the letter should be approximately 180–200 words.
Length: the body of the letter should be about 180–200 words. You have 45 minutes in the test: 5 minutes to read, 40 to write. Letter type: Referral letter.
Case notes
Patient details
- Name: Toby Javadi
- DOB: 18/09/2021 (5 yrs 2 mths)
- New address from 12/12/26: 27 Riverside Parade, Brisbane QLD
Social background
- Lives with parents and older sister (8 yrs)
- Sister: no speech or language concerns
- Family relocating to Brisbane 12/12/26 (father's job transfer)
- Due to start Prep late 01/27
- Attends kindergarten 3 days/wk; teacher reports plays well but difficulty following group instructions
- Loves dinosaurs and trains → useful for engagement in sessions
- Mother reports paternal grandmother thinks Toby is 'just lazy'
- Mother unhappy with kindergarten — says teacher 'doesn't bother' with Toby
Developmental and medical history
- Term birth, uncomplicated
- First words 20 mths; 2-word combinations approx. 3 yrs
- Audiology 04/26: hearing normal bilaterally
- Recurrent ear infections age 2 — resolved; no grommets
- Mild eczema — moisturiser BD
- Paediatrician review 05/26: motor and social development age-appropriate; no other diagnoses
Initial assessment (05/26)
- Referred by GP 04/26 following kindergarten concerns
- CELF-P3: core language score well below average; receptive and expressive language both affected, expressive > receptive
- Diagnosis: developmental language disorder (DLD)
- Speech sounds age-appropriate; intelligible to unfamiliar listeners
- Language sample: short sentences (3–4 words); omits 'is' and verb endings (-ing, -ed); pronoun errors (e.g. 'him go')
- Limited vocabulary; frequent use of 'thing' for unknown words
Therapy and progress
- Weekly 45-min individual sessions since 05/26 (approx. 24 sessions); mother attends all
- Goals: (1) 'is' + verb-ing (2) regular past tense -ed (3) he/she pronouns (4) vocabulary — describing objects by category and function
- Approaches: recasting, focused stimulation, visual sentence frames; word mapping for vocabulary
- Progress: 'is' + verb-ing approx. 80% in structured play; he/she consistent in structured tasks, emerging in conversation; past tense -ed approx. 40%
- Vocabulary: now names categories (animals, food) and describes function; uses 'thing' ↓
- Mother does home practice 10 min daily with picture books; confident using recasting
- Missed 3 sessions 08/26 — family holiday
- Therapy room air conditioning broken 10/26 — Toby distracted in 2 sessions
Plan
- Continue: past tense -ed; pronouns in conversation; introduce following multi-step instructions and narrative skills before school starts
- Formal reassessment due 05/27
- Recommend liaison with new school re classroom supports (e.g. visual instructions)
- Mother consents to sharing of reports; assessment and progress reports enclosed with referral; last session here 04/12/26
Who is reading, and what do they need?
Ms Alavi is a senior paediatric speech pathologist who will take over therapy and has not met Toby. She needs the diagnosis, language profile, goals, progress levels, approaches that worked, and what is due next, so she can continue without repeating assessment. Clinical specifics matter more than family background.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| DLD diagnosed 05/26; receptive and expressive affected, expressive > receptive | The diagnosis and profile tell the new clinician what she is treating and why. |
| Hearing normal bilaterally 04/26; paediatrician found no other diagnoses | These help rule in the DLD picture and save the receiver from repeating referrals. |
| Short 3–4 word sentences, omits 'is' and verb endings, pronoun errors, limited vocabulary | Gives the baseline language features that the goals were built on. |
| Four goals with recasting, focused stimulation, visual frames, word mapping | The receiver can continue the same approach and goals rather than starting over. |
| 'is' + verb-ing about 80%; he/she emerging in conversation; -ed about 40% | Current levels show what is achieved and what remains, supporting the next-phase plan. |
| Mother attends all sessions; daily 10-min home practice; confident with recasting | Shows parent involvement the new therapist can build on. |
| Plan: -ed, conversational pronouns, multi-step instructions, narratives; reassessment 05/27 | These are the actions the referral asks the receiver to continue and schedule. |
| Prep late 01/27; school liaison; consent; reports enclosed; last session 04/12; dinosaurs and trains | Covers school transition, the permission to share records, handover timing and engagement tips. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Grandmother thinks Toby is 'just lazy' | Family opinion unrelated to the referral request; including it adds nothing clinically and could be unfair to the family. |
| Mother unhappy with kindergarten; teacher 'doesn't bother' | A complaint, not a clinical finding. Trap: the teacher's report about group instructions is relevant, but the mother's criticism is not. |
| Missed 3 sessions in 08/26 for holiday | A resolved scheduling issue that does not affect the plan. |
| Air conditioning broken 10/26; distracted in 2 sessions | A temporary environmental event with no bearing on future therapy. |
| Eczema, term birth, sister's normal development, father's job transfer | Not relevant to continuing language therapy; compress or omit. |
A paragraph plan for this case
Start with the request and relocation timing, then give diagnosis, assessment findings and relevant history. Next give therapy goals, approaches and current progress, then the plan, school liaison, consent and enclosures.
Where candidates slip on this task
- Do not blur the dates: today is 20 November, the last session is 4 December, and the move is 12 December. Present the last session as upcoming, not completed.
- State reassessment as due in May 2027 and school start as late January 2027; do not invent specific scores for CELF-P3, since none are given.
- Include the teacher's difficulty-with-group-instructions report only as a school-based observation to justify the multi-step instruction goal and classroom supports, not as criticism of the kindergarten.
No model letter is published here. Write for the named reader from the case notes in the timed editor, then get it marked.
Write it in the timed editor and get marked on the 6 criteria
More Speech Pathology letter tasks
- Vocal nodules: referral for voice therapy closer to home referral letter
- Silent aspiration on swallow study: update on fluid and medication changes update letter
- Motor neurone disease: progressive dysarthria and dysphagia update letter
Your profession's guide: OET Speech Pathology. Layout and structure: OET letter format.
Questions about this task
Should the family's views about Toby appear?
No. The grandmother's comment and the mother's complaint about kindergarten are opinions, not clinical data. The receiver needs findings, goals, progress and plan; the mother's active involvement in therapy is the only family detail that matters.
How should I present progress figures?
Give them as the notes state, with approximate values for 'is' + verb-ing and -ed, and the qualitative status for he/she. Do not convert them into claims such as mastery or add percentages not given.
Sources
Last checked 22 Oct 2026. Rules and prices change: confirm on the official page before you book or apply.
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