Pediatric Assessment Templates

The templates included here are provided as a resource only and do not reflect ASHA policies regarding documentation or clinical practice. Templates for other clinical areas will be added as they become available. To request customizable templates in Word format, please e-mail healthservices@asha.org and indicate which templates you would like to receive.

Available Templates

Videofluoroscopic Swallowing Studies

Infants (Consuming liquids only) [PDF]
Developed by Special Interest Group 13 (Swallowing and Swallowing Disorders [Dysphagia])

Children (Consuming liquids and solids) [PDF]
Developed by Special Interest Group 13 (Swallowing and Swallowing Disorders [Dysphagia])