You do not have JavaScript Enabled on this browser. Please enable it in order to use the full functionality of our website.

Pediatric Documentation Templates

The templates included here are provided as a resource only and do not represent ASHA policy. To request customizable templates in Word format, please e-mail [email protected] and indicate which templates you would like to receive. These templates were developed by a work group of affiliates from Special Interest Group 13 (Swallowing and Swallowing Disorders [Dysphagia]).

Available Templates

Feeding History and Clinical Assessments

User's Guide to Pediatric Clinical Feeding Assessment Templates [PDF]

Pediatric Clinical Assessment Template (Liquids only) [PDF]

Pediatric Clinical Assessment Template (Liquids, semi-solid and solid foods) [PDF]

Speech and Language Assessments

Pediatric Stuttering Assessment Template [PDF]

Videofluoroscopic Swallowing Studies

Infants (Consuming liquids only) [PDF]

Children (Consuming liquids and solids) [PDF]

ASHA Corporate Partners