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Speech/Language Assessment > Ch 5 - Quiz 3 > Flashcards

Ch 5 - Quiz 3 Flashcards

(60 cards)

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1
Q

8 common assessment methods

A
  1. Oral-facial exam
  2. DDK syllable rate/alternating speech movements
  3. Speech and language sampling
  4. Reading passages
  5. Evaluating rate of speech
  6. Determining intelligibility
  7. Syllable-by syllable stimulus phrases
  8. Chartin
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2
Q

Purpose of oral facial examination

A

Identifies or rules out structural or functional factors
Observe state of sensory/motor functions of cranial nerves
Note if variations in structure and function not related to speech or swallowing

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3
Q

Tools needed for oral facial exam

A

At minimum:
Disposable gloves
Stopwatch
Small flashlight
Tongue depressor
Additional:
Bite block
Cotton gauze
Toothette
Mirror
If use food get parental permission

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4
Q

Universal precautions (UP) when conducting oral facial exam

A
  1. Sterilize all equipment used in mouth
  2. Wash hands before and after contact
  3. Wear gloves
  4. Remove gloves inside out
  5. Wash hands after removing gloves
  6. Wear eye and mouth protection if applicable
  7. Gown and shoe coverings, if applicable
  8. Change clothes if get body fluid
  9. Never use single-use equipment more than once
  10. Follow infection control policies for facility
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5
Q

What is abnormal color of tongue, palate or pharynx?

A

Gray - muscular paresis/paralysis
Blue - excessive vascularity/bleeding
White - border of palate means there is a submucosal cleft
Dark/translucent on hard palate - palatal fistula or cleft
Dark spots - oral cancer

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6
Q

Abnormal height or width of palatal arch

A

Wide or high - may have difficulty with palatal/lingual sounds
Low/narrow with large tongue - consonant disturbances

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7
Q

What does asymmetry of face or palate mean in Oral/facial exam

A

May have neurological problems or muscle weakness
May exhibit aphasia, dysarthria, or both

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8
Q

What does deviation of tongue or uvula imply?

A

Implies neurological problems
Tongue deviates to weaker side b/c it cannot match extension of stronger side
During phonation uvula may deviate to stronger side

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9
Q

What if client has enlarged tonsils on OFE

A

May have problem with resonance, hearing, abnormal artic (From forward carriage of tongue)

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10
Q

What can result if client is missing teeth?

A

Problems with articulation

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11
Q

What if client has mouth breathing?

A

May have congestion/restricted passageway to nasal cavity if persists and
Hypo nasal speech refer to ENT
May have anterior posturing of tongue at rest

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12
Q

What does poor intraoral pressure mean?

A

Indicate labial weakness (poor maintenance of air in cheeks)
velopharyngeal insufficiency (structural problem) - nasal emission
Velopharyngeal incompetence (functional problem) - nasal emission
May have dysarthria, hypernasality or both

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13
Q

What if client has prominent palatal rugae?

A

Associated with tongue thrust
Abnormally narrow or low palate or both

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14
Q

What if client has short lingual frenum?

A

Can prevent client from placing tongue on alveolar ridge or teeth
Interfere with sound productions:
/s/, /z/, /t/, /d/, /n/, /l/, /ch/, /j/, /sh/
Reference to physician if needs clipped
Articulation disorder

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15
Q

What if client has weak, asymmetrical or absent gag reflex

A

MAY indicate muscular weakness of velopharyngeal area
Possible neurological deficits BUT
Some people do not have gag reflex

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16
Q

What if client has weakness of lips, tongue or jaw?

A

Common with neurological impairment
May have aphasia, dysarthria, or both

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17
Q

What is the purpose of DDK syllable rates?

A

Evaluate client’s ability to make rapid, alternating speech movements

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18
Q

Another name for DDK?

A

Alternating or sequential motion rate

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19
Q

What does DDK provide?

A

Info related to client’s motor and speech planning ability
Measures:
Ability to sequence same and different syllables
Accuracy of productions, fluency, rhythm, voicing, rate, coordination of respiration, phonation and articulation

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20
Q

Ways to measure DDK

A

Count number of syllable repetition a client produces in predetermined number of seconds
How many seconds does it take to produce a number of syllables

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21
Q

What words can be used for children for DDK

A

Buttercup and patty cake

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22
Q

Purpose of speech and language sampling

A

Assess client’s speech and language skills in a narrative or conversational content

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23
Q

What can be assessed with speech language sampling?

A
  1. Identify sound errors in connected speech
  2. Compare sound errors from articulation test to errors in connected speech
  3. Determine intelligibility
  4. Assess imitation
  5. Evaluate rate of speech
  6. Determine MLU
  7. Assess comprehension
  8. Assess semantic, syntactic, morphological skills and linguistic complexity
  9. Assess narrative skills
  10. Assess voice quality/resonance
  11. Assess pragmatic skills
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24
Q

How many words needed for speech language sample?

A

Minimum of 50-100 utterances.
200 or more for better data set

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25
Recommendation while collecting speech language sample
1. Establish positive relationship BEFORE 2. Be unobtrusive; minimize interruptions and distractions 3. Wait for client to talk 4. Preselect material and topics that are interesting to client 5. Vary subject matter 6. Do in multiple environments 7. Alter contexts 8. Use good quality digital recorder. Video if possible 9. If can’t record, get from someone else 10. Ask questions to elicit lengthier response 11. Avoid yes/no questions 12. Contribut to convo 13. Consider age, culture
26
How to collect speech language sample
Conversation starters, pictures, and narrative eliciting material
27
Use 2 or more to get varied data for speech language sample
Conversation Narrative retell or generation Expository writing Younger children: activities, objects, or toys
28
Pictures and speech language samples
Use known context Pictures that illustrate a variety of actions Use pictures to transition to another dialogue
29
What is the difference between a narrative and conversation
Narrative: client is expected to use certain rules of cognitive organization Language sequencing to relay events that have a beginning, middle and end
30
One way to assess narrative production
Story retell Clinician tells the story and client retells the story
31
Ways to elicit narratives
Retelling familiar children’s story Retell movie plot Sequence picture cards Wordless story books Wordless movies
32
What can oral reading be used to assess?
Articulation Voice Fluency Reading abilities
33
What should oral reading results be compared to?
Single-word and short-phrase utterance Conversational speech samples
34
What can rate of speech affect?
Articulation Intelligibility Voice production Fluency
35
What clients benefit from measurement of speech rate over time?
Clients with fluency or intelligibility goals
36
How to determine speech rate
1. Time the sample 2. Count number of words produced 3. Divide 60 seconds by # of seconds in sample 4. Multiply number of words in sample by #3 5. =wpm
37
What is essential in determining a plan of care for poor intelligibility?
Identifying factors that contribute to poor intelligibility
38
Factors that negatively influence intelligibility
-# of sound errors, more errors less intelligibility -types of errors -inconsistency of errors -vowel errors -rate of speech (excessively slow or fast) -Atypical prosodic speech -length and linguistic complexity of utterance -insufficient vocal intensity, dyshponia, hyper/hypo nasality
39
Factors that negatively influence intelligibility 2
-disfluency -lack of paralinguistic cues (gestures) -testing environment -client’s anxiety about test -client’s lack of familiarity w/ stimulus materials -client’s level of fatigue -clinician’s ability to understand speech -clinician’s familiarity with client and client’s speaking context
40
In most case, there are multiple factors that influence intelligibility This means the clinician needs to:
-id factors that affect intelligibility -view rating as being approximate -take more than one speech-language sample -secure a representative sample of speech’s
41
How should intelligibility be reported?
Report a percentage range Show intelligibility in varying contexts
42
What are syllable-by-syllable stimulus phrases valuable for evaluating?
Stimulability Assessing Maintenance of newly learned target behavior Client’s max phrase length for optimal speech produciton
43
What can syllable-by-syllable stimulus phrases assist in determining?
Nasality Optimal speech rate Fluency Articulation Voice quality
44
What is charting useful for?
Diagnostic and treatment activities Provides a method of score responses Objectively id client communicative abilities and deficits Provides an assessment baseline Demonstrates progress in treatment Desirable and undesirable behaviors can be charted
45
Ways to chart behaviors
1. Note each time a preselected behavior is exhibited 2. Note each instance of both correct and incorrect behavior 3. Note behaviors according to one of several preselected criteria
46
What are other terms for oral-peripheral speech mechanism
Oral-peripheral examination Oral facial examination Speech mechanism examination
47
When do you complete the oral exam?
After collecting case history
48
Cranial nerves
12 pairs 6 are important for speech and swallowing
49
How to examine CN function of infants
-observe resting child looking for facial symmetry -observe during spontaneous activities -assess oral reflexes -if absence at birth or persist past age at which they are expected to be gone, refer to pediatric specialist or neurologist
50
Review procedures for oral exam from slides
Look at slides
51
When to refer to neurologist from oral facial exam
1. Facial asymmetry 2. Ptosis 3.rigid or reduced facial tone 4. Decreased sensitivity to light facial touch 5. Asymmetry of nasolabial fold or drooping of corner of lips 6. Lingual deviation 7. Uvular asymmetry 8. Tongue fasciculations 9. Abnormal velum elevation
52
When to refer to ENT from oral facial exam?
1. Short frenulum - interferes with function 2. Enlarged tonsils/adenoids 3. Mouth breathing 4. Poor condition or deviant structure of hard or soft palate 5. Discoloration of oral pharynx 6. Sores in oral cavity that will not heal 7. Appearance of leukoplakia, erythroplakia, or erythroleukoplakia
53
When to refer to dentist from oral facial exam
1. Restricted range of jaw motion 2. Pain in the TMJ 3. Poor dental hygiene 4. Dental abnormalities 5. Presence of malocclusions
54
What is early intervening services?
IDEA allows at schools Id kids with learning problems that cannot be from lack of experience with tasks Responsiveness to Intervention (RTI) and dynamic assessment (DA)
55
What is the purpose of RTI and DA?
Intervening approaches Used to decrease unnecessary referral to special ed Children can benefit from modified instructional techniques
56
What is a test accommodation?
Minor adjustments made to testing situation Does not compromise tests standardized procedure
57
What are test modifications?
-reword and provide additional test instructions -provide additional cues or repeat stimuli -allow extra time -skipping items that are inappropriate for students -asking for explanation of correct or incorrect responses -using alternate scoring rubrics
58
Purpose of comprehensive speech-language assessment
Addresses speech, language, cognitive-communication and/or swallowing function
59
Expected outcomes for comprehensive speech-language assessment
Identify and describe strengths and weaknesses related to Speech, language, cognitive and/or swallowing That affect communication and swallowing performance Effects of impairment on activities Contextual factors that serve as barrier to or faciliatators of communication and swallowing
60
Comprehensive speech language assessment may result in:
Diagnosis of communication and/or swallowing disorder Description of characteristics of impairments Id of a communication difference, possibly co-occurring with SLP/swallowing disorder Prognosis for change Recommendation for intervention and support Id of effectiveness of intervention and support Referral for other assessments or services

Speech/Language Assessment (6 decks)

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