chapter 6 basic unit Flashcards
1
Q
What is Assessment?
A
set of procedures that are used to gain a clear description of the speech sound production skills of a child
2
Q
What is the goal of assessment?
A
goal is to determine if there is a speech sound disorder
3
Q
What is Diagnosis and the two steps?
A
—conclusion you arrive at
1) Determine if the child has a clinically significant problem
2) Describe the characteristics of problem
4
Q
What are speech screenings?
A
Screening: pass/fail procedure that can be conducted quickly with a large numbe of individuals in a short period of time
5
Q
What are screenings for children?
A
converse, say ABCs, count to 10
6
Q
What are screenings for adults?
A
conversation, reading
7
Q
In schools in California..
A
- We don’t automatically screen any more
- It is all based on teacher and parent referral
8
Q
In the schools..
A
-Put the child on “monitor” status
-I say to a kindergarten teacher, e.g.:
“He is still quite young, so I will re-check him again in January. If he still doesn’t technically qualify for speech, I can re-screen him in first grade.”
9
Q
Review the Client’s Background:
A
- Written case history forms
- Information from other professionals
- Conduct interview
10
Q
- Written case history forms
- What does the family think is the problem?
A
- speech, lang, developmental history
- Prenatal and birth history
- Medical history (eating problems, ear infections)
- Educational history(did they go to preschool, have they moved to a lot of different schools)
- Social history(childs relations with others, discipline problems, is the child frustrated)
11
Q
- Information from other professionals
A
- Written release
- Sometimes you have to ask around verbally
12
Q
- Conduct an interview
A
-Information-gathering interview
-Develop rapport
-Orientation: what will happen in assessment
“I understand from his file that…”
13
Q
We need to ask:
A
- Do others make fun of the child?
- Older client: are you bothered by this? Impact on your life?
14
Q
Close the interview
A
- Recap important points
- Be sure to tell the person that you will share test findings with them
- Thank them for their time
15
Q
Plan Assessment Session
A
- select appropriate tests
- prepare bribes!(stickers, toys, games, prizes)
16
Q
Prepare Testing Area
A
- clean and clutter free
- not distracting
17
Q
Assess Related Areas
A
- hearing
- Orofacial structure
- DDK syllable rate
- speech rate
- Speech intelligibility
- level of stimulability
18
Q
Screen language
A
- I usually like to give a receptive vocabulary test(just ask them to point to things)
- This works well if they are unintelligible
19
Q
Administer Tests
A
- Get a spontaneous sample
- Use standardized tests—some school districts demand norms
20
Q
Discuss Findings and Make Recommendations
A
-share info
Be positive, clear
21
Q
Write Report
A
-legal document-attorney
22
Q
Hearing Screening
A
- SLPs can screen
- In the schools, nurse usually does this
- Pure tone air conduction thresholds at 20 or 25 dB
- Refer to physician, audiologist if suspect a problem
23
Q
DIADOCHOKINETIC SYLLABLE RATES
A
- DDKs refer to the speed and regularity with which a person produces repetitive articulatory movements
- Alternating motion
- Sequential motion
- We are evaluating oral motor coordination
24
Q
What is alternating motion?
A
—same syllable /pʌpʌpʌpʌ/
25
What is sequential motion?
—different syllables /pʌtʌkʌpʌtʌkʌ/
26
In evaluating oral motor coordination, we are looking for:
Speed(how fast)
Accuracy(do they get the syllables in a row)
Sequencing problems?
27
What is the purpose of conducting an oral peripheral examination?
- Helps differentiate: functional or organic
- Functional: not associated with an organic or neurological impairment
- Organic: some underlying structural, sensory, or neurological cause or related factor
28
What supplies do you need for an oral peripheral examination?
- What to bring with you when you do an oral peripheral exam: Penlight, gloves, stopwatch, tongue depressors
- Tasty tongue depressors are best!
- R’s wad ‘o gum technique
29
Assessment of Structure and Function of Facial Muscles
1. General symmetry of face at rest—drooping? Twitches?
2. Facial symmetry during smiling, opening mouth
3. Structural integrity of lips—drooping? Mouth breathing?
4. functional integrity of lips-Have client smile-symmetrical?
-Ask for uuu-eee and papapa
-is there adequate speed and range of motion?
Puff cheeks and hold air in
30
Assessment of Structure and Function of Tongue
1. structures integrity-normal color?
- Abnormal movements life fasciculations/tremors?
2. Functional integrity
- Stick out your tongue-does it come out far enough? Deviate to one side?
- Stick out your tongue, hold it to the count of 5
- Protrude your tongue, resist the tongue depressor
- elevate and lower tongue tip, side to side
31
Assessment of Hard Palate
- Normal color?
- Normal height and width? (too narrow?)
- Clefts?
32
Assessment of Soft Palate
-Problems-> VPI (velopharyngeal incompetence)
-Bifid uvula-> submucous cleft?
-Good oral-nasal resonance balance?
Prolong /a/ -does velum move up and back to meet pharyngeal wall?
33
Assessment of Teeth
Labioverted-tilt outward toward lips
Linguaverted-tilt inward toward tongue
Maloclusion
Open bite-lack of contact between upper and lower teeth
Cross bite-lateral overlapping of upper and lower dental arches
34
OBTAINING A SPONTANEOUS SAMPLE
- Ideal—representative of daily life
- Collect 50-100 utterances
- Time-consuming, hard with highly unintelligible children
35
Practical Tips:
- Bring in Family member, friend if needed
- No loud toys
- Let them hear themselves
36
Advantages of Standardized tests:
- quick (15-20 min.)
- sample all consonants
- you know what the highly unintelligible ch should be saying
37
Disadvantages of Standardized tests:
- Just single words, not connected speech
- Children with oral motor problems do better in single words
- Each phoneme sampled only once in each position (false negatives, false positives)
38
Obtaining Responses:
Direct vs. delayed imitation
39
Recording Responses:
1. Plus/minus technique
| 2. Whole word transcription
40
Record type of error:**
a. Omission (-)
b. Substitution t/k, d/g, w/r
c. Distortion—D or D1-D3
d. Addition—transcribe whole word
41
Commonly-Used Tests: Phonological Processes
1. Assessment of Phonological Processes- Revised (APPR; Hodson) 2008 March—APP:3 (computerized version too)**
- Severity rating
2. Khan-Lewis Phonological Analysis (first give Goldman-Fristoe) (10 PPs)
3. Clinical Assessment of Articulation and Phonology
42
Our clinic uses the CAAP:
Clinical Assessment of Articulation and Phonology
43
Commonly-used Tests: Articulation
1. Arizona Articulation Proficiency Test-3
2. Photo Articulation Test (PAT:3)
3. Goldman-Fristoe Test of Articulation:2
44
When you record:
Be sure to gloss or restate the child’s attempt into the recording (what they say)
45
Speech Discrimination Testing
Minimal pairs
46
Stimulability Testing
Stimulability is the child’s tendency to make a correct or improved production of a misarticulated sound when given a model or additional stimulation by the examiner
47
Contextual Testing
- McDonald’s Deep Test
- Secord Contextual Articulation Tests (S-CAT)
- Special procedure that can help id a facilitative phonetic context for correct production of a particular phoneme
48
Analysis of Speech Sound Production
- Independent analysis
- Id sounds that are in the child’s phonetic inventory
- Relational analysis
49
What is independent analysis?
child’s productions transcribed without reference to adult model
50
What is Relational analysis?
compare child’s production to standard/adult form
51
What is Traditional Analysis?
- Errors IMF
| - Error types—omission, distortion, substitution, addition
52
What is Developmental Analysis?
Compare child’s production to norms for CA (**public schools)
53
What is Pattern Analysis?
1. Distinctive Features
2. Place-Voice-Manner
- PVM: teach exemplars in the sound classgeneralization
- Teach /k/ /g/
(fricatives) Teach /f/ /s/
3. Phonological Process Analysis**
- Analyze PPs in terms of frequency, percentage of occurrence
- Total # of occurrences of final cons. deletion = 10
- Total # of opportunities for the process = 50
- Total = 20% occurrence
54
What is Phonetic Inventory Analysis?
Does the client have the motor ability to make the sound?
| -motor means physical
55
What is Intelligibility Analysis?
- 60 intelligible words out of 170 words = 35% intelligibility
- 30 intelligible words out of 56 words = 54% intelligibility
- Usually—subjective statement “This examiner estimates that in a known context with an unfamiliar examiner, Joey is 50% intelligible in connected speech.”
56
Making a diagnosis: Typical Speech Skills
1. Errors-within normal age range
2. Errors->L1 transfer(transferred from first language)
3. Errors, but don’t interfere with life
57
Disorders—Articulation Disorder
1. Errors asscociated with organic, structural, or neurological origin
2. Errors not typical of same-age peers
3. No patterns to errors
4. Errors don’t significantly compromise intelligibility
5. Errors on only a few sounds
58
Disorders—Phonological Disorder
1. Highly unintelligible speech
2. Multiple misarticulations
3. Restricted phonetic inventory
4. Patterns of errors (ex: final consonant deletion, cluster reduction)(Test 3)
59
Severity Estimate--Disorder is:
- Mild
- Mild-moderate
- Moderate
- Moderate-Severe
- Severe
- Profound
60
What is a Diagnostic Statement?
- A summary—one of the last portions in a written report
- It’s very important that this be well done, because it’s all most people ever read (e.g., parents, principals, pediatricians)
61
DETERMINING PROGNOSIS
- Prognosis = estimated course of a disorder under specified conditions
- E.g., what will happen if tx is offered—or not?
- Variables contributing to prognosis (p. 301—please know for exam)
62
Roseberry:
Under-promise and over-deliver
63
3 Major components of a good prognostic statement (p. 302):
1. Goal statement- skills child expected to achieve-be specific (fair, good, excellent)
2. Judgment of success
3. Prognostic variables that justify the judgement
64
MAKING THERAPY RECOMMENDATIONS
1. Child has SSD-recommend treatment
2. Child has errors, but age-appropriate-no treatment, re-evaluate later
3. Typical Speech-no treatment-maybe first language transfer, or subtle problems that don’t impact life
4. Child has SSD, but no immediate treatment
65
Concluding the assessment process
- Diagnostic report
| - Conduct information-giving interview
66
Information-giving interview
- Begin with the positives
- Summarize findings, conclusions, recommendations-next steps
- Don’t fear the butter
67
What is a diagnostic report?
- Legal document-could end up in the hands of a lawyer without your permission
- Typos, other errors are death
- Peoples first impression of you!
