11/4 Assessment Procedures Common to Most Communicative Disorders Flashcards
What are the procedures for the most common communicative disorders?
- Oral-facial examination
- Speech and Language Sampling
- Evaluating Rate of Speech
- Determining Intelligibility
- Syllable-by Syllable Stimulus Phrases
- Reading Passages
- Charting
What is involved during a Oral-facial examination?
- abnormal color of the tongue palate and pharynx
- grayish- paresis (paralysis)
- blueish- bleeding in the system
- whitest- submucous cleft
- black- oral cancer
- abnormal height and width of the palatal arch
- Asymmetry of the face or palate
- neurological impairment
- dysarthria of speech
- Deviation of the tongue or uvula to the left or the right
- neurological impairment
- Enlarged tonsils
- this causes problems with nasality, affects hearing, ET, forward carriage of the tongue
- Missing teeth
- doesn’t impact arctic much, but it does for chewing
- Mouth breathing
- restrictive passage in the nasal cavity
- hypernasality
- hyponasality
- Poor intramural pressure
- puff cheeks up
- dysarthria
- prominent ridges
- narrow low palate
- short lingual frenulum
- Weak or absent gag reflex
- weakness or neurological impairment
- difficulties with eating, chewing, and swallowing
- Weakness of the lips, tongue or jaw
- neurological impairments
What is involved during a speech and language sampling?
- Conversation Starters
- open ended questions (most important)
- spontaneous speech sample is best
- use toys
- Jenga
- Ask them what they did this weekend and WAIT
- good quality tape recorder
- Pictures
- You will get a very scripted description of the picture (downside because they aren’t really talking about what is in the sample)
- Narratives with pictures
- sequencing cards
- repeat back a story you have read them
What is involved during an evaluation of rate of speech?
- Allows you to evaluate how rate of speech affects the client’s communicative abilities
- Speech rates of children are slower than adults
- Adults 270 words per minute in conversation and 160-180 words per minute in oral reading
- 1st graders 125 words per minute
- 5th graders 142 words per minute
What factors can negatively affect intelligibility?
- Length and linguistic complexity
- give client a something easy to read
- insufficient vocal intensity, dysphonoia, hyper/hyponasalilty
- Dysphonoia- voice disorder
- Vocal intensity- ESL clients, increase their volume of their speech
- Dysfluency
- Lack of gestures/paralinguistic cues
- Testing environment
- they could react differently in different environments
- Client’s anxiety
- i.e. client hasn’t had a test since high school or college
- Lack of familiarity with stimulus materials
- i.e. if you like dinosaurs and your client doesn’t, you wouldn’t want to talk to them about dinosaurs
- Client’s level of fatigue
- TBI clients
- Clinician’s ability to understand “less intelligible” speech
- trained ear
- Clinician’s familiarity with the client and the client’s speaking context
What is the formula for determining the speech rate?
- Time the sample (i.e. 20 seconds)
- Count the number of words produced (62)
- Divide the number of seconds in a minute(60) by the number of seconds in the sample(20): 60 divided by 20 = 3
- Multiply the number of words in the sample (62) by the number in Step 3 (3): 62 x 3 = 186
The WPM is 186
What can be affected by rate of speech?
- Fluency
- voice quality
- intelligibility of speech
How many words are you looking for in a speech and language sampling?
50 minimum speech sample
If your client can’t produces the DDK sounds what words can you use instead?
- Buttercup
- Topeka
What is diadochokinetic (DDK)?
- AKA alternating motion rates or sequential motion rates
- Evaluates the client’s ability to make rapidly alternating speech movements
What is involved in determining intelligibility?
Factors that can negatively affect intelligibility :
- Number of sound errors
- Type of sound errors
- omissions and additions will decrease intelligibility much more than substitutions and distortions
- Inconsistency of errors
- good indicator this phonological process is resolving
- Vowel errors
- ESL clients work a lot on vowels
- Rate of speech
- Atypical prosodic characteristics of speech
- asperger’s clients/higher level autism sound singsongy
- fake sounding
What is valuable when determining the syllable-by syllable stimulus phrases?
- Evaluating stimulability
- Assessing the maintenance of newly learned target behaviors
- Determining client’s maximum phrase length for optimal speech production
What are some popular reading passages for children and adults?
Children’s reading passages:
- The amazing Spider
- The Toothbrush
Three adult reading passages:
- The Grandfather
- Rainbow
- Declaration of independence
What is involved during charting?
Don’t look down when charting. You might miss something!!!
- Provides a baseline for diagnostic decisions
- Demonstrates progress in treatment
- Behaviors that can be charted:
- Correct/incorrect productions of a specific sound at a specified syllable or word level
- Frequency of dysfluency types
- Instances of motor behaviors
- groping/pre-posturing (i.e. apraxia)
- Specific language features
- Word finding difficulties
- Correct and incorrect phonotory behaviors
