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Exam 3 SPHP 126 > chapter 6 basic unit > Flashcards

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

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2
Q

What is the goal of assessment?

A

goal is to determine if there is a speech sound disorder

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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

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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

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5
Q

What are screenings for children?

A

converse, say ABCs, count to 10

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6
Q

What are screenings for adults?

A

conversation, reading

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7
Q

In schools in California..

A
  • We don’t automatically screen any more

- It is all based on teacher and parent referral

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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.”

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9
Q

Review the Client’s Background:

A
  1. Written case history forms
  2. Information from other professionals
  3. Conduct interview
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10
Q
  1. 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)
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11
Q
  1. Information from other professionals
A
  • Written release

- Sometimes you have to ask around verbally

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12
Q
  1. Conduct an interview
A

-Information-gathering interview
-Develop rapport
-Orientation: what will happen in assessment
“I understand from his file that…”

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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?

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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
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15
Q

Plan Assessment Session

A
  • select appropriate tests

- prepare bribes!(stickers, toys, games, prizes)

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16
Q

Prepare Testing Area

A
  • clean and clutter free

- not distracting

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17
Q

Assess Related Areas

A
  1. hearing
  2. Orofacial structure
  3. DDK syllable rate
  4. speech rate
  5. Speech intelligibility
  6. level of stimulability
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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
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19
Q

Administer Tests

A
  • Get a spontaneous sample

- Use standardized tests—some school districts demand norms

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20
Q

Discuss Findings and Make Recommendations

A

-share info

Be positive, clear

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21
Q

Write Report

A

-legal document-attorney

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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
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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
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24
Q

What is alternating motion?

A

—same syllable /pʌpʌpʌpʌ/

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25
Q

What is sequential motion?

A

—different syllables /pʌtʌkʌpʌtʌkʌ/

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26
Q

In evaluating oral motor coordination, we are looking for:

A

Speed(how fast)
Accuracy(do they get the syllables in a row)
Sequencing problems?

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27
Q

What is the purpose of conducting an oral peripheral examination?

A
  • 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
Q

What supplies do you need for an oral peripheral examination?

A
  • 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
Q

Assessment of Structure and Function of Facial Muscles

A
  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
Q

Assessment of Structure and Function of Tongue

A
  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
Q

Assessment of Hard Palate

A
  • Normal color?
  • Normal height and width? (too narrow?)
  • Clefts?
32
Q

Assessment of Soft Palate

A

-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
Q

Assessment of Teeth

A

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
Q

OBTAINING A SPONTANEOUS SAMPLE

A
  • Ideal—representative of daily life
  • Collect 50-100 utterances
  • Time-consuming, hard with highly unintelligible children
35
Q

Practical Tips:

A
  • Bring in Family member, friend if needed
  • No loud toys
  • Let them hear themselves
36
Q

Advantages of Standardized tests:

A
  • quick (15-20 min.)
  • sample all consonants
  • you know what the highly unintelligible ch should be saying
37
Q

Disadvantages of Standardized tests:

A
  • 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
Q

Obtaining Responses:

A

Direct vs. delayed imitation

39
Q

Recording Responses:

A
  1. Plus/minus technique

2. Whole word transcription

40
Q

Record type of error:**

A

a. Omission (-)
b. Substitution t/k, d/g, w/r
c. Distortion—D or D1-D3
d. Addition—transcribe whole word

41
Q

Commonly-Used Tests: Phonological Processes

A
  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
Q

Our clinic uses the CAAP:

A

Clinical Assessment of Articulation and Phonology

43
Q

Commonly-used Tests: Articulation

A
  1. Arizona Articulation Proficiency Test-3
  2. Photo Articulation Test (PAT:3)
  3. Goldman-Fristoe Test of Articulation:2
44
Q

When you record:

A

Be sure to gloss or restate the child’s attempt into the recording (what they say)

45
Q

Speech Discrimination Testing

A

Minimal pairs

46
Q

Stimulability Testing

A

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
Q

Contextual Testing

A
  • 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
Q

Analysis of Speech Sound Production

A
  • Independent analysis
  • Id sounds that are in the child’s phonetic inventory
  • Relational analysis
49
Q

What is independent analysis?

A

child’s productions transcribed without reference to adult model

50
Q

What is Relational analysis?

A

compare child’s production to standard/adult form

51
Q

What is Traditional Analysis?

A
  • Errors IMF

- Error types—omission, distortion, substitution, addition

52
Q

What is Developmental Analysis?

A

Compare child’s production to norms for CA (**public schools)

53
Q

What is Pattern Analysis?

A
  1. Distinctive Features 
  2. Place-Voice-Manner 
    - PVM: teach exemplars in the sound classgeneralization
    - 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
Q

What is Phonetic Inventory Analysis?

A

Does the client have the motor ability to make the sound?

-motor means physical

55
Q

What is Intelligibility Analysis?

A
  • 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
Q

Making a diagnosis: Typical Speech Skills

A
  1. Errors-within normal age range
  2. Errors->L1 transfer(transferred from first language)
  3. Errors, but don’t interfere with life
57
Q

Disorders—Articulation Disorder

A
  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
Q

Disorders—Phonological Disorder

A
  1. Highly unintelligible speech
  2. Multiple misarticulations
  3. Restricted phonetic inventory
  4. Patterns of errors (ex: final consonant deletion, cluster reduction)(Test 3)
59
Q

Severity Estimate–Disorder is:

A
  • Mild
  • Mild-moderate
  • Moderate
  • Moderate-Severe
  • Severe
  • Profound
60
Q

What is a Diagnostic Statement?

A
  • 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
Q

DETERMINING PROGNOSIS

A
  • 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
Q

Roseberry:

A

Under-promise and over-deliver

63
Q

3 Major components of a good prognostic statement (p. 302):

A
  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
Q

MAKING THERAPY RECOMMENDATIONS

A
  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
Q

Concluding the assessment process

A
  • Diagnostic report

- Conduct information-giving interview

66
Q

Information-giving interview

A
  • Begin with the positives
  • Summarize findings, conclusions, recommendations-next steps
  • Don’t fear the butter
67
Q

What is a diagnostic report?

A
  • Legal document-could end up in the hands of a lawyer without your permission
  • Typos, other errors are death
  • Peoples first impression of you!

Exam 3 SPHP 126 (3 decks)

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