chapter 7 Flashcards
decisions to be made
does the child need services
if so, how much/often
what behaviors should be targets for therapy
eligibility criteria
standardized scores
intelligibility
severity
Phonological error patterns
stimulability
developmental appropriateness
intelligibilty influenced by
number of errors
type of errors
consistency of errors
child’s prosody
familiarity of communication partner
content of message
intelligibility measured by
open set - listening & writing down exactly what’s heard
closed set - compared to set of prechosen words
rating scale - assign a number according to severity, more subjective across SLPs
degrees of severity
mild
moderate
severe
ambiguous to define
what determines severity
not a solid answer
likely based in many factors
PCC
PCC formula
(number of consonants correct / total number of consonants) x 100
PCC scale
85-100 mild
65-85 mild/moderate
50-65 moderate/severe
> 50 severe
Phonological patterns evaluations
evaluated in different ways
common analysis - PVM
place
voice
manner
or a combo of the 3
systematic sound preference
child using 1 or 2 phonemes to replace many or all phonemes in a particular sound class (or multiple sound classes)
coalesence
features from 2 adjacent phonemes are combined so that 1 phoneme replaces both phonemes
why is assessment of Phonological patterns helpful
comparing the number & type of patterns a child is producing to what they should be producing at their age is useful diagnostically
treatment targets may be more easily selected when a pattern of errors is established
stimulability
often indicated that the child is “ready” to acquire that sound & may do so w/out therapy
some children may still need therapy to acquire the sound
other things to consider
case history
assessment
referrals
populations to consider for therapy
children between 2.5-3 who are unintelligible
children over 3 who have severe unintelligibly or idiosyncratic patterns
children under 8 who perform below 1 standard deviation from the mean on a standardized Phonological assessment
children 9+ w/ consistent errors
teens & adults who report difficulties w/ speech production
best approach for SSDs
do not assume they all occur for the same reason (motor, linguistic)
do not assume they will all respond to the same treatment at the same rate
developmental appropriateness
compare child’s production to normative data for individual sounds
compare child’s productions to normative data for Phonological patterns
complexity approach
targeting sounds that are more complex
greater system-wide change
more efficient
substantial support/approach
choosing targets factors to consider
developmental appropriateness
Phonological patterns
stimulability
frequency of occurrence
contextual analysis
dialectal differences
not delays or disorders
should not be used when evaluating for treatment
accent modification within our scope of practice – elective service
social / emotional considerations
child & family’s attitudes toward SSD
child emotional reactions
eg - child is embarrassed, think about treatment even if their disorder is not very severe – interaction between learning & social interactions
computer-assissted phonological analysis
software programs
time saving & efficient
do not take place of clinical judgement
PCC, individual analysis, comparative analysis, target selection, treatment plan, etc
why is severity important
may affect access to service
may affect caseload management
may influence our treatment choices
what factors affect severity
specific skills the speaker may be lacking (disability)
effect of skill reduction on the speaker’s daily functioning (handicap)
gold standard
ideally - some ultimate standard or reference to compare against
judgment of experienced clinicians is usually seen as next best thing
who defines severity categories
insurance
testing companies
sometimes left up to us to decide
problems w/ boundaries set by test developers
usually arbitrary
not clear how they would relate to boundaries used by a diff test developer
rely solely on number of errors & don’t consider other factors
rely solely on single word productions
