Childhood assessment Flashcards
What are the components of the Evaluation of Speech Sound Disorders?
History
Contributing Factors
Screening
Analysis
Language Evaluation
OME
Determine diagnosis
Providing information
What are contributing factors to speech sound disorders?
Medical/neurological factors
Hearing
Dental problems
Motor development
Intelligence and cognition
Age/gender
Family history
Primary language, dialect, culture
Motivation and level of concern
What does the history portion consist of?
Written case history
Intake interview
Information from other professionals
What does assessment of speech sound disorders consist of?
Screening
Formal and informal testing
Speech sampling
Stimulability of errors
What does analysis of speech sound disorders consist of?
Number of errors
Error types
Form of errors
Consistency of errors
Intelligibility
Rate of speech
Prosody
What is the purpose of screening?
Quickly identify those who are WNL and those who are not
What tools are used for screening?
Formal tools
Informal tools
Apps (Little Bee Speech, Smarty Ears)
What are the cons of using formal tests during screening?
Only elicit phonemes in one phonetic context (words)
Only looking at word level so cannot see effects of articulation
Some only look at consonants, no vowels
Does not account for disorders with variable sound production
What are examples of formal tests that can be used during screening?
Arizona-4
Goldman Fristoe
CAAP-2
Hodson assessment of Phonological Patterns
What does a speech sample allow you to analyze?
Error types
Patterns of errors
Number of errors
Consistency of errors between sample and artic tests, within same sample, between samples
Correctly produced sounds
Intelligibility
Speech rate
Prosody
What is stimulability?
Ability to produce a correct (or improved) production of a previously incorrect phoneme
Stimualbility provides ____ information
Diagnostic
How can you assess stimulability?
The clinician produces the phoneme correctly and has the client imitate it
Tell the client explicitly how to produce the phoneme
Mirror, tongue depressor, tactile feedback
What are developmental norms used for?
Normative data that helps us know if a child is developing within normal expectation
What are the cons of using developmental norms?
They use the average age that the skill develops/occurs
Norms may be skewed because true norms are from a randomly collected sample and this is usually not the case
Norms change and disagree from study to study
What are the pros of using developmental norms?
Useful for estimating approximately how well the child’s sounds are developing
What is frequency of occurrence and what does it tell us?
Sounds that are used more in speech and affect intelligibility the most
/n/ /t/ /s/ /r/ /d/ /m/ represent about 1/2 the consonants used in English
j ch sh th are least used
What are the descriptive features of phonemes?
Grouping/separating phonemes based on similar/dissimilar features
Helps us find phonological processes and make note if errors occur in specific categories
What are phonological processes?
Processes that simplify speech, patterns of error
Impair intelligibility
When do children tend to outgrow phonological processes?
Age 8
What are the most common phonological processes in normal development?
Unstressed syllable deletion
Final consonant deletion
Gliding
Cluster reduction
What is childhood apraxia of speech (CAS)?
Difficulty sequencing sounds, syllables, and words for speech
No muscle weakness, paralysis, or other physical limitation
Begins in childhood and usually of unknown etiology
CAS impacts ____ and ____ development
Linguistic, phonologic
Do children outgrow CAS?
No
What are the core features of CAS?
Inconsistency of errors
Speech is lengthened and disrupted
Inappropriate prosody
What is dysarthria?
Motor speech sound disorder due to neuromuscular weakness, paralysis or incoordination of muscles needed to produce speech
What does speech look like with dysarthria?
Slurred, distorted, ranges in intelligibility based on extent of neurological weakness
What are the types of pediatric dysarthria?
- Too much tone (spasticity)
- Too little tone (hypotonicity)
- Fine motor movements that control respiration, phonation, resonance and articulation are affected
What types of articulation errors may be seen with dysarthria?
Vary in severity
Prosodic errors due to difficulty changing pitch and loudness and slow rate of speech
Hypernasailty due to improper VP closure
What is selective mutism?
Anxiety-based communication disorder in children
Inability to speak in some settings and ability to speak in other settings
Cause is unknown, likely rooted in family history, individual temperament and environmental factors
What is selective mutism?
Anxiety-based communication disorder in children
Inability to speak in some settings and ability to speak in other settings
Cause is unknown, likely rooted in family history, individual temperament and environmental factors
Features of selective mutism: social, interferes
Social: consistent failure to speak in specific social situations in which there is no expectation for speaking
Inteferes: failure to speak interferes with educational/occupational achievement or social communication
Features of selective mutism: longevity and language
Longevity: behavior lasts for at least 1 month
Language: not due to lack of proficiency or comfort with the expected language
Selective mutism is no better explained by another ____
Diagnosis
Children with selective mutism oftentimes speak fine at ___ but do not speak at ____
Fine at home, do not speak at school
Children with selective mutism may communicate through
Gestures
Drawing/writing
Whispering
Single word/short phrases
Adopt an altered voice
Use a language only certain people understand
Speak through an intermediary
Children with selective mutism may try to …..
Escape/avoid fear-inducing situations
What is the SLP’s role in assessing selective mutism?
Identify speech-language abilities and deficiencies
May have primary role of diagnosing selective mutism
May have primary role in educating family and school personnel
When assessing selective mutism what current speaking behaviors are looked at?
Who does the child talk to?
What entices the child to talk? What causes the child to fail to talk?
Where does the child talk or fail to talk?
When does the child talk or fail to talk?
How does the child communicate?
When assessing selective mutism what does collecting information refer to?
Interviewing parents, teachers, etc.
Direct observation in a range of environments/situations
Recorded videos of various settings
Observe through one way mirror/video streaming with parent
When assessing selective mutism how do you revise social and emotional status?
Gather information about the child’s communication anxiety/general emotional anxiety
Selective mutism questionnaire for parents
Selective mutism stages of social communication comfort scale (assess severity)
When assessing selective mutism, we also need to assess speech and language because ….
Selective mutism co-occurs with SM in 30-75% of children
Need to determine if the child failed to answer because of selective mutism, because they did not know the answer or both
When assessing selective mutism, create a ______ setting
Low-anxiety
Avoid too much eye contact, do not pressure child into speaking, avoid questioning, allow period of silence, relax and give the child time to communicate
A selective mutism diagnosis can be made when
Behavior cannot be better explained by a communication disorder or other disorder
Child uses communication abilities to communicate with some people and not with others
