Exam 3 Flashcards
Entire process of ST services
screening
assessment
therapy
discharge
assessment includes
case history
hearing screening
speech mechanism
standardized tests
non-standardized tests
for < 3 years old
main purposes of screening
- to answer a BROAD problem/no problem question
- to determine if an individual would benefit from further evaluation
screening procedure
typically occurs before an assessment
intended to be quick
pass/fail
examiner determines criteria
formal or informal
screening: parent, teacher, caregiver report
informal screening
screening: observation
informal screening
screening: SLP samples
informal screening
screening: single word tasks
informal screening
screening: reading samples
informal screening
screening: reading samples
informal screening
screening: other clinician-constructed measures
informal screening
screening: diagnostic screen
formal screening
screening: FLUHARTY-2
formal screening
screening: Speech Ease Screening Inventory
formal screening
Should screening be the formal test?
NO
determines if there are enough red flags to warrant an evaluation
a purpose for screening
screening can result in:
recommend monitoring for speech and re-screen
referral for a comprehensive speech sound assessment
recommend a comp. language assessment, if language delay or disorder is suspected
“process of collecting valid and reliable information, integrating it, and interpreting it to make a judgement”
assessment
the process of arriving at a diagnosis
assessment
can be synonymous with evaluation and/or diagnosis
assessment
purpose: to obtain a good understanding or diagnosis of a client’s problem
assessment
purpose: to identify need for referral to other professionals
assessment
purpose: to identify the need for treatment
assessment
purpose: to determine the focus, structure, length and frequency of treatment
assessment
purpose: to monitor the client’s progress in treatment and describe changes in the communication disturbance
assessment
comprehensive assessment, evaluation
case history
hearing screening
speech mechanism examination
speech sampling
standardized assessment
possible additional screening or comprehensive measures
case history
can be obtained via intake form via patient/family interview, review of previous medical records, & conversations with other treating professionals
facilitates: gaining a preliminary and general understanding of the client
case history
facilitates: formulating interview questions for clarification
case history
facilitates: determining areas of communication to assess
case history
facilitates: planning assessment procedures to administer
case history
facilitates: developing an appropriate diagnosis
case history
areas of case history
pregnancy & birth, medical, developmental, educational, family history, social history
size, symmetry, and appearance of the head and facial structures
evaluation of the speech mechanism
silent breathing: closed mouth, no clavicular breathing, breathing during speech
evaluation of the speech mechanism
the oral and pharyngeal cavity structures - teeth, tongue, hard and soft palates: a blue tint may suggest a submucous cleft
evaluation of speech mechanism
functionally assessing the speech mechanism - the movement pattern, range of motion, speech
evaluation of speech mechanism
diadochokinetic rates: to test the speech of movement of the articulators
evaluation of speech mechanism
norm-referenced tests
standardized speech assessments
compare child to standardized norms
standardized speech assessments
administration is dictated by an Examiner’s Manual
standardized speech assessments
Client is typically shown a picture and instructed to name the object
standardized speech assessments
responses are transcribed and recorded on test protocol
standardized speech assessments
provide an identifiable unit of production that examiners can more easily transcribe
standardized speech assessments
result in statistical scores
standardized speech assessments
pros of standardized speech assessments
easy to administer and score
time efficient
assess all English phonemes
child cannot apply avoidance strategies
examiner knows target production
norm-referenced
cons of standardized speech assessments
single word responses
not enough for a comprehensive phonological analysis
limited the contexts
do not account for coarticulation
vowels are not usually tested
single word articulation tests
test all english phones in all sound positions:
prevocalic
intervocalic
postvocalic
prevocalic
consonants that precede a vowel (CV) and initiate a syllable (Soap, Cat)
intervocalic
consonant that is embedded (VCV) between two vowels (caMel, eaGer)
postvocalic
consonants that follow a vowel (VC) and terminate the syllable (soaP, caT)
used for children who are highly unintelligible and have multiple speech sound errors
phonological tests
analyze error patterns across words
phonological tests
assist in differential diagnosis of speech sound disorder
phonological tests
age of Goldman Fristoe Test of Articulation-3
2;0-21;11
gender-based norms
Goldman Fristoe Test of Articulation-3 examines
articulation in words and sentences
intelligibility
stimulability
can be used with the Khan-Lewis test
Goldman Fristoe Test of Articulation-3
age of Khan Lewis Phonological Analysis-3
2;0-21;22
age of Khan Lewis Phonological Analysis-3 examines
10 developmental phonological processes
standard scores, percentiles, test age equivalents, and percent-of-occurrence for individual processes by age
age of Diagnostic Evaluation of Articulation and Phonology
3;0-8;11
Diagnostic Evaluation of Articulation and Phonology examines
articulation single-word production (30 pictures): phoneme stimulability & oral motor screen
phonology single-word production (50 pictures): connected speech is a three-picture description task that targets 14 words
age of Arizona Articulation and Phonology Scale-4
18 months - 21;11
gender-based norms
Arizona Articulation and Phonology Scale-4 examines
word articulation
sentence articulation
phonology
age of Clinical Assessment of Articulation and Phonology-2
2;6-11;11
Clinical Assessment of Articulation and Phonology-2 examines
articulation in words
articulation in sentences
phonology
age of Hodson Assessment of Phonological Patterns-3
3-8 yo
Hodson Assessment of Phonological Patterns-3 examines
object naming word level for assessment of phonological processes
cannot provide diagnosis
screening
standardized measures
compare child to standardized norms
administration is dictated by an Examiner’s Manual
result in statistical scores
non-standardized measures
compare child to themselves or informal norms
administration is determined by clinician
result in informal info or scores
example: intelligibility rating
non-standardized measures
examples: phonological process analysis
non-standardized measures
example: percentage consonant correct (PCC)
non-standardized measures
example: accuracy of production of specific sounds
non-standardized measures
example: phoneme inventory
non-standardized measures
example: syllable structure inventory
non-standardized measures
advantages of speech-language sample
best way to assess intelligibility
most valid representation of ability
can assess impact on other areas
disadvantages of speech-language sample
reluctant child
unintelligible child
time and expertise required
optimal speech sample
reflects actual production
reveals patterns
contains all English phonemes
preschool speech sampling
play
parent-child observation
school-aged speech sampling
conversational discourse
narratives
reading samples
strategies for speech-language sampling: general considerations
gain prior knowledge of the client’s interests
record the sample
aim for 50-100 productions/utterances
strategies for speech-language sampling: materials & environment
allow the parent to participate
create a natural setting
follow the client’s lead
use toys/objects that are interesting to the child
engage in topics that will stimulate conversation
strategies for speech-language sampling: conversational style
enthusiastic but calm
limit yes/no ?s
minimize one-word response ?s
minimize ?s
reduce complexity of language
prepare possible comments/?s
avoid talking too much
materials for speech sampling: age 3
books, dress up clothes, puppets, toy kitchen, doll house, barn animal toys
materials for speech sampling: kindergarten & early elementary
toys with many pieces (puzzles, shapes, legos), action figures, puppets
independent analysis
syllable shape inventory
phonetic inventory
best for v young children or children who are v unintelligible
child’s production is NOT compared to the adult target
results yield an inventory of sounds and syllable structures produced
relational analysis
PCC
percent vowel correct (PVC)
phonological processes
best for older children regardless of intelligibility
child’s production IS compared to adult target
results yield types of errors and operating phonological processes
child’s production is compared to adult target
relational analysis
purpose of independent analysis
to describe the phonemes and syllable shapes that occur in a speech sample
independent analysis is necessary for:
children in the First 50 Word Stage
children < 30 months of age
children with very low intelligibility
independent analysis: phonetic inventory
list of consonants produced and frequency count
sometimes includes vowels
record all phonemes produced in the sample and a frequency count for each
productive inventory
phonemes produced at least 3x
marginal inventory
phonemes produced < 3x
independent analysis: syllable structure inventories
list of syllable types and frequency count
record all syllable structures produced in the sample and a frequency count for each
will look at the specific analysis when we look at preschoolers and school-aged children
relational analysis
PCC
independent analysis
Inventory of phonemes
independent analysis
inventory of syllable stress
independent analysis
PVC
relational analysis
phonological processes
relational analysis
early childhood speech-production assessment
review case history
parent interview
informal assessment via speech-language sampling
oral mechanism exam
assess speech production in children under 3 yo
speech sampling
independent analysis - phonetic inventory & syllable structure inventory
norms review
detecting a problem
productive and marginal inventory
phonetic inventory
independent analysis for 3 years and under
phonetic inventory
syllable structure inventory
~12 months: Norms - Syllable Structure Inventory
v
cv
cvc
cvcv
~24 months: Norms - Syllable Structure Inventory
v
cv
cvc
cvcv
cvcvcv
clusters emerging
identifying a potential speech sound disorder (birth-12 months)
delay in initiation of babbling
lower frequency of babbling
limited variation of syllables
use of single-syllables vs. repeated syllable combinations
higher frequency of vowel, glide, and glottal sequences
lower frequency of canonical babbling
identifying a potential speech sound disorder (24 months): based on independent analysis
has a limited inventory of Cs and syllable structures (compared to norms)
identifying a potential speech sound disorder (24 months): based on relational analysis
2;0-2;11 /b d p m n h w/
incorrectly produces of phonemes above
identifying a potential speech sound disorder (36 months): based on independent analysis
lacks complex syllable/word shapes
lacks an entire place or manner category
produces speech that is unclear, even to familiar individuals
identifying a potential speech sound disorder (36 months): based on relational analysis
2;0-2;11 /b d p m n h/
3;0-3;11 /g k t f ng j/
incorrectly produces phonemes above
observed phonological processes usually suppressed by 3 years old
speech -production assessment in preschool & school-aged children
review case history
parent interview
hearing screening
formal test
informal tests
other measures
oral mechanism exam
formal measures for assessment in preschool & school-aged children
articulation exams
phonological process exams
informal measures for assessment in preschool & school-aged children
sampling techniques
relational analysis
traditional analysis
phonological process analysis
intelligibility
PCC/severity
stimulability
informal measures: relational analysis
traditional analysis considers 2 variables:
position in which the sounds are misarticulated
types of errors made
traditional analysis are most appropriate for:
children with few articulation errors
relatively good intelligibility
problem seems to be phonetic (articulatory)
sound errors
omissions
substitutions
distortions
additions
omissions
omit a sound in a word
/bu/ for /book/
substitutions
replace one or more sounds with another sound
wed for red
distortions
sounds are altered or changed (lateral “s’”)
additions
insert one or more extra sounds into a word
/bulack/ for black
descriptive term used to identify patterned misarticulations in a child’s speech
phonological process
phonological process analysis is most appropriate for
children who are highly unintelligible
children with multiple misarticulations
problem appears to be phonemic (phonological)
glottal replacement
nondevelopmental process
substitution of later developing sounds for earlier developing ones (e.g., affrication)
nondevelopmental process
ICD
nondevelopmental process
backing
nondevelopmental process
frequency of occurrence
of times a particular process occurs in a sample
percentage of occurence
more specific
criteria for a phonological process
must have at least 4 opportunities to produce the process within a single sample
must occur in at least 20% of occurrences
intelligibility
measure of how understandable a person is in given conditions
a functional indicator of oral communication competence reflecting the talker’s ability to convert language to a physical signal and the listener’s ability to perceive and decode the signal to recover the meaning of the talker’s message
intelligibility
intelligibility norm: 2 years
50%
intelligibility norm: 3 years
75%
intelligibility norm: 4 years
100% ( a few errors may persist)
attempts to quantify the degree of involvement
severity analysis
use the percentage of the consonant correct to measure the
severity of involvement
PCC formula
of correct consonants/total consonants x 100
severity levels
85-100% mild
65-85% mild to moderate
50-65% moderate to severe
<50% severe
factors that influence severity
child’s age
intelligibility
number of errors or phonological processes
consistency of errors
client’s ability to make a correct or improved production of a misarticulated sound when given a model or additional stimulation
stimulability testing
may be component of some norm-referenced articulation test
stimulability testing
helps with selection of therapy targets
stimulability testing
can also identify cues/prompts that may be helpful in therapy
stimulability testing
