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exam 3 sphp 126 > exam 3 > Flashcards

exam 3 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 – GOAL is to determine if there is a speech sound disorder

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2
Q

what is diagnosis

A

CONCLUSION you arrive at

1) determine if the child has clinically significant problem
2) describe the characteristics of problem

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3
Q

What are the speech screenings

A

-pass/ fail procedure that can be conducted quickly with a large number of individuals in a short period of time
EX:
-Ch: converse, say ABCs, COUNT to 10
-Adults : conversation, reading

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4
Q

in schools in California…

A
  • we don’t automatically screen anymore

- it is all based on teacher and parent REFERRAL

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5
Q

in schools…

A
  • put the child on “monitor” status

- she says to kindergarten teach that the child is still young and will recheck him again later on in the year

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6
Q

general principles of Assessment

a. Review the clients background

A
  1. written case history forms
  2. information from other professionals
  3. conduct interview
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7
Q

written case history forms

A
  • what does the FAMILY THINK is the problem?
  • speech, lang, developmental history
  • prenatal and birth history
  • medical history ( eating problems, ear infections)
  • educational history
  • social history (ch’s relations with others, discipline problems, is ch FRUSTRATED?
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8
Q

information from other professionals

A
  • written release

- sometimes you have to ask around verbally

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9
Q

conduct an interview

A
  • information gathering interview
  • develop rapport
  • orientation: what will happen in the assessment
  • I understand from his file that …”
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10
Q

what do we need to ask?.

A
  • do other make fun of ch?

- older client: are you bothered by this? IMPACT on your LIFE?

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11
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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12
Q

B. plan assessment session

A
  • select appropriate tests

- prepare BRIBES (stickers, toys, games, prizes)

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13
Q

C. Prepare testing area

A
  • clean and clutter free

- not distracting

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14
Q

D. Assess Related Areas

A
  1. hearing
  2. orofacial structures
  3. DDK syllable rate
  4. speech rate
  5. speech intelligibility
  6. level of stimulability.( cant imitate a model)
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15
Q

screen language

A
  • give a RECEPTIVE VOCABULARY test (n bring in test and ask client to point at stuff)
  • this works well if they are unintelligible
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16
Q

F. Administer tests

A
  • get a spontaneous sample

- use standardized tests– some school districts demand norms

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17
Q

G. Discuss Findings and Make Recommendations

A
  • share info

- be positive and clear

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18
Q

H. Write a report

A

-legal document - attorney

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19
Q

hearing screening

A
  • SLPs can screen
  • in schools, nurse usually does it
  • pure tone air conduction thresholds at 20 or 25 dB
  • refer to physician, audiologist if suspect a problem
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20
Q

Diadochokinetic syllable rates

A
  • DDKs refer to the speed and regularity with which a person produces repetitive articulatory movements
  • alternating motion - same syllable /p^p^p^p^/
  • sequential motion - different syllables /p^t^k^p^t^k^/
  • we are evaluating ORAL MOTOR COORDINATION
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21
Q

In evaluating oral motor coordination, we are looking for…

A
  • speed
  • accuracy
  • sequencing problems
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22
Q

conducting an oral peripheral examination

A. Purpose

A
  • helps differentiate: functional or organic
  • functional: not associated with an organic or neurological impairment (have no idea)
  • organic : some underlying structural , sensory, or neurological cause or related factor
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23
Q

B. supplies

A
  • penlight, gloves, stopwatch, tongue depressors
  • tasty tongue depressors are best
  • Dr. R’s was ‘o guim technique
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24
Q

C. 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?
    - is there adequate speed and range of motion?
    - puff cheeks and hold in air
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25
Q

D. Assessment of structure and function of tongue

A
  1. structural integrity - normal color
    - abnormal movements like fasciulations/tremors
  2. Functional integrity
    - stick out your tongue - does it come out far enough? deviate to one side?
    - stick out your tongue and hold it (5)
    - protrude your tongue, resist the tongue depressor
    - elevate and lower tongue tip, side to side
26
Q

E. Assessment of Hard Palate

A
  • Normal color?
  • normal height and width? (too narrow?)
  • clefts?
27
Q

F. 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?
28
Q

G. assessment of teeth

A
  • LABIOVERTED- tilt outward towards lips
  • LINGUAVERTED- tilt inward toward tongue
  • MALOCCLUSION
  • OPEN BITE- lack of contact between upper and lower teeth
  • CROSS BITE: lateral overlapping of upper and lower dental arches
29
Q

Obtaining a spontaneous sample

A
  • ideal- representative of daily life
  • collect 50-100 utterances
  • time-consuming, hard with highly unintelligible children
30
Q

practical tips

A
  • family member, friend if needed
  • no loud toys
  • let them hear themselves
31
Q

administering standardized tests

A. introduction

A
  • advantages
  • quick (15-20 min)
  • sample all consonants
  • you know what the highly unintelligible ch Should be saying
32
Q

Disadvantages of administering standardized tests

A
  • just single words, not connected speech
  • ch w/ oral motor probs. do better in single words
  • each phoneme sampled only once in each position (false negative, false positives)
33
Q

B. obtaining responses

A

-direct vs. delayed imitation

34
Q

C. recording responses

A
  1. plus/minus technique

2. whole word transcription

35
Q
  1. 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

36
Q

D. Commonly-used tests: phonological process.

A

ASSESMENT OF PHONOLOGICAL PROCESSES
-severity rating
-nationwide! (do by hand or computer version, might be true or false question)
KHAN- LEWIS PHONOLOGICAL ANALYSIS

37
Q

Our clinic use the CAAP

A

clinical assessment of articulation and phonology

38
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 (nationwide, year 200)
39
Q

When you record

A

-be sure to gloss or restate the child’s attempt into the recording
(record and repeat what the child says)

40
Q

other types of assessment

A

A. Speech discrimination testing
-minimal pairs
B. Stimulability Testing
-child’s tendency to make a correct or improved production of a misarticulated sound when given a model or additional stimulation by the examiner

41
Q

C. Contextual Testing

A
  • McDonald’s Deep Test
  • SEcond Contextual Articulation Test (S-CAT)
  • special procedure that can help ID a FACILITATIVE PHONETIC CONTEXT for correct production of a particular phoneme
42
Q

Analyzing and interpreting assessment information

A

A. Analysis of speech sound production

  • independent analysis: childs production transcribed without reference to adult model
  • ID sounds that are in the childs phonetic inventory
  • relational analysis: compare childs production to standard/adult form
43
Q

C. traditional Analysis

A

`1. errors IMF

2. Error types– omission, distortion, substitution, addition

44
Q

D. developmental analysis

A

compare childs production to norms for CA (public schools)

45
Q

E. 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/
46
Q
  1. Phonological process analysis
A
  • analyze PPs in terms of frequency, PERCENTAGE OF OCCURENCE
  • Total # of occurrences of final cons. deletion =10
  • Total # of opportunities for the process=50
  • Total= 20% occurrence
47
Q

F. Linear Phonological error pattern analysis

A

-

48
Q

G. Phonetic Inventory analysis

A

-does the client have the motor ability to make the sound?

49
Q

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 “
50
Q

Making a diagnosis.

A. Typical Speech Skills

A
  1. errors- normal age range
  2. errors –> L1 transfer
  3. errors, but don’t interfere with life
51
Q

B. Disorders-articulation Disorder

A
  1. Errors associated 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
52
Q

C. Disorders- phonological disorder

A
  1. highly unintelligible speech
  2. MULTIPLE MISARTICULATION
  3. restricted phonetic inventory
  4. PATTERNS of errors (e.g., final consonant deletion, cluster reduction)
53
Q

D. Severity Estimate– disorder is

A
  • mild
  • mild-moderate
  • moderate
  • moderate-severe
  • severe
  • profound
54
Q

E. Diagnostic Statement

A
  • a SUMMARY – one of the last portions in a written report

- its very important that this be well done, because it all most people ever read ) parents, principles, pediatricians)

55
Q

Determining prognosis

A

-prognosis: estimated course of a disorder under specified conditions
EX: what will happen if teaching is offered– or not?
-variables contributing to prognosis (pg 301 know for exam)

56
Q

Roseberry

A

under-promise and over deliver

57
Q

Major components of a good prognostic statement (pg 302)

A
  1. GOAL STATEMENT: skills ch expected to achieve- be specific (fair, good, excellent)
  2. JUDGEMENT OF SUCCESS
  3. PROGNOSTIC VARIABLE - that justify the judgment
58
Q

Making Therapy Recommendation

A
  1. Ch has SSD- Recommend treatment
  2. Ch has errors, but age appropriate - no treatments, re-eval later
  3. Typical speech-no treatment- maybe 1st lang transfer, or subtle problems that don’t impact life
  4. Ch has SSD, but no immediate treatment (motivation is structure)
59
Q

Concluding the Assessment Process

A
  • diagnostic report

- conduct information giving interview

60
Q

information-giving interview

A
  • begin with positives
  • Summarize findings, conclusions, recommendations-next steps
  • don’t fear the butter
61
Q

Diagnostic report

A
  • legal document- could end up in hands of a lawyer w/o your permission
  • typos, other errors are death
  • peoples first impressions of you

exam 3 sphp 126 (2 decks)

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