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Assessment of Disorders of Speech, Voice, Fluency and Swallowing > L5 Speech Sound Disorders > Flashcards

L5 Speech Sound Disorders Flashcards

1
Q

consequences of a speech impairment on a child

A
  • functional
  • social interaction
  • self-esteem
  • frustration
  • academic
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2
Q

components of a comprehensive speech evaluation

A
  • Auditory discrimination
  • Phonology/articulation test
  • Stimulability assessment
  • Phonological awareness
  • Conversational speech assessment
  • Oro-motor examination
  • Hearing test
  • Additional measures of overall development: motor, cognitive - refer to other professions
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3
Q

what is a stimulability assessment

A
  • Phoneme repetition: “watch and listen to what I’m going to say, then you say it”
  • Hierarchy: sound/syllable/word
  • Cued stimulability
  • Visual
  • Phonetic (place/ manner of artic)
  • Tactile
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4
Q

why do we test for stimulability

A
  • To find out whether production is possible when elicitation conditions are modified.
  • Better prognosis for stimulable sounds: may develop spontaneously
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5
Q

describe phonology/articulation tests

A
  • Elicit spontaneous naming of pictures presented
  • Test most consonants in initial/medial/final position
  • Mostly single word responses
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6
Q

advantages of phonology/articulation tests

A
  • Easy to administer and score
  • Quick
  • Data easily quantifiable
  • Some provide standardised scores
  • Document need for, and progress in therapy
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7
Q

disadvantages of phonology/articulation tests

A
  • Single word production not necessarily representative of production in connected speech
  • May not provide enough data for a phonological analysis
  • May not test all sounds e.g. vowels, clusters
  • Sounds not in comparable phonetic contexts e.g. words of varying length & complexity
  • Different sounds before and after tested consonants
  • Explores performance on a specific day, with specific items in a unique situation
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8
Q

why do we like the DEAP

A

it’s standardised for irish children

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9
Q

four assessments of the DEAP

A
  • diagnostic screen
  • articulation and oro-motor
  • phonolgy
  • inconsistency
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10
Q

diagnostic screen

DEAP

A

Name 10 pictures twice + speech sound stimulability

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11
Q

articulation and oro-motor assessment

DEAP

A

name 30 pictures, stimulabiltity, oro-motor including DDK screen

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12
Q

phonology assessment

DEAP

A

name 50 pictures, picture description task for connected speech

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13
Q

inconsistency assessment

DEAP

A

production of 25 words 3 times and ensure elicited the same way each time

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14
Q

what qualitative data is retrieved from the DEAP

A
  • Phonetic consonant inventory
  • Error patterns
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15
Q

what quantitative data is retreived from the DEAP

A
  • DDK, isolated movements, sequenced movements
  • PCC, PVC, PPC
  • Single word vs connected speech agreement
  • Inconsistency rating
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16
Q

cueing hierarchy

elicitation

A
  • Semantic cue - its an animal that lives in the zoo
  • Syntactic cue - an animal that is like a horse but it has black and white stripes is
  • Phonological cue - it starts with /z/
  • Binary choice - is it a zebra or an elephant
  • Imitation - say zebra
17
Q

typical phonological processes

according to DEAP

A
  • Weak syllable deletion
  • Final consonant deletion
  • Cluster reduction
  • Context-sensitive voicing
  • Velar fronting
  • Palatal fronting
  • Stopping of fricatives
  • Stopping of affricates
  • Deaffrication
  • Gliding of liquids
  • De-rhotacization
18
Q

disordered phonological processes according to DEAP

A
  • Backing stops/fricatives
  • Affrication
  • Initial consonant deletion
  • Medial cons. deletion
  • Instrusive consonants
  • Denasalisation
  • Favoured sound
  • Glottal replacement
  • Stops replace glides
  • Metathesis
  • Migration
  • Unusual substitutions
  • Vowel processes
19
Q

assessment of polysyllabic words

A
  • Children produce polysyllabic words less accurately than 1 or 2 syllable words
  • Phonological processes occur more frequently
  • Percent phonemes correct is also lower
  • Phonological processes are evident for longer
    • Evident for up to 7 years for WSD (James et al, 2008)
20
Q

how to measure consistency of errors

A
  • This is measured by getting the child to repeat a series of words more than once.
  • DEAP screener = 10 words
  • Calculate the number of inconsistent words, i.e. words produced differently on both occasions (e.g. 3/10 = 30%).
  • If >40% inconsistent then you administer the Inconsistency subtest of the DEAP. This will impact on diagnosis.
21
Q

factors to consider when choosing assessment

A
  • Appropriateness for age/developmental level
  • Standardised?
  • Facility for analysis(phonetic and phonemic)
  • Speech sample
    • Adequate
    • Relevant
  • Culturally appropriate
  • Time it takes
  • Word and conversation level?
    • Words: adequate representation of words in all positions
    • Phonetic environments
    • Syllable shapes
    • Multisyllabic words
  • Syllables and stress?
  • Stimulability?
  • Inconsistency?
22
Q

assessing a conversational speech sample

A
  • More representative of normal speech
    • Assimilation
    • Expressive language demands
  • Plan for diversity
    • Picture description/ story telling/ problem solving
    • Conversation (Levels of questions)
    • Play with carer
  • Target sounds that artic. test did not sample, or that child produced as error in artic test
    • Compare productions citing/talking
    • Provide objects or pictures that may elicit the target sounds
  • Recommended length = 200-250 words (Grunwell 1987)
  • Minimum = 100
  • It takes approx. 10 to 15 minutes to gather this size sample
  • Need to video/tape and transcribe
  • Gloss and transcribe live as much as possible
23
Q

considerations when assessing conversational speech sample

A
  • More complex linguistic content causes an increase in misarticulations (Pangos et al 1982)
  • Different communicative needs may influence production accuracy, e.g. improve when trying to tell you something very important (Menyuk 1980)
24
Q

analysing the data retrieved from conversational speech sample

A
  • Identifying processes: typical and atypical
  • Percentage Consonants Correct (PCC)
  • Phonotactics
    • The frame of words – syllable/word shape – e.g. CV, CVCV, CVCVC
  • Measure of intelligibility
  • Observe voice and resonance
    • Any abnormal hoarseness or breathiness, hypo or hypernasality
  • Fluency (stuttering or cluttering)
25
Q

measuring severity

A
  • intelligibility
  • concern caused to child, parent or teacher
  • consequences
26
Q

influencing factors on intelligibility

Connolly, 1986

A
  • Loss of phonemic contrasts - Number of meaning distinctions lost
  • Extent of difference between target and realisation
  • Consistency target/realisation relationship
  • Frequency of abnormality
  • Familiarity of the listener
  • Communicative context
27
Q

consequences of speech disorder

measuring severity

A
  • Emotional consequences - frustration, anxiety
  • Inappropriate behaviour - withdrawal, tantrums
  • Influence on ability to from relationships
  • Elicit changes in adult language - lower expectations
28
Q

assessing a child with emerging phonolgy

A
  • Cannot use an articulation test due to their limited vocabulary
    • Try naming common objects
    • Have carer bring a number of objects child can name
    • Carer keeps log of words and pronunciation
    • Family tape-record child at home
  • Speech sample
    • Observe child with carer before/after session (if shy)
    • Choose a topic and attempt to structure situation as much as possible - Routine events + Descriptions of an action just completed together
    • This will facilitate you to know what the target vocabulary was within the interaction
  • Oro-motor
  • Report the child’s phonetic inventory, i.e. consonants used, vowels used, syllable shapes used and any constraints observed.
29
Q

red flags for speech delay in toddlers

A
  • Extremely limited phonetic inventory (e.g., only labial consonants; only central vowels)
  • Word-final phonetic inventory substantially larger than wordinitial inventory
  • Unusual vowel errors
  • Atypical consonant substitutions (e.g., substitution of glottal consonants; backing)
  • Atypical consonant deletions e.g. frequent initial consonant deletion

Assessment of Disorders of Speech, Voice, Fluency and Swallowing (8 decks)

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