Lecture 3 Flashcards
What are the different assessment possibilities
> Screening> Comprehensive appraisal (Core procedures= required and optional procedures = not required)
What is the purpose of screening?
To identify the need for further assessment
What 4 things are involved in the Core assessment?
- Case History2. Oral peripheral exam/screen3. Single word testing (Artic/phonology)4. Spontaneous speech
Give summary of option procedures in assessment
> Stimulability testing (important for TX)> Contextual facilitation testing (important for TX)> Vowel testing (proposed core)> Phonological awareness (important for DDX)> Speech motor Testing (important for DX/DDX).> Auditory discrimination tests (important for DX/TX)> Cognitive Appraisal (not S-LP domain)
What does informal screening involve?
- Collecting language sample (observing play, reading passage, giving information - address + name, or rote counting/color naming) > Speech perception screening> Vowel Screening > Consonant screening> Speech Characteristics Rating
What are some formal screening tests and how long is each?
> Hodson Assessment of Phonological Patterns (HAPP-3) (preschool and school age) 2-5 min> Sunny Articulation Phonology Test (ipad app) - Evaluation of Articulation and Phonology > (DEAP) -10 items -5 min> Schedule for Oral Motor Assessment (SOMA): 6 months to 2 years (oro-motor control and dysphagia).> Language Screening 1. Clinical eval of language fundamentals-4 screening test; CELF-42. Preschool Language Scale-4 Screening Test (PLS-4)
What is deaps assessment process
> Articulation Ax is followed by a motor screening> Phonological assessment * if consistent ur done* if inconsistent run oro-motor screening
What are the 3 purposes of assessing?
> To identify a disorder and associated areas of difficulty (diagnostics)> To select/revise treatment approach(es) and set long and short term goals> To monitor progress (may include treatment efficacy and decisions regarding discharge)
What is the progression of steps from theory to measuring outcomes?
Theory > assessment > diagnosis/ differential diagnosis > Treatment > Outcome assessment
In the first step of core assessment, What are some possible things to cover in a case history
General identification info (name, age, gender, contact info, caregiver info)Birth history:(pre/peri/post-natal, jaundice, cyanosis, trauma, APGAR score 7-10 normal)Communication: (1st word/phrase? Intelligibility? Fluency, speech characteristics etc)Hearing: (Otitis media?responds when called from different room? Follows instructions? etc)Developmental: (motor milestones-crawl, situp, walk, self-feed? etc)Medical: (Seizures, asthma, allergies, measles, high fevers etc)Educational /School: (Any concerns from teacher?)Psychosocial: (siblings, other adults at home, playmates, strategy for handling frustration? type and level of play, attention, joint attention, intentional communication etc-tx prequisites)Dental: (any concerns?)Nutrition/Swallowing: (drooling, tongue thrust, gagging, head extn for liquids –gravity use etc)Areas of concern identified by Care Givers, othe
What are the two different assessments within the oral mechanism exam (core assessment)
Assessment of structureAssessment of function
Single word testing (core) is usually _____-elicited encouraging _____ production
picture, spontaneous
List some advantage and disadvantage of single word testing
> Easy to administer and score> Fast & Quantifiable data> Control of inventory (syll structure, IMF positions etc)> Pictures usually interesting > provides standard score
List some disadvantage and disadvantage of single word testing
> not representative of connected / natural speech.> Single word tests poorly correlated to speech intelligibility > Often only a single opportunity to produce each sound in each word position exists (attention confounds) > Not all word positions tested for each phoneme > don’t look at vowel production & few clusters
List 5 phonological and articulation assessment tools commonly used in clinical settings
> Goldman-Fristoe Test of Articulation-2 (GFTA-2; GFTA-3)>Structured Photographic Articulation Test (SPAT-D)>Diagnostic Evaluation of Articulation and Phonology (DEAP)> Hodson Assessment of Phonological Processes – (HAPP-3 ed.)> Khan–Lewis Phonological Analysis-2 (KLPA-2, 3)
How shoul SLPs score errors on single word tests
Full word IPA transcription: precise, info on process, vowel distortions, misarticulation
The final core assessment is collecting a spontaneous speech sample - what does this involve?
> Start with standard artic tests > Use age appropriate stimuli to elicit speech> 100 word min, 200-250 perferred> Diverse sample (picture descript, story telling)> DO live transcription
What is Stimulability (optional)
Testing a child’s ability to correctly produce a misarticulated sound when stimulated by the clinician.
When would you want to test for Stimulability (optional) ? What 2 things will this test help you determine?
If there is more than 1 sound involved in the error, run stimulability testing: > To determine which sound you will target in treatment > To determine which complexity level (e.g. syll, word, phrase, sentence) and cueing level you want to start treatment
When testing stimulability what level do you start at and how do you proceed?
> Start at word levelIf they struggle:> Increase cues (in 2-Demensions)> No success go to Syllable level> No success go to IsolationIf good at word level:> Go to Phrase and then sentence level
What are the 3 demensions of the 3-D model of stimulability?
- Time (Temporal domain), 2. Space (cues), and 3. Complexity (linguistic level)
How can we manipulate the temporal domain (From easier to harder)
Simultaneous (Say it with me), Direct imitation (say it after me), Delayed imitation and spontaneous
How can we manipulate the Space domain (From easier to harder)
- Aud + Visual + Tactile cue2. Aud + Visual cue3. Auditory only
How can we manipulate the level of complexity domain (from simple to complex)
- Isolation2. Syllable3. Word4. Phrase5. Sentence
_____ stimulability (easier to elicit) = rapid Tx success. Based on this should we target non-stimulable sounds or stimulable sounds?
High> B/c high stimulability means child is on verge of acquisition, may actually be better to target non-stimulable sounds because they won’t develop without treatment. > However it’s Recommended you choose a bit of both. Stimulable sounds reinforce success and motivation in Tx and lay foundation for development of non-stimulable items while non-stim targets induce widespread change in system.
What are the 7 optional procedures?
- Stimulability testing (important for TX)2. Contextual facilitation testing (important for TX)3. Vowel testing (proposed core)4. Phonological awareness (important for DDX)5. Speech motor Testing (important for DX/DDX).6. Auditory discrimination tests (important for DX/TX)7. Cognitive Appraisal (not S-LP domain)
Within optional category, what is contextual facilitation testing (3 main components)
> Using the context to facilitate phoneme acquisition1. Syllable stress: Always embed target in STRESSED position2. Word position: Where the sound is in the word (initial sp and tr/dr/gr clusters are easier)3. Adjacent sounds (feature sharing facilitates production - ex. using alvelors/velars to facilitate [r] ex 2. [ts] cluster easier for /s/ production like in cats)
At the word position level, what are the two rules to determine what phonetic environments will be easier to elicit a target
Easier in phonetic environments that (a) share at least some articulatory features OR (b) reduction of articulatory load/complexity.
Vowel testing is another optional procedure. what accounts for vowel distinctiveness in speech?
vowel distinctiveness is the product of tongue height, front-back and lip rounding/ spreading and it accounts for 50% of variance in speech intelligibility
Vowels are largely neglected by most articulation tests except…?
exception DEAP, New GFTA-3
What 6 process errors can occur with vowels?
- Backing [I]→[ʊ] same height.2. Fronting [u] → [i]3. (de)centralization [ԑ]→ [ᴧ]; [ᴧ] → [ԑ]4. Raising /Lowering [æ]→[ԑ] (vice versa).5. Dipthongization [a] → [ai] 6. Harmony [tԑdi] → [tԑdԑ]
True or false. Instead of running a full vowel screening you can simply listen to vowel errors on artic test and transcribe them?
True
Review samanthas case of vowel errors
And ask aravind if ur right
True or false, Children with phonological disorders often have deficits in PA abilities and are at risk for poor long term outcomes in reading and writing without intervention
True
Phonological awareness, phoneme-grapheme correspondences, and phonetic decoding skills are indicators of ______ success.
reading
What is the Informal testing of phonological awareness?
Phonological awareness skills test (PAST)-See RESOURCE hand out 9** need to work on if child missed >2 of 6
What is the formal assessment of phonological awareness?(probs not super important)
Phonological awareness test-2 (5yr-9yrs)-40 minSubtests: Rhyming Discrimination, Blending Syllables and Phonemes, Graphemes etcFlexible Item Selection Task
