Speech Comprehension assessment and intervention Flashcards
What is aim of assessment?
What does this inform?
Identify level of breakdown of auditory comprehension.
Informs level of intervention and avice given to PwA and family.
Name the 3 levels of auditory comprehension assessed.
Single word comprehension
Phrase and sentence comprehension
Discourse comprehension
PALPA bottom up model
spoken word
auditory phonological analysis: speech sounds identified
phonological input lexicon: speech sounds recognised as word
Semantic system: understanding, the meaning of the word accessed.
The bottom up model is not used exclusively, what other model is used?
The top-down model.
The speaker has expectation of what a speaker will say.
PALPA top-down model
Environment, context
Knowledge of topic and of speaker
Syntax
Semantics
Top down and bottom up processes are used at the _____ ____.
same time.
Speech Comprehension
Single Word level.
Assessment.
Aphasia Screening Test- single word to picture matching
PALPA 53- single word to picture matching
CAT- single word to picture matching with phonological, semantic and unrelated distractor.
Informal test e.g. lift the cup.
Speech Comprehension
Single word level
Intervention
Often starting point for therapy :)
When appropriate move to phrases.
Tasks similar to those in assessment- but not test material.
More likely to understand:
high frequency words
concrete words
vocabulary of significance
Keep stimuli meaningful and functional, interesting to them
Consider number of items presented
Consider nature of distractors e.g. semantic
What should you be careful not to do?
Don’t eye point to correct answer.
What is it important to minimise?
Minimise distraction
Minimise fatigue
Consider yourself
consider: speech rate speech clarity use of encouragement, recognition and reinforcement of correct response. use of cues. feedback to PwA.
Phrase and sentence level
Assessment.
Aphasia Screening Test
CAT
PALPA
spoken sentence to picture matching
Set of pictures (1 target 3 distractors) usually used.
Informal:
give them instructions involving them doing something with and object. e.g. lgive me the banana.
answering Y/N questions e.g. is it friday today?
Use passive SVO sentences, relatively short and simple.
Why is sometimes natural speech easier than single word level to understand?
Can use syntactic structure and other words around words they don’t understand to help them work out meaning of sentence.
Also situational context can help with meaning.
Factors affecting comprehension of speech
hearing acuity cognition motivation fatigue education and experience speaker rate, loudness and clarity of speech familiarity with speaker context both linguistic and natural.
Phrase and Sentence level
Intervention.
picture choice from auditory stimulus e.g. the woman is driving.
hierarchy of complexity, distractors etc.
Carrying out instructions
Answering closed questions- Y/N questions
Mapping Therapy- listen to sentence then answer questions.
