1. n Assessment Procedures for Children with Speech Sound Disorders

2. For assessment and other information about speech sound diorders: n http://www.asha.org/public/speech/disorders/ SpeechSoundDisorders/

3. I. INTRODUCTION** n Assessment—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 n Diagnosis—conclusion you arrive at n 1) Determine if the child has a clinically significant problem n 2) Describe the characteristics of problem

4. II. SPEECH SCREENINGS** n Screening: pass/fail procedure that can be conducted quickly with a large numbe of individuals in a short period of time n No info on test 3 re: specific screening instruments (p. 263) n Ch: converse, say ABCs, count to 10 ä Adults—conversation, reading

5. I assessed Emmanuel n 5 years old, Spanish at home— difference or disorder? n Tx or no tx— give him time?

6. In schools in California

7. In the schools…** n Put the child on “monitor” status n I say to a kindergarten teacher, e.g.: n “He is still quite young, so I will re-check him again in January. If he still doesn’t technically qualify for speech, I can re-screen him in first grade.”

8. III. GENERAL PRINCIPLES OF ASSESSMENT** n A. Review the Client’s Background ä 1. Written case history forms ä 2. Information from other professionals –3. Conduct interview

9. 1. Written case history forms

10. 2. Information from other professionals

11. 3. Conduct an interview

12. We need to ask:

13. Close the interview** n Recap important points n Be sure to tell the person that you will share test findings with them n Thank them for their time

14. n B. Plan Assessment Session n C. Prepare Testing Area

15. n D. Assess Related Areas

16. E. Screen language

17. n F. Administer Tests** n Get a spontaneous sample n Use standardized tests—some school districts demand norms

18. n G. Discuss Findings and Make Recommendations n H. Write Report

19. IV. HEARING SCREENING** n SLPs can screen n In the schools, nurse usually does this n Pure tone air conduction thresholds at 20 or 25 dB n Refer to physician, audiologist if suspect a problem

20. V. DIADOCHOKINETIC SYLLABLE RATES** n DDKs refer to the speed and regularity with which a person produces repetitive articulatory movements n Alternating motion—same syllable /p ʌ p ʌ p ʌ p ʌ / n Sequential motion—different syllables /p ʌ t ʌ k ʌ p ʌ t ʌ k ʌ / n We are evaluating oral motor coordination n You do NOT need to memorize the chart on p. 266!

21. In evaluating oral motor coordination, we are looking for:

22. VI. CONDUCTING AN ORAL PERIPHERAL EXAMINATION** n A. Purpose n Helps differentiate: functional or organic n Functional: not associated with an organic or neurological impairment n Organic: some underlying structural, sensory, or neurological cause or related factor

23. B. Supplies

24. C. Assessment of Structure and Function of Facial Muscles** n 1. General symmetry of face at rest— drooping? Twitches? n 2. Facial symmetry during smiling, opening mouth n 3. Structural integrity of lips—drooping? Mouth breathing?

26. D. Assessment of Structure and Function of Tongue

27. n 2. Functional integrity

28. n E. Assessment of Hard Palate** n Normal color? n Normal height and width? (too narrow?) n Clefts?

29. Narrow, high, vaulted hard palate: (normal, thumb sucker)**

30. n F. Assessment of Soft Palate

31. n G. Assessment of Teeth

32. Crossbite

33. Tonsils/adenoids**

35. More tonsils/adenoids**

36. Swollen tonsils/adenoids**

37. Bifid Uvula**

40. VII. OBTAINING A SPONTANEOUS SAMPLE** n Ideal—representative of daily life n Collect 50-100 utterances n Time-consuming, hard with highly unintelligible children

41. Practical tips:

42. VIII. ADMINISTERING STANDARDIZED TESTS** n A. Introduction n Advantages n -quick (15-20 min.) n -sample all consonants n -you know what the highly unintelligible ch should be saying

43. Disadvantages:

44. n B. Obtaining Responses** n Direct vs. delayed imitation n C. Recording Responses 1. Plus/minus technique 2. Whole word transcription

45. 3. Record type of error:** a. Omission (-) b. Substitution t/k, d/g, w/r c. Distortion—D or D1-D3 d. Addition—transcribe whole word

46. D. Commonly-Used Tests: Phonological Processes** (for the exam, you only have to know the ones in orange font) n 1. Natural Process Analysis (NPA) (8 PPs) n 2. Assessment Link Between Phonology and Articulation (ALPHA) (50 words; transcribe  PPs or artic)

47. n 3. Assessment of Phonological Processes- Revised (APPR; Hodson) 2008 March—APP:3 (computerized version too)** Severity rating

48. n 4. Bankson-Bernthal Test of Phonology (BBTOP) (80 words; 9 PPs)** n 5. Khan-Lewis Phonological Analysis (first give Goldman-Fristoe) (10 PPs) n 6. Phonological Process Analysis (12 PPs) (Weiner)

49. Our clinic uses the CAAP:** n Clinical Assessment of Articulation and Phonology

50. E. Commonly-used Tests: Articulation** n 1. Arizona Articulation Proficiency Test-3 n 2. Photo Articulation Test (PAT:3) n 3. Goldman-Fristoe Test of Articulation:2 n 4. Test of Minimal Articulation Competency (TMAC)

51. When you record….

52. Youtube n GFTA-2 n TAGroup

53. IX. OTHER TYPES OF ASSESSMENT** n A. Speech Discrimination Testing n Minimal pairs n B. Stimulability Testing n **Stimulability is the child’s tendency to make a correct or improved production of a misarticulated sound when given a model or additional stimulation by the examiner

54. n C. Contextual Testing** –McDonald’s Deep Test –Secord Contextual Articulation Tests (S- CAT) –Special procedure that can help id a facilitative phonetic context for correct production of a particular phoneme

55. X. ANALYZING AND INTERPRETING ASSESSMENT INFORMATION** n A. Analysis of Speech Sound Production n Independent analysis: child’s productions transcribed without reference to adult model n Id sounds that are in the child’s phonetic inventory n **Relational analysis: compare child’s production to standard/adult form n B. Linear Phonological Error Pattern Analysis (not on test)

56. n C. Traditional Analysis n 1. Errors IMF n 2. Error types—omission, distortion, substitution, addition n D. Developmental Analysis n Compare child’s production to norms for CA (**public schools)

57. n E. Pattern Analysis 1. Distinctive Features  2. Place-Voice-Manner –PVM: teach exemplars in the sound class  generalization –Teach /k/  /g/ –(fricatives) Teach /f/  /s/

58. –3. Phonological Process Analysis** –Analyze PPs in terms of frequency, percentage of occurrence –Total # of occurrences of final cons. deletion = 10 –Total # of opportunities for the process = 50 –Total = 20% occurrence

59. n F. Linear Phonological Error Pattern Analysis pp. 282-middle of 283 not on exam n G. Phonetic Inventory Analysis ä Does the client have the motor ability to make the sound?

60. n H. Intelligibility Analysis** n 60 intelligible words out of 170 words = 35% intelligibility n 30 intelligible words out of 56 words = 54% intelligibility n Usually—subjective statement “This examiner estimates that in a known context with an unfamiliar examiner, Joey is 50% intelligible in connected speech.”

61. XI. MAKING A DIAGNOSIS n A. Typical Speech Skills n 2. n 3.

62. n B. Disorders—Articulation Disorder

63. C. Disorders—Phonologicval Disorder

64. D. Severity Estimate-- Disorder is:** n Mild n Mild-moderate n Moderate n Moderate-Severe n Severe n Profound

65. E. Diagnostic Statement** n A summary—one of the last portions in a written report It’s very important that this be well done, because it’s all most people ever read (e.g., parents, principals, pediatricians)

66. On the bottom of p. 299 and the top of p. 300…** n There are some really good examples of diagnostic statements n Please feel free to use in your group project report

67. XII. DETERMINING PROGNOSIS** n Prognosis = estimated course of a disorder under specified conditions n E.g., what will happen if tx is offered—or not? n Variables contributing to prognosis (p. 301— please know for exam)

68. Roseberry:

69. 3 Major components of a good prognostic statement (p. 302):

70. XIII. MAKING THERAPY RECOMMENDATIONS

71. XIV. CONCLUDING THE ASSESSMENT PROCESS** n Diagnostic report n Conduct information-giving interview

72. Information-giving interview

73. Roseberry’s examples:** n I loved working with Manuel. He is so cooperative and sweet! We will definitely need to enroll him in speech for ****. I look forward to working with him. n Jennifer is so much fun—and so motivated to improve! I am looking forward to seeing her for therapy.

74. XV. DIAGNOSTIC REPORT