PEL 232 - Assessment of Communication Disorders

A child excitedly points at text and pictures and orally recalls sentences and phrases from a story. What is this an example of...

Written text can be spoken words. Phonemic awareness is individuals sound in spoken words. Phonological awareness is spoken parts of sentences or words.

For ethnographic interviewing use

Open ended questions, avoid why questions and yes or no, avoid back to back questions, restate verbatim don't paraphrase.

Re reading text fluently to understand a new word promotes

Deeper comprehension of text and improved meta awareness or reflection.

Informal or non standardized assessments yield information - the best ways are

Pragmatic and behavioral observations in natural settings, structured and spontaneous sample of client language. Sample in more varied situations gives accurate profiling.

Dynamic assessment can help distinguish

A language disorder vs a language difference (I.e., in short term teaching sessions children who make significant changes have a language difference. Children who can't make changes regardless of short term intervention probably have a disorder).

Coughing is a protective reflex of the airway for

Clearing particles, foreign matter, and mucous.

Larynx rests on top of

Trachea

In speech sound production, single word testing accounts to identify

Production units and eliciting sound but not in connected speech if it's just phoneme production in single words.

Connected speech sampling collects data on

Phoneme production in normal conversation.

Ways to collect connected speech sample

Story, retell, picture description, varied speech tasks with parents, teachers, peers

To evaluate the phonological system

Initial, medial, and final word positions, consonant clusters, vowel combinations, blends sequences, syllable shapes like CV to CCVCC, errors of substitution, omission, deletion, addition, consistent distortion, phono error patterns like stops or fricatives, and multisyllabic words.

For speech perception testing employ

Stimulability testing

Auditory discrimination of speech sounds

Speech production perception task - pictures are presented to student

And they are required to point to the picture the clinician says

mispronunciation task - visual picture and audio recording of a word, either pronounced correctly or not or with a single phoneme error.

Lexical decision or judgement task - contrasting phonemes by multiple speakers. Must select picture or X.

To assess fluency

Spontaneous speech sample

The onset (beginning) of stuttering comes around the ages of

2.5 and 4 years of age.

chronic vocal strain/abuse, which can create

nodules or polyps on the vocal cords causing hoarseness and discomfort

Many vocal and resonance disorders originate from

Velopharyngeal dysfunction (VPD)

Velopharyngeal dysfunction

inadequate closure of the port between the velum and pharynx, allowing air leakage into the nasal passages during speech.

VPD can be caused by

cleft palate, a shortened soft palate, a deep pharynx, anomalies of the cervical spine, etc.; physiological/neurological disorders, e.g., apraxia. Dysarthria and irregular articulation patterns and abnormal placement (velopharyngeal mislearning).

One of the best known VPD causes is

cleft palate

Speech evaluation with suspected VPD, an evaluation would consist of

Perceptual speech evaluation, articulation evaluation, dysphonia assessment, oral mechanism evaluation, standardized speech and lan assessments, and instrumental evaluation.

Standardized speech and language assessments provide valuable comparisons of client performance to

population norms

Children who have cleft palates and/or suspected velopharyngeal dysfunction (VPD) can have

nasal air emission due to VPD, resonance disorders due to either or both cleft palate and VPD or both of these coexisting.

SLPs assess resonance by having the client utter

voiced sounds including vowels, vocalic consonants (e.g., /b/, /d/, /g/, /dʒ/, /l/, /m/, /n/, /r/, /v/, /w/, /j/ [the initial letter y], and /z/) and nasal consonants (e.g., /m/, /n/, and /ŋ/).

Infants with cleft palate produce fewer

consonants and multisyllabic productions, and they tend to avoid alveolar (t,d,n, s,z, l) and palatal consonants (ch, j, y)

The early consonant sounds of children with a cleft or VPD are

nasal, glide, and stop

SLPs assess airflow and air pressure by having the student produce

high-pressure consonants including stops (e.g., unvoiced: /k/, /p/, /t/;and voiced: /g/, /b/, /d/), fricatives (e.g., unvoiced: /f/, /h/, /s/, /ʃ/;and voiced: /v/, /z/, and /ʒ/), and affricates (e.g., unvoiced: /ʧ/; and voiced: /dʒ/).

When the SLP is evaluating articulation as part of an assessment of a client with identified or suspected cleft palate and/or suspected velopharyngeal dysfunction (VPD)

the evaluation should include both a speech sample of conversation and informal, structured speech tasks such as having the client repeat consonant-vowel (CV) utterances, words, and sentences, and activities involving elicited naming.

Pointing at a picture, object, or body part, retrieving an object when asked, and following unfamiliar directions are examples of

action responses

Nodding, gesturing, and facial expressions in response to questions are examples of

conversational/social response

The latter of receptive communication requires

joint attention and nonverbal or prelingual communication

In action/active responses

a child might select familiar objects, identify familiar pictures in books, follow new directions, or demonstrate receptive understanding of action verb meanings by completing requested actions.

In conversational/social responses, a child might respond to questions such as

a child might respond to questions such as "Is this where I should put this?" or "More?" by head nodding/shaking, physical gestures, and/or facial expressions, without needing to respond with any other action or activity.

Children with age-level receptive action skills but low receptive communication/social skills typically have

age-level cognitive ability but difficulties with speech and nonverbal communication skills

The expressive subscale includes

naming objects; using concepts describing objects; expressing quantity; and using grammatical markers

For older children, the expressive subscale includes

word segmentation, analogy completion, and sequential short storytelling,

Three major categories of communication skills included in pragmatics are explained as follows

Language for various purposes - greet, request, demand, inform, or promise

Changing language corresponding to a situation's or listener's needs

Following rules for conversing and storytelling

Individuals with autism spectrum disorders (ASDs) frequently have deficits in the ability to

interpret the meaning of nonverbal communicative signals.

ASD individuals tend to understand only

literal word meanings

SLPs can explain what to those with ASD who are literal language oriented

metaphors, analogies, and other figurative expressions to them; with enough exposure, experience, and practice, they can learn to recognize and/or decipher figurative meanings

SLPs can help those with ASD to learn to increase eye contact gradually to

facilitate communicative and social interactions. Help with sensory sensitivity

When deciding on an AAC...

An ecological inventory is one example of a valid evaluation procedure. Typical components include briefly describing the setting, persons present, and how many reasonsand opportunities the examinee was given to participate and/or communicate

To conduct an ecological analysis for AAC evaluation, first the SLP should

observe a typical, nondisabled peer of the client participating in the applicable activity in the specific setting identified.

Next the SLP would measure the client's abilities and compare them to the abilities demonstrated by the peer during the observation.

When assessing an individual for potential augmentative/alternative communication (AAC) device use

the SLP needs to obtain input from multiple multidisciplinary service providers.

Then the SLP can match the individual client's skills with

different AAC options whose operational requirements are most compatible

individuals with hearing losses above 25-30 dB

do not produce otoacoustic emissions.

Speech testing can be done in noisy environments for

understanding speech in presence of background noise

FM/DM system helps reduce

background noise

Otoacoustic Emissions

-decrease or become undetectable when hearing loss exceeds 25-30 decibels (dB) --> mild

- detect mild hearing impairment