115 Chapter 13: Clinical Methods Speech

Articulation and phonology

Difficulty producing and organizing speech sounds

Fluency

Smoothness of speech

Voice

Vocal quality

Assessment Process

Determine there is a problem

Identify the problem

Establish intervention goals

Questions to answer with an assessment

What can the client do independently?

What can’t the client do independently?

What can the client do with help (and what kind of help?)

Therapy Process

Collect baseline (pre-intervention) data

Use evidence-based practice to provide intervention (collect data each session)

Collect post-intervention data

Assessment

A systematic process for gathering information from a variety of sources to describe a client’s strengths and weaknesses and how to address them

Standardized Assessment

Provides information about how a client’s performance compares to a group and/or standard

Dynamic Assessment

Provides information about the types of support that improves client performance

Authentic Assessment

Provides information about how a client functions in their “natural” environment

Objective for speech assessment in children

Assess the ability to fluently produce speech sounds in isolation, in words, and in sentences using standardized and unstandardized assessments

Standardized speech assessment for children

GFTA-3, CAAP-2, or SSI-4

Unstandardized speech assessment for children

Observation, parent/teacher report, or conversation

Objective in speech assessment for adults

Identify the presence of a motor speech or voice disorder using standardized and unstandardized assessments

Standardized speech assessment for adults

ABA-2, FDA-2, or CAPE-V

Unstandardized speech assessment in adults

Observation, family report, or conversation

Client Specific strategy for establishing goals

Targets are chosen based on person’s specific needs

Baseline Data

Shows current performance on specific therapy tasks

Uses therapy-specific tasks and stimuli

Taken without cues or feedback to measure independent performance

Guides treatment planning and progress monitoring

Assessment tells you

What to treat

Baseline tells you

Where to start and how to measure goals

Client preference

Client testimony

Internal evidence

Unpublished data

External evidence

Published, peer-reviewed, scientific studies

How to teach new skills

In highly structed situations with multiple prompts and maximal support

How to handle intermediate skills

Increase level of difficulty/complexity and decrease support from the clincian

How to handle advanced skills

Client demonstrates generalization of each newly learned behavior by using it in novel situations or context

Speech therapy for infants/preschool children

Play-based activites

Speech therapy for school-aged children

Play-based, structed therapy activities

Speech therapy for adults

Structured therapy and functional activities

How to determine termination of therapy

Client’s communication skills align with chronological/developmental age, functional communication skills allow them to function in daily environment with minimal assistance, and progress has plateaued for a pre-determined amount of time

S in SMART Goals

Specific

M in SMART Goals

Measurable

A in SMART Goals

Attainable

R in SMART Goals

Relevant

T in SMART Goals

Time-Based