Unit 3 Exam Peds Speech Sound Disorders

determining eligibility

Examination of scores on standardized tests

• What is the cutoff score?

• Intelligibility

•Severity

•Phonological error patterns

•Stimulability

•Developmental appropriateness

intelligibility

How understandable is the client in conversational speech?

•Unintelligibility = social and academic difficulties

•The less intelligible the client, the more likely they should be receiving services.

severity

•Significance or degree of phonological impairment

• Mild, moderate, or severe.

•Percentage of Consonants Correct

• Correlates best with SLPs’ severity ratings of continuous speech.

analysis of phonological patterns

Methods of analysis:

• Formal assessment instruments

• Place-Voice-Manner Analysis

• Phonological Pattern Analysis

Multiple Pattern Occurrence

• Ex: Production of /du/ for “shoe” (/d/ for /ʃ/)

• depalatalization (place of articulation)

• stopping (manner of articulation)

• prevocalic voicing

• Idiosyncratic patterns

• Systematic sound preference: using a sound(s) for a large number of sounds or for an entire sound class(es).

Benefits of a phonological pattern analysis:

• Diagnostic decisions

• Selecting treatment targets

stimulability

The ability of a client to imitate the correct form of an errored sound:

• increases the probability that the client will spontaneously correct the misarticulation and/or

• will make faster progress in therapy.

•Do NOT use stimulability as the sole basis for deciding whether a client should receive intervention.

candidates for intervention

More than 1 SD below the mean on a standardized measure.

• Children 2.5-3 years old who are unintelligible.

• Children 3 years or older who are unintelligible and produce idiosyncratic phonological patterns.

• Children 8 years and younger who score at least 1 SD below the mean.

• Children 9 years or older who consistently produce speech sound errors.

• Teenagers and adults with a negative perception of their phonological errors.

• Consider for evaluation:

Children of any age who are (or parents are) overly concerned about their speech sound productions

target selection

•Developmental Appropriateness

•Individual Speech Sounds

•Phonological Patterns

•Complexity Approach

•Overall intelligibility

•Stimulability

•Frequency of Occurrence

•Contextual Analysis

dialect

A consistent variation of a language, reflected in pronunciation, grammar, or vocabulary

. • Used by a particular subgroup of the population.

• Certain geographical area

• Sociocultural identification

• Ethnic identification

• A person with a “nonstandard” cultural dialect should be considered for intervention when:

• their phonological patterns are outside the cultural norm for their region or ethnic group, or

• the individual wishes to learn a different dialect.

• Dialectal differences are NOT delays or disorders.

social-vocational expectations

With regard to social-vocational expectations, clinicians should consider:

• if there is an extreme concern by the client or family of an articulatory difference

• the perception of the client’s SSD by others (e.g., teachers, peers, etc.)

• the impact of the client’s SSD vocationally and socially

relational analysis (speech sound sampling)

Refers to an analysis of speech sounds where they are compared to the adult or target form of sound productions.

independent analysis (speech sound sampling)

Refers to an analysis of speech sounds without comparison to the target sound or intended production.

 Most commonly used with individuals who are very young or who have limited phonological repertoires.

goals of a speech sound assessment

To determine whether the speech sound system is normal or warrants intervention.

 To identify factors that may be related to the disorder/delay.

 To determine the direction of treatment and selection of targets.

 To make a prognosis.

 To monitor progress.

goals for screening for speech sound disorders

To determine whether young children (e.g., preschoolers, kindergarteners) have age-appropriate speech sound production skills.

 To determine whether older children have resolved developmental errors via maturation.

 To determine the speech sound status of clients referred for other speech-language impairments (e.g., language, voice, fluency)

informal screening measures

An SLP develops or clinic develop their own screening tool.

 Not standardized.

 Do not include normative data.

formal screening measures

Include normative data and/or cutoff scores

 May screen for speech sounds as well as other aspects of speech and language

connected/conversational speech sampling

Observation of speech sound productions in “natural” speaking contexts.

 Allows for contextual testing

Elicitation procedures:

 Engage the client in spontaneous conversation.

 Reading a passage

 Retelling a story

 Telling a story: spontaneous and/or via use of a picture book

Problems with connected/conversational speech sampling:

 Client hesitant to engage in conversation.

 Difficult to obtain a representative sample of all phonemes

.  Unintelligibility.

 Client avoids the production of certain phonemes.

intelligibility (comprehensive speech sound assessment)

Not easily measured.

 Influenced by

:  Number of errors

 Type of errors

 Consistency of errors

 Prosody

 Familiarity of communication partner

 Content of message

Three commons ways to measure:

 Open set

 Closed set

 Rating scale (most problematic)

single word sampling

Examination of phoneme production in the initial, medial, and final position of words.

Elicitation procedure:

 Client names single words in response to picture stimuli.

 Useful in in assessing unintelligible conversational speech

Problems with single word sampling:

 Unable to examine phoneme production in all contexts (e.g., CV vs. CCV vs. CVCV)

 Mostly nouns are used.

goals of stimulability testing

To determine the severity of a SSD.

 To determine which sounds to target in treatment.

 To determine prognosis for treatment.

Elicitation procedure: Ask client to repeat a phoneme that was produced in error.

 If the client can produce the sound with a model, the client is stimulable.

 If the client is not stimulable, provide various level of scaffolding to see if child can produce the sound.

contextual testing

To examine how a phoneme is produced within various phonetic contexts.

 Some phonemes are easier to produce in certain contexts than others:

 Ex: The /k/ sound in “coop.” (easier)

 Ex: The /k/ sound in “clown.” (harder)

 Ex: “dog” (easier)

 Ex: “dogs” (harder)

error pattern identification

To identify use of phonological patterns.

 Ex: Production of /t/ for /s/ and /ʃ/ (phonological pattern of Stopping)

 Helpful in diagnosis and treatment (motor-based vs. linguistically based)

assessmnt in very young children

Assessing phonology in 18-24-month-olds can be complicated.

 Bound by the child’s limited vocabulary skills

.  If phonological system is delayed, semantic system may be delayed as well.

Independent analyses are helpful.

 Examination of what phonemes and phoneme patterns (e.g., CV vs. CVCV) the child is producing

comprehensive assessment of speech sound production

Standardized testing

 Additional single-word testing

 Connected speech sampling

 Intelligibility

 Phonological analysis

 Place-Voice-Manner analysis

 Error pattern analysis

 Stimulability testing

 Contextual/Inconsistency testing

 Speech perception testing (if discrimination abilities are in question)

related assessmetn procedures

Case history

 Hearing screening/evaluation

 Oral mechanism examination

 Language assessment

 Voice and fluency assessment

 Speech perception testing (if discrimination abilities are in question).