Chapter 6: Assessment and Appraisal

assessment

clinical evaluation of a clients disorder

appraisal

the collection of data

diagnosis

the end results of studying and interpreting the data

4 steps to appraisal

• case history

• interviews with parents and other professionals

• school and medical records

• evaluation by the clinician

data tells us…

is a speech sound disorder present

co-existing factors

any functional deficits or strengths related to communication performance

evaluation

the ACTUAL TEST being given

comprehensive evaluation

• hearing screening

• oral mech exam

• standardized measures (including stimulability)

• conversational speech sample

• language, phonological awareness, voice, fluency

4 possible protocols for hearing screening

Pure Tone Screening Only - 20 decibels (dB) at frequencies 1000,
2000, & 4000 hertz (Hz)
● Pure Tone Screening and Typanometry- tympanmetry measures
mobility of the tympanic membrane and status of middle ear
transmission system
● Otoacousitc Emissions (OAEs) screening - a direct measure of the hair
cells and cochlear function in response to acoustic stimulation
● OAEs and Tympanometry

what do we look at in an oral mech?`

• head and facial 

• breathing

• oral and pharyngeal cavity

• teeth

• tongue

• palates

• function assessment

• diadochokinetic rate 

Standardized speech assessments examine

sound articulation in selected isolated words. However, evaluating speech sound production based on single-word responses can never render adequate information about a client’s production realities in connected speech

supplemental measures

• transcribe entire words w/ abberant vowel or consonant productions

• use additional utterances that address the problems/concerns

  • target sounds should be sampled in various vowel contexts and word positions- may develop your own list or use one

• Sample and record continuous speech
  ○ Production difference exist between single-word tasks and
  spontaneous speech
  ● Stimulability
  ○ Many standardized measures include this

two-way scoring

• right/wrong

five way scoring

• correct or

• deletion

• substitution

• distortion

• addition

stimulability

• testing the clients ability to produce a misarticulated sound in an appropriate manner when stimulated by the clinician to do so

contextual testing

• The use of specific phonetic
  contexts to possibly facilitate
  correct speech sound production

testing multisyllabic words

Multisyllabic words gives the SLP a really good look at several of the
child’s skills including, manipulation of phonotactics,
prosody, language, and phonological processing skills

spontaneous speech sample

supplies additional information about language, voice, and prosody. It also provides specific semantic, morphosyntactic, and pragmatics
information to inform language testing when required

how to get a spontaneous speech sample?

Record on a device from the facility - not your cellphone.
● Provide objects or pictures to elicit the target sounds
● Plan the length
● Plan for diversity
● Monitor the recording and gloss any utterances that might later be difficult or impossible to understand
● Listen to a small portion of the sample before recording
● Test the recording

additional measures

language screening: necessary bc of the high percentage of comorbitidies

prosodic screening: loudness and rate. rhythm

phonological and phonemic awareness: strong predictor of reading and spelling success

cognition: be cognizant of comorbid language difficulties

assessing a child w/ emerging phonology

independent Analysis:
- Considers only the child’s
productions, but does not
compare them to the adult
model.
*Inventory of speech sounds
*Syllable shapes used
*Constraints noted on sound
sequences

Mean babbling and syllable
structure level:
- Summarizes phonetic and
syllable shapes for babbles that
can show progress over time.