SLP PRAXIS Children
History to Obtain
Obtain Medical History: Collect information through medical records, case summaries, and by asking relevant questions.
Client Interview: Gather information about premorbid skills through parental inquiries:
When did your child start talking?
Is there a family history of speech and language disorders?
How many words does your child say? What are they?
Does your child become frustrated when trying to communicate?
How do they communicate at home?
How often do you think they are understood by others?
Are they understood by unfamiliar communication partners?
What are your biggest concerns?
Do they use two-word utterances or more?
Are they receiving any other services (e.g., OT, PT)?
Did your child babble? When?
Orofacial Mechanism Evaluation: Assess the structural and functional integrity to determine if the anatomical structures are there and functioning.
Evaluate Functional Abilities: Assess the child's functional skills in a variety of contexts.
Screen Hearing: Conduct preliminary hearing evaluations; if issues are identified, refer to an audiologist.
Improvise During Wait: Use AAC (Augmentative and Alternative Communication), whiteboards, etc.
Analyze Assessment Information: Carefully analyze the collected data.
Share Clinical Findings: Communicate findings with clients and caregivers through formal written records and meetings.
Areas to Address in Diagnosis
Form: Involves syntax, morphology, and phonology.
Syntax: Structure for constructing and understanding sentences, including stages of noun phrases and verb phrases.
Morphology: Study of smallest meaningful language units, including free and bound morphemes and mean length of utterance (MLU).
Phonology: Sound system of a language and the rules governing phoneme distribution and sequencing.
Phonological Awareness
Definition: Ability to hear and manipulate sounds in spoken language, which is critical for developing strong reading skills.
Phonemic Awareness: Understanding that spoken words consist of phonemes and can be rearranged to create different words (e.g., "map" and "pan").
Content and Use
Content (Semantics): Understanding word meanings and their relationship in sentences.
Use (Pragmatics): Involves social language behaviors and includes the theory of mind.
Five Domains to Consider
Early Pragmatics:
Prelinguistic communication, joint attention (10-12 months), requests for objects or information, early discourse skills.
Vocabulary Development:
Begins at 1 year; first words (10-16 months); vocabulary reaches 200-500 words by age 2.
Multiple Word Combinations:
Begin after acquiring ~50 words; learning verbs can be difficult due to abstraction.
Morphosyntactic Development:
Complexity of sentences at around 24-36 months; by age 5, children use complex syntax.
Discourse Skills (Ages 3-7):
Include reasoning, predicting events, showing empathy, and using sarcasm in conversation.
Language Sample and its Components
Criterion Reference Tasks: Child's output is compared with developmental benchmarks.
Evaluate Spontaneous Speech: Collect data in natural contexts to formulate therapy goals.
Gold Standard for identifying language impairments; qualitative and quantitative measures utilized.
Transcription of Samples: Include vocal variants and ellipses; do not count interjections or disfluencies as morphemes.
Mean Length of Utterance (MLU)
MLU Calculation: Determine the average number of morphemes per utterance.
Use total morphemes divided by total utterances from a sample.
General Metric of Language Productivity: Helps to assess a child's development stage in language.
Semantic Relations**
Examples include combinations of agent + action, action + object, etc.
MLU norms based on age.
Dynamic Assessment
DELV: Assess comprehension and vocabulary, focusing on nonword learning and directional following skills.
Fast-Mapping: Evaluates if children associate pseudo-words with presented objects to assess language skills.
Non-Word Repetition: Uses made-up words to gauge attention, memory, and phonological assembly abilities.
Narrative Assessment: Evaluates storytelling skills, cohesion, comprehension, and theory of mind abilities.
Pediatric Disorders and Assessment Considerations
SLI: Specific language impairment without other disabilities.
Assessments: TILLS for literacy deficits and CELF-5 to assess broad language categories.
Potential Therapy Approaches
For ID: Related disorders and their impact on speech, language, and adaptive behaviors.
For Hearing Loss: Screening protocols and referral processes.
Fluency Disorders
Characteristics: Repetitions, prolongations, and blocks.
Fluency Strategies: Techniques to help children develop more fluent speech.
Apraxia of Speech and Dysarthria
Assessment: Involves motor considerations and includes dynamic assessments to differentiate between types of speech disorders.
Language Sample Goals
To compare developmental language abilities using dynamic assessments. Goals include improving children's utterance complexities and fluency. Assessments help pinpoint specific areas for intervention.
Key Considerations for Assessments
Multiple assessments tailored for various age groups focusing on expressive and receptive language skills, pragmatic language use, auditory processing, and overall literacy capabilities.