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

  1. Early Pragmatics:

    • Prelinguistic communication, joint attention (10-12 months), requests for objects or information, early discourse skills.

  2. Vocabulary Development:

    • Begins at 1 year; first words (10-16 months); vocabulary reaches 200-500 words by age 2.

  3. Multiple Word Combinations:

    • Begin after acquiring ~50 words; learning verbs can be difficult due to abstraction.

  4. Morphosyntactic Development:

    • Complexity of sentences at around 24-36 months; by age 5, children use complex syntax.

  5. 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.