424 final

formula for MLU count

# of morphemes/# of utterances

EBP as it relates to evaluation

(be able to explain)There are two major implications of EBP, the first is selecting diagnostic measurements, it is the clinicians responsibility to choose those that have the most scientific support and psychometric adequacy. The second implementation, involves the notion that assessment is ongoing and it is only through such continued evaluation that we can monitor treatment progress on the goals we have selected as targets. EVP: 1. scientific evidence 2. client beliefs and values 3. clinician experinece

What do we assess in school age evaluation?

- immediate imitation - elicit delayed imitation; when they imitate you but it is not immediate - close method; "i shut the....", "i turn on the...." -spontaneous evoked; naming pictures or describing, barrier therapy like the game battle ship where you cannot see what the child has and vise versa. This forces the child to tell you what they want. -narratives; very important (microstructure: noun phrases, conjunctions, independent clauses, T-units. more referential, not brown's stages because language is too complex, use t-units. Macrostructure: -conversation -free play

BDAE-3: Boston Diagnostic Aphasia Examination-3

-Adult Test: assesses aphasia -for under 40.0 years

Western Aphasia Battery

-Adult Test: assesses content, fluency, auditory, comprehension, repetition, and naming -for adults with stable chronic infarction, or a head injury

Kinds of Play

-Cooperative Play: concerned with solving a problem by working together to achieve a common goal -Solo Play: playing alone, talking and working through a task by themselves (private speech) -Parallel Play: playing along others, (may or may not involve observing) lack of group involvement. When there is a group of children and one child walks away it doesn't affect the other children -Sociodramatic Play: when children begin to engage in role playing games of roles in society. -Pantomime: expressing info or telling a story without words, they express info by using body movements and facial expressions, like charades. -Symbolic Play: using one object to represent another object; basically pretending -Exploratory Play: when children use their senses of smell, taste, and touch to explore and discover the textures and functions of things around them -Functional Play: objects used for intended purpose of play, ball is for rolling not biting -Interactive Play: allowing flow of play between 2 children influencing or having an affect on each other -Imitation: repeating actions or speech after seeing somebody else do it

Difference between delay vs disorder

-Delay show that development occurs to a certain level and then stops somewhere below chronological age. -Disorder shows hit and miss skills below and at age level.

SSI-4: Stuttering Severity Instrument-4

-Fluency Test -for 2.10 years +

what are the components of bedside evaluation?

-History -Oral motor -Trial Swallowing -Voice -Positioning -Cough/gag reflex

PPVT-4: Peabody Picture Vocabulary Test-4

-Langauge Test: assesses receptive -for 2.5- 90 years

ROWPVT-4: Receptive One Word Picture Vocabulary Test-4

-Language Test: assesses receptive -for 2.0- 95 years

PLS-5: Preschool Language Scale-5

-Language Test: assesses receptive and expressive -for birth- 6.11 years

REEL Test-3: Receptive Expressive Emergent Language Test-3

-Language Test: assesses receptive and expressive -for infant-3.0 years

CAPE-V: Consensus Auditory Perceptual Evaluation of Voice

-adults: assesses voice- overall severity, roughness, breathiness, strain, pitch, and loudness -for adults

AAPS-3: Arizona Articulation Proficiency Scale-3

-articulation/phonological test: assesses articulation -for 1.5 - 18 years

GFTA-2: Goldman Fristoe Test of Articulation-2

-articulation/phonological test: assesses articulation -for 2.0-21.11 years

KLPA-2: Khan Lewis Phonological Analysis-2

-articulation/phonological test: assesses phonological process usage -for 2.0- 21 years

KNOW HOW TO PERFORM

-determine the percentage of disfluency index (number disfluent words / total number of words -calculate speaking rate: total number of words spoken/ number of minutes it took to speak them

developmental apraxia of speech

-highly inconsistent. the child might say "lemon" three different ways. -when you ask the adult or child to do some kind of motor movement on command they cannot do it, but they can do it involuntary. Cannot produce more complex utterances, speech will begin to deteriorate

Piaget's Stages: as they relate to our assessment

-object permanence: around 10 months, when the child realizes and object is there even though they can't see it deferred imitation: suggested that it arises out of the child's increasing ability to form mental representations of behavior performed by others. -imitiation: copying the adult. This is a foundation of language. -Causality: "if i push the object it will fall". -Means-end: when the child can carry out a sequence of steps to achieve a goal. I'm using my cognition to figure out how things work. "if the bottle is on the table the baby figure out to hit the table cloth to knock the bottle off"

questions from class between artic, phonology, apraxia, and dysarthria

-phonetic errors: articulation -difficulty with forms of speech: articulation -difficulty understanding organization of phonemes with a linguistic system: phonology -minimal pair therapy: phonology -highly inconsistent and highly variable (libel to change): apraxia -vowel distortions: apraxia ??-consistent and inconsistent productions: phonology -errors do not effect language or reading: articulation -child may have CP(cerebral palsy ??): dysarthria -exhibits speech sound errors that fall into typical patterns of simplified speech: phonology -evidence of incoordination and observation of groping and searching: apraxia -has couple of errors: articulation -placement repetitions and drills: articulation - reduced range of motion and strength and labored movements: dysarthria -lateral /s/: articulation -suppressions: phonology

Types of Scores

-raw score: -basal: level at which all items of a test are passes just before the first failure. All items below the basal are considered correct. -ceiling: the highest item of sequence in which certain number of items has been failed -standard scores: raw scores are converted into standard score, those scores are related to standard deviation. Minus or plus 15 from 100. -percentile rank: percent of subjects or scorers in reference group who fall at or below a particular raw score. - scaled scores: looking at smaller groups of numbers. Instead of looking at 100 as your mean, with these your looking at 10 as your mean on a scale of 1-20 - staines: statistical measure that measures 1-9 of the range of standard scores of a distribution. Standard deviation of stanines are much smaller, usually 2.

under tests and observations what needs to be included

-receptive/expressive language -pragmatics -speech -oral periph exam -voice -fluency -hearing

CELF-5: Clinical Evaluation of Language Fundamentals

-tests language -for 5.0- 21.11 years

Outline of school age evaluation.

1. Case History 2. Interview 3. Choose a battery of tests (older child above the age of 5 you want to give standardize test) 4. Informal Measures (a. obtain a narrative; explaining a task or telling a story with plot and sequencing in tack "tell me what your routine is before you go to school" b. story retelling; the SLP or teacher gives a story and you evaluate if the child can remember the story, retelling the story) 5. writing sample; very important, similar to language sample but the child writes. You give the child a category and ask them to write a description of an item in that category and the SLP has to try to guess what they are describing. This works on literacy, phonolgy, syntax.. 6. reading skills; how quickly, decode, can they read and understand what they read, these are the kids that have trouble sounding out words, or can sound it out but cannot tell you what it means

Know components of post assessment

1. exit interview/post interview 2. gather formal test data 3. gather informal 4. compile the information into a diagnostic report

criterion to diagnose disfluency

1. total of disfluency index of 10% or greater 2. disfluency indexes for repetitions, prolongations, and pauses of 3% or greater 3. duration of disfluencies of 1 second or longer 4. the most prevalent disfluency types are part-word repetitions, monosyllabic whole word repetitions, silent pauses or broken words 5. secondary behaviors are present 6. the client's own consideration or desire for therapy

hearing screening- what is in our scope of practice

3 years and older

Late Talker characteristics and dilemma

?? don't have 50 words, they have communicative intent, catch up by age 3 or 4

Differential diagnosis of apraxia of speech vs dysarthria

Apraxia of speech is differentiated from dysarthria by the preponderance of phonemic substitutions compared to distortion errors and intact neuromuscular functioning with the exception of facial weakness and hemiplegia. apraxia: articulation errors in the absence of muscle slowness, weakness, uncorrdination, owing to disruption of cortical programming for the voluntary production of speech sounds. there is no obvious dysfunction except when the person is asked to execute voluntary movements. dysarthria: there are distinct patterns of speech owing to weakness, slowness, and uncorrdination of speech muscles. Oral movements are disrupted and reflect different types of neuropathy. There is obvious defectiveness: slow, weak, and uncoordinated. Vegetative functions (sucking, chewing,) as well as speech movements are disturbed.

Formal Language assessment tools

CELF-5 (Clinical Evaluation of Language Fundamentals) formal language assessment tool.

be able to identify/discriminate common medical diagnoses for the adult population

CVA: cerebro vascular accident TBI: traumatic brain injury Dementia Degenerative Illnesses Tumors

Measures of Central Tendency and Bell Curve

Central Tendency is the statistic that could mean something to us. The tendency of samples of a given instrument to cluster around some central value. -mean: the average -median: the middle score. It throws out the outliers. in order from least to greatest -mode: most frequently occuring score -variance: tied to standard deviation. (the fact or quality of being different) Numerical index describing disruption of a set of scores around the mean of distribution Know where to label items on bell curve

what would you need to consider in the language assessment for the diagnosis of aphasia? Know the general battery.

Comprehension evaluation of an adult with aphasia includes: 1. review of pertinent medical information and the sequence leading up to the referral 2. a preliminary interview with the patient's spouse or other close relatives 3. a case history, including information about the impact of brain injury on the patient and how much natural or spontaneous recovery has taken place 4. an inventory of the client's language/communication performance 5. observation and related testing (including informal assessments, oral peripheral examinations, hearing tests, and the like) 6. a diagnostic determination with recommendations as to the nature of treatment and a judgement about the individual's prospects for recovery.

Criterion Referenced vs Norm Referenced

Criterion Referenced: compares a child's performance with a standard. Items are organized in a developmental sequence. May help answer the question "how does a client's performance compare to an expected level of performance". It is assumed there is a level of performance that is acceptable and anything below that level is considered deviant. Most common for voice disorders. fluency, neurogenic disorders, and speech. May or may not be standardized. Norm Referenced: Compares a child's abilities to those of his or her peers. Might answer the question "how your child compares to the average". A snapshot. Will allow the clinician to determine if a problem truly exists- diagnosis. Administered individually in an unfamiliar context. always standardized.

Sensitivity and Specificity

Deals with measuring the outcomes of a test measure, 4 possible outcomes: 1. True Positive: a person with a disorder is accurately identified with a disorder (sensitivity) 2. False Positive: a person who does not have a disorder is identified with a disorder 3. False Negative: a person who has a disorder tests within normal range 4. True Negative: a person that does not have a disorder tests within normal range (specificity)

What kind of instrumental assessment do we do for swallowing assessment?

FEES: fiberoptic endoscopic evaluation of swallowing, MBS: modified barium swallow Videofluoscopy

Formal vs Informal

Formal: follows a protocol must adhere to specific guidelines to administer and score. Could include criterion testing, norm referenced testing, standardized protocols Informal: does not follow specific protocol in assessing the components. Flexible in assessment. Can consist of: charts, observations, checklists, and unstructured tasks.

Post Assessment Protocols

Impressions, Prognosis, Recommendations

Reliability

Is the test consistent. The dependability of a test as reflected in the consistency of its scores upon repeated measurements of the same group. If you get on a scale and then immediately step on again it should say the same thing if it is reliable.

on handout on direction following and hierarchy of responses, could you differentiate the most complex level of naming from the easier and easiest levels?

LOOK AT HANDOUT FROM BB

know where information should be included: diagnosis, prognosis, recommendations, background information, tests and observations, impressions

LOOK AT REPORT EXAMPLE

Recognize Occlusions and bites

Normal Occlusion is a Class I: the lower molar is a 1/2 tooth before of upper molars. Neutrocclusion is also a class I: maxilla and mandible are in direct occlusion however teeth are jumbled or rotated Distocclusion Class II: mandible is too far back in relation to the maxilla. Often referred to as an overbite. Mesiocclusion Class III: mandible is too far forward in relation to the maxilla. Often referred to as an underbite. Open bite: gap between biting surfaces Closed Bite- maxilla teeth completly cover mandibular teeth Cross bite: teeth are crossed. speech will be lateralized, might have problems chewing certain foods. Tongue thruster: the tongue goes to the front of your mouth instead of back of mouth when swallow, creates an open bite Overjet: the lower teeth are more at a horizontal position, not just an overbite.

Can you differentiate phonological awareness from a phonological processing disorder?

Phonological awareness: is the ability to hear sounds that make up words in spoken language. This includes recognizing words that rhyme, deciding whether words begin or end with the same sounds, understanding that sounds can be manipulated to create new words, and separating words into their individual sounds. Phonological processing disorder: involves patterns of sound errors. For example, substituting all sounds made in the back of the mouth like "k" and "g" for those in the front of the mouth like "t" and "d" (e.g., saying "tup" for "cup" or "das" for "gas") Clarification: phonological awareness vs. phonological processing disorder. First of all the statement on study guide should be know the difference between phonological processes disorder (output) vs. phonological processing( input) which happens to include phonological awareness

Pre and Post Interview Guidelines

Pre- before assessment. Planned, actively listening so you can respond with things you hadn't planned. Trying to gain information. Reciprocation. Post- after assessment (summary/wrap up) Things to work on as student interviewer: patient, flexible knowledge, confident, poised, mature, professional, keep nerves under control, eye contact, posture, personal space, neutral face, don't always have to put a positive spin on things. Purpose of interview: to obtain information (set the tone as you gain info), to give information (usually happens in post interview, deals with questions from client, provides resources), to provide release and support

Describe a fluency evaluation.

Procedures: 1. Perform base rate: use a tape recorder- determines the percentage of disfluent speech during various speech tasks (such as; rote, imitation, picture naming, confrontation naming, oral reading) Percentage can be based on total number of words or syllables -to analyze- obtain the total disfluency index (count the number of disfluent words and divide it by the total number and multiply by 100 per task to obtain a percentage of disfluency (count repetitions as 1) -informal assessment 2. describe disfluencies and determine the index for each type: by counting the total of each type of disfluencies and dividing by the total number of disfluencies. General types of disfluencies include: repetitions, prolongations, interjections, broken words; a silent pause within words, incomplete phrases; grammatically incomplete utterances, revisions. 3. look for tension of lips, tongue, larynx, forehead 4. describe any secondary characteristics (eye blinking, head jerking, tapping) 5. look at covert measures- assess whether there are negative attitudes and emotions, fears, negative experiences (if the client is a child and these are not present it is a good sign) 6. look at awareness of the problem- with a child a lack of awareness is another good indicator that it could be a normal non fluent behavior (the presence of awareness is a red flag) 7. look at avoidance issues- is the client avoiding talking or situations where he/she needs to talk 8. look at the duration of the stuttering moment- how long does the stuttering moment last. Begin y counting the number of seconds from the time the client begins to say the word to the time he/she gets the word out 9. determine the rate of speech 10. conduct stimulability testing: what strategies help improve fluency? (singing, unison speech, slow, easy speech, DAF (delayed auditory feedback), speech ease pg368) 11. determine adaptability (dynamic testing) assess the same speech task 3 times to see if fluency improves 12. complete a thorough oral peripheral examination 13. may have to differentiate between stuttering and cluttering 14. severity scales; can use the SSI-4 15. determine prognosis: length of time, the longer the stuttering the poorer the prognosis -awareness- the more aware the poorer prognosis -level of intelligence- can also affect prognosis -openness to counseling increases prognosis fluency evaluation- need to assess speech, language, pragmatics, and screen hearing

Other Terms

RTI: response to intervention (consists of a serious of tiers provides intervention and ongoing assessment) WHO: World Health Organization (responsible for developing an international classification of Functioning ICF) ASHA PPP: preferred practice patterns (define acceptable approaches to assessment and treatment of communication disorders) ASHA NOMs: national outcome measures (a document that includes functional outcome measures for every aspect of communication based on a scale of 1-7 for each area of communication

Define Standard Error of Measurement and Confidence Interval

SEM: basically discussing reliability factor -confidence intervals: are important to determine cutoffs for abnormality. These are used to explain SEM. confidence intervals are the range in which a score falls at various intervals, those intervals are 95, 90, and 68%. -95% if i gave a test 100 times, the score is going to fall within a range, the range is going to be bigger -90%: 90 percent of the time i am going to get scores that fall within a range of numbers 68% is the same but the range will be smaller know formula to calculate this SS=50 95% +/- 8 = (-) lowest - (+)highest -42-+58 90% +/- 7= (-) - (+) -43-+57 68% +/- 4= (-) - (+) -46-+54

Screening vs Assessment vs Evaluation

Screening: see if they need further evaluation Evaluation: the interview/ counseling to determine how to assess the client Assessment: once you figure out evaluation then you can assess them through formal and informal testing

Components of language

Semantics: meaning of word, sentence, phrase or text Syntax: formation of sentences Morphology: putting words together Pragmatics: context language is used Phonology: system of sounds in a language

Standardized Testing vs Non-standardized Testing

Standardized Testing: that have standard procedures for administration and scoring. Non-Standardized Test: tests that do not have standard procedures and scoring but some may have standardized scoring. check notes for more information

Static Assessment vs Dynamic Assessment (can you think of ways to apply this term across the different components of communication)

Static: passive, examiner observes, the therapist is there to collect data, more quantitative identify deficits, administration standardized, formal. Dynamic: active, examiner participates, ask questions and gets feedback results describe modifiability, administration fluid, informal, non standardized, more qualitative, more flexible.

Validity

The test measures what it says it measures.

Formal protocols for both voice and fluency

VOICE: CAPE-V (consensus auditory- perceptual evaluation of voice): to measure overall severity; roughness; breathiness; strain; pitch; loudness (on various speech tasks such as sustaining /a/ and /i/; sentence production and conversation) Voice Handicap Index-30: questionnaire which asks the client to rate answers based on a scale of 0-4. Questions vary from attitudes regarding voice to perception of the voice, investigating the physical, the functional, and the emotional, domains the voice, commonly administered during an initial evaluation of a client with voice problems. FLUENCY: SSI-4 (Stuttering Severity Instrument-4): It measures stuttering severity in both children and adults in the four areas of speech behavior: (1) frequency, (2) duration, (3) physical concomitants, and (4) naturalness of the individual's speech. Frequency is expressed in percent syllables stuttered and converted to scale scores of 2-18. Duration is timed to the nearest one tenth of a second and converted to scale scores of 2-18

language loss terms

anomia: when you cannot think of a word aphonia: loss of the ability to speak perseveration: repeating an answer that was once correct but is no longer correct paraphasia: verbal and phonemic. verbal: when you substituting a word with a word that is roughly in the same class. phonemic is like phonological disorder, a replacement of phonemic difference agrammatism: lack of function words or connecters alexia: lost your ability to read agraphia: lost your ability to write repetition: a good technique to help assess the communication disorder of CVA types f aphasia are not mutually exclusive of each other (not true at the same time)

Differential diagnosis of aphasia vs dementia

aphasia: has rapid onset, cognition and memory intact, mood is appropriate with occasions of depression or frustration, socially appropriate may have comprehension issues, repetition is slightly to severely impaired, word retrieval for semantics can be mild-severe, syntax is affected to varying degrees, phonology is impaired in non-fluent aphasia (rapid onset, memory and cognition in tact) dementia: slow onset and progressive deterioration, cognition is mild- profoundly impaired, memory ranges from mild- profound, person can exhibit depression and is easily broken down, social skills are mild-severe affected, repetition is generally intact, semantics includes impairment ranges from mild-to severe word retrieval, syntax is intact when disorder is mild, phonology is generally intact, dysarthria is possible (slow onset, repetition intact, phonology intact)

H_PAT: Hear Builder Phonological Awareness

assesses using 15 subtests assessing the following: letter-sound identification, rhyming (awareness and production), initial sound identification, blending words syllables and sounds, segmenting words syllables and sounds, deleting initial and final sounds, and subsituting initial and final sounds -for 4.6-9.11 years

Closed Ended types of questions

closed or limited response from interviewee 1. yes/no (most common) 2. identification (who, what, where, when; requiring only 1 word answer) 3. closed ended choice questions: using a rating scale define your scale, selection embedded within the question (refrain from using true/false, or Yes/no as your choices) - these are good to begin in an interview because it is easier for people to answer. Summary Probe: summarizing what client or interviewee says, clinician might reformulate what person said, the clinician will use their own words -gives the client/caregiver a chance to clarify if there was a misunderstanding by clinician -lets the client/caregiver know we are listening

What type of speech tasks are used in a voice evaluation?

compare pitches and ask yes/no. S/Z ratio have them hold /s/ for as long as possible and then /z/, then take how many seconds for /s/ and divide by seconds of /z/. if more than 1.0 should be concerned about vocal fold pathology. -outline of rote tasks- counting, saying ABC's and months of the year. -Reading passage "the rainbow passage" -conversational topic

differentiate between confrontational naming, responsive naming, and generative naming

confrontational naming: naming of items as the individual is confronted with the item by the clinician on flash cards, printed words, pictures or both. responsive naming: In responsive naming, the client responds to a characteristic of the object, "What do you eat with?" generative naming: task in which the client names as many items as he can think of in a specified category in a certiain time period

perpetuating factors

currently affecting the client.. cochlear implants

what does aphasia affect? what are common affects on communication?

defined as the loss of language function due to an injury to the brain in an area associated with the comprehension and production of language.It affects: Trouble speaking, like "getting the words out" Trouble finding words Problems understanding what others say Problems with reading, writing or math Inability to process long words and infrequently used words

syllable reduction

deletion of a syllable, usually occurs in unstressed syllables

Use of language sample. What can we asses using a language sample?

determines if the child's length of utterance typical for his/her age level. with the language sample: 1. phonological analysis: analyze and interpret child's speech output 2. language analysis: content (type of word, nouns, verbs, adjectives), morphology (internal structure, inflections such as plurals and possessives, verb tense), syntax (word order)

secondary behaviors

escape behaviors: when the speaker is stuttering and attempts to get out of the stuttering and finishes the word (eye blinks, head nods, interjections, such as uh) avoidance behaviors: the speaker anticipates the stuttering (they may change words, pause, hand movements)

pitch

how high or low the pitch level is- depends on the variations of the vocal folds -optimal pitch- most appropriate pitch for the client, your "best pitch". To test ask yes/no questions, the client can respond by saying uh-humm -habitual pitch- pitch level that client uses daily. Is it higher or lower than optimal pitch. -look at variability of pitch (in vocal function exercises high to low; low to high) -look for pitch breaks -instrumentation- electromyography, stroboscope, visipitch

Informal Assessment, know techniques

identify number of morphemes with utterance, know what and what no to include for morphemes

Report writing. Difference between impression vs observation

impressions: what do the scores mean from a test. observations:

phonology

inconsistent errors. can say word with imitation, three common phonological processes (syllable structure, assimilation, and substitution). simple phonological processes should be suppressed by kindergarden. usually better prognosis than apraxia

Authentic Assessment

informal assessment. -non traditional approach performed in the context of real situation -assessment is either used in an evaluation or in therapy -more authentic, in classroom then pulling out of environment, same goes for the clients home rather than in a clinic -assessment should be constant, on going -more planning and time -usually qualitative

Assessment of Early Language Development

intention, signaling, babling, guestures, and play

what is confabulatory langauge

involves confusion not very certain, aphasia or TBI

resonance

is assessed through counting tasks.

nasality

is evaluation in a variety of speech tasks -hypernasility too much resonance through nose -hyponasality too much resonance through oral cavity on nasal sounds /b for m, d for n, g for nj/ -test by having the client say at rapid rate: "maybe, baby, maybe, baby" (if it comes out "maybe" all of the time- hypernasality, if it comes out "baby" all of the time-hyponasality)

Chronological Age

know you add 30 to days, subtract from number then add 12 to months and subtract from year (if you add 12 to months)

Oral Peripheral Exam, what do we assess and how?

look at structures involved in speech and the function of the articulators (movement, ROM, speech, tonicity; muscle tone flaccid, or low tone, strength, tactile sensitivity; peoples willingness to have each other people touch them or things in their mouth) through oral peripheral examination

breath features

looking at the way the client breathes (diaphragmatic vs clavicular) -diaphragmatic: most efficient way of breathing- efficient expansion of diaphragm during inhalation (contract inward) little chest movement during exhalation (for example, trained vocalists would use this form) -thoracic: this pattern of breathing is "adequate for speech production", the pattern uses the thoracic muscles to expand and contract the chest during inhalation and exhalation. -clavicular: inefficient way of breathing- involves shoulder elevation, upper thoracic tension, neck muscles, strain and upper chest expansion (also called shallow breathing)

dysarthria

motor speech disorder resulting in muscular impairments. Brought on by a motor pathway damage at singular or multiple sites from cortex to the muscles. Shows weakness and lack of coordination with speech and non speech movements. Affects respiration, low volume or irregular volume. Articulation involves poor contact points. clients will have voice problems too.

precipitating factors

no longer operating in person, but did previously.. ear infection

final consonant deletion

omission of a consonant that terminates a word or syllable

describe a voice evaluation

oral peripheral exam and interview. During the interview ask about onset and length of problem, description of daily vocal performance, ask about job and if they use a lot of voice in job, medical/health conditions, pitch loudness and quality of voice, and how they breath. the evaluation is highly dependent of clinician's listening skills of pitch, loudness, and quality

Formal language tests for aphasia

page 224 ??

What parameters are assessed and how?

parameters assessed are: Pitch loudnesses quality of the voice pathologies (such as nodules, polyps,) resonance nasality breath features

loudness

perceived as how soft or loud a person's voice is- deals with intensity -check to see what the client's loudness level is during theses tasks- is it too soft/loud? -can the client vary the loudness?

quality

perceived as the pleasantness or appeal of the voice. -Does the quality of the voice sound appropriate? Is there any harshness, breathiness, hoarseness? -are there periods of aphonia? if so, are they constant or intermittent? -can the quality be changed for the better? s/z ratio should be as close to 1.0 as possible -if the ratio is as close to 1.0 but the number of seconds to sustain these sounds is less than normal there could be a problem in the efficiency of respiration. If the ratio is greater than 1.2 then there could be a laryngeal pathology. (some clinicians do not use this task in evaluations)

phonetic inventory vs phonemic inventory

phonetic inventory: sounds that are produced both correctly and incorrectly. (if "th/s" never used, "th" correctly where is it required to be used; "th" is still present in phonetic inventory) phonemic inventory: sounds that are used contrastively to make a meaning difference in language. (if "th" is not used where it is supposed to be used then it is not apart of the phonemic inventory)

pre disposing factors

potential link to third agent (stuttering, autism, )

Pre evaluation vs Evaluation vs Post Evaluation Process

pre assessment: -case history -any other reports -interview ** interview part of pre assessment and assessment assessment: -formal testing -informal testing -interview -observation post- assessment: -get scores and look at observations -analyze -diagnosis -treatment plan then make recommendations -prognosis -make referral to other services if needed -discussing and counseling information with family members (very important)

Core behaviors

repetitions prolongations blocks

Open Ended types of questions

require client or interviewee to recall events, feelings or experiences in own words. -"why" questions are very powerful -for adults it is important to get them to describe or recall events - get the client to explain why the problem is affecting their quality of life

determining prognosis

the likelihood of the course of disorder. -age -severity -motivation -support from family members -how long have they had a problem

initial consonant deletion

the omission of a consonant that initiates a word

intervocalic consonant deletion

the omission of a word-medial consonants

Exit Interview- what are you expected to discuss? What are some of the challenges? Troubleshooting?

three primary goals: -give information -get information -provide release and support

articulation

usually consistent errors, motor problem, not recommended to give standard score. SODA (substitution, omission, deletion, addition) better prognosis than phonology