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Purpose of an initial evaluation
- 1.Determine the reality of the problem
- -Describe Artic/Phono development/status.
- -Determine if deviation from normal expectations warrant concern or intervention.
- 2.Determine the etiology(ies)
- -Identify factors that relate to the presence or maintenance of the speech disorder.
- 3.Provide a clinical focus as to potential treatment approaches
- -Monitor changes in A/P abilities across time.
Assessment process includes
- Case history
- Planning for treatment
Assessment Process Overview
- 1. Referral
- 2. Data Gathering
- 3. The Diagnostic/Evaluation
- 4. Results
- 5. Diagnosis or conclusions
- 6. Recommendations
- 7. Share clinical findings
- Allows clinician to:
- Anticipate areas needing assessment
- Identify topics requiring further clarification
- Pre-select appropriate evaluation materials and procedures
Case History asks questions about:
- General nature of communication &problem
- General development; motor, cognitive, social,
- Health history
- Educational background
- History of support services
The Case History: Limitations
- Difficult Terminology
- Insufficient Time
- Respondent does not give enough information
- Significant time has elapsed between problem onset and time of assessment
- Other life events have hindered respondents ability to recall
- Cultural differences may have interfered.
- An opportunity to obtain information regarding the situation.
- Introduce Self
- Ask questions/Discuss
- Summarize Major points from interview
The Diagnostic/Evaluation Procedures
- A. A comprehensive phonetic-phonemic evaluation is the core.
- -Sample client’s speech. (Client Observation)
- -Formal & Informal Tests
- -Conversational speech assessment in varying contexts
- -Measures of intelligibility
- B.Oral-facial mechanism examination: structural & functional
- D.Hearing Screening (obtain information about hearing abilities)
- E.Screen related and collateral areas.
- Speech Intelligibility can also be evaluated from a speech/language sample.
- It is required by law to have a speech sample of at least 20 utterances.
- A.Score tests
- B.Analyze & integrate data (Evaluate assessment info) to determine:
- Impressions: Disorder?
- Clients Strengths & Weaknesses
Diagnosis or conclusions
- A.Statement of Severity
- B.Statement of Prognosis
Share clinical findings...
through an interview with client or caregiver, or other indicated professionals as requested via informal verbal summary and a formal written record (Evaluation report).
- Protocol (Structure/Tools) will Differ based on:
- -Type of Disorder
- -Client’s history
- -Involvement of Caregiver
(Evaluation by the Clinician)
- -Collecting Data-through formal and informal observation. Notice features of articulation
- Assists in “tuning in your ear” for the pattern of artic/phono being used.
- Allows clinician opportunity to solidify procedures being planned.
Formal and Informal Procedures
- -Articulation Tests
- -Collecting a Speech Sample
- -Probe Lists
- -Intelligibility Measures
- -Diadochokinetic Measures
- -Oral Mechanism/Peripheral Examination
- 1. Easy to give/score
- 2. Provide clinician with a quantifiable list of “incorrect” sound productions in different word positions.
- 3. Yields a standardized score. –important for insurance companies
A formal test places into common language and measurement...
what an excellent clinician already knows or suspects
Formal Artic/Phono Tests
- 1. Sounds in words (initial medial final); may not represent child’s ability to produce a particular sound under natural speech conditions.
- 2. Do not provide enough information about phonological system.
- 3. Not test all sounds: no vowels and few consonant clusters.
- 4. Probes a limited number of chances for each exemplar to occur.
Considerations in selection of Artic/Phono tests
- 1. Appropriateness for age/developmental level of client
- 2. Format for Error Analysis==Artic or Phono or Both
- 3. Normed Referenced yielding standard score or is it Criterion Referenced
- a. Reliability of Test
- b. Validity of Test
Common types of tests
Do not attempt to compare an individual’s performance to anyone else’s, rather they identify what a client and cannot do compared to a predefined criterion.
Answers the ?—How does a client’s performance compare to an expected level of performance
Normed Reference test are always standardized. They allow a comparison of an individuals performance to the performance of a larger group, called the normative group.
Statistical Considerations of Tests
- Reliability: the dependability of a test or procedure to result in consistent results over repeated administrations and by different examiners
- Validity: the degree to which a procedure actually measures what it proposes to measure.