Speech and Language Assessment Overview

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Components of a Comprehensive Speech and Language Assessment

• Getting background information is a crucial first step
• Information can be gathered from other professionals involved with the client
• Retrieving the client's case history is important
• This includes a written case history
• Preparation for the client interview consists of an introduction, body, and closing
• This process should involve parents or clients themselves
• Observation and test results are vital components
• Conducting observations and collecting speech samples in a naturalistic environment yields the most accurate results
• Standardized testing should be avoided when collecting speech samples
• Standardized tests should be referred to AFTER speech samples are collected
• Conducting stimulability screenings is necessary
• Examples of important tests include hearing screenings, orofacial exams, language and sample analysis, selected standardized tests, alternative procedures, behavioral screening, and stimulability screenings
• Summarizing and prognosis
• Findings should summarize and include the severity, name of the disorder, and characteristics of the diagnosis
• Prognosis should note progress on goals, professional judgment of client motivation and familial support, areas for improvement, and client stimulibility
• Recommendations
• Based on collected results, referrals to other professionals can be written
• Treatment and therapy goals should be confirmed
• Areas for more assessment should be identified

Documentation of Referral Source Importance

• Referrals provide information on where the child received previous treatment and how to move forward
• Referrals give a multidisciplinary source of information from various professionals

Clinical Interview Guidelines

• Avoid using excessive medical terms
• Important information said by the client should be noted, but avoid writing too much information overall
• The interview location should be comforting

Hearing Screening

• dB levels used: 20-25dB
• Frequencies used: 1000, 2000, 4000, 5000Hz

Orofacial Examination

• The purpose is to examine oral structures and determine if the speech disorder stems from structural issues
• Structural adequacy: observing how structures move relative to each other
• Functional adequacy: testing the function of speech muscles regarding speech production

Diadochokinesis (DDK) Rates

• DDK rates measure rate, accuracy, and consistency in producing sounds
• DDK is used to test for aphasia
• Common words used in DDK help examine sound production in different mouth areas (e.g., "pa-di-cake")
• Slow production can indicate dysarthria because muscle movement is the source of slow muscle production

Stimulability Testing

• Stimulability testing records a child's therapy response
• Stimulability testing reveals approaches or modifications that can be made to treatment plans
• Tasks for stimulability testing should be diagnosis-based

Arguments For Standardized Tests

• Convenient due to adequate materials
• Normative results provide help when comparing a child's scores with their normative group
• Standardized tests can help with paying a qualifying for services
• Standardized tests are free of bias and do not take note of a child's ethnocultural background
• Standardized tests provide varied speech skills

Arguments Against Standardized Tests

• Not a catch-all for all unique speech disorders and may not be able to recognize a child with a disorder
• Test norms might be based on localized scores rather than national
• Standardized tests cannot provide functional analysis and only compare with current behaviors
• Test structures do not account for natural responses by the child

Test Scores

• Scoring 50% means the client answered half the questions correctly
• Scoring in the 50th percentile means the client scored higher than 50% of people in the same test category

Differences Between Scores

• Percentiles: a range that represents child scores
• Standard Scores: The degree to which a child deviates from the mean, represented in standard deviation
• SD: the measure of the distance between the group mean and an individual score
• A child within normal limits of standard scores are those that fall near the means
• Stanine: a 9-unit scale with a mean of 5 and a standard deviation of 2
• Raw scores are converted to one of the single digits with the range

  • 4% has a score of 9, 7%, 12%, and 17% is 2, 3, and 4

  • Above average is 6, 7, 8, and 9

Equivalent Scores

• They represent a particular age group or grade
• Scores labeled as behind occur if the client's score is equivalent to scores believed to be normal in another grade
• This notion does not account for variations in performance expected in a group
• The bottom 5% of test-takers should be a point of concern

Test Selection Criteria

• The test should have a detailed and comprehensive test manual
• The test should be based on a large and diverse normative sample
• The test should sample skills adequately
• Select a recently revised test that provides current normative data
• The test should have strong reliability and validity
• The test should have appropriate stimulus items
• The test should be administered with adequate training in administration and scoring
• It should yield useful diagnostic information and help design treatment goals or procedures