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Pediatric & Adolescent Clinic

Evaluation (PACE):
Assessing Childrens Speech
and Language
Getting on the same
page

Areas of Discussion
Website
Coming

soon.

Overview
link

at bottom of PACE home page

Areas of Discussion
The

Assessment

Language

Comprehension
Language Expression
Articulation/Phonology
Phonemic Awareness/Preliteracy
Play
Structural-Functional/Oral-Motor Exams

Areas of Discussion
Making
To

Recommendations

treat or not to treat?

What

is normal?
Is the person functional without treatment?
Are they ready for treatment?
What do I recommend?

Reports
Tutorials
Assignments

Assessing Language
Comprehension over the
Childhood Years

Assessing Language
Comprehension
You

must do both formal and informal


assessments.
Formal
Standardized

tests

Informal
Observation

in low structured contexts


But, you must set up the opportunities!

Assessing Language
Comprehension
You must determine if the data
collected support one another.
If they are discrepant, you must ask
yourself Why? You will need to try
to figure out why and talk about it in
the report.

Formal Assessment of
Comprehension
Formal
Know

assessment measures

what they assess


Know how they assess (e.g., pictures,
objects, toys, etc.)
Know age ranges

Informal Assessment of
Comprehension 0 ~ 4 years

Areas to consider:

Ability to engage in joint attention

Following directions with/without gestures some general


age ranges to keep in mind:
12-18

months follows simple 1 step command


24 30 months carries out a series of 2 related commands
3 3;6 years responds to commands involving 2 actions and
responds to commands involving 2 objects.
3;6 4 years responds to commands involving 3 actions

Answering simple yes/no, wh-questions (age ranges for


these)

Responding to various semantic relations

Understanding developmentally appropriate locatives

Informal Assessment of
Comprehension 3 years and up
Areas

to consider:

Answering

wh-questions

Understanding

concepts

developmentally appropriate

Following

multi-step directions in the absence of


cues (e.g., Simon Says)

Making

See

inferences (~4 + years)

selections from The Clinical Assessment


of Language Comprehension

Assessing Language
Expression over the
Childhood Years

Expressive Language Areas to


Consider
Expressive

Language

Form

Form
Content

Content

Use

Use

These are separated for simplicitys sake. But keep


in mind there is overlap between the three areas
and they must all be considered. The interaction
between the three also must be kept in mind.

Expressive Language Form


Form

MLU
syntactic structure
grammatical morphemes
complex sentences
speech sound production*
intonation, prosody, inflection

*We will talk about the speech sound production


aspects in a separate section

Content
topics

discussed (here/now; past,


present, future events)
appropriateness of language to context
vs tangential or echolalic language
perseverative language
semantic relations
vocabulary
narrative skills

Use
communicative

intentions
eye contact/physical proximity and body
language
topic initiation, maintenance, conclusion
turn taking skill
Language use is context and partner
dependent and is best done via
informal, careful observation.

Formal measures
Many

formal measures have subtests


that primarily assess in one domain
PLS-4, CELF-P:2/CELF-4 to help
you diagnostically, BUT
Do not forget to look at the whole
picture!

Informal Assessment

Low-structured language sampling

Play-based
Show-n-share
Conversation

Must set up opportunities to discuss a variety of topics including


things in the past, present and future
Must provide opportunities for child to maintain a conversation
initiated by you
Must provide opportunities for child to initiate conversation

See also

Owens (3rd ed.) (computer lab)


Chapters

5, 6 and 7 for How Tos and ways to analyze the

samples
Appendix F for specific Indirect Elicitation Techniques to
elicit various types of expressive language

Narratives: Why Assess Them


Predictor

of persistent language

disorder
Have ecological validity natural part
of daily interaction
Test of language content, form and use;
an interaction between the 3 areas.
Can set up opportunities for dynamic
assessment add supports to see if
they help the child.

Narratives
Discourse

(narrative or expository)
Story retelling
Story generation with a picture
Story generation with a series of
pictures

Hierarchy of Procedures for


Collecting Narratives
Narrative Samples
Spontaneous
Personal

Fictional

Elicited
Personal

Script

Fictional

Story Generation

From The Guide to Narrative Language

Story Retelling

Eliciting Narratives
Narratives
Discourse
Low-structured

play for 0 4 years


Show-n-tell for 4 years +

Eliciting Narratives
Narratives
Story

Retelling with visual support

Bus

Story (story retelling) for 3;9 - 8;3 with caveats


Sequence Cards (2, 3, 4, 5, 6 step)
See

Story

Make-A-Book in materials room

Retelling without visual support

Strong

Narrative Assessment Procedure (SNAP) for K


through 8

Story

Generation with visual support

Expression

Connection (notebook) 6 years +

Narrative Test
Test

of Narrative Language

The tiny nutshell description:


Story

Retell (no picture)


Story generation with sequence pictures
Story generation with a single picture

Speech Formal
Assessment of
Connected speech sample(for all ages)
Articulation/Phonology

Consonant and vocalic repertoires


Syllable shapes
Stress patterns
Consistent or inconsistent consonant
or vocalic errors
Can

also judge rate, prosody, intonation,


inflection, etc. as appropriate

Speech Informal
Assessment of
Use a language sample during
Articulation/Phonology

play/conversation or
CPAC provides story-retelling contexts to
set up opportunities for speech sounds
Compare errors in connected speech
samples to performance on standardized
tests (do they match?)
Determine intelligibility rating from
connected speech

Speech Formal Assessment of


Articulation/Phonology
There

are some articulation tests


that are standardized down to age
2;0

The question is, how easy is it to


get a 2-year-old to sit for your
test?

Speech Formal Assessment of


Articulation/Phonology
For

children over the age of 3, any


(age-appropriate) articulation or
phonology test (e.g., SPAT, GoldmanFristoe, HAPP-3) will do.

Speech Issues in the


Assessment of
Developmental
articulation delay
Articulation/Phonology
See

age ranges of normal consonant


development to determine if the child has a
problem.

Phonological
Use

Delays/Disorders

information you learned in


Articulation and Phonological Disorders
class.

Speech Issues in the


Assessment of
Dyspraxia
Articulation/Phonology
For

motor planning problems

Hierarchy

for Motor Speech Examination


Motor Speech Examination form any one
that you like as long as it is comprehensive

Speech Issues in the


Assessment of
Determining if a child needs speech
Articulation/Phonology
treatment depends on a variety of
factors:
Age-appropriateness

of errors/patterns
Typical vs atypical errors/patterns
Effect of errors on intelligibility
Level of stimulability
Childs (not parents) awareness and distress

Stimulability
Purpose:
Brief

trial teaching to determine clients


ability to produce a correct (or
improved) production of an erred sound.
Indicates readiness to learn (important
prognostic indicator).
Also consult Eliciting Sounds:
Techniques and Strategies for Clinicians,
2nd Edition, by Secord et al

Stimulability
It

is highly advisable to practice teaching


stimulabilty techniques with your
colleagues before you actually try to do it
on a client.
This

will help you know what types of prompts


and cues that you can use to help elicit a
sound, so you wont freeze up in the eval.

Only

do stimulability on sounds actually in


error (not just because the parent wrote it
on the form).

Assessing Phonemic
Awareness

General Information about


Phonemic Awareness
Standardized

Tests

CTOPP

(Clinical Test of Phonological


Processing)
PAT (Phonological Awareness Test)
CELF-P:2 & CELF-4 have

PA screening subtests

Assessing Play

Assessment of Play
Play

is considered a window into


cognition

As

one of our previous students wrote in a


report:
Informal

play assessments provide an


opportunity to examine a childs understanding
of objects and events, and their relationship.
As knowledge of objects and events grows, so
does the foundation for acquiring language.

Informal Assessment of Play


Resources:
Assessing

Linguistic Behaviors (Carpenters


Play Scale, in computer lab)

Observation

of Cognitive Development from


Transdisciplinary Play-Based Assessment
(notebook)

Structural-Functional/Oral-Motor
Exams

After the Information is


Collected:
Making Recommendations

Making Recommendations: To
Treat or Not to Treat
Is

treatment warranted?

Consider

developmental norms is the


child within normal limits?
Functionality
Readiness to learn

What is Normal??

Test Scores and What they


Mean

SCORE INTERPRETATIONS RELATIVE


TO THE NORMAL CURVE
Decision
Superior
Above average

z-score range
> +1.65
+1.01 to +1.65

Normal (WNL)

+/- 1.0

Borderline

-1.01 to -1.65

Deficient

< -1.65

(In your reports


for us use significantly
delayed or area of
significant difficulty)

Scores and Informal


Observations
You

must consider test scores within


the context of what the child is
actually doing with communication.

Do

the scores and what you see the


child doing match?

If

they dont, why not?

Functionality
Do

the areas of difficulty determined


by the assessment impair the childs
ability to
Interact

with family and peers?


Do well in school?
If

so, treatment may be warranted.

In

articulation treatment sometimes our


test scores indicate a serious delay, but if
you look at the qualitative data, treatment
may actually not be warranted.

Readiness to Learn
Stimulability

or Dynamic Assessment

Is

the child ready to learn these new


behaviors?

Cognition

can play a big role in this.

If

not, it may make more sense to wait a


little for treatment, or consider a
different approach
e.g.,

Parent training

So treatment is warranted: What


do I recommend?
This

will be unique to each case.

You

will need to draw on all your


knowledge gained from previous classes
to make educated suggestions.
Your recommendations will need to
match the needs of the family.
Some

families will want to know where to go


to get help.
Some families will want to specifically know
what they can be doing to help.
Some families do not want help.

What Goes in the


Recommendation Section?
Since this practicum is focused on
clients who have already been
accepted into our program for the
summer, we will recommend
treatment.
What should be the focus of
treatment?
What are some broadly written
behavioral objectives?

What Goes in the


Recommendation Section?
Suggestions for parents or other
professionals to help with childs
needs
Parent Articles
Recommended books
Recommended websites

During the assessment


During

the assessment, we try to stay


out of the room unless we see you
struggling.
Please do not be offended if we come in
to help you.
If you are struggling but for some reason
we have not come in, please call for us.
Do your best.
Make no assumptions and ask lots of
questions.

Tutorials
There are a number of tutorials that you should
carefully review:
1.
2.
3.
4.
5.
6.

Preplanning *
Day of Evaluation *
Hearing Screening *
Interviewing *
PACE Reports
Report Writing Hints

* Please be sure to review these before your first


evaluation session.

If you have questions

Please do not hesitate to


ask your supervisor!

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