Mallory - Assessment Plan (Final)

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Apr 3, 2024

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KeAnn Chan Christina A. Mejia May 16, 2023 SLP 5115-Speech Sound Disorders Assessment Plan
Name: Mallory CA: 4 years, 6 months old Reason for Referral Mallory is a 4 year, 6 month old child who is presenting difficulties with intelligibility. Parents have indicated she has reached each age-appropriate developmental milestone except for oral speech. Health history has not had any factors that might affect her speech development. Case History The case history will be obtained by either gathering information from the initial intake form or can be obtained verbally by asking caregiver questions at the beginning of the assessment. We will be looking for additional data such as other language(s) being used at home, the parent’s and teacher’s perception of Mallory’s speech, and/ or any history of speech and/ or language difficulties that run in the family. According to ASHA (2016), the data pertaining to one’s case history needs to be collected to administer a comprehensive assessment. It is important to collect case history data to get a better understanding of Mallory’s speech and language development. The case history information could help provide further insight to why Mallory’s speech and language is developing the way it is. Hearing Screening A hearing screening will be conducted on Mallory. The purpose behind a hearing screening is to initially rule out any indication of hearing loss, and to identify her ability to distinguish sounds. Considering the test is on a pass or fail basis, if she does not pass, she can receive “more in-depth testing” to check for hearing loss and suitable treatment options (ASHA). The hearing screening includes an otoscopic inspection of both the ear canal and tympanic membrane, followed by pure-tone audiometry, and the assessing of her middle ear function (ASHA). For children of
Mallory’s age, a common hearing screening is Conditioned Play Audiometry. The test is given to children ages 2-5 and will be asked to complete a short task each time they hear a sound play. For example, she may be asked to “put a block in a box” or place an item on top of another object (ASHA). Oral Mechanism Examination We will complete an oral mechanism examination by examining the structure and function of Mallory’s articulators. This will consist of examining her dental occlusion and perhaps any missing teeth. In addition to the internal structure of her mouth and the function of various articulators such as her tongue, lips and or jaw. Some tools may include a tongue depressor and a flashlight for visibility. As ASHA (2016) stated, the oral mechanism examination needs to be conducted to see whether Mallory’s system is suitable for speech production. This examination is important so it can further tell us if Mallory’s articulators are reducing her intelligibility. For example, if Mallory has missing teeth or has weak lip retraction, these would be just a few examples that can impede her speech. Single-word Testing A component of her speech sound assessment will be Single-word Testing. It presents an opportunity for most consonants to be “elicited in a number of phonetic texts” (ASHA). This is used to take phonetic inventory and to determine a clients’ speech sound errors. Based on her age, a norm-referenced test that will be conducted is the Arizona Articulation and Phonology Scale 4th. (Eisenberg & Hitchcock, 2010). It is suitable for clients ages 18 months-21 years of age. The test can be taken in 5-20 minutes while assessing consonants and vowels. It is a standardized measure that also tests the positions of the sounds produced. The format Mallory
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will receive the exam is through naming objects, repeating a word or “reading stimulus content” (Fudula & Stegall). Connected Speech ASHA indicates that Connected speech sampling “reflects production of the same sounds” (ASHA). Assessing connected speech is performed because single-word testing does not provide sufficient information regarding the child’s speech sound capabilities (Bankson, Bernthal & Flipsen 154). To obtain a sample of connected speech, Mallory would be assessed through the retelling of a story. Considering Mallory’s age, an age-appropriate test would be Goldman-Fristoe Test of Articulation, 3rd edition (GFTA) since it is administered to people ages 2:0-21:11. Mallory will listen to a story with pictures that go along with it and then be asked to retell what she heard. This will assess her overall intelligibility and severity (Bankson, Bernthal & Flipsen, 155). Severity To determine the severity of the client’s speech sound disorder, we will take a quantitative approach (Shriberg & Kwiatkowski, 1982a, 1982b). To determine the percentage of correct consonants (PCC), we will obtain a speech sample and phonetically transcribe it (ASHA). We will take the total number of consonants correctly produced and divide it by the total number of consonants in the overall sample and multiply the answer by 100. The score determines a placement on a continuum that spans from mild to severe and profound. A PCC between the range of 85-100 would be considered mild. A PCC that is anything less than 50, this would be severe (ASHA). For a child who is 4;6, it is typical for 94 percent of their consonants to be produced correctly (Bankson, Bernthal & Flipsen, 80).
Intelligibility Assessing intelligibility is part of a comprehensive assessment that determines how much of a child’s spontaneous speech an individual can understand. We can determine Mallory’s intelligibility by utilizing Coplan and Gleason’s (1988) standardized intelligibility screener that is based on a parent’s perception of how much an individual can understand their child’s speech. By utilizing the screener we can achieve Mallory’s intelligibility percentage. According to Coplan and Gleason, Mallory’s speech should be understood at 100% by an individual. In addition, a rating scale can also be utilized to determine how well a child’s speech is understood (Ertmer, 2010). For example, 1 being totally intelligible to 10 unintelligible. Stimulability To assess stimulability, we will evaluate Mallory’s abilities to correctly “imitate a misarticulated sound when the clinician provides a model (ASHA).” We will examine how well she imitates a sound in one or more contexts. According to Glaspey, Stoel-Gammon, Powell, and Miccio (1996-2007), we will administer a standardized stimulability subtest from the Goldman-Fristoe Test of Articulation. This will determine how well Mallory can imitate a sound, which cues were most effective, at what level the sound was stimulable for, and appropriate targets for therapy (ASHA). Speech Perception A speech perception test will be administered to determine whether Mallory will be able to distinguish between varying speech sounds. We can determine this by giving the speech production- perception task. For example, showing a picture of a red crayon to a child. We can proceed by asking which one is correct, is it “red” or “wed”. Performing this task will tell us whether Mallory can spot the difference between the standard production versus the distorted
production. According to Locke (1980), this task will tell us if the child can “judge whether the speaker says the item correctly.” Phonological Processing Assessment We will administer the Comprehensive Test of Phonological Processing to determine if Mallory has a phonological disorder. This assessment will cover the three components of phonological processing that are vital for the processing and overall development of spoken and written language abilities (ASHA). The test is appropriate for Mallory as the age ranges from 4 years to 24 years and 11 months of age. The test will assess her speech sound segmentation, blending, manipulation of structure of words, and the ability to retrieve phonological information (ASHA). Language A language assessment will be administered to determine whether there is a language disorder if Mallory did not pass the prior language screening. The assessment we could use is the Preschool Language Scale (PLS), which will test her expressive and receptive language. According to Pearson, the assessment is used to test ages from birth to 7 years. It will assess an area of language such as play and social communication skills. As Shriberg and Austin (1998) stated, it is important to give a language assessment due to the high incidence of language problems that co-occur with speech sound disorders.
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References American Speech-Language-Hearing Association. (2016a). Code of ethics [Ethics]. Available from www.asha.org/policy/ American Speech-Language-Hearing Association. (n.d.). Speech sound disorders: Articulation and phonology . American Speech-Language-Hearing Association. https://www.asha.org/practice-portal/clinical-topics/articulation-and-phonology/ (ArizonaTM-4) Arizona articulation and phonology scale, fourth revision . (ArizonaTM-4) Arizona Articulation Phonology Scale, Fourth Edition. (n.d.). https://www.wpspublish.com/arizona-4-arizona-articulation-and-phonology-scale-fourth- revision Bernthal, J. E., Bankson, N. W., & Flipsen, P. (2017). Articulation and phonological disorders: Speech sound disorders in children . Pearson. Eisenberg, Sarita & Hitchcock, Elaine. (2010). Using Standardized Tests to Inventory Consonant and Vowel Production: A Comparison of 11 Tests of Articulation and Phonology. Language, speech, and hearing services in schools. 41. 488-503. 10.1044/0161-1461(2009/08-0125). Ertmer, D. J. (2010). Relationship between speech intelligibility and word articulation scores in children with hearing loss. Journal of Speech, Language, and Hearing Research, 53, 1075–1086. Preschool language scales: Fifth edition . PLS-5 Preschool Language Scales 5th Edition. (n.d.). https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessm ents/Speech-%26-Language/Preschool-Language-Scales-%7C-Fifth-Edition/p/10000023 3.html?tab=product-details