Kenneth G. Shipley

Assessment of Language

This chapter focuses on the evaluation of developmental language disorders. Those language disorders that result from neurological damage, specifically aphasia and cognitive impairments due to traumatic brain injury, are addressed in Chapter 9.

Assessment Procedures Common to Most Communicative Disorders

This chapter contains eight basic methods for assessing most speech and language disorders — particularly articulation, language, voice, and fluency. You will not need every procedure for each client, although a majority of your assessments will include several, if not most, of the procedures described here.

Assessment of Voice and Resonance

Voice disorders are classified according to etiology or symptoms. The etiology is its cause, which is either organic or functional. Organic disorders are those that have a known physical cause (e.g., vocal fold paralysis). Functional disorders, which may result in physical changes, do not have a known physical etiology. Table 8–1 lists 26 voice problems categorized by organic or functional cause.

Obtaining Preassessment Information

Thorough assessments involve obtaining as much information as possible about your clients and their communicative disorders. We recommend collecting as much information as you can before the actual assessment session is conducted. Primary sources of preassessment information include: A written case history; An interview with the client, parents, spouse, or other caregivers; Information from other professionals.

Assessment of Neurologically Based Communicative Disorders

This chapter focuses on five types of neurologically based communicative disorders: dysarthria, apraxia, aphasia, traumatic brain injury, and dysphagia. Apraxia and dysarthria are motor speech disorders that affect expressive speech abilities. Aphasia is characterized by expressive and/or receptive language impairment. Disorders such as dysarthria and apraxia often occur simultaneously with aphasia.

Reporting Assessment Findings

There are two primary methods for conveying clinical findings, conclusions, and recommendations: information-giving interviews and written reports. In some cases the telephone may be used to convey information. For example, you may wish to call the client’s physician to report findings to expedite insurance coverage. Information conveyed by telephone is typically a brief, summarized oral report of clinical findings and often followed up by written correspondence.

Assessment of Hearing

The assessment of hearing is within the professional province of the audiologist, not the speech-language pathologist. However, the speech-language clinician is interested in clients’ hearing abilities since hearing loss directly affects the development or maintenance of optimal communicative skills. Specifically, we are interested in the effects of hearing impairment: On the assessment of communicative development and abilities, On the development or maintenance of a communication disorder, On treatment recommendations and the selection of appropriate treatment procedures and target behaviors, and On communicative and academic development.

Evaluating Information from Case Histories

Several methods of gathering information for a complete diagnostic evaluation were described in Chapter 1, including information-getting interviews, written case histories, and information from other professionals. Occasionally, clinicians obtain valuable information from one or more of these sources without really understanding the potential clinical implications. The materials in this chapter are provided to help you interpret certain types of case history information.

Assessment of Articulation and Phonological Processes

Normal articulation is a series of complex actions. Accurate articulation requires exact placement, sequencing, timing, direction, and force of the articulators. These occur simultaneously with precise airstream alteration, initiation or halting of phonation, and velopharyngeal action. It is no wonder that the assessment of articulation is complex, requiring a good deal of skill and knowledge.

Assessment of Fluency

Fluency is a speech pattern which flows in a rhythmic, smooth manner. Dysfluencies are disruptions or breaks in the smooth flow of speech. Even speakers who are normally fluent experience dysfluencies. A speaker is dysfluent when unintentionally repeating a word or phrase, forgetting a word mid-utterance, or interjecting too many “uhs” or “OKs” during speech. It is the speech-language pathologist’s responsibility to differentiate between normal dysfluencies and a fluency disorder.