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Stack #4628858
| Question | Answer |
|---|---|
| The Oral Mechanism | The oral mechanism needs to be carefully evaluated as part of your evaluation. |
| Where is speech produced | produced in the oral cavity, therefore, we need to check to make sure the oral motor structures and functions are functioning properly |
| During Oral mechanism exam | face, lips, tongue, teeth, hard palate, soft palate, pharynx |
| What do we look at? | structures and functions |
| Structures | checking to make sure the structures are the right size, shape, and color (ex: down syndrome patients have larger tongues. |
| Functions | How the structures move and perform during speech production. Up and down? Touch the roof of your mouth? |
| Equipment | tongue depressor, gloves, mirror, flashlight, stopwatch |
| Face | looking for muscle weakness and asymmetry, assess the face. Open mouth, raise eyebrows, close eyes tightly |
| Lip Structure | looking for symmetry, cleft lip, or scar from repaired lip assess lip structure, lips at rest for symmetry, contour, condition, and the amount of issue -look for the presence of scar tissue |
| Lip Function | lips are important for speech production; we want to make sure they are able to move adequately for speech |
| Non-Speech Tasks | -Unilateral retraction of the lips to each side of the face -Bilateral retraction of the lips (smile) -Pucker, smileLip Function |
| Speech Tasks | -Repetition of /uiuiuiui/ -Repetition of “puh” |
| Lip Strength | Looking at the strength of the labial seal -Ask the client to puff out the cheeks, then you gently push on each cheek and then both cheeks to see if the labial seal is broken with air escaping out the mouth |
| Teeth | -general condition of the teeth -the occlusion (how they close) -deviations in the teeth -look for missing teeth -dental appliances (dentures, braces, expanders… |
| Tongue Structure | Evaluate the tongue structure at rest by observing the following… -Observe the tongue size, shape, and condition -Ask the client to protrude the tongue (stick out tongue) -Observe length of lingual frenum |
| Tongue Function | evaluated using non-speech task and speech task |
| Nonspeech tasks | -Elevate tongue tip to the alveolar ridge -Wiggle tongue side to side -Make a circle around lips with tongue |
| Speech Tasks | -Diadochokinetic production of “puh” (20 repetitions) -Diadochokinetic production of “tuh” (20 repetitions) -Diadochokinetic production of “kuh” (20 repetitions) -Diadochokinetic production of “puh,tuh,kuh” (10 repetitions) |
| Tongue strength | -Asking client to protrude tongue & provide resistance when force applied w/ tongue depressor on the left, right, and center of the tongue -Ask the patient to place his tongue against the inside of the cheek and provide resistance as you apply force |
| Hard Palate Structure | -size and shape (height and width) -color (normal color: pink and white) -look for any fistulas (openings which would allow air to escape to the nasal cavity) |
| Velopharyngeal Mechanism Structure | The velopharyngeal mechanism structure is made up of the velum (soft palate), and pharynx (back and side walls of throat) |
| Velopharyngeal Mechanism Structure | The velopharyngeal mechanism opens and closes during speech and swallowing to prevent food/liquids and air to escape through the nasal cavity |
| Velopharyngeal Mechanism Structure | -the soft palate for intactness and symmetry at rest -look for intactness and symmetry during repeated /a/ |
| Velopharyngeal function | -Observe speech during conversation -Place a nasal mirror under nostrils and have client produce non-nasal words, look for clouding of the mirror -Have the client produce /a/. Look for an up and back movement of the soft palate |
| Reliability | the type of measurement error that reflects variability between repeated administration of the test |
| Factors that can influence reliability | Behavior of the client (taking or not medicine) Inconsistent measurements (stutters) Inadequate data collection (100 word sample) |
| Three ways to determine reliability | Agreement - deciding the presence or absence of something (stuttering or not) -Interjudge Reliability - two people observing the same thing (compare) -Intrajudge Reliability (one clinician observing something) |
| Stability | -Test-Retest Reliability (when you take test scores from administration and then compare test results that were administered. |
| Validity | The extent to which a test measures what it sets out to measure The question that you should ask when assessing validity is: “Were the observations made appropriate for answering the question asked?” |
| Internal Consistency | test developer wants to determine if both test are reliable |
| Three types of validity | concurrent, predicative, and construct |
| Concurrent Validity | a new or untested measure is compared with another measure that is widely regarded as accurately measuring the same property |
| Predictive | used to make predictions about a person's performance in some other place or time |
| Construct Validity | used to measure a hypothetical trait or attribute that we believe underlies the person's performance. |
| Norm Referenced Interpretation | ■Norm-referenced tests are also called standardized tests ■Normative Group: representative sample of individuals who are the same age and possibly the same sex as the client |
| Criterion-referenced Interpretation | there is some level of performance that can be viewed as minimal for it to be acceptable |
| Client-referenced Interpretation | Comparing a client’s performance in one area of communication at 2 or more points in time |
| Golden Standard | It is a standard that is assumed to be the truth ■It is what you use to compare your results to |
| Two ways to compare client performance to a normative group | Standard scores, median score, standard deviation, percentile score, raw scores, standard deviation |
| Standard Scores | Standard scores evaluates the client’s placement within the normative group |
| Median Score | the 50th percentile and it's where we divide the group into the upper and lower half |
| Standard Deviation | another way to talk about scores, extent to which the score deviates away from the mean |
| Percentile Score | the average score |
| Equivalent Score | Identify the group of individuals that are most likely to achieve a given score, not always 100% accurate |
| Age equivalent | they are performing at a certain age level |
| Grade Equivalent Score | they are performing at a certain grade level |
| Raw score | typically number of correct Reponses |
| Median Score | the 50th percentile and it's where we divide the group into the upper and lower half |
| Testing Environment | Appealing and comfortable Free of distracting noises and interruptions Ample lighting Earlier in the day better |
| Seating | The clinician should be seated across the table from the client |
| Preparing the client | Engage in general conversation Explain testing Begin testing |
| Test Procedures | Make sure to review the manual carefully!!! Administration of all test items vs. obtaining basal and ceiling. |
| Test Procedure | Basal Ceiling: Each test will have a different basal and ceiling. Therefore, it is important to read the manual carefully |
| Test Procedures | Repetition Comments of encouragement |
| Recording Responses | Record responses whether correct or incorrect Transcribe the response Audio record/Video record |
| Administration Time | The test manual should list the administration time More than one session |
| Chronological Age | Identify the item number to begin testing Identify the appropriate table to use in determining normative scores |
| Chronological Age | Subtract the Date of Birth from the Date of Test Begin subtracting with the day When the Date of Testing day is less than the Date of Birth day, borrow 30 days form the Date of Test Month (all months are assumed to have 30 days) |
| Chronological Age | When the Date of Testing month is less than the Date of Birth month, borrow 12 months from the Date of Testing year. DO NOT round months up when days exceed 15 |
| Basal | a specific number of consecutive correct answers (e.g., 3 or 4) that allows the examiner to assume all previous, easier items would also be answered correctl |
| Ceiling | the stopping point of a standardized test, determined when a client misses a predetermined number of consecutive items. |
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