Bleile, K. (2002). Evaluating articulation and phonological disorders when the clock is running. American Journal of Speech-Language Pathology, 11, 243-249.
TAP
The topic of this article is one author’s opinion and procedures for an articulation/phonological evaluation of a pre-schooler. The intended audience is the student of Communication Disorders who wishes to understand how theoretical basis can effect an assessment. The purpose of the article is to share a step-by-step look at an author’s assessment process.
Claims
· Time constraints can have many different effects on an evaluation and its components. It is up to the clinician how to handle the time-restricted evaluation. Informal evaluation becomes very important. Other areas of communication must be assessed even if the referral states that the problem lies in a specific area.
· It is important to make the child as well as the mother feel comfortable during an evaluation.
· A linguistic-motor view of articulation and phonological disorders can have an effect on what is focused on during the evaluation.
Evidence
· Sixty to 90 minutes is not enough time to complete an evaluation and fully understand an articulation or a phonological disorder. Even when the only areas that are assessed in the evaluation are what are indicated on the referral as the main problem, this is not enough time. It is impossible to completely understand the nature of the child’s deficit in this time frame. Instead, the clinician should attempt to decide if the problem warrants therapy and understand only the general nature of the communication problem. A complete understanding can be left to the early parts of therapy when the clinician will have time to conduct further testing. It may become necessary to assess areas of communication during some informal play and simply note what should be looked into further at a later date. Getting background information and asking appropriate questions will aid in this as well. A clinician should only ask questions that can be related to the client’s communication problems.
· Setting is very important in making a child feel comfortable and able to attend to the clinician. A room with too many toys or objects could distract them. Asking a child if they would like to play while interviewing the parent is a good technique to make the child feel more comfortable. If the interview is done early in the assessment, then the child will get a chance to relax and take in his/her surroundings. Questions that the parent will be able to answer more easily will make them feel more comfortable and able to communicate with the clinician. Explaining what is done during the evaluation may ease a parent’s nerves regarding leaving their child in the room alone with the clinician. Give them the option of whether or not to leave the child alone. The clinician should ask the parent as well as gauge the child’s response to being without the parent. Children who are in pre-schools may feel more comfortable without the parent. The clinician should invite the parent back into the room if issues such as behavioral problems arise due to their absence.
· The assessment of articulation and phonology is lead by the clinician’s belief in particular theories. A problem in the linguistic-motor domain means that the client cannot properly shape the oral cavity to produce the sounds that are in error. Activities such as minimal pairs will help the client begin to hear the differences in sounds he/she already perceives. Under this theory, the clinician will focus on the client’s production abilities. There are two goals of the articulation and phonological section of the evaluation. Determine if the articulation and phonological abilities are age-appropriate and decide on possible things to target in the following treatment.
Connections
Text-to-self – Reading this article does not remind me of many things in my past because I have not had much experience in the area. It does however make me think about our discussion in class last week. We had to think about what the most important questions are in an assessment as well as what questions should be answered by the information gathered. I did not see the real importance in this because I assumed that everyone felt the same about it. It is interesting to understand that it is, for the most part, an objective opinion and many professionals believe differently.
Text-to-text – This article makes me think about the manual from Diagnostics class last semester. We discussed extensively the sections that need to be a part of an evaluation as well as what order they should go in. This article agrees with what we learned in class. The interview should be done in the beginning of the evaluation. Assessing voice, fluency, pragmatics, etc. can be done informally during any number of activities (unless this is the primary concern of the referral or case history).
Text-to-world – This article will come in handy in the broader clinical world because it connects theory to real-life practices. Every time I have learned about theory in the past it has always been very abstract and hard to relate to therapy. This article does a good job of explaining how the author’s specific theoretical beliefs impact his evaluations. It is a good way to see that theory is very important and will affect the way we practice. In later articles, I am sure that other author’s will address certain areas differently than this one because of specific theories.
