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Evaluation. Workshop on Universal Reporting Parameters for the Speech of Individuals with Cleft Palate Washington DC, April/May 2004 Triona Sweeney, Dublin & Tara Whitehill, Hong Kong. Introduction.

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Presentation Transcript
evaluation

Evaluation

Workshop on Universal Reporting Parameters for the Speech

of Individuals with Cleft Palate

Washington DC, April/May 2004

Triona Sweeney, Dublin & Tara Whitehill, Hong Kong

introduction
Introduction
  • Original premise of project was to map information from current practice, without any/much modification in practice.
  • Need to be aware of range of current practice in evaluation
  • ? Flexibility vs. conformity
14 variables in evaluation at least
Context

Who

Frequency

When

Purpose

Duration

Protocol

Recording

Reliability

Speech materials

Parameters

Language specificity

Developed vs. developing countries

Diagnosis

14 variables in evaluation (at least!)
context
Context
  • Assumption: Speech evaluation done by an individual working within part of a cleft team
  • “Screening” during team visit

Vs

  • Lengthier evaluation as a “one-off”
  • (Other)
slide5
Who
  • Speech-language therapist (/SLP/equivalent) with experience/expertise in cleft palate
    • Full-time dedicated to cleft vs. not
  • ‘Generalist’ SLP
  • Other professional (dedicated to cleft)
    • With or without specialist training
    • With or without ‘expertise’ in cleft
      • See #12
  • (Other)
  • (Levels of Input)
frequency
Frequency
  • How frequently is child seen for speech screening/evaluation?
  • E.g., once a year, every 2-3 years, every 6 months
  • (Other)
when is data collected
When is data collected
  • ? Full records at specific ages

eg - 5 years

10 years

15 years

purpose
Purpose
  • Clinical/Service
  • Research
  • Clinical audit
  • (Combination)
  • (Other)
duration
Duration

For example,

  • 5-10 minute screening
  • 1 hr. or more speech-language evaluation
  • (in between)
  • (other)
protocol
Protocol
  • Is the speech evaluation protocol individual to the centre/unit/hospital

vs

  • An agreed protocol used in the district/

country/region

  • (Something between)
recording
Recording
  • “live” - written record only
  • Audiorecording
    • analogue
    • digital
  • Videorecording
    • analogue
    • digital
  • (Combination)
  • (Other)
reliability
Reliability
  • No prospect for assessing (e.g. live)
  • Prospect (recordings) but not routinely done
  • Routinely assess intrajudge reliability

and/or

  • Routinely assess interjudge reliability
  • ‘blind”/randomized evaluation
  • (Other)
speech materials
Speech materials
  • What speech materials are used in evaluating speech? (usually combination)
  • For example,
    • Sustained vowels
    • Single words
    • Articulation/phonology test (single words and/or sentences)
    • Sentences
    • Connected speech
    • Conversation
  • For each: Elicited, repetition, reading, spontaneous
  • (Other)
parameters
Parameters
  • What parameters are routinely covered in the speech evaluation
  • For example,
    • Speech - resonance

- nasal emission/nasal turbulence

- articulation/phonology

    • Voice
    • Language
    • (Hearing)
    • (Other)
resonance assessments

Parameters, continued

Resonance assessments
  • Equal Appearing Interval Scales (EAI)
  • Visual Analogue Scales (VA)
  • Descriptive Scales
  • Classification - mild/mod/severe
  • Numerical Scales - varying points (0 - 4; 1-5; 1 - 7)
  • Other
nasal emission

Parameters, continued

Nasal Emission
  • Nasal emission

‘vs’

  • Nasal turbulence
nasal emission nasal turbulence assessments

Parameters, continued

Nasal emission/nasal turbulence assessments
  • Present/absent
  • EAI
  • VA
  • Numerical Scales
  • Classification - mild/mod/severe
  • Descriptive - severity/ frequency/ consistency
  • Other
assessment of consonant production

Parameters, continued

Assessment of Consonant Production
  • Cleft Type Characteristics
  • Compensatory Articulations
  • Cleft related articulations
  • ?Phonological implications
  • Other
language specific factors
Language Specific Factors
  • Debate regarding the extent to which we can compare results across languages
  • Several cross-language initiatives - focusing on phonemes/aspects shared between languages
developed vs developing countries
Developed vs. Developing Countries
  • Or, countries with well-established speech/language profession and/or specialization in cleft vs. those without
  • System can/should only be used by qualified SLP/equivalent with specialization in cleft?
  • What about a context, for example, where individual focuses primarily on speech, and may have many years experience with cleft, but without formal education/training
  • (Other combinations/situations)
diagnosis
Diagnosis
  • Which diagnoses are made by the SLP/equivalent carrying out the evaluation, and which by other members of the team:
    • Cleft diagnosis
    • Occlusion
    • Fistula
conclusion
Conclusion
  • To what extent is consistency in evaluation materials/procedures necessary, and to what extent might the system allow for flexibility in evaluation materials/procedures?