Articulation and Fluency Assessment

ARTICULATION AND PHONOLOGICAL ASSESSMENT

Per ASHA, Articulation disorders focus on errors (e.g., distortions and substitutions) in production of individual speech sounds. Phonological disorders focus on predictable, rule-based errors (e.g., fronting, stopping, and final consonant deletion) that affect more than one sound.

Many times it is difficult to clearly differentiate between articulation and phonological disorders; therefore clinicians prefer to use a broader term, "speech sound disorder," when referring to speech errors.

The assessment of speech-sounds involves:

• Taking a detailed case history via parent interview - This includes the family's concerns about the client's speech pronunciation or clarity. In the case history, we also collect information about past ear infections or incidence of any speech-language or hearing disorders in the immediate family.

• Oral mechanism examination - This includes observation of the appearance and function of structures involved in speech production, like the lips, tongue, palate, dental occlusion etc,. These structures could directly or indirectly cause changes in the way a speech sound is produced.

• Speech-sound testing in words - In this section, a formal or standardized tool, for example Goldman-Fristoe Test of Articulation (GFTA-3) or Peabody Picture Vocabulary Test (PPVT) is used, to identify the type of errors, the frequency of errors and the position in which the error is occurring. This detailed analysis paves the path to making a suitable treatment plan.

• Speech-sound testing in connected speech - In this section of the assessment, a speech sample of around 500 words, is recorded in various settings, eg - while narrating an event, during a conversation with the family, and conversation with the clinician. The sample is then analyzed for errors in detail. The type and position of error, frequency of error and the effect of the error on the "intelligibiltiy" ie the clarity of production and the "comprehensibility" ie how well the client's speech is understood by a listener, are assessed.

FLUENCY ASSESSMENT

The term "fluency" refers to the smoothness and effort of speech. Thereby a fluency disorder is an interruption in the flow of speaking characterized by atypical rate, rhythm, and disfluencies (e.g., repetitions of sounds, syllables, words, and phrases; sound prolongations; and blocks), which may also be accompanied by excessive tension, speaking avoidance, struggle behaviors, and secondary mannerisms (American Speech-Language-Hearing Association [ASHA], 1993).

The most common term associated with a "fluency disorder" is "stuttering". These are commonly observed as repetitions (repeating a sound or part of word eg - b-b-ball), prolongations (elongating a sound in a word, eg ssssssnow), or blocks (silent struggles to get the sound out). Stuttering is accompanied by other issues such as negativity associated with specific speaking situations, avoidance behaviors, or physical tension.

Assessment of fluency includes :

• Detailed case history

• Speech sample recording

• Using a real time tool for severity testing