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The most common test for dysarthria is called the Frenchay. More qualitative than quantitative. Presents problems in reliability, which is really important in tests and assessments. The largest reliability problem is inter-judge reliability, means how close will two or more clinicians judge the same client, are the results similar and how similar.
The more similar they are the higher the reliability, which is easy to do on quantitative but less easy on a qualitative. In-experienced judges — tend to do one of 3 things: 1. Tend to judge too high, 2. Too low 3. Take the safe ground and go as close to the center as they can. In order to make this as reliable as possible, make the judging criteria very clear and as quantitatively based as possible. Reflex — cough, swallow, drool, lips at rest, spread, seal, alternated, in speech, jaw at rest, etc, look at test protocol Normal function is between B and A.
Tasks: observe drink cold glass of water and a cookie ask about swallowing, score seconds with an average of 8 is normal, longer than 8 sec.
Take a breath through the mouth and let out slowly not phonating but audible, score the second attempt, normally 5 sec air should be expelled slowly and smoothly.
Want to do whatever you can to take hypernasality out of the equation. Someone who has weak adduction of the medial edges of the folds will have problems with volume from the get go.
You are asking them to increase the tightness of adduction in a very controlled manner. Tongue Really important larynx is really important too. Neurological deficit with tongue and larynx are really going to cause artic problems. Observe tongue at rest for at least a min, because the tongue may not go to rest completely right after the mouth is open, a period of time should lapse before observation is made.
Tongue in speech — hard to observe. Using the frenchay, what are the effects of that diagnosis on the aspects of the speech mechanisms? Acts as a good baseline measuring order to show progress especially to insurance companies, easiest way to show progress is to start with baseline. Will tell you how the dysarthria has affected the speech mechanism. We also need to know how that dysarthria has affected their intelligibility because the ultimate treatment goal is compensated intelligibility.
In order for this to occur you need a baseline of that information before treatment begins. You are able to measure quantitatively how your therapy has improved their intelligibility with the Assessment of Intelligibility of Dysarthric Speech.
Its primary goal or purpose is to measure intelligibility, as a function of severity. Assessment of Intelligibility of Dysarthric Speech: Can be used as many times as you want without having the client use the same stimulus tasks. They will never have the same stimuli on any of the retests. You are able to obtain the following information: Single word intelligibility Can be evaluated by a judge not you 2 different ways: 1st by having the judge write down the words that he or she hears the client say; this is the preferred way if you have a client with a fairly mild dysarthria mild to moderate , then you record the percentage that the judge correctly wrote down.
Intelligibility of sentences Always done by having the judge write the whole sentence. Sentence intelligibility is also evaluated by intelligibility as the function of the length of the sentence. The percentage correct is the total number of correctly transcribed words, you need to evaluate how the length of the sentence affected intelligibility — this is not a part of the test but good information for you to obtain from the test.
Regardless of the severity of the dysarthria, single word intelligibility is always less than sentence intelligibility. Sentences provide context, syntactic, semantic context — which means the judge or any listener is able to fill in what they might not be able to understand just from the context of the sentence, single words have no context.
Often times you will need to slow the client down because they are trying to talk at the same rate they did before the incident. You can also determine the communication efficiency ratio. Judging the Sample You must tape record the testing. You do not want someone who is familiar with the client, you want a judge that is unfamiliar and has never talked to them, can be another clinician, not the husband, boyfriend, etc.
You administer 50 single words while you tape record. When you tape record, you can count, number 1, and point to the circled word for the client to read, then pause so the judge has time to process and judge what they think. Try and make sure there is no other background noise. On the other hand if they have a moderate to severe aphasia — you hand them a blank score sheet and have them circle what they heard. Sentence task — you have random numbers.
Starts with 5 word sentences, record the client as they read the 2 sentences. Point to the sentence and have them read it. Allow enough time for the judge to have enough time to write down the sentence that they hear the client say. One chance, cannot replay it again. Do the same thing with 6 word sentences — all the way to 15 word sentences reading 2 of each. Now this can present certain problems, if the client is a poor reader or illiterate, then you have to read the sentence to the client, and then have the client repeat what they hear.
How can you expect them to remember a 15 word sentence perfectly? The judges score will be higher on sentences. Percent correct: divide total words by correctly written by the judge. This is very valuable, especially if you need to slow down the clients speech. Once they are speaking at a slower rate, you want to see if their intelligibility is better next time you administer the AIDS. You want to see an increase in the communication efficiency ratio — you want to see it increase as close to 1.
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