SLP Diagnostic Practice (Audiology)

2 Mar

Client w/hearing problem or history of middle ear infections

May have pitch problems, breathy/HARSH speech, INFLECTION PROBLEMS, hypo/hyper-nasality, can’t differentiate between stressed and unstressed syllables.  Also their speaking rate may be slower, include more pausing, and have more breaks.

1.  You would first collect a history.

What age did hearing loss first occur?  Younger = larger problem

What is degree/severity of hearing disability?

What are speech problems?

2.  A person with earlier and more severe hearing loss would probably have a lot of speech sound errors.    When there are a lot of errors, a phonological assessment is warranted.

3.  Methods used to evaluate an individual with speech errors based on hearing loss, would include, an articulation test to see specific errors, a phonological exam to get an idea of phonological processes exhibited, stimulabity to see how correctable errors are, and a spontaneous speech sample.

4.  Most important are probably the phonological assessment, because they likely have many errors, and the spontaneous speech sample because a speaking rate, voice quality, and % intelligibility can all be garnered.

5.  The organic condition would be hearing loss with these particular speech sound errors.  A child with early or severe hearing loss would have interrupted sound acquisition.  Development of a speech inventory would be very difficult when reception of speech sounds is limited or eliminated all-together.  Articulation is affected because high frequency sounds would be missed to weak syllable deletion and final consonant deletions would most likely be a problem.  Phonological problems would result for the same reason.  Language might be delayed when reception is missing.  Perception would be really skewed when auditory sounds could not be distinguished.  Contextual factors would be impacted depending on the frequencies of the words.

Prognosis depends on extent of the hearing loss, age of onset, and duration of hearing disability.  Earlier onset, high severity, and long duration would have the worst speech sound dysfunction.

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