SLP Diagnostic Practice (Physical or Neuro-muscular)

3 Mar

Speech Mechanism Examination is part of a comprehensive speech sound evaluation.

The lips, tongue, dentition, hard palate, soft palate, velopharynx, FAUCES (tonsils) should be checked.

Problems could include short frenum, open bite, cleft palate, enlarged fauces, etc. . .  The physical attributes of the oral cavity might contribute to a speech sound error.  Such organic disorders might be corrected with surgical intervention combined with speech therapy.

A lot of the time, the physiological reasons for an error would be minimal.  So an articulation test would suffice.  Unless there was some huge, compromising physical attribute that affected a large number of speech sounds, in which case a phonological assessment to see a pattern in multiple errors would be needed.

Methods to evaluate a speech sound disorder from a physical condition would be:

A background history.  It would be especially important to know what medical background, previous intervention, including surgical means, and speech disruption history is present.  An articulation test, stimulability results, and spontaneous connected speech sample would also be used.  A phonological test would probably not be necessary, unless there were a lot of errors.

Because a lot of speech sound errors are self-corrected when physical abnormalities are present, stimulability results would be particularly useful.  If a person with missing incisors only had errors with /s/ and /z/ and were able to compensate when shown proper tongue placement, their prognosis for treatment is better.  The spontaneous connected speech would show how affected the overall communication is with the physical reason for speech errors.

A physical problem with vocal cavity is an organic disorder.  Usually, the speech problems are very minimal and only a small segment of the population with the errors displays speech sound dysfunction.  Prognosis, then, is very good for these individuals once they undergo speech therapy.

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