Question

1. Discuss speech sound disorders(SSD) What are the 2 categories of SSD and thoroughly describe the differences between them. Finally discuss specific evaluation measures we may employ when assessing a client with SSD.

2. What are the 5 levels of the language rule system (list and define) Discuss developing language skills in children from birth to age 5 and how we can assess these skills (formal and informal testing) What does a screening for written language typically include? If a comprehensive assessment is warranted, who else besides the SLP should collaborate?

3. What are Cultural competence(CC) and Inter-professional Practice(IPP)? Why are they important to us and what specific elements of CC and IPP must we consider when performing evaluations and assessments?

Answer 1

Answer:-Speech Sound Disorders (SSDs) is a generic term used to describe a range of difficulties producing speech sound  in children.

Classification. Speech sound disorders may be subdivided into two primary types articulation disorder  (also called phonetic disorder ) and phonemic disorders  (also called phonological disorder ).

Articulation disorder: A speech disorder involving difficulties in articulating specific types of sounds.Articulation disorder often involve substitution of one sound for another, slurring of speech or indistinct speech . Treatment is speech therapy.Sometimes an articulation disorder can be caused by a physical problem , such as: Changes in or problems with the shape of the mouth (such as cleft palate), bones, or teeth. Brain or nerve damage (such as cerebral palsy )

Phonemic disorder

In a phonemic disorder (also called aphonological disorders) the child is having trouble learning the sound system of the language, failing to recognize which sound-contrasts also contrast meaning.

Children with phonological disorder do not use some or all of the speech sounds to form words as expected for a child their age.

Causes

This disorder is more common in boys.

The cause of phonological disorders in children is often unknown. Close relatives may have had speech and language problems.

SSDs include articulatory, phonological, and motor speech disorders. They can co-occur with other communication impairments, such as language impairment, literacy difficulties, or fluency disorders. Given the complexity of SSDs, differential diagnosis is essential to designing effective intervention.

Assessment requires several steps, including:

• Identifying that an SSD is present
• Analyzing the errors or error patterns
• Differential diagnosis

A basic assessment battery includes:

• Hearing and speech mechanism assessment
• Developmental, educational, medical, and family case history
• Receptive, expressive, and literacy language skills assessment
• Speech skills (including single words, connected speech, and stimulability) and perception skills assessment  

Making a Differential Diagnosis

For some children, we need to go beyond a basic assessment to make a differential diagnosis of a motor speech disorder or to differentiate learners and their skills for intervention planning. We may need to include perception testing and more in-depth stimulability testing in order to make intervention decisions related to type of approach and level of intervention, as well as make informed decisions about target selection. If a motor speech disorder is suspected, additional testing may include maximum performance tasks such as diadochokinetic rate, multisyllabic words, and non-word repetition to assess stress patterns and phonotactic constraints. We may also include cueing levels as part of a dynamic assessment to provide information for intervention planning.

SSDs are complex, diverse, and multifaceted. Assessment does not stop at a single-word test; rather, it involves sound decisions regarding how to best analyze the child’s errors and plan effective intervention. Your assessment may need to go beyond a basic assessment battery to include additional testing, such as perception, stimulability, and maximum performance tasks to make a differential diagnosis and intervention decision based on the child’s abilities in perception and stimulability.

Just because SSDs are the most common communication disorder doesn’t mean they are simple to assess. As with intervention decisions, we need to use sound clinical decision-making based on reasoned evidence-based practice to design the most appropriate and effective intervention given the characteristics of each unique child’s SSD.

2.The five level of language rule systems are,

• Phonetics, Phonology This is the level of sounds
• Morphology This is the level of words and endings, to put it in simplified terms.
• Syntax This is the level of sentences.
• Semantics This is the area of meaning.
• Pragmatics The concern here is with the use of language in specific situations  

Developing language skills in children from birth to age 5 :-

You might hear babbling, jargon and new words together as your child gets closer to saying first words.

12-18 months
At this age, children often say their first words with meaning. For example, when your child says ‘Dada’, your child is actually calling for dad. In the next few months, your child will keep adding more words to their vocabulary. Your child can understand more than they can say and can follow simple instructions too. For example, your child can understand you when you say ‘No’ – although they won’t always obey!

18 months to 2 years
In your child’s second year, their vocabulary has grown and they’ll start to put two words together into short ‘sentences’. Your child will understand much of what you say, and you can understand what your child says to you (most of the time!).

Language development varies hugely, but if your child doesn’t have some words by around 18 months, talk to your GP or child and family health nurse or another health professional.

2-3 years

Your child can speak in longer, more complex sentences now, and is getting better at saying words correctly. Your child might play and talk at the same time. Strangers can probably understand most of what your child says by the time your child is three.

Find out more about language development from 2-3 years.

3-5 years
You can expect longer, more abstract and more complex conversations now. For example, your child might say things like, ‘Will I grow into a watermelon because I swallowed the watermelon seed?’

Your child will probably also want to talk about a wide range of topics, and vocabulary will keep growing. Your child might show understanding of basic grammar, as they experiment with more complex sentences that have words like ‘because’, ‘if’, ‘so’ or ‘when’. And you can look forward to some entertaining stories too.

The development of communication skills is a dynamic process that is shaped by
interdependent factors intrinsic to the child and in interaction with the environment.
The reciprocal and dynamic interplay between biology, experience, and human
development converge to influence developmental experiences. Most importantly,
the course of development is alterable through provision of early intervention
services.
The early intervention practices described in the Roles and Responsibilities of
Speech-Language Pathologists in Early Intervention: Guidelines include those
based on both internal (e.g., policy, informed clinical opinion, integrative scholarly
reviews) and external evidence (e.g., empirical data) from the literature. As the
Committee evaluated available external evidence, variation was apparent both in
strength of the research designs and implementation (e.g., randomized control vs.
observation without controls). Many of the practices detailed in the guidelines have
not yet been studied adequately; however, when considered in terms of internal
and external evidence, the practices demonstrate promise and were therefore
included in the guidelines document.
Roles and Responsibilities of Speech-Language Pathologists in Early
Intervention:

Speech-language pathologists (SLPs) will need to consider both the strengths and
the limitations of current empirical studies when evaluating the preponderance and
quality of evidence for practices presented here. The Committee recognized that
there are few areas of early intervention practice in which clear, unequivocal
answers emerge from empirical research that can be applied confidently to broad
classes of infants and toddlers with disabilities. In recognition of this, no attempt
was made in this document to prioritize specific assessments, interventions, or
treatment programs. The goal was to present a range of assessment and intervention
practices with some basis in either internal or external evidence, in an effort to
provide a backdrop against which clinicians can evaluate newly emerging external
and internal evidence in making service decisions for particular children and
families.

The purpose of these guidelines is to address the role of the SLP in the provision
of early intervention services to families and their infants and toddlers (birth to 3
years of age) who have or are at risk for developmental disabilities.1
The roles and
responsibilities of SLPs serving infants and toddlers include, but are not limited
to, (a) prevention; (b) screening, evaluation, and assessment; (c) planning,
implementing, and monitoring intervention; (d) consultation with and education
of team members, including families, and other professionals; (e) service
coordination; (f) transition planning; (g) advocacy; and (h) awareness.

3.The process model of cultural competenceviews cultural awareness, cultural  knowledge, cultural skill, cultural encounters, and cultural desire as the five constructs of cultural competence.

Interprofessional Practice (IPP) is a collaborative practice which occurs when healthcare providers work with people from within their own profession, with people outside their profession and with patients and their families. ... Using appropriate language when speaking to other healthcare providers or patients/families.

Five essential elements for assessing and evaluating cultural competance are

• Valuing diversity.
• Having the capacity for cultural self-assessment.
• Being conscious of the dynamics inherent when cultures interact.
• Having institutionalized culture nowledge.

The evaluations of interprofessional education(IPE). We present the following twelve steps that are central to this process: formulating evaluation questions, agreeing on the evaluation approach, using evaluation frameworks, drawing upon evaluation expertise, reviewing the literature, selecting a methodology and design, securing ethical approval, accessing data, addressing fieldwork issues, using evaluation instruments, considering resources, and outlining disseminating choices.