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Apr 70 IEI 110 IMO Speech, Language, and Communication Disorders DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE OE FORM 6000,2(69 OFFICE OF EDUCATION =KM. Ilt.r1J11IKr.ZrUIVIC. ERIC ACC. NO. ED 039 380 IS DOCUMENTCOPYRIGHTED? YES 0 NO Iii CH ACC. NO. P.A.PUBL. DATE ISSUE ERICREPRODUCTION RELEASE? ,YES 0 NOti! AA 000 558 Apr 70 R I EOCT70 LEVELOF AVAILABILITY IEI 110 IMO AUTHOR TITLE Speech, Language, and Communication Disorders. Papers Presented at the Annual International Convention of the Council for Exceptional Children (48th, Chicago, Illinois, April 19-251970). SOURCE CODEINSTITUTION (SOURCE) FGK19725 Council for Exceptional Children, Arlington, Virginia SP. AG. CODESPONSORING AGENCY EDRS PRICE CONTRACT NO. GRANT NO. 0.50;5.00 REPORT NO. BUREAU NO. AVAI LABILITY . JOURNAL CITATION DESCRIPTIVE NOTE r 98p. DESCRIPTORS *Exceptional Child Education; *Communication Problems; *Speech Handicaps; *Language Handicaps; *Conference Reports; Educational Diagnosis; Speech Therapy; Psycholinguistics; Measurement Techniques; Rating Scales; Neurological Defects; Aural Stimuli; Cerebral Palsy I DENTI Fl ER S Ohio Tests of Articulation and Perception of Sounds; Bobath Neurodevelopmental Treatment ABSTRACT Speech, language, and communication disorders were among the topics of papers presented at the convention of the Council for Exceptional Children in Chicago, 1970.Discussions include evaluation theory and caseload selection by Lear Ashmore, differential diagnosis in a rural school by William L. Shinder,- the practical application of differentialdiagnosis for urban school clinicians by Patricia Brown, the use of motor and language development scales by Joann Fokes, and the Ohio Tests of Articulation and Perception of Sounds byRuth Irwin and Aleki Nickles.Additional papers are concerned with the therapy implications of recent developments in psychoPuguistics (Sue Pace), implications for new speech techniques with the neurologf -;:ally impaired (Lois Sanders), the Bobath neurodevelopmental treatment in speech therapy (Suzanne Morris), and the effects of sensory modality stimulation on the disarthria of cerebral palsy (Russell Love).(JM) ; 41111.....1.4014 Speech, Language, and Communication Disorders Papers Presented at the 48th Annual International Convention The Council for Exceptional Children Chicago, Illinois April 19-25, 1970 Compiled by The Council for Exceptional Children Jefferson Plaza Suite 900 1411 South Jefferson Davis Highway Arlington, Virginia 22202 Table of Contents Page Evaluation Theory and Caseload Selection: Diagnosis and Disposition 1 Lear Ashmore Differential Diagnosis in a Rural Public School Setting 9 William L. Shinder Practical Application of Differential Diagnosis for Urban Public School Clinicians 12 Patricia Brown Use of Motor and Language Development Scales 33 Joann Fokes Ohio Tests of Articulation and Perception of Sounds (OTAPS) 40 Ruth Becky Irwin and Aleki Nickles Recent Developments in Psycho linguistics: Implications for Therapy 55 Sue A. Pace Newer Speech Techniques with the Neurologically Impaired: Some Implications of Current Linguistic Research 60 Lois Joan Sanders Bobath Neurodevelopmental Treatment in Speech Therapy 68 Suzanne Evans Morris Effects of Sensory Modality Stimulation on the Disarthria of Cerebral Palsy 80 Russel1J. Love Evaluation Theory and Caseload Selection: Diagnosis and Disposition Lear Ashmore University of Texas Austin, Texas There are at least two things to be accomplished in thispresentation. One is a brief review of the procedures of evaluation and the other is to look at, in asmuch depth as possible, a theory of evaluating communication behavior as it appears atthe time of evaluation. Evaluation of speech and hearing behaviors in the schools has beentraditionally short-changed because of the belief that there is not enough time to do anything indepth. A procedure which has been followed in thepast, at least in situations I have knownabout, has been to see the children for a screening evaluation,then seeing those children who failed to meet the minimum criteria of the screening for a bit moreof an evaluation to get some idea of the nature of the communication problem, and thenstarting the therapy process.In some school systems, the children go from screening totherapy without the intermediate step.Then, with the children in therapy, there is periodicappraisal to see if they are making progress on what they are being utherapized" for.If the children do not make progress after a semester or a year of therapy, thenthere may be an attempt to find out what theproblem is and why it isn't moderating with therapy. For fulfilling the criterion of expediency,the previously described procedure has been considered effective for those children who have clear-cutand relatively uncomplicated speech and hearing problems. But how about those childrenwho have spent a semester or a year in a type of therapy which has not been effectivefor them.They, all too frequently, get disgusted, unhappy and fed-up with the process and otherproblems begin to develop on top of the communication problem. This has happened in clinics as well as inpublic schools. The justification for this type of practice maybe explained by a theory of behavior modifi- cation which has been present in our field.This is the idea that the clinician works withthe manifest behavior and, with principles of learningtheory, controls and directs the communi- cation behavior by strictly applied schedules ofreinforcement (reward and punishment, etc. ). It is probable that all communicationbehavior can be modified in such a way,if it is done correctly and with a thorough knowledge of the stepsinvolved. Speech is a learned behavior as far as we know, but the clinician must know thebases of the learned behavior and what aspects of it can and cannot be modified by such anapproach. This is where the importance of evaluation comesin.I do not believe that the clinician can take the speech behavior atface value and start modifying it and have onehundred per cent success. This is the type oftherapy the parent applies when she says "talkslower" or "say soup not thoup", and thisapproach is apparently effective with the vastmajority of children. At least 90 to 95% of them are not recipientsof our services. But with the other 5 to10% there must be something different about themthat caused them to end up stuttering or saying"thoup" in the second grade In spite of mother'steaching technique. The parents didn't have differential diagnosticinformation to help them in their therapies. In a like manner, I believe that in thepast, there were a number of speechclinicians who didn't have and who didn't attempt to get thisdifferential diagnostic information. As indicated,this was in the past. Now, I sensethat the majority of speech clinicians in theschools are seeking more effective ways of determining their case loadsand the types of remedial procedures which thew. children need. Thereupon rest the reasons forthis presentation. Following is a brief review of the steps in diagnosiswhich you had drilled into you in your training days.In my opinion, the most importantevaluation tool is the case history.If we were having a diagnostic contest and I had come upwith a sound and meaningful evaluation and I could choose only one instrument, I would choose the casehistory.If a clinician is skillful at inter- - 2 - viewing parents or guardians, the clinician can get the very exact andcomplete information which he needs to arrive at some kind of an appraisal of the problem. However,let me stress that the case history is like any other instrument a clinician might use and itis no better than the person who uses it. A clinician can do a poor case history and itwill tell him nothing or he can do a good case history and itis better than a thousand Peabody's, Wepman's, audicrinetrics, ITPA' s, etc.Obviously, I am not talking about the type of printed case history filled withlittle blanks that the mother takes home and fills out and mails back to the clinician. Another step in evaluation is observing and describing the child's communicationbehavior during the evaluation sessions. Accurate observing of behavior is always structuredalthough the degree of structure may vary.I am going to talk in more detail about this step later on. The next step is usually a tentative statement of the problem, the natureand degreA of involvement, perpetuating factors, etc.This statement should be as complete as possible and as detailed as necessary. The fourth step involves the design of a future program for the child. Theclinician should answer questions such as: What kind of a program canbe designed for him? Can it be handled in the currently existing school program? Is the school program thebest one for him? If the clinician's case load is full, what alternative plans are there ? What can be done athome? The next step evolves from the previous one and it is a. statement of prognosiswhich involves the utilization of information from all the preceeding steps. We all know our guessingrate could be improved but if the clinician looks at all this accumulatedinformation, he should be able to come up with a fairly accurate statement of prognosis.For example, "If he is placed in this specialized, strongly speech-oriented program for slow-learning children in Xschool, the chances are good that he will acquire auseful basic vocabulary, be able to express most of his needs, learn to interact verbally with his peers on a relatively direct level, etc." -- 3 - been since you These then are theessential steps of a completeevaluation. How long has it experience ? have taken or been allowedthe time to do an evaluationof this detail in your school part is what goes on It is very easy tospell out the things oneshould do. The complicated In view of the as subsectionsof each one of thesemajor divisions of the processof evaluation. discuss the second step fact that I think the casehistory is the most importantstep, I am going to in for detailed case in evaluation with you.It is difficult forschool clinicians to get parents behavior. histories so the next best thingis to conduct the bestevaluation possible of communication evaluation Allow me one more digression.As you may haveobserved by now, I talk about the time the speech and not diagnosis.
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