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Evaluation

Evaluation. Workshop on Universal Reporting Parameters for the Speech of Individuals with Cleft Palate Washington DC, April/May 2004 Triona Sweeney, Dublin & Tara Whitehill, Hong Kong. Introduction.

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Evaluation

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  1. Evaluation Workshop on Universal Reporting Parameters for the Speech of Individuals with Cleft Palate Washington DC, April/May 2004 Triona Sweeney, Dublin & Tara Whitehill, Hong Kong

  2. Introduction • Original premise of project was to map information from current practice, without any/much modification in practice. • Need to be aware of range of current practice in evaluation • ? Flexibility vs. conformity

  3. Context Who Frequency When Purpose Duration Protocol Recording Reliability Speech materials Parameters Language specificity Developed vs. developing countries Diagnosis 14 variables in evaluation (at least!)

  4. Context • Assumption: Speech evaluation done by an individual working within part of a cleft team • “Screening” during team visit Vs • Lengthier evaluation as a “one-off” • (Other)

  5. Who • Speech-language therapist (/SLP/equivalent) with experience/expertise in cleft palate • Full-time dedicated to cleft vs. not • ‘Generalist’ SLP • Other professional (dedicated to cleft) • With or without specialist training • With or without ‘expertise’ in cleft • See #12 • (Other) • (Levels of Input)

  6. Frequency • How frequently is child seen for speech screening/evaluation? • E.g., once a year, every 2-3 years, every 6 months • (Other)

  7. When is data collected • ? Full records at specific ages eg - 5 years 10 years 15 years

  8. Purpose • Clinical/Service • Research • Clinical audit • (Combination) • (Other)

  9. Duration For example, • 5-10 minute screening • 1 hr. or more speech-language evaluation • (in between) • (other)

  10. Protocol • Is the speech evaluation protocol individual to the centre/unit/hospital vs • An agreed protocol used in the district/ country/region • (Something between)

  11. Recording • “live” - written record only • Audiorecording • analogue • digital • Videorecording • analogue • digital • (Combination) • (Other)

  12. Reliability • No prospect for assessing (e.g. live) • Prospect (recordings) but not routinely done • Routinely assess intrajudge reliability and/or • Routinely assess interjudge reliability • ‘blind”/randomized evaluation • (Other)

  13. Speech materials • What speech materials are used in evaluating speech? (usually combination) • For example, • Sustained vowels • Single words • Articulation/phonology test (single words and/or sentences) • Sentences • Connected speech • Conversation • For each: Elicited, repetition, reading, spontaneous • (Other)

  14. Parameters • What parameters are routinely covered in the speech evaluation • For example, • Speech - resonance - nasal emission/nasal turbulence - articulation/phonology • Voice • Language • (Hearing) • (Other)

  15. Parameters, continued Resonance assessments • Equal Appearing Interval Scales (EAI) • Visual Analogue Scales (VA) • Descriptive Scales • Classification - mild/mod/severe • Numerical Scales - varying points (0 - 4; 1-5; 1 - 7) • Other

  16. Parameters, continued Nasal Emission • Nasal emission ‘vs’ • Nasal turbulence

  17. Parameters, continued Nasal emission/nasal turbulence assessments • Present/absent • EAI • VA • Numerical Scales • Classification - mild/mod/severe • Descriptive - severity/ frequency/ consistency • Other

  18. Parameters, continued Assessment of Consonant Production • Cleft Type Characteristics • Compensatory Articulations • Cleft related articulations • ?Phonological implications • Other

  19. Language Specific Factors • Debate regarding the extent to which we can compare results across languages • Several cross-language initiatives - focusing on phonemes/aspects shared between languages

  20. Developed vs. Developing Countries • Or, countries with well-established speech/language profession and/or specialization in cleft vs. those without • System can/should only be used by qualified SLP/equivalent with specialization in cleft? • What about a context, for example, where individual focuses primarily on speech, and may have many years experience with cleft, but without formal education/training • (Other combinations/situations)

  21. Diagnosis • Which diagnoses are made by the SLP/equivalent carrying out the evaluation, and which by other members of the team: • Cleft diagnosis • Occlusion • Fistula

  22. Conclusion • To what extent is consistency in evaluation materials/procedures necessary, and to what extent might the system allow for flexibility in evaluation materials/procedures?

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