MATIAS, Kristelle D.

4SLPA, Intern

CASE #1

Patient Name: Mr. Sandoval Age: 32

Medical Diagnosis: Ischemic Stroke Sex: Male

Area Procedure Rationale Materials Activity

Prolonged Production of /a/

● The clinician will ask

Maximum Phonation To determine if the patient has good respiratory capacity for ❖ Timer
the patient to take a
Time (MPT) functional speech production. ❖ Pen and Paper
deep breath and
produce /a/ as long as
he can.

Repetition
❖ Word and Sentence
Dynamic Evaluation ● The clinician will ask
Speech To differentiate apraxia of speech and dysarthria, and attain List with Increasing
of Motor Speech the patient to repeat
the patient’s repetition skills. Length and
Skills (DEMSS) words and sentences
Complexity
with increasing length
and with delay.

Conversation

To gather speech samples from the patient’s connected ❖ List of Topics of ● The clinician will
Conversation Tasks
speech. Interests initiate a topic of
interest and prompt
the patient to produce
 connected speech.

Reading
To assess the patient’s reading and articulation skills in the
❖ Rainbow Passage ● The clinician will
Reading Tasks context of reading since he also attempts to practice reading
❖ Halu-Halo Espesyal present reading
words out loud.
passages and ask the
patient to read them.

MSE

● The clinician will

assess the patient’s
To assess the structural integrity and functioning of
Motor-Sensory ❖ MSE Form and Pen OPM structures and
oral-pharyngeal structures used for speech and swallowing,
Evaluation ❖ Tongue Depressor function, consisting of
and their corresponding cranial nerves (CN).
the musculature
appearance, range of
motion, strength, and
OPM endurance.

DDK

● The clinician will ask

To assess the child’s ability to produce alternating and
❖ Timer the patient to perform
Diadochokinesis sequential movements and identify possible problems that
❖ Pen and Paper alternating range of
may contribute to speech sound errors.
motions (AMR) and
sequential rate of
motions (SMR).
 CASE #2

Patient Name: JR Age: 48

Medical Diagnosis: Cardioembolic Subcortical Hypertensive Cardiovascular Sex: Male

Disease, Congestive Heart Failure, And Status Post Coronary Artery Bypass Graft

APPROACH RATIONALE MATERIALS AND PROCEDURE

STG 1. At the end of 1 month, JR will be able to produce functional words 90% of the time given maximal cues.

Cueing Hierarchy This will be utilized and applied in all approaches to Materials: Visual Stimuli (if needed)
● Visual determine the effective cues to the patient that will allow
● Auditory him to understand and produce the correct productions of Procedure:
● Kinesthetic speech sounds. 1. The clinician will ask the patient to produce a word.
● Tactile 2. If the patient presents difficulty in the production of
speech sounds, the clinician will provide the appropriate
cues.

Dynamic Temporal and Tactile Cueing (DTTC)
This is a treatment method designed to improve the
efficiency of neural processing for the development and
refinement of movements.
Materials: Visual Stimuli (if needed)
Procedure:
1. First, the clinician will ask the patient to repeat a word.
2. If the patient is unable to perform it, simultaneous
production will be employed with cues.
3. Next, direction imitation will then be employed without
the cue.
4. Delay repetition will also be conducted in which the
clinician will first say the target word and then prompt
the patient to say it after a few (e.g. 5) seconds.

Melodic Intonation Therapy (MIT) This consists of melodic and rhythmic prosody, a slower Materials: None
rate of articulation, and continuous voicing that will allow
improvement in verbal fluency and speech output.
Procedure:
1. First, the clinician will hum a tone and then ask the
patient to imitate it.
2. Second, tapping will be incorporated.
3. Third, a word will be hummed.
4. After the patient’s successful repetition, a question will
be asked and the patient has to answer with the intoned
word.