Reproducible Forms a3 CHECKLIST OF CHILDHOOD APRAXIA OF SPEECH CHARACTERISTICS Name Date Birthdate Chronological Age \ Mark those characteristics observed during evaluation Speech Characteristics 1 InconsistencyNariability © Token-to-token inconsistency (variations in repeated productions of the same word) © Phoneme error variability (produces a phoneme differently on different occasions, e.g,, /s/ produced as /s, t, p, hi) © Positional variability (phonemes produced correctly only in certain positions of words) 1 Contextual limitations (phonemes produced correctly only in certain words or in certain facilitating coarticulatory contexts) C Atypical errors (phonetic and phonemic errors not commonly observed in children with articulation or phonological disorders) Syllable segregation (noticeable within-word gaps between syllables) Limited phonetic inventory of consonants and vowels 1 Higher than expected incidence of vowel errors (distortions, substitutions, omissions) Predominant use of simple syllable shapes 1 Increased errors as the complexity of the syllable shape increases a Connected speech is more unintelligible than the child's phonetic inventory or results on a single-word articulation test suggest Limited vocalizations/babbling during infancy Limited diversity of babbled phonemes before the age of two Differences in performance of automatic versus volitional speech pfofojo Groping/struggling to speak continuesa4 Here's How to Treat Childhood Apraxia of Speech 1 Atypical levels of regression (loss of sounds or words) 1 Poor diadochokinesis (reduced rates and poor coordination) Characteri Nonspeech Mot ies Difficulty imitating and sequencing nonspeech oral movements Possible difficulty (or history of difficulty) with feeding Possible drooling Later attainment of motor milestones (e.g., crawling, walking) ofojojaja Poor fine and gross motor coordination Suprasegmental Characteristics Prosodic disturbances (atypical lexical and phrasal stress, intonation, and/or rhythm of speech; excessive equal stress) 1 Prolonged pauses or breaks between phonemes, syllables, and words 1 Vocal pitch differences (lack of variation in vocal pitch) 1D Rate differences (typically slower rate of speech, though rate may be rapid or fluctuating) (Loudness differences (lack of variation in vocal loudness or habitual loudness that is louder or quieter than normal) U0 Resonance differences (hypernasality, hyponasality, or fluctuating resonance) Linguistic Characteristics 1 Slow development of speech (late to produce first words) 1 Receptive language (typically) exceeds expressive language, although receptive language also may be delayed 1 Morpho-syntactic difficulties (word order confusion, incorrect use or omission of grammatical morphemes, telegraphic speech) C Socialipragmatic language difficulties 1 Greater risk of literacy difficulties (reading, spelling, writing); delayed phonological awareness skillsReproducible Forms a5. MOTOR SPEECH EVALUATION ANALYSIS FORM Name: Evaluation Date: Date of Birth: Chronological Age: Evaluator: Language(s) Spoken by Child; NONSPEECH ORAL MOTOR TASKS. Describe any noticeable difficulties in the child's ability to produce isolated movements of the lips, tongue, and jaw, repeated productions of the same tongue or lip movements and repeated production of alternating movements (e.g., round and then retract lips, click tongue and then smack lips). Note any struggle or groping as well as differences in symmetry or coordination of movements. Isolated movements: Repeated single movements: Repeated alternating movements: DIADOCHOKINESIS Rates: Describe the child's accuracy of repeated productions of /pW, /tal, kN and /pataka/ at slow, normal, and fast rates. D Stow D Normal O Fast Coordination: Describe the child's ability to achieve accuracy of syllable sequences and good rhythmicity under the above rate conditions Sequencing errors 1 Rhythmicity errors OVERALL INTELLIGIBILITY RATING Percent intelligible Words in Language Sample and/or Single-Word Identification Task’ Rating Scale (1-5 or 1-7); PERCENTAGE OF PHONEMES CORRECT Percentage of Consonants Correct (PCC-R): Percentage of Vowels Correct (PVC-R) continuesa6 Here's How to Treat Childhood Apraxia of Speech continued PHONEME INVENTORY Circle all phonemes the child was heard to produce in single words or connected speech. Consonants IpbtdkgmnanwifvedszsshY did Vowels Pure Vowels: fi 1 cr £ @ UY OUD aA a Diphthongs: Jar av of Rhotics: Je Far er or ar amr aur ou! PHONEME STIMULABILITY List all phonemes not accurately produced by the child spontaneously, but for which the child was stimulable, PHONEME ERRORS Summarize place, manner, and voicing errors. Note any two or three feature errors (phoneme errors involving any two or three of place, manner, oF voicing). Summarize substitution, omission, distortion, and addition errors, Substitutions: Omissions (phonemes and syllables): Distortions: Additions: PHONOLOGICAL PATTERNS List percent of occurrences of commonly occurring phonological patterns (40% or greater after analysis of phonology test).Reproducible Forms a7 continued SYLLABLE SHAPE INVENTORY List all syllable shapes in child's repertoire with examples (e.g., V /al; C m/; CV Inow!; VC inl; CV.CV reduplicated /ma,ma/; /CV,CV harmonized /ma,mi/; CV.CV variegated /pow.nil; CVC Ipatl; CV.CVC Hat.tun, CVC.CVC Jkap.kerk/, CCVCC /spunzi, complex multisyllabics) Examples: SYLLABLE SHAPE ERRORS Check the types of errors with examples. 1 Reduplication 1 Harmony Phoneme/syllable omissions 1 Additions SYLLABLE SHAPE STIMULABILITY List those syllable shapes not produced by the child spontaneously for which the child was stimulable. INCONSISTENCY AND VARIABILITY Indicate if the child exhibits speech inconsistencies or variability. Give specific examples. Token-to-token variability: Yes No Phoneme error variability: Yes No Positional variability: Yes No Contextual flexibility: Yes No Increased errors as syllable shape complexity increases: Yes No Increased errors as utterance length increases: Yes No Examples: continuesane Here's How to Treat Childhood Apraxia of Speech RATE OF SPEECH O Slow Oi Fast 1 Within normal limits INFLUENCE OF SPEAKING RATE ON SPEECH INTELLIGIBILITY Was the child able to gain greater speech intelligibility when the rate of speech was reduced? Yes No SYLLABLE STRESS PATTERN INVENTORY List all syllable stress patterns observed in the child’s inventory, even if the syllable stress pattern used was incorrect, for example, $$ (hotdog); Sw (bunny); w5 (balloon); wSw (banana); Swnw (calendar); SwS (kangaroo); SwSw (motorcycle); wSw5 (apologize), and so on. Does the child exhibit excessive equal stress across syllables of multisyllabic words? Yes No SYLLABLE STRESS PATTERN ERRORS List errors noted in the child's application of syllable stress in words. SENTENCE STRESS, RHYTHM, JUNCTURE, AND TONE OF VOICE Does the child use appropriate contrastive stress within phrases/sentences? Yes No Does the child exhibit excessive equal stress across all/most words in sentences? Yes No Does the child exhibit natural sounding phrasal stress? Yes No Does the child demonstrate natural sounding rhythm of connected speech? Yes No Does the child pause at natural phrase breaks? Yes No Does the child express emotion appropriately through tone of voice? Yes No VOCAL RESONANCE 1D Normal 1 Hypernasal 1 Hyponasal 1 Fluctuating hypernasality and hyponasalityReproducible Forms 419 continued If hypernasal or hyponasal, does this difference in resonance have an impact on overall speech intelligibility? Yes No I yes, describe: (OTHER PERTINENT FINDINGS Describe any other pertinent speech-related findings related to vocal quality, vocal loudness, respiratory control, speech fluency, and so on. MULTISENSORY CUES ‘Which multisensory cues (described in Chapter 9) are beneficial toward increasing accuracy of word production? Check all that apply. Visual Metacognitive Cues Simultaneous production 11 Phonetic placement cues (e.g., /f/—"Bite 1 Direct model your lip, then blow.”) (Delayed model 1 Metaphors (e.g., popping sound /pl, © Mirror cueing hissing sound /s, bee sound /2/) Miming CI Hand cues C Mouth picturesivideos 7 Manual signs Auditory 1 Mouth shape pictures T Simultaneous production O Graphic cues ( Rate reduction 1 Blocks representing the number of syllables 1 Direct model (Delayed model CJ Tapping out syllables Backward chaining 1 ture ofeon for moo pls Petre ot 1 Forward chaining fetter V) Tactile Informal tactile cues or formal cues such as PROMPT® cues continues420 Here's How to Treat Childhood Apraxia of Speech SPONTANEOUS VS. IMITATED WORD PRODUCTIONS Child's word productions were better: When words were produced spontaneously . When words were produced following a model ADDITIONAL OBSERVATIONS 0 Groping 1 Difficulty achieving initial articulatory configurations of words C0 Slow transitions between movement gestures 1 Syllable segmentation (noticeable within-word gaps between syllables) (0 Other