Speech Pathology, Aphasia & Adult Stuttering Assessment

This article discusses the assessment of clients with aphasia and adult stuttering, including key assessment activities, methods, and sources of information. It also explores the processes involved in adult stuttering and how receptive and expressive language processes can be disrupted. The article includes annotated bibliographies of relevant journals and studies.

Speech pathology, Aphasia & adult Stuttering Assessment
Speech pathology, Aphasia & adult Stuttering Assessment
Name
Institution
Professor
Course
Date

Speech pathology, Aphasia & adult Stuttering Assessment
Task 1
Guide to the assessment of clients with aphasia
Individual clients with aphasia are basically identified by clinicians present in a
hospital. In a particular acute setting, the pathologist always have a brief dimension in which
they do clear clinical assessment and evaluator examination in order to identify the existence
and overall effects of aphasia(Baker, Rorden & Fridriksson,2010).
Accurate assessment of aphasia usually depends upon proper and precise clinical
examination (Fridriksson, Richardson, Baker & Rorden, 2011). Comprehensive and
precise assessment of language capabilities by the speech pathologist is important as it is
aimed at the development of a clear wide range of knowledge of patient communication
ability involving the strengths and weaknesses of an individual's speech (Fridriksson et al,
2011).
Key assessment activities
Standardized assessment. These are an assessment in which the given procedure
involved for the correct administering of the test items are well prescribed in a properly
defined manner offering room for comparisons.
Norm-Referenced tests. These usually yield outcomes that can be quantitively compared
with the performance of a normative test sample. The activities include both corrected and
standard scores from a formal comparison group. A criterion-referenced test gives
outcomes with a given standard and not performance. The western Aphasia battery is an
example of such a test activity. It is aimed at determining aphasia severity and not the
placement of patients with aphasia with a normal comparison group (Coppens, 2016).

Speech pathology, Aphasia & adult Stuttering Assessment
Dynamic assessment. These activities take an experimental approach in a bid to identify
the negative impacts of factors such as task modifications, context factors, and
environmental supports
Formal and informal methods. Formal assessment involves systematically applied
procedures and process whereas informal lacks clearly defined procedures. The activities
done include systematic assessments such as functional behaviour assessment (Cheng et
al, 2014).
Methods and procedural activities
The WHO'S ICF usually recommends assessments of the various levels of
impairment, limiting activities participation mode restrictions and barriers to the physical
and personal environment. Clinicians and speech pathologist assess the functional effect of
a person's cognitive communication difficulties on social performance (Hurkmans et al,
2012).
Sources of information and Importance
 Observations
 Research studies on periodicals, newspapers, websites,
 Interviews with patients in the society.
 Questionnaires conducted to nurses and speech pathologist
 Hospital previous data
Determine the presence of aphasia
This assessment might be composed of unstructured evaluations which are considered
around more test-style tasks and techniques. The rise of this particular informal approach
has risen from clinician experts to form a great awareness on the patient's requirements in

Speech pathology, Aphasia & adult Stuttering Assessment
the early stages and also to respond to the periodical environmental acute settings
(Knollman, 2008). Researchers indicate that the utilization of non-standardized
examination is important in the diagnoses of the existence of the conditions effects on
individual patients. In acute settings, it is not mandatory to conduct a comprehensive
standardized testing for diagnostic aims and objectives (Poslawsky, Schuurmans,
Lindeman & Hafsteinsdóttir, 2010).
Evaluations differ according to their period required to be done and content. However
each of the available speech pathologists typically asse3ss the following major language
concepts such as repetition of words, reading, writing, word finding and comprehension of
a particular spoken language with the continuous follow-up of command sand questions.
A judgment of severity is thus a significant clinical measure to assess aphasia. In
addition to aiding with prognosticating process measure, severity ratings also give a useful
and important guide for the proper selection of treatment goals and intervention plans, for
example, giving and assigning individual patients to language treatment groups (Lazar et
al, 2010).
ICF normally provides the required policies and guidelines which are both comprehensive
and reliable. Their flexibility nature enables proper evaluation goals to be clearly
examined by the clinical nurses. The persons with such severe conditions and those with
minimal communicative abilities are known, identified and recorded (Lambon et al, 2010).
Domains mapped
Domain
Impairment Difficulties in body
structures and
Impaired or abnormal neuroanatomical,
neurophysiological structures and various

Speech pathology, Aphasia & adult Stuttering Assessment
functions like
important
deviations and loss
functions that provide support to
cognitive-communication.E.g abnormal
memory, visual language
Participation in life
activities
The various domains
of functioning
based on societal
perspective
Participating in everyday tasks and
involving in social situations may be
difficult because of problems in
conversations, limited ideas, social
isolation and opinion. A patient’s
inability to resume to initial lifestyle
roles.
Contextual
environmental
factors
Affect disability of
individuals
environment
Difficulties imposed like impaired cognitive
functioning, inflexibility in work
environment and societal altitude
Contextual personal
factors
Individual patient
influences on
performance in a
more personal level
environment.
For example
lifestyle,background,age,motivation,basic
upbringing and the character to adjust to
aphasia disability

Speech pathology, Aphasia & adult Stuttering Assessment
Task 2-
Adult Stuttering Assessment plan.
The context describe both the historical and the current approaches to stuttering
treatment to the adults. Here the treatment is handled under the approaches in different
management practices, the fluency capability and both the combined. Generally the fluency
shaping approaches tend to be more robust compared to the stuttering management practices.
Assessment for the adult stuttering.
Attention for the adult who stutter.
In most of the studies the stuttering is described as the surface fear that may result
from the shame, anxiety and even hopeliness .Most methods of behaviour therapy is
enhanced through the version, through the cognitive behaviour therapy and through the use of
multidimensional factors. The assessment reveals the surface stuttering which addresses
primarily the cognitive dysfunction.
The Neurophysiological and the genetic assessment resolution.
Receptive language is generally referred as the understanding words and languages
(Bishop, 2014). It revolves getting the necessary information and then deciding the
targeted meaning from the identified routine( for example the lesson is over so it is not to
go home ),getting the appropriate information from the within and outside environment
(for example on road on seeing the green light means to cross),interpreting sounds and
words (for example hearing bell and corresponding to the activity ) , concepts on
colours ,different sizes and lastly the written information.

Speech pathology, Aphasia & adult Stuttering Assessment
Expressive language explains how people communicate on their wants and needs. It revolves
around both the verbal and nonverbal communication and how an individual uses
language techniques (Bishop, 2014).
The process involved in adult stuttering.
The following are the processes used in receptive and expressive language based on the
contest of cognitive and the psychological model.
a) Being attentive and concentrating. This involves sustained efforts, carrying various
activities without the distraction and being in a position to keep the activity carried
out for a long time (Chare et al, 2014).
b) Carrying out pre-language activities. Involves the way we express our ideas and
communicate without the use of the words. This uses nonverbal communication skills
such as gestures, facial expressions and use of eye conduct to convey some
information.
c) The aspect of social skills. Forms a vital process whereby it can be determined
through one's ability to interact with different people either verbally or non-verbally.
Also compromising and being able to conform to different values and norms.
d) Play skills form the core building block for receptive and expressive language. This
involves engaging activities voluntary which may not be of an important or without a
certain goal (Chare et al, 2014).
How receptive and expressive language processes can be disrupted in adult stuttering.
It is categorized in different levels.
a) First is on the level of linguistic. In most cases at this level, you find that agent or the
speaker of information comes up with his or her own ideas and then try to encode
those ideas into specific words that give a certain meaning. The common

Speech pathology, Aphasia & adult Stuttering Assessment
communication disorder here is the aphasia whereby the shortage of adequate oxygen
gas in brains tissues causes the language shortcomings (Dodd, 2013).
b) Disruptions based on physiological level. The communication shortcoming comes
from the disruptions in the vocal structures. Dysarthria is on impairment which is
mostly found in nerves thus hindering the transfer of signals from the brain tissues to
the mouth, tongue, and lips. On another hand, dyspraxia involves difficulties in
alternating words, challenges in pronouncing long words and also constraints in
sequencing words in specific utterances. Hearing impairment hinders the ability to
monitor sound from the speech, different sounds thus propagating to a number of
errors and in so doing difficulties in articulation (Dodd, 2013).
c) Thirdly is disruption on the acoustic level. This mostly occurs in noisy places, for
example, holding a conversion in a room with loud music. One cannot concentrate
keenly and neither can he talk loudly nor be heard.
d) Lastly is the multi-component disruption. This mostly appears to people with stroke
and head injury thus leading to difficulties in expressing languages, leading to
dysarthria and also facilitating the receptive language disorders. Therefore this forms
the communication disorder which disrupts receptive and expressive languages in
most of the people.
Real life indicators of semantic issues.
Semantic issues are evident in different ways (Kaderavek, 2011).The following are
some of the problems experienced by people thus showing the semantic problems.
a) Difficulties in following and using critical verbal directions.
b) Use of a few words to describe something.
c) Challenges in asking and answering questions. Mostly found in young people.

Speech pathology, Aphasia & adult Stuttering Assessment
d) Struggling to comprehend the relationship between words, sentence construction and
identifying the word with the suitable category.
e) Difficulties in following different conversations and failing to identify the figurative
languages in sentences.
Tasks used to assess semantics.
The following subtasks help in assessment semantics (Kaderavek, 2011).Tasks involved in
the context of the cognitive and psychological model are;
a) The task on semantic similarity between different words and the identified phrases. In
this task, it focuses to evaluate the similarity in different words and the sequences
resulting from the various words. (For example on close interaction, the contact) –the
sequence is semantically relevant and close to the meaning. In this task, it explains
core problems experienced in word sequencing pair which form semantically distinct
phrases (Manolitsi & Botting, 2011).The task is formal since the evaluation criteria
are given based on ability to recall and remember phrases. All languages should be
submitted precisely.
b) Secondly, the task involves the use of semantic in compositionality in context.
Involves ability to determine whether a word or a phrase is used in context either
literal or in figurative language (Medwetsky, 2011).For example, using a word such
as a "big school" to mean a certain figure. One is in a position to know whether a
word is used as a figuratively within a context.

Speech pathology, Aphasia & adult Stuttering Assessment
Task 3-
Annotated bibliography.
Assessment and diagnosis of the cognitive disorder in clients with aphasia.
(A).Journals.
Simmons-Mackie, N., Threats, T. T., & Kagan, A. (2005). Outcome assessment in aphasia: A
survey. Journal of Communication Disorders, 38(1), 1-27.
The journal argues that there is increased attention for the speech-language. The
journal describes the survey that was to reveal the outcome of the assessment in aphasia.
The issue is evident mostly in adults. Funding sources need to improve communication in
order to enhance the quality of people with aphasia (Simmons et al,2005).The disorder is
common among young with an adult giving a small percentage. The journal shows how
speech-language pathologists have been in a position to use various tools to detect the
outcome of the aphasia. Simmon et al, 2005 page 45 show the exact number 45% with
aphasia disorder. The author shows how different assessment have been achieved to curb
aphasia.
Salis, C., Murray, L., & Bakas, K. (2018). An International Survey of Assessment Practices
for Short-Term and Working Memory Deficits in Aphasia. American journal of speech-
language pathology, 27(2), 574-591.
Salis et al, 2018 shows how an international survey has been practicing different
measures in order to treat the short-term aphasia disorder. It focused to identify short-term
memory and the active memory. The major aim was to identify assessment on the number
of individuals with aphasia, search assessments criteria that includes the active memory

Speech pathology, Aphasia & adult Stuttering Assessment
and then form positive attitudes on the short-term assessment. The journal is different
from the previous work which concentrated more on aphasia assessment practices (Salis et
al, 2018).Clinical procedures are outlined each with the corrective procedures for the
disorder. The aspect of carefulness is advocated in evaluating the assessment task
identified during the research.
(B).Clinical guideline.
Rosenfeld, R. M., Culpepper, L., Doyle, K. J., Grundfast, K. M., Hoberman, A., Kenna, M.
A., ... & Yawn, B. (2004). Clinical practice guideline: otitis media with effusion.
Otolaryngology-Head and Neck Surgery, 130(5), S95-S118.
The clinical assessment shows how children are prone to aphasia. The diagnosis and
treatment of disorder have important aspects to the children. A literature review carried in
2004 about the speech communication disorder shows the major assessment methods that
guided the clinic measures. Recommendations about disorders and treatment need to be
apt and effective (Rosenfeld et al, 2004). Alternative treatments and use of medicine are
highly preferred. The critique and justification for treatment are evident on page 56 on the
table about clinical measures to curb the communication disorder. The evaluation on the
task forms a formal criterion that target on performance that is reflecting the semantic
usage of words and phrases.
(C).Book.
Papathanasiou, I., Coppens, P., & Davidson, B. (2016). Aphasia and Related Neurogenic
Communication Disorders: Basic Concepts, Management, and Efficacy. Aphasia and
Related Neurogenic Communication Disorders, 3.
The authors of this book known as Coppens aims to impart readers with basic knowledge and
research skills regarding the communication disorder in patients with aphasia. Readers

Speech pathology, Aphasia & adult Stuttering Assessment
will be able to define the aphasia topic and describe the epidemiology of aphasia. It also
basically describes the principles of care of the individual patients suffering from aphasia
to ensure proper understanding of the ICFG framework (Papathanasiou et al, 2016). It
enables clinicians to understand key issues regarding the efficacy of aphasia therapeutic
practices. Its main objective is to study the Assessment and diagnosis of cognitive disorder
in clients with aphasia in order to offer support to patients with aphasia
(D). Evidence based on websites
Swartz, R. H., Cayley, M. L., Lanctôt, K. L., Murray, B. J., Cohen, A., Thorpe, K. E., ... &
Herrmann, N. (2017). The “DOC” screen: Feasible and valid screening for depression,
Obstructive Sleep Apnea (OSA) and cognitive impairment in stroke prevention
clinics. PloS one, 12(4), e0174451.
[Html] plos.org
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0174451
https://query.library.utoronto.ca/index.php/search/q?kw=Author:Karen%20R%20Lien
The aim of this website article is to describe the feasible screening methods for individuals
with impaired cognitive communication development. In the modern era, clients are being
affected by the disorder without their knowledge (Swartz et al, 2017).These websites are
aimed at creating awareness to individuals in the society of the presence of aphasia
condition and its effects on speech and communication. Since the global world has been
greatly influenced by technological advancement in the communication websites, patients
suffering from the disorder can get the chance to access the website. This is aimed to give
them a platform to air their ideas, opinions and converse with other individuals. This gives
them a conducive environment to develop their communication in the internet

Speech pathology, Aphasia & adult Stuttering Assessment
Conclusion
In the current era, there exists a gradual rise in various patients suffering from aphasia
conditions in the society (Paul & Norbury, (2012).It is a severe condition which affects the
cognitive ability of individuals thus affect effective communication in the society and the
personal ability of an individual to conduct his/her lifestyle roles in a conducive
environment. Speech is a very significant aspect of human life(Savage et al ,2015).The
conducted significant research aimed at improving the situation of the patients and also
offer probable solutions on the same (Whitworth Webster & Howard, 2014). It gave made
me acquire important knowledge on how to handle such clients and create awareness on
the existence of the disorder. It ensured obtaining of a higher understanding of modern
medical status of patients (Shipley & McAfee, 2015.The information obtained from the
research ensured future providence of education, care and support for patients by focusing
on their functioning, personal interests and individualised care (Snowden et al,
2011).These possible research findings are significant in backing up future clinical
rationale and also the existing management plans for aphasia conditions.

Speech pathology, Aphasia & adult Stuttering Assessment
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Coppens, P. (2016). Aphasia and related neurogenic communication disorders. Jones &
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Speech pathology, Aphasia & adult Stuttering Assessment
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