Evaluation And Diagnosis In Speech Therapy: Effective Tools And Approaches
One of the functions of the speech therapist, the professional specializing in hearing, swallowing, communication and language development disorders — also called speech therapist — is speech therapy evaluation. Based on this procedure, the professional makes an assessment of the alterations with which the patient comes to the consultation, and if they have sufficient requirements, they can arrive at a diagnosis based on the evaluation.
The importance of diagnosing patients lies in the fact that only in this way is it possible to decide which treatment is the most appropriate to solve their problem, always adhering to scientific evidence. To carry out the evaluation and diagnosis processes, the speech therapist deploys a series of effective tools and approaches designed specifically for this type of problems. Let’s see what they are.
What does the speech therapy evaluation of a patient consist of?
There are various reasons why a person may go to the speech therapist. Although this type of professionals can intervene in speech and language disorders at any stage of the life cycle, it is true that it is mostly families who come to consultation worried about their child’s behavior. In general, The parents of the children state that their child has any of the following characteristics:
Therefore, evaluation is the method by which the professional must proceed whenever he or she presumes the presence of some type of alteration and/or discomfort in a patient.
It is important that the evaluation be carried out by the professional as quickly as possible, especially if the patient is a preschool-age child, since it is during this period when the child begins to develop speech. Furthermore, the speech therapist must be able to differentiate whether the problem to which the consultation is due is rooted in difficulties with communication, understanding, speech or expression, since the diagnosis and approach must be carried out based on to the patient’s particularities.
The necessary tools for a speech therapy evaluation
1. Information collection
In the first instance, the speech therapist needs collect information from other professionals if the patient was treated previously and referred to the speech therapist. These professionals can come from the educational environment (teachers, pedagogues, counselors, psychologists) or from the medical field (pediatricians, neurologists, otorhinolaryngologists, phoniatricians, etc.).
2. Anamnesis
The anamnesis is the procedure from which the professional collects data about the patient’s medical history. This procedure is carried out during an interview. However, it is important to highlight that it does not consist of an interrogation. The speech therapist must position himself from a highly human approach, assuming that the interview is a situation where two or more agents meet in asymmetrical power relations (possessor of professional knowledge – non-possessor).
In the anamnesis, the professional must investigate the patient’s life history, family history, diet, sleep, how language developed in the previous stages of life, among other data; but he must also ensure that he gathers this information with emotional proximity, warmth, empathy and respect. This, also, ensures that patients return to the consultation and can adhere to subsequent treatment if needed. It requires work to support patients or families. The speech therapist must convey that he is interested in the patient’s pain and discomfort and that he will deal with it with empathy and responsibility.
After collecting data from other professionals and taking the anamnesis, the speech therapist observes the child in a first session to capture what obstructs language development under normal conditions. The speech therapist must observe the child’s attitude in relation to the materials presented or people present and make an assessment in relation to his or her age and abilities. Activities are carried out to observe if he is tense, inhibited, calm or participatory; simultaneously attending to their level of understanding of the instructions, the way in which they express themselves, whether they are able to associate objects with their names, their gesticulation and facial expression, their fine motor skills, etc.
4. Orofacial evaluation
If the child manages to carry out the activities proposed during the observation, the speech therapist can proceed with the orofacial evaluation, with the aim of detecting whether the child has anatomical alterations in the organs from which he carries out phonation or feeds. , as appropriate to your problem.
5. Application of tests or tests
Finally, in an evaluation, tests are applied to patients to evaluate different aspects that could provide indicators to learn more about their problem. For example, An assessment of auditory and phonological discrimination is usually carried out in which the child is presented with a sound and four images, having to be able to identify which image corresponds to the sound; They are also given identical tests but in which they are presented with not one but two sounds simultaneously, or others in which they must phonologically discriminate the words presented. There are also other tests that evaluate mastery of phonemes.
The importance of considering the evaluation to arrive at a diagnosis
Once the patient has been evaluated, it is possible for the speech therapist to arrive at a diagnosis in order to proceed with the application of treatment or referral to another health or language professional if necessary. To facilitate the task of diagnosis, it is important that the speech therapist has adopted both a qualitative and quantitative approach. That is to say, that reconciles the collection of numerical data obtained in the tests with the particularities that that case presents conceiving what the patient’s history is, with what difficulties or facilities his early development in relation to speech occurred, his socioeconomic context—to analyze whether a treatment is viable or not—, what is his place in that family, etc.
It is of little use to have a wealth of tests carried out and supposedly objective data if qualitative data are ignored and vice versa. For this reason, we cannot think of both phases separately: the diagnosis goes hand in hand with the evaluation in any speech therapy assessment.
