- red, orange, purple, blue
- van, car, truck, train
- pig, cow, horse, cat
- piano and guitar
- necklace and scarf
- chair and sofa
- brushing your teeth
- doing the laundry
- making a sandwich
- Your friend’s birthday is one week away. You guy her a gift and pay extra for 3-day shipping. How many days before her birthday does her gift arrive?
More Cognition Resources
- The Adult Speech Therapy Starter Pack
- How to Make a Memory Book
- Cognitive Speech Therapy Activities
Assessing Visual Neglect
The Catherine Bergego Scale and Albert’s Test (below) are well-regarded for detecting even mild visual neglect. Beyond that, there are some cognitive screens and formal batteries that have a visuospatial component.
Consider what’s best for you, your patient, and your specific setting when deciding whether to invest the time and money required to complete a formal battery. Consider using screens, parts of formal cognitive evaluations, and/or informal cognitive-linguistic evaluations.
Know your setting’s expectations and your patient’s needs and insurance constraints when choosing assessments.
Visual Neglect Assessments
Functional Scales and Cognitive Screens
- The Catherine Bergego Scale (CBS) is sensitive enough to detect mild visual neglect. Here’s the PDF and a supporting article.
- Albert’s Test is an quick, effective screen
- The MoCA, MMSE, and SLUMS have visuospatial sections
- Informal evaluations often include cancellations tasks, reading aloud, scanning a picture, reading clocks, and copying written information
Formal Batteries
- Parts of the Test of Everyday Attention
- Parts of the Delis-Kaplan Executive Function Systems
- Parts of the Wechsler Adult Intelligence Scale
More Visual Neglect Resources
- How to Treat Visual Neglect
- 2 Quick Visual Neglect Screens
Assessing Motor Speech
A motor speech assessment consists of a case history, oral mechanism examination, connected speech and reading sample, assessment of diadochokinetic rate, repetition of words and phrases, naming, picture description, and tests for limb and oral apraxia.
Motor Speech Assessments
Informal Assessments
- The Adult Speech Therapy Evaluation Pack
- Word Intelligibility Test . Scroll down to pages 11-12 and 18-19 for the lists
Formal Batteries
- Assessment of Intelligibility in Dysarthric Speech
- Apraxia Battery for Adults
How to Assess Motor Speech
- First, complete a case history
- Mandible (CN V): at rest, open (pressure), close (pressure), lateralization, protrusion, retraction
- Lips (CN VII): at rest, protrusion, retraction, repetitive protrude/retract, puff cheeks, strength, sensitivity (CN IX)
- Tongue (CN XII): at rest, protrusion (strength), stick up (strength), stick down (strength), lateralization (strength), retraction (CN V, XII), strength, lick teeth, lick lips
- Velum: at rest (CN IX), prolonged “ah” (CN X), repetitive “ah” (CN X)
- Reflexes (CN IX, X): gag, faucial arches
- act, action, activity
- hip, hippo, hypocrite
- miss, missile, Mississippi
- “Smile”
More Motor Speech Resources
- The Adult Speech Therapy Starter Pack
- Dysarthria Exercises
- Phonemic Word Lists
Assessing Apraxia
Apraxia evaluations consist of a case history, connected speech and reading sample, assessment of diadochokinetic rate, repetition of words and phrases, naming, picture description, and tests for limb and oral apraxia.
Apraxia Assessments
Informal Assessments
- The Adult Speech Therapy Evaluation Pack
- Apraxia of Speech Rating Scale (scroll to Appendix)
- Differential Diagnosis Chart
Formal Batteries
How to Assess Apraxia
- First, complete a case history
- Diadochokinetic Rate (Complete three trials of each of the following): “puh puh puh” (CN VII), “kuh kuh kuh” (CN XII), “tuh tuh tuh (CN XII), “puh tuh kuh”
- act, action, activity
- hip, hippo, hypocrite
- miss, missile, Mississippi
- “Smile”
- “Pretend that you’re blowing out a candle”
- “Pucker your lips like you’re about to whistle”
- “Pretend that you’re brushing your teeth”
- Pretend that you’re combing your hair”
- “Stick out your tongue”
- “Blow a kiss”
- “Give me a thumbs up”
- “Snap your fingers”
Record latency time, naming accuracy, and phonetically transcribe responses as needed.
- “Describe the picture”. Present the Cookie Theft picture
- “Read this story aloud.” The Rainbow Passage
- “Count from 1 to 30”
- “Count backward from 30 to 1”
More Apraxia Resources
- The Adult Speech Therapy Starter Pack
- Apraxia Worksheets for Adults
- Phonemic Word Lists
Assessing Voice
To assess voice, complete an oral mechanism evaluation and collect a connected speech sample and reading sample. Measure vocal quality. Complete an acoustic analysis.
Voice Assessments
Informal Assessments
- The Adult Speech Therapy Evaluation Pack
- Measure Vocal Quality: Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V)
- Acoustic Analysis: Free Praat software
- Communicative Effectiveness Survey. The patient rates their own communication effectiveness
How to Assess Voice
- First, complete a case history
- Mandible (CN V): at rest, open (pressure), close (pressure), lateralization, protrusion, retraction
- Lips (CN VII): at rest, protrusion, retraction, repetitive protrude/retract, puff cheeks, strength, sensitivity (CN IX)
- Tongue (CN XII): at rest, protrusion (strength), stick up (strength), stick down (strength), lateralization (strength), retraction (CN V, XII), strength, lick teeth, lick lips
- Velum: at rest (CN IX), prolonged “ah” (CN X), repetitive “ah” (CN X)
- Reflexes (CN IX, X): gag, faucial arches
RECORD THE PATIENT SPEAKING:
Obtain signed permission, as appropriate.
- Provide the following prompts. Write down your observations.
- “Tell me about your speech. Tell me about your speech concerns.”
- “What are your speech strengths? Weaknesses?”
When the sunlight strikes raindrops in the air, they act as a prism and form a rainbow. The rainbow is a division of white light into many beautiful colors. These take the shape of a long round arch, with its path high above, and its two ends apparently beyond the horizon. There is, according to legend, a boiling pot of gold at one end. People look, but no one ever finds it. When a man looks for something beyond his reach, his friends say he is looking for the pot of gold at the end of the rainbow. Throughout the centuries people have explained the rainbow in various ways. Some have accepted it as a miracle without physical explanation. To the Hebrews it was a token that there would be no more universal floods. The Greeks used to imagine that it was a sign from the gods to foretell war or heavy rain. The Norsemen considered the rainbow as a bridge over which the gods passed from earth to their home in the sky. Others have tried to explain the phenomenon physically. Aristotle thought that the rainbow was caused by reflection of the sun’s rays by the rain. Since then physicists have found that it is not reflection, but refraction by the raindrops which causes the rainbows. Many complicated ideas about the rainbow have been formed. The difference in the rainbow depends considerably upon the size of the drops, and the width of the colored band increases as the size of the drops increases. The actual primary rainbow observed is said to be the effect of superimposition of a number of bows. If the red of the second bow falls upon the green of the first, the result is to give a bow with an abnormally wide yellow band, since red and green light when mixed form yellow. This is a very common type of bow, one showing mainly red and yellow, with little or no green or blue.
- Other observations during conversational speech
- Prosody
- Speech rate (# words per minute during connected speech)
- Breathing pattern (e.g., quick inhale, slow controlled exhale)
- # of words in each breath
- Pitch breaks
- Aphonia
- Phonatory onset of vowels
- Glottal fry
- Vocal tremor
- Resonance
- Intelligibility (% words understood)
- Loudness (using a sound level meter)
-
“Say ‘eee’ for four seconds using your typical pitch and loudness. Repeat fifteen times.”
More Voice Resources
- The Adult Speech Therapy Starter Pack
- Voice Therapy Exercises
- LSVT Loud vs SPEAK OUT!
