Adult Speech and Language Evaluation
ASU Speech and Hearing Clinic
Spring Testing
Name:______________________________________________ DOB:_________________ Gender:______
Examiner:_____________________________________________________
Date:___________________
Instructions: Administer the following screening tools and standardized tests/batteries. This sheet serves
as a guide to organize and provide efficiency in administering your assessment. Once you have completed
your assessment and scored your protocols, please use the template for SHS 580 Adult Testing to provide a
brief and formal narrative of results.
I. INTERVIEW: Educational, Social, Medical History
Are you right or left handed?________________
Do you wear glasses or contacts?__________________________
Do you wear hearing aids?______________________________
Do you have any difficulty with your hearing?______________________
Do you speak another language aside from English?________if so, what?______________________
What is your major? _____________________________________What year are you in? __________________
What are your grades like?___________________Are you having any trouble in school?___________
If so, describe:_________________________________________________________________________________________
Are you married or single? _____________ Any children? ________________
Do you work? _______If so, what is your occupation? _____________________________________
Do you live alone?_________roommates?___________ parents?_____________ siblings?_________________
Do you have any pets? ____________ If so, what kind?_____________________
Do you have any of the following medical conditions or complaints with the following: (Circle all that apply)
allergies
anomalies
trouble swallowing
excessive mucus
previous intubation
surgeries
frequent upper respiratory infections
problems
enlarged tonsils or adenoids
trauma
trouble breathing
mouth breathing
thyroid condition
asthma
other: _______________________________________________
deviated septum
frequent infections
bulimia
Are you taking any medications?_________________________________________
sleep apnea
reflux
craniofacial
psychological
Do you smoke?_________ if yes, how much?_______________________________
If no, do you have a history of smoking? _______________how much? ___________ and how long?__________________
Are you exposed to smoke?________ how frequently?_____________
Where?____________________________
Do you drink alcohol?__________ ,how much?_______________________
Do you drink coffee, tea or soda with caffeine?_______how much?_____________
How many cups of water do you drink daily?_____________________
Do you have any complaints with your voice or breathing?____________
If yes, then ask to describe:
____________________________________________________________________________________________________________________________________
________________________________________________________________________________________________
Do you experience or do any of the following vocal behaviors: (Circle all that apply)
Throat clearing
muscle tension
excessive talking
Loud talking
loud singing
smoking
Fatigue
noisy environment
cheerleading
Yelling
excessive dust/noxious gases
Sound imitations
Stress
impersonations
solo singing
gargling
dramatics
coughing
choir
sporting activities
other: ____________________________
Respiration: (make the following observations about the client’s breathing at rest)
Visible tension present? _____ neck, ______chest, _______none
_____clavicular breathing _________thoracic breathing
________audible breathing
________appropriate
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The following items should be done using Multispeech or the Visipitch.
Use Multispeech - set on wave form and capture above at 60 secs
Phonation:
1. “Take a deep breath and exhale on /s/ as long as you can.” (Repeat for /z/ for a total of 3 trials each)
/s/ ____ seconds
Average
/z/ ____ seconds
____
____
____ (normal is 20-25 sec)
Average ____
____
____
**____ s/z ratio (normal is 1.0)
**reduced vital capacity = clients with <20 seconds for both /s/ and /z/ and so still have s/z ratio of 1.0
++problems with laryngeal valving = clients who can sustain /s/ for 20-25 sec but less for /z/ resulting in ratio of >1.4
2.
“Take a deep breath and say /a/ for as long as you can.” (Repeat with /u/ and /i/ and then calculate
average maximum phonation time)
/a/ ______ seconds /u/ _______ seconds
/i/ ________ seconds
Average MPT ________ seconds (normal is >14.3 for females and >15.0 for males)
Speech:
“Read the following passage, The Grandfather Passage, and I will listen to your voice, loudness, and rate of
reading”. (Circle all the apply during your observation; use multispeech to time the passage for rate. Measure
pitch range, loudness and mean frequency. Remember to set the capture rate to at least 60 secoonds).
Tone Focus:
retracted tongue
closed mouth
appropriate
Quality:
aphonia
diplophonia
appropriate
monotone
appropriate
dysphonia
Pitch Level:
too high
Variability:
fading at ends of sentences
Vocal Fry:
frequent
Visible Tension:
Resonance:
hypernasal
Fluency:
throat clearing
Poor rate
too low
occasional
present
hyponasal
appropriate
never
absent
appropriate balance
cluttering
repetitions
interjections
prolongations
other:_______________________
Average decibel speaking level: __________dB (normal conversational speech is 60-80 dB)
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Average words per minute (WPM): _____________ (normal is 150-160wpm for reading)
Vocal Fundamental Frequency in Young Adults ____________________ Hz (Y Female = 197.2 (16.61); Y Male
= 110.3 (14.08) from B. Benjamin, 1981.
**At this point, make a clinical judgment of your client’s voice.
____________WFL
____________Not WFL characterized by:____________________________________
Alternating Motion Rates (diadochokinetic rates): Use Multispeech and make sure you have the capture
window set for 5 seconds.
Directions to patient: “Take a deep breath and say (e.g., /papapa/ as long and as fast and as evenly as you
can. I will tell you when to stop.” You want to make sure that you have 5 seconds of connected
production. Repeat this with /tatata/ and /kakaka/. For each measure count the number of syllable
produced. Double the number and stick a period in it to get a syllable/sec rate: E.g. 30 reps would be 6.0
syllable per second. Use the table below to record your data.
Demonstrate what you want them to do.
Is AMR slow?
Yes
No
Is AMR excessively fast? Yes
Is AMR dysrhythmic?
No
Yes
No
Is AMR uneven in pitch? Yes
No
Is AMR uneven in loudness?
Is there a tremor?
Yes
Yes
No
No
Is there equal spacing between syllables? Yes
No
Is there blurring (lack of differentiation between syllables)? Yes No
Is there hypernasality?
Yes
Is there nasal emission? Yes
No
No
Is there restriction in amplitude of motion of lips and jaw? Yes No
Are there imprecise or distorted consonants?
Yes
No
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Sequential Motion Rate (SMR)
Directions to patient: “Now I want you to make those three sounds, ‘puh’, ‘tuh’, and ‘kuh’
together.” Demonstrate.
Is patient able to move smoothly from syllable to syllable? Yes No
Are sounds blocked, transposed, or omitted?
/pa/ ______________
/ta/___________
Yes
No
/ka/______________
/pataka/ ____________________
Male young adult – /pa/ 6.3(.53), /ta/ 6.1(.50), /ka/ 5.8 (.55), /pataka/ 6.36 (.42)
Female young adult – /pa/ 6.2(.61), /ta/ 6.2 .64), /ka/ 5.5 (.75), /pataka/ 6.27 (.31)
*norms based on Lass and Sandusky (1971)
Intonation:
Open up Realtime pitch and have the client produce the following phrases:
“Are you going to the zoo?”
Is there a rising intonation for the question? Y N
Apples, pears and bananas” Can the student produce a rising, rising, falling list pattern Y N.
II. Oral Motor Exam: Please use Brief Oral Motor Exam form for the structural-functional examination. Don’t do
the the acoustic portion as you have essentially done this above.
III. Revised Token Test (RTT): Please review administration and scoring thoroughly. There are diacritical
elements in the scoring system that you will need to become very familiar with. There will be scoring forms
available for each client.
IV. Peabody Picture Vocabulary Test, 4th ed. (PPVT-4): See manual to obtain accurte scores for either
version A or B.
Raw Score: _________Standard Score: ____________ %ile:________________ 95% confidence
interval:___________________________ Qualitative description______________________
VI. Expressive Vocabulary Test, 2nd ed. (EVT-2): See manual to obtain accurate scores for either version A or B.
Raw Score: _________Standard Score: ____________ %ile:________________Stanine:______________
VII. Closing Impression: If any, briefly discuss any concerns you may have with your client. Let them know that
accurate results will follow in a report and require approval by your supervisor. They can have a copy of the
report emailed to them.
Email:____________________________________
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