ABSTRACT
ASSESSING SPEECH DIFFICULTIES Mrs Williams is 68 years old and has some difficulties with her speech. Please assess her speech problem and suggest a diagnosis.
Conduct of the interview Makes appropriate introduction of self Gains consent for the interview Explains the purpose of the interview Attempts to establish the patient’s name Attempts to test the patient’s orientation in time and place Gives opportunity for the patient to identify her own speech difficulty Checks for dysarthria (e.g. asks the patient to say ‘baby hippopotamus’) Checks for expressive dysphasia Checks for receptive dysphasia Checks for nominal dysphasia (shows the patient common objects and asks her to name them, e.g. pen or watch) Checks for dysgraphia (asks the patient to write a sentence)
General use of the following communication skills Moves at a pace that is comfortable for the patient, i.e. does not rush or interrupt her If appropriate, rephrases questions/statements to aid the patient’s understanding Demonstrates understanding and empathy towards the patient’s difficulties Acknowledges the patient’s distress or discomfort
Examiner global rating Role-player global rating
KEY This station not only tests whether you can distinguish between the different types of speech difficulty (namely dysarthria, receptive dysphasia and expressive dysphasia), but also tests your professional attitudes towards disability. Speech difficulties are usually secondary to a cerebrovascular accident (CVA). They can also be part of other disease processes such as dementia, depression and parkinsonism, but you are much less likely to be asked about these.
