Dynamic Evaluation of Motor Speech Skill

DEMSS MANUAL

Dynamic Evaluation of Motor Speech Skill (DEMSS) Manual

by
Edythe A. Strand, Ph.D., CCC-SLP
Emeritus Professor, Mayo College of Medicine
Emeritus Consultant, Department of Neurology, Mayo Clinic
Rochester, Minnesota
Affliate Professor, University of Washington
Department of Speech and Hearing Sciences
Seattle, Washington

and
Rebecca J. McCauley, Ph.D., CCC-SLP
Department of Speech and Hearing Science
The Ohio State University
Columbus, Ohio

Contents

• About the Online Materials
• About the Authors
• Acknowledgments

Chapter 1 Overview of the Dynamic Evaluation of Motor Speech Skill (DEMSS)

1. Introduction
2. Intended Purpose of the DEMSS
3. Rationale

Chapter 2 Specific Scoring Timing and Instructions

1. Specific Scoring After the First Attempt
2. Scoring Instructions After All Cueing
3. Missing Data
4. Cueing Hierarchy
   • Suggested Hierarchy of Cues
   • Types of Cueing Not Allowed During the DEMSS
5. Scoring Examples

Chapter 3 Interpreting the DEMSS

1. Interpreting DEMSS Results in the Context of a Comprehensive Battery
2. Relative Contributions of Different Skill Areas to Performance
3. Impact of the Child's Chronic Communication Problems
4. Using the DEMSS Score to Make Diagnostic Decisions Regarding Childhood Apraxia of Speech
5. Using Other Observations of Speech Characteristics Associated With Childhood Apraxia of Speech to Facilitate Diagnosis
6. Diagnostic Statements
7. Case Examples
   • Severe Childhood Apraxia

About the Authors

Edythe A. Strand

Dr. Strand is an emeritus professor in the Mayo College of Medicine and former Head of the Division of Speech Pathology, Department of Neurology at the Mayo Clinic, in Rochester, Minnesota. She has a long history of clinical experience, including public schools, private practice, and hospital and clinic settings. Her research has focused on developmental, acquired and progressive apraxia of speech, and issues related to intelligibility and comprehensibility in degenerative dysarthria.

Rebecca J. McCauley

Dr. McCauley is a professor in the Department of Speech and Hearing Sciences at The Ohio State University, where she has taught from 2008 to the present. Her research and writing have focused on assessment and treatment of pediatric communication disorders, with a special focus on speech sound disorders, including childhood apraxia of speech.

Introduction

This chapter provides potential users of the Dynamic Evaluation of Motor Speech Skill (DEMSS) with the rationale for its development and information regarding its intended purpose. Descriptions of the target population, content, and administration times expected for its use are also provided.

Assessment is undertaken for many purposes, including screening, comparing performance with a normative sample, and differential diagnosis and treatment planning. Clinicians must take several important steps when assessment is focused toward differential diagnosis.

The primary purpose of the DEMSS is to aid clinicians in differential diagnosis of SSDs in children 3 years of age and older who may be quite impaired in their speech production. It is not intended for children under 3 years of age because its reliability and validity were not examined for children that young.

The Role of the DEMSS in Differential Diagnosis

Determining to what degree motor speech impairment contributes to the child’s SSD is one of the most significant challenges in differential diagnosis of SSDs. The DEMSS was designed to assist in determining whether deficits in praxis contribute to the child’s SSD.

Benefits of Dynamic Assessment

Dynamic assessment allows observation of behaviors that might not be seen in spontaneous speech. It provides systematic cueing as the child makes repeated attempts to produce an utterance. Scoring reflects the child’s change in performance as a result of cueing, revealing emerging skills.

Table 1.1. Typical assessment components for speech sound disorders

Observations of Speech Characteristics

Evidence that a child is likely to benefit from therapy can be observed through correct movement with minimal cueing. Conversely, a child requiring significant assistance may indicate a more severe speech disorder.

Treatment Planning

The DEMSS supports treatment planning by aiding clinicians to choose early stimulus sets based on errors and facilitating performance improvements in ongoing treatment.