DEMSS excerpt.pdf
Dynamic Evaluation of Motor Speech Skill
DEMSS MANUAL
About the Authors
Edythe A. Strand, Ph.D., CCC-SLP
Emeritus Professor, Mayo College of Medicine
Emeritus Consultant, Department of Neurology, Mayo Clinic
Rochester, Minnesota
Affiliate Professor, University of Washington
Department of Speech and Hearing Sciences
Seattle, Washington
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)
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. Finally, this chapter discusses the qualifications and training requirements expected for clinicians using the DEMSS and provides an overview of how the test is administered and interpreted.
Intended Purpose of the DEMSS
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. Our goal was to design a test that could be used even for those children who have little or no functional verbal communication but who can at least attempt imitation.
Rationale
The DEMSS was motivated by the need for:
- A criterion-referenced tool for children who are young and/or severely speech impaired.
- A dynamic tool to facilitate judgments of severity and prognosis.
- A tool that would better facilitate treatment planning and stimulus selection.
Several existing measures to examine aspects of oral-motor and motor speech skill in children had been developed when formal development of the DEMSS began. None were able to address the full range of purposes established for the DEMSS, nor to meet all fundamental psychometric standards related to reliability and validity.
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 term motor speech impairment denotes that at least some of the child’s difficulty in speech acquisition is due to deficits in planning and programming movement for speech, deficits in the execution of speech movement due to weakness or incoordination, or both.
Benefits of Dynamic Assessment
The title of this assessment tool was devised to highlight the fact that the DEMSS employs dynamic assessment. The clinician 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.
Observations of Speech Characteristics
Dynamic assessment allows observation of behaviors that might not be seen in spontaneous speech. Providing support may elicit observations important to differential diagnosis or classification of subtypes of SSDs.
Severity and Prognosis
The potential to better judge severity and prognosis is one important benefit of using dynamic assessment. Observing a child who is frequently able to produce accurate movements for an utterance with little or only moderate cueing provides evidence that he or she is likely to benefit fairly quickly from therapy.
Treatment Planning
The DEMSS supports treatment planning in several ways. The types of cues that help a child improve during the DEMSS will likely facilitate performance improvements in ongoing treatment.
Table 1.1. Typical Assessment Components for Speech Sound Disorders
| Task | Appropriate for |
|---|---|
| History | All children |
| Language sample | All children (include a description of nonverbal communication attempts) |
| Phonetic and phonemic inventories | All children |
| Receptive and expressive language testing (informal and standardized measures) | All children with choice of specific measures based on developmental and language level |
| Articulation tests or measures of phonologic performance | Children who have at least a rudimentary speech sound inventory and can name pictures |
| Structural-functional examination | All children |
| Examine oral nonverbal praxis | Children who can attempt direct imitation of volitional nonspeech oral movement tasks |
| Motor speech examination (e.g., the Dynamic Evaluation of Motor Speech Skill) | Children who can attempt direct imitation of at least simple (consonant-vowel [CV]) words or phrases and for whom there is a question of deficits beyond simple speech delay or consistent phonologic processes |
Excerpted from Dynamic Evaluation of Motor Speech Skills (DEMSS) Manual by Edythe A. Strand, Ph.D., CCC-SLP, and Rebecca J. McCauley, Ph.D., CCC-SLP