Transcript Communication Assessment

Communication Assessment
Chapter 8
Perry C. Hanavan, Au.D.
Goals of Initial Assessment
Determine communication demands in
everyday life
Evaluate impact of hearing loss
Identify settings where problems arise
Document social activities in which
person engages
Assess effective use of communication
strategies
Chronicle employment responsibilities
Conversational Fluency
Definition:
– how smoothly conversation unfolds
Conversational Fluency Factors
Time spent repairing communication
breakdowns
– if need for clarification is low, then fluency is high
Exchange of information and ideas
– is conversation easily and successfully share
information, then fluency is high
Speaking time shared
– equal time, few silences, few interruptions, then
fluency is high
Time spent in silence
(Erber 1996; Erber 1998)
Index of Sharing Speaking Time
Conversational turn:
– period participant delivers a contribution to a
conversation
Mean length (speaking) turn (MLT)
– average number of words spoken during a set
number of conversational turns
Mean length turn ratio (MLT ratio)
– ratio of two speakers in a conversation
Example 1: Conversational Fluency
Teacher: Is Sarah studying at home, much?
Parent: Yes, and I’m thrilled with her.
Teacher: You said several weeks ago she only
watched TV and used her PlayStation after school.
Parent: Yes, but we have been following your
suggestions of turning off the TV.
Teacher MLT = 10.5 words (21 words/2 utterances)
Parent MLT = 9.5 words (19 words/2 utterances)
MLT ratio: 1.1 (1.0 = equal length of speaking time)
Example 2: Conversational Fluency
Sue: Has your new furniture arrived yet?
Tom: Huh?
Sue: Your new furniture!
Tom: Yup. (looks around and shakes head)
Sue: How are you doing? How is your wife? Mary?
Tom: Fine.
Sue’s MLT=6 words (18 words/3 utterances)
Tom’s MLT=1.0 words ( 3 words/3 utterances)
MLT ratio: 6.0 (1.0=equal length speaking time)
Traditional Audiologic vs Conversational
Fluency Measures
Most audiologic test lists present unrelated speech
stimuli (spondees, PB words, etc.)
Clients usually must repeat what they hear
verbatim (Say the word _____)
No interaction with communication partners
Hearing tests do not allow for use of repair
strategies and facilitative strategies
Problems Measuring
Conversational Fluency
Varies with the conversational setting, situation,
and communication partner
Varies with the topic of discussion
Communication breakdowns may not arise in the
clinical setting
No one evaluation adequately measures
conversational fluency
Assessment Procedures
Interview
Questionnaire
Daily Log
Group Discussion
Structured Communication Interaction
Unstructured Communication Interaction
Interviews
Basic assessment procedure to elicit specific
information about an individual’s hearing related
communication difficulties
Client provides subjective impressions of
conversational fluency in various settings
Interviews can be structured or unstructured
“Generous listening”
Advantages
– client specific information
Disadvantages
– difficult to quantify information
Example interview
Questionnaires
 Questions that probe subjective
information about conversational
fluency
 Open-ended and close-ended
questions
 Advantages
– quick, easy to administer
 Disadvantages
– may miss client-specific
information
Questionnaire/Inventory/Survey
Adults
 HHI-S / HHI-A Questionnaire
 SAC / SOAC Questionnaire
 GHABP
 SSQ
 APHAB
 IOI-HA
 ECHO
 SADL
K-12 students
 Listening Inventories For Educators
(L.I.F.E.)
 Children’s Auditory Performance
Scale (CHAPS)
 SIFTER
 CHILD
 ELF
Go to
www.hear2learn.com
for additional surveys
Daily Log/Diary
Self-reports of behavior used by
respondents for self-monitoring
Advantages
– quantitative information
Disadvantages
– can be a reactive process
Example daily diary
Group Discussion
A forum for members to discuss
communication issues
Advantages
– introspection and reflection
Disadvantages
– reluctance to participate
Examples: Active Communication
Education
– discussion topics
Structured Communication
Interactions
 Simulated communication
interactions
 Advantage
– good face validity
 Disadvantage
– can be time consuming to score
Structured Communication
Interaction
TOPICON
 Each participant independently examinees a list of topics and
indicates topics of personal interest or familiarity
 One participant selects a topic for conversation from the list–
reflecting personal interest, that of the other participant, or both
 The client and the partner conduct a brief conversation on the chosen
topic--2 to 5 minutes while the clinician evaluates the conversation
(example)
– Background noise, visual distractions, and/or speech and language
difficulties may be introduced during the conversation, while the
clinician monitors and assesses events
 The participants and the clinician discuss the content and fluency of
the conversation, considering avoidance or resolution of difficulties.
– (Erber, 1996)
Structured Communication
Interaction
Quest?AR
 Conversation-based communication
therapy procedure that provides interactive
practice with common question-answer
sequences.
 The client asks a series of questions and
learns to anticipate and accurately receive
spoken messages
 Provides person with hearing loss
confidence in asking response-limiting
questions
ASQUE (yes/no; choice; wh questions, etc.)
– (in Erber, 1996)
Active Communication Education
(ACE)
Group training program to help people over the age
of fifty with HL to become more effective
communicators in everyday life.
program offers guidance and strategies that will help
to:
– Improve the person’s communication abilities
– Reduce the hearing difficulties experienced
– Improve the person's quality of life.
Unstructured Communication
Interaction
 Spontaneous interaction with few external
constraints
 Free flowing conversation between patient
and communication partner
 Advantage
– good ecological validity—mimics real-world
interaction
 Disadvantage
– results may vary as a function of the
communication partner
– Example: Dyalog, ratings, transcription
analysis
Unstructured Communication
Interaction
 DYALOG
 Software with computer to objectively measure the
fluency of conversation before, during, and after
communication therapy
 Observe the client in conversation (live or
videotaped). Press the "space bar" on the computer
keyboard whenever misunderstanding occurs during
conversation and "repair" (e.g., repetition, clarification)
is needed. Release the space bar when fluent
conversation is restored. At the end of the conversation
(or after a pre-selected interval), the computer will draw
a graph of conversational fluency as a function of time,
and also will display:
– amount of conversation time (sec) that contained
breakdown/repair percent of conversation time that
contained breakdown/repair number of
breakdown/repair events average time (sec) per
breakdown/repair
Unstructured Communication
Interaction
 Ratings of conversations
 Transcription analysis of
conversations