Specific information on speech material and elicitation
From about 3 years of age, a single-word test by picture naming should be used (Fitzpatrick et al., 2020). From about age 5 years, the single-word test can be combined with sentence repetition. Continuous speech should preferably be elicited at all ages.
Single word lists
If a specific test material is to be devised for the assessment of cleft palate speech it is suggested that the guidelines for the restricted word list is followed but expanded with more consonants and consonant clusters included in the language of choice. Besides that, medial and final position of the consonants can be added. The restricted word list for cross-linguistic comparison can be included in the word test.
How to elicit picture naming of single words
When naming pictures, ensure the parents do not interfere with the child’s production. The following hierarchy of elicitation techniques is suggested:
- Child names pictures
- Sentence completion ("the boy is lying in his –" (bed))
- Delayed repetition: Either the SLP/SLT mention the word and ask the child what is was ("this girl's name is Sue, what is the girl's name?") or gives a forced alternative with the correct response first ("is this a cat or a car"?)
- Direct repetition: SLP/SLT names and the child copies ("say cat")
The inclusion of carefully constructed sentences permits the assessment of target consonants in different word positions, aiming to include vulnerable speech sounds similar to the sounds in the single word test, for example ‘Bob is a baby boy’.
In order to standardize the production as much as possible the recommended elicitation technique is repetition of the sentences.
It is important to collect and record a speech sample that is representative of a child's/adult’s everyday conversational speech to be able to the assess articulation, velopharyngeal competence and intelligibility in this context. Continuous speech as opposed to single words or very short phrases is preferable.
In younger children (pre-school children) a play activity with small toys (e.g., Playmobile) is often effective in eliciting continuous speech. Both the parent and the SLP/SLT can be involved in the play activity, but it is important that the adults don't speak too much. If the child is more communicative playing with the parent, the SLP/SLT can have minimal interaction with the child. Wherever possible, conduct the play at a table so that the audio-video or audio recording can be done with good quality.
The older the child the more choices of elicitation techniques are avialable. To get as much continuous speech as possible it is important to talk about a topic that is interesting for the child. One possibility is to say: I want to listen to your speech, is there anything you want to tell me about such as something you like to do (sports, hobbies), a game you like to play, a movie you have seen etc. If the child doesn’t find a topic, you can ask questions instead, such as “What do you like to do when you are not in school?” Try to use open ended questions. A verbal description of a thematic picture or a book with pictures is another good way of obtaining a continuous speech sample. Retelling of a narrative is another choice. An example of this is The Bus story test (Renfrew, 1997). The SLP/SLT tells the story about the bus while looking at series strip together with the child. Afterwards the child is asked to retell the story while looking again at the series strip. Reading and retelling a text is another way to get continuous speech, however it may not be totally representative of conversational speech.
* Fitzpatrick B, Coad J, Sell D, Rihtman T. Assessing speech at three years of age in the cleft palate population: a scoping review of assessment practices. International Journal of Language and Communication Disorders, 2020;55:165-187.
* Renfrew, C. E. Bus Story Test: A Test of Narrative Speech, Bicester, Oxon: Winslow Press; 1997.