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Severity Matrix

The document outlines a severity/intervention matrix for speech and language services. It divides severity of disorders into 4 levels - mild, moderate, severe, and profound - and recommends the number of service units (time per week) based on severity. For each area of articulation/phonology, language, fluency, voice, the matrix describes characteristics of the disorder at each severity level to determine appropriate intervention. Services may include augmentative communication systems for more severe impairments.

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Caroline
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2K views

Severity Matrix

The document outlines a severity/intervention matrix for speech and language services. It divides severity of disorders into 4 levels - mild, moderate, severe, and profound - and recommends the number of service units (time per week) based on severity. For each area of articulation/phonology, language, fluency, voice, the matrix describes characteristics of the disorder at each severity level to determine appropriate intervention. Services may include augmentative communication systems for more severe impairments.

Uploaded by

Caroline
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Severity / Intervention Matrix for Speech and Language Services

Mild Moderate Severe Profound


1-Unit 2-Units 3-Units 5-Units
(Minimum 15 – 30 (Minimum 31 – 60 (Minimum 61-90 (Minimum 91+ minutes
minutes per week) minutes per week) minutes per week) per week)
Impairment minimally Impairment interferes with Impairment limits the Impairment prevents the
Severity of
affects the individual’s the individual’s ability to individual’s ability to individual from
Disorder
ability to communicate communicate communicate communicating
Intelligible over 80% of Intelligible 50-80% of the Intelligible 20-49% of the Speech is unintelligible
the time in connected time in connected speech. time in connected speech. without gestures and cues
speech. and/or knowledge of the
context.
No more than 2 speech Substitutions and Deviations may range from
sound errors outside distortions and some extensive substitutions and Usually there are
developmental guidelines. omissions may be present. many omissions to additional pathological or
extensive omissions. A psychological problems,
Articulation / Students may be There is limited limited number of such as neuro-motor
Phonology stimulable for error stimulability for the error phoneme classes are deficits or structural
sounds. phonemes. evidenced in a speech- deviations.
language sample.
Consonant sequencing is
generally lacking.

Augmentative Augmentative
communication systems communication systems
may be warranted. may be warranted.
The student demonstrates a The student demonstrates a The student demonstrates a The student demonstrates a
deficit in receptive, deficit in receptive, deficit in receptive, deficit in receptive,
expressive, or pragmatic expressive, or pragmatic expressive, or pragmatic expressive, or pragmatic
language as measured by language as measured by language as measured by language, which prevents
two or more diagnostic two or more diagnostic two or more diagnostic appropriate
procedures / standardized procedures / standardized procedures / standardized communication in school
tests. tests. tests (if standardized tests and/or social situations.
can be administered).
Language
Augmentative Augmentative
communication systems communication systems
may be warranted. may be warranted.

Performance falls from 1.0 Performance falls from 1.5 Performance falls from 2.0 Performance falls from 2.5
to 1.5 standard deviations to 2.0 standard deviations to 2.5 standard deviations standard deviations below
below the mean standard below the mean standard below the mean standard the mean standard score
score (SS = 85 – 77.5). score (SS = 77.5 - 70). score (SS = 70 – 62.5). (SS = 62.5-).
2-4% atypical disfluencies 5-8% atypical disfluencies 9-12% atypical More than 12% atypical
within a speech sample of within a speech sample of disfluencies within a disfluencies within a
at least 100 words. at least 100 words. speech sample of at least speech sample of at least
100 words. 100 words.
No tension to minimal Noticeable tension and/or Excessive tension and/or Excessive tension and/or
Fluency tension. secondary characteristics secondary characteristics secondary characteristics
are present. are present. are present.

Rate and/or Prosody has Rate and/or Prosody limits Rate and/or Prosody Rate and/or Prosody
minimal interference with communication. interferes with prevents communication.
communication. communication.
Voice difference is Voice difference is of Voice difference is of Speech is largely
appropriate for the concern to parent, teacher, concern to parent, teacher, unintelligible due to
Voice student’s age is of minimal student, or physician. student, or physician. aphonia or severe
Including concern to parent, teacher, Voice is not appropriate Voice is distinctly hypernasality.
hoarseness, student, or physician. for age and sex of the abnormal for age and sex Extreme effort is apparent
nasality, denasality, student. of the student. in production of speech.
pitch or intensity
Medical referral may be Medical referral may be Medical referral is Medical referral is
indicated. indicated. indicated. indicated.

Adapted from ASHA by Joleen R. Fernald, MS CCC-SLP

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