Name of the Procedure:

Spoken Language Expression Functional Limitation, Current Status at Therapy Episode Outset and at Reporting Intervals (G9162)

• Common name: Speech Fluency Assessment
• Technical/Medical Term: Functional Communication Measure (FCM) for Speech Expression

Summary

This procedure assesses a patient's ability to express themselves verbally at the beginning of a therapy episode and at specific intervals during treatment. It helps track progress and effectiveness of therapeutic interventions aimed at improving speech fluency and overall communication abilities.

Purpose

• Medical Conditions: Speech and language disorders, such as aphasia, dysarthria, stuttering, and apraxia of speech.
• Goals/Outcomes: To evaluate and document the current status of a patient’s spoken language abilities, to guide therapy plans, and to monitor improvements over time.

Indications

• Symptoms/Conditions: Difficulty in forming words, stuttering, reduced speech clarity, challenges in verbal expression due to stroke, traumatic brain injury, neurodegenerative diseases, or developmental disorders.
• Patient Criteria: Individuals experiencing noticeable difficulties in spoken language that interfere with daily communication.

Preparation

• Pre-procedure Instructions: No specific preparation needed.
• Diagnostic Tests/Assessments: Initial speech and language evaluation, possibly including screening tools like the Boston Diagnostic Aphasia Examination (BDAE) or the Speech Mechanism Screening Test (SMST).

Procedure Description

1. Initial Assessment:

   • The speech-language pathologist (SLP) will conduct a comprehensive interview to gather patient history.
   • The SLP will administer standardized and non-standardized assessment tools to evaluate the patient’s spoken language abilities.

2. Regular Monitoring:

   • Periodic reassessments are conducted at set intervals during the therapy program.
   • These assessments involve repeating previously used tools to ensure consistency in measurement.

3. Documentation:

   • The SLP documents the patient's current functional status at each interval, noting any improvements or changes in spoken language abilities.

• Tools/Equipment Used: Standardized assessment tools, recording devices for speech samples, computer software for analysis.
• Anesthesia/Sedation: Not applicable.

Duration

• Initial assessment typically takes 1 to 2 hours.
• Follow-up assessments usually take 30 minutes to 1 hour.

Setting

• Conducted in a variety of settings including hospitals, outpatient clinics, rehabilitation centers, or private practices specializing in speech therapy.

Personnel

• Conducted by licensed Speech-Language Pathologists (SLPs).
• May involve support staff for administrative and documentation purposes.

Risks and Complications

• Common Risks: Minimal risk; procedure is non-invasive.
• Rare Risks: Emotional distress if the patient becomes frustrated or anxious during assessment.
• Management: Emotional support and reassurance from the SLP, possible referral to counseling services if needed.

Benefits

• Expected Benefits: Improved ability to communicate verbally, increased confidence in speaking situations, better quality of life.
• Timeframe for Realization: Varies based on individual therapy progress; improvements may be seen within weeks to months of consistent therapy.

Recovery

• Post-procedure Care: No specific recovery needed; patients continue with their daily activities.
• Expected Recovery Time: Not applicable.
• Restrictions/Follow-up: Regular follow-up appointments for continued assessment and therapy adjustments.

Alternatives

• Other Treatment Options: Augmentative and Alternative Communication (AAC) devices, sign language, written communication training.
• Pros and Cons: AAC devices can provide immediate communication support but may not help improve verbal speech. Sign language and written communication are effective for some but depend on the patient’s ability and the context in which they communicate.

Patient Experience

• During the Procedure: Patients might feel nervous but the setting is generally supportive and encouraging.
• After the Procedure: Patients may feel tired but typically experience a sense of accomplishment and hopefulness as they chart their progress.
• Pain Management/Comfort: No physical pain, but emotional support and comfort measures are provided to reduce anxiety.