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OLFACTION AND TASTE (See neurologic impairment rating section.)
DYSARTHRIA Impairment rating in this section is concerned with voice production and articulate speech. Language content and receptive speech disorders are considered in the section on impairment rating of neurologic disorders.A classification chart, oral reading paragraph, and examining procedures for use in estimating speech impairment are described below.
Classification Chart Judgments as to the amount of impairment should be made with reference to the classes, percentages, and examples provided in the Speech Classification Chart (on page 150). The fifteen categories of the chart suggest activities or situations with different levels of impairment. Data gathered from direct observation of the patient or from interviews should be compared with these categories, and values should be assigned considering the specific impair ments that are present.
Oral Reading Paragraph The paragraph of 100 words, entitled, “The Smith House,” composed of 10 sentences, provides a uniform means of comparing a speech example of the patient with the performance of normal speakers. The phonetic elements of the paragraph are selected particularly for their relevance to intelligibility of speech.
“The Smith House”
Larry and Ruth Smith have been married nearly 14 years. They have a small place near Long Lake. Both of them think there’s nothing like the country for health. Their two boys would rather live there than any other place. Larry likes to keep some saddle horses close to the house. These make it easy to keep his sons amused. If they wish, the boys can go fishing along the shore. When it rains, they usually want to watch television. Ruth has a cherry tree on each side of the kitchen door. In June they enjoy the juice and jelly. Examining Procedures
General Orientation The examining physician should have normal hear ing as defined in the earlier section on Hearing.The setting of the examination should be a reasonably quiet office that approximates the noise level conditions of everyday living. The examiner should base judgments of impairment on two kinds of evidence:
(1) Direct observation of the patient’s speech in the office; for example, during conversation, during the interview, and while reading and counting aloud; and
(2) reports pertaining to the patient’s performances in situations of everyday living. The reports or the evidence should be supplied by observers who know the patient well.
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