1.06 - Exam 1 Review Flashcards
A four year old who is unintelligible to novel listeners usually has a _______.
Phologicial Problem
Intervention (therapy) is a ______ process. This means the clinician must ______ the patient’s progress towards the set goals and _______.
Dynamic
Continuously assess
Modify them if necessary
Any speech/language therapy must be designed with careful consideration of a client’s _______.
Verbal and nonverbal plus cognitive abilities
Knowledge of a client’s level of cognitive function is critical in making decisions about _______ and selecting ________.
Eligibility for treatment
Appropriate therapy objectives
The ultimate goal of speech/language therapy is the teach strategies that _________ rather than teaching isolated skills.
Facilitate the communication process
Skills are required to _________ in given situations.
Achieve specific outcomes
Strategies enable the individual to know when and how to ______.
Use their skills in new and varied learning contexts
When possible, teach in ________ to provide opportunities to engage in ______ communicative contexts.
Realistic contexts
Meaningful
Intervention strategies should be specific to the client’s _____ and individual _____.
Deficits
Learning style
We should ensure that the client experiences _____ throughout all stages of therapy.
Success
Therapy goals are tailored to promote a clients knowledge ______ the current level.
One step beyond
When should therapy be terminated?
2
Once the client has achieved all goals
If the client is no longer demonstrating progress
Who decides when therapy should be terminated?
It is a team decision (even if the team is just the client and the clinician)
Therapy should be based on _______.
Scientific Evidence
Therapy should be sensitive to a client’s ________ background.
Cultural & Linguistic
What is programming?
3
Selecting therapy targets
Sequencing therapy targets
Generalizing therapy targets
How do we find the level that we need to begin the Therapy Targets?
Assessments
Client request/concerns
What is Behavior Modification?
The systematic use of specific Stimulus-Response-Consequence procedures
What are Key Teaching Strategies?
Using basic training techniques to facilitate learning
What is Session Design?
Organizing and implementing therapy sessions
What does Session Design include?
Interpersonal dynamics
What is data collection?
The systematic measurement of client performance and treatment efficacy
What four factors influence the selection of Therapy Targets?
Establish goals
Take pretreatment baselines
Where do baselines fit into Developmental/Normative development
What issues most concern the client
What is a Developmental/Normative Strategy?
Targets are taught in the same general order as they emerge in a typically developing individual
What is a Client Specific Strategy?
Targets are based on the the individual’s specific needs and concerns
(Sounds in important words like own name, common communication environments, etc.)
Is it better to use a Developmental or a Client Specific strategy?
It’s better to use both and focus on whichever one fits the particular client’s need
What are the three parts to Therapy Targets?
Also referred to as “Sequencing of Therapy Targets”
Stimulus Type
Task Mode
Response Level
What are Stimulus Types?
The input that is used to elicit a response in therapy
What are the three kinds of Stimulus Types?
Direct physical manipulation
Concrete symbols
Abstract symbols
What are concrete symbols?
3
Objects
Photographs
Drawings
What are abstract symbols?
2
Oral language
Written language
What is the Task Mode?
2
The support/scaffolding that the clinician uses
This guides the client to the desired response
What are the three kinds of Task Modes?
Imitation
Cue/Prompt
Spontaneous
What is the Response Level?
The degree of difficulty required in the client’s response
What are the two ways of increasing the Response Level?
Increasing the complexity of the response (length, syntax, maturity, etc.)
Decreasing the latency (response time) between when the stimulus is present and when the client responds.
What is Branching?
Increase (or decreasing) the difficulty of a task when it becomes apparent that the task is too easy (or hard) for the client
When is Branching used?
2
In the middle of a therapy session
When the client’s performance does not match what was expected
When Branching, a good rule of thumb is to modify the difficulty level by _____ according the the therapy sequence hierarchy.
One step
Where do you learn the specific rules of Branching?
You can’t. You have to be creative in the moment.
Whose job is it to set the difficulty level of a therapy session?
The clinician
What is generalization?
When the client is able to transfer newly mastered behaviors into new or everyday environments
What is a synonym for generalization?
Carryover
What are three factors that can be modified to increase the probability that a skill will become generalized?
Stimuli
Physical Environment (Location)
Audience (Communication partners)
Should we keep working with a client after they have attained communication skills that correspond with the client’s chronological and/or developmental age?
No. This a a good discharge guideline.
Should we keep working with a client after they have obtained communication skills that correspond with their premorbid status (based on disease or disorder)?
No. This a a good discharge guideline.
Should we continue working with a client who has obtained functional communication skills allowing them to naviagate their daily life without significant handicap?
No. This a a good discharge guideline.
Should we continue working with a client who is continually not making progress?
No. This a a good discharge guideline.
What does “programming” mean in regards to therapy?
5
Selecting therapy targets
Designing therapy sessions
Formulating behavioral objectives
Designing behavior modification (if needed)
Choosing teaching strategies
What is a Behavioral Objective?
ONE SENTENCE that descrives one short term goal
A Behavioral Objective must describe a _________, it must be ______, and it must be ______.
Specific target behavior
Observable
Measurable
What are the three components of a Behavioral Objective?
Do Statement
Condition
Criteria
What is the Do Statement (in a Behavioral Objective)?
An specific action (action verb) that states what the client will do
What is the Condition (in a Behavioral Objective)?
The situation where the target behavior will be performed
What is the Criteria (in a Behavioral Objective)?
How well the target behavior must be performed
The level that determines success
How is the Criteria (in a Behavioral Objective) usually measure?
(4)
By percent correct
By response time
By maximum number of errors
By minimum number correct
What theory is Behavior Modification based on?
Theory of Operant Conditioning
What are the three components of Behavior Modification?
Stimulus
Response
Consequence
What is a Stimulus?
The antecedent event
What precedes and elicits a response from the client
What is a Response?
The behavior that resuls directly from the stimulus
What is a Consequence?
3
The event that follows the response
It must be contingent to the response and follow it immediately
(In therapy, the consequence is given by the clinician)
What are the two types of Consequences?
Reinforcements
Punishments
What is a Reinforcement?
Something given or performed that increase the likelihood that a behavior will be repeated
Encourages a behavior
What is a Punishment?
Something that is given, performed, or removed that decreased the chances that a behavior will be repeated
Stops a behavior
What are the two types of Reinforcement?
Primary Positive Reinforcement
Secondary Positive Reinforcement
What is Primary Positive Reinforcement?
Something is given to the client that they already see as rewarding
(Candy, toy, sticker, etc.)
What are the downsides to Primary Positive Reinforcement?
It is susceptible to satiation (the reward is no longer “rewarding” - need bigger “prize”)
It makes skills hard to generalize outside of the therapy environment (why do it when there is not reward)
It is difficult to reinforce immediately (it should ideally follow the response by milliseconds)
What is Secondary Positive Reinforcement?
Something that the client is taught to see as rewarding
What are three kinds of Secondary Positive Reinforcement?
Social
Token
Performance Feedback
What is Social Reinforcement?
Verbal praise, smiling, eye contact, etc.
What is Token Secondary Reinforcement?
2
Symbols or objects
Often these can be traded in for a reward if enough are collected
What is Performance Feedback?
Giving the client honest feedback on their performance
This can be accompanied by biofeedback, graphs, rating scales, etc.
Is Performance Feedback given as praise?
No.
It let’s the client find intrinsic encouragement
What are the two types of Punishment?
Negative Reinforcement
Punishment
What is Negative Reinforcement?
Something unpleasant is removed once the desired behavior is presented
(Think in terms of math not emotion. Negative=subtraction, Positive=addition)
What is Punishment?
A undesired behavior is immediately followed by a unpleasant event (loud noise, time-out, scolding, etc.)
What are Positive Behavioral Supports?
A way to minimize opportunities for problemative behavior
A way to encourage more socially useful/acceptible behaviors
Positive Behavioral Supports is a ______ approach that uses ______ and ______ strategies.
Proactive
Interpersonal
Environmental
Positive Behavioral Supports are more _____ and _____ in nature.
Preventative
Positive
SLPs can prevent problematic behaviors if materials are ______ and ______ and our sessions are ______.
Creative
Interesting
Paced well`
What are the two types of reinforcement schedules?
Continuous
Intermittent
What is Continuous Reinforcement?
You reinforce after every correct response
What is Intermittent Reinforcement?
Reinforcements are only given after some correct responses
What are the four kinds of Intermittent Reinforcement?
Fixed Ratio
Fixed Interval
Variable Ratio
Variable Interval
What is a Fixed Ratio?
A reinforcement is given after _____ correct responses
What are Fixed Intervals?
A reinforcement is given for the first correct response after a set window of time
(The first correct response every 30 seconds, etc.)
What are Variable Ratios?
The number of correct responses required for a reinforcement changes each time.
This is preset by the clinician
(7 correct - reward - 3 correct - reward - 9 correct - reward, etc.)
What are Variable Intervals?
The window of time changes after each reinforcement is given
This is preset by the clinician
(30 sec - reward - 15 sec - reward - 25 sec - reward, etc.)
What is direct modeling?
You perform the behavior
The client copies
What is indirect modeling?
The client is exposed to the target behavior repeatedly but not asked to repeat
What is shaping?
Breaking a target behavior into smaller components
These are taught in increasing levels of difficulty
What are prompts?
Verbal or nonverbal cues to facilitate the client’s production of the correct response
(“What do we say?” “Thank you”)
( “Oh it’s my turn”)
What is fading?
Teaching strategies are gradually reduced while maintaining the target behavior
Goal is independence
What is expansion?
Reformulating the clients utterance into a more mature or complete one
(“bye bye” -> “good bye”)
(“doggie go bye” -> “the dog went away”)
What is negative practice?
Drawing the client’s awareness to errors
You said “Captain American and Four”
When should negative practice be used?
ONLY once a client has mastered a skill
What is Target Specific Feedback?
Providing specific information to the client about the accuracy/inaccuracy of the target behavior
(When you said “Thor” you didn’t put your tongue between your teeth so it sounded like “Four”)
What is homework? What is it’s purpose?
Activities to be done at home
To improve and generalize the skill
Tasks given as homework should be ______.
Ones that have been previously mastered
What are the five Training Protocol Steps?
Present stimulus
Client responds
Present consequence
Record client response
Remove stimulus
What should tasks be ordered in a therapy session?
Easy - Hard - Easy
What four things affect the Dynamics of Therapy?
Clinician-Client relationship
Pace of Session
Materials
Proxemics (placement of client and clinician)
What four things affect Group Therapy Design?
Size
Composition
Clinician Role (Directive or non-directive)
Procedures
What are advantages to group therapy?
Interaction
Generalization
Relationships/Support
What are disadvantages to group therapy?
Less attention
May not fit all clients
What are the four Service Delivery Models?
Collaborative Partnership
Response to Intervention
Treatment Efficacy
Evidence Based Practice
What are Collaborative Partnerships?
3
Consultative
Team Teaching
Self Contained
What is Response to Intervention?
A category to place kids who are struggling but who do not have IEPs
What is Treatment Efficacy?
How effective your treatment is
What is Evidence Based Practice?
4
Best scientific evidence
Clinician expertise in condition
Meeting client values, beliefs, preference, etc.
Being sensitive to cultural and linguisitc factors
The data collection formation should be chosen _______.
Prior to the session
The data collection notation system should provide the _____.
Most relevant information
Your data collection should distinguish between __________ responses.
(4)
Imitative
Cued/Prompted
Self-Corrected
Spontaneous responses
You should use the ______ data collection method for the client’s current level of function.
Most efficient
You can use _______ to help keep track of response.
Tokens or stimulus items
When taking data, you should record every response because even a ________ is a response.
Lack of a response
What are probe?
Mini assessments
They look at the clients growth/progress
How often should probes be administered?
Throughout treatment
What are seven types of reports an SLP may have to write?
SOAP Note
IEP
IFSP
ISP
Treatment/Therapy Plan
Diagnostic Report
Treatment/Discharge Report
What is a SOAP Note?
Subjective (Client’s affect)
Objective (What was done)
Assessment (What worked or didn’t work)
Plan (What to focus on next time)
What is an IEP?
Education Plan
Ages: 3-21
What is an IFSP?
Short Term Care/Services Plan
Ages: Birth-3
What is an ISP?
Long Term Care Plan
Ages: 3-Death
What is a Treatment/Therapy Plan?
4
Description of problem
Long term goals - short term objectives
Methods you will be using
Why the above is EBP
What is a Diagnostic Report?
A summary of a diagnostic evaluation
What is a Treatment/Discharge Report?
Summary of the treatment you provided
Not always a discharge - sometimes an review or annual report
What is the best predictor of cognitive-communicative behaviors?
Socio-economic status (SES)
What are three kinds of linguistic differences?
Nonverbal
Paralinguistic (nonlexical communication)
Verbal
What are three kinds of bilinguals?
Ambilingual
Equilingual
Semilingual
What does Ambilingual mean?
Speaks both languages as well as a native speaker
What does Equilingual mean?
Is an effective communicator in both languages
What does Semilingual mean?
Mastery of both languages is poor
What are the two scales that we can use to gage someone’s mastery of a language?
Basic Interpersonal Communication Skills
Cognitive-Academic Language Proficiency Skills
How do L1 and L2 influence each other?
Language Interference/Transfer (L1 syntax used in L2)
Language Loss (Loss of skill in L1)
What is a Simultaneous Bilingual?
Both languages learned from birth
What is a Sequential/Successive Bilingual?
L2 learned later in childhood usually after 3 yrs
Significant portion of Basic Interpersonal Communication Skills already learned in L1
What is interference/transfer
When an aspect of L1 (syntax, vocabulary etc.) is generalized to L2
What is interlanguage?
The speaker develops a personal linguistic system while attempting to produce the target language
What is the Silent Period?
When there is more observation and less speaking in L2
What is code switching?
Easily alternating between two languages or dialects
What is language loss?
When skills in L1 decline while L2 is being learned
Are dialects a inferior to the standard language?
No
Do all individuals speak with a dialect and/or and accent?
Yes
What are ideals when working with an interpreter?
4
Interpreter is….
Proficient in both languages
Trained in cross cultural communication Knowledgable of issues relating to SLP Is not the client or a family member
What are the five Key Traits of Counseling?
Appropriate Sharing
Being nonjudgemental
Being tolerant of crying and emotional responses
Being Client/Family Centered
Not solving client issues
What six things should you do when counseling?
Listen
Give purposeful silence
Asking open ended questions
Give attentive nonverbal signals
Paraphrase content
Be respectful of client and client’s culture/beliefs towards communicative disorders
What are eight emotional reactions to communication disorders?
Grief
Anger
Depression
Guilt
Shame
Anxiety
Inadequacy
Isolatioin
