Assessment Flashcards
What is the role of the speech and language pathologist?
The role of the speech and language pathologist is :
- Identification and selection of clients
- Assessment
What are six different intervention settings?
Intervention Settings: Hospitals Rehabilitation centers Skilled nursing facilities Nursing home Private offices/centers Patients home
Limited to what the insurance company will provide in all settings
Be sure notes are very detailed to provide information to insurance co.
Impact on abilities going forward in life is what will convince them to give more sessions
“At risk for” “re entering hospital”
What are the different ways to identify and select clients?
Selecting and Identifying clients: Screenings Physician referral Team member referral Potential trial for progress (no adult returns to complete normal, but can progress for years and years. Excellent, fair, guarded)
What are six different aspects of assessment?
Intervention Administration (insurance, soap notes, plans) Consultation (swallowing, hearing test) Counseling Education Research
What are the areas that we assess?
Hearing (always do when possible) Speech (voice articulation and fluency) Language (speaking, listening, reading, writing, printed form) Reading Writing Nonverbal communication (social issues, do/understand expressions and gestures) Cognitive functioning (in all patients) Swallowing (screen)
What are the two types of assessment?
Standardized
Functional
What are some cultural considerations when planning assessment?
Select tools that have included clients ethnic/cultural group
Avoid tests with known bias(research if a specific population consistently does poorly on a test)
Interpret data cautiously (only a brief snippet in time)
Use content oriented assessment
Learn about clients culture (view toward medical community, beliefs about health care, disease, disability, and disorder)
What are characteristics of standardized tests?
Allow comparison to other individuals with aphasia or normal population
Allow quantitative monitoring of progress (insurance: client was here now is here)
Good for research (administrative rules, reproducible)
Can assist with classification of type and severity of disorder
May be biased (ethnocentric)
What are characteristics of functional assessment?
Look at every day skills
Less biased
Document changes in fu city all skills which is really the goal of therapy
Extensive systematic observations
Required: relate what you are doing back to functional every day life
What are the general purposes of assessment?
Determine patient performa cd in speaking, listening, reading, and writing, cognition, functional communication (primary goal)
Identify areas of strength and weakness
Determine type of communication disorder
Gather information to plan intervention
What are the legal purposes of assessment?
Competency hearing (elder law) (can client care for himself?)
Compensation-degree of disability
Malingering- faking it
Must be thorough, never know if that client is go g to apply for disability
What are our possible diagnosis?
Dysarthria (type and severity)
Dysphasia (stage and severity, oral or pharyngeal)
Apraxia (presence/absence, severity, childhood/adult acquired)
Aphasia (expressive/receptive, severity)
Cognitive-linguistic deficits- type and severity
*functional impact on communication functioning
The purpose of assessment changes by setting. In acute care we:
In a cute care we:
Discharge planning (make a diagnosis, plan for when they leave you.)
Can the client go home?
Do they have language and cognitive skills to say basic needs and remember that they turned the stove on?
The purpose of assessment changes by setting. In rehabilitation we:
In rehabilitation we: Plan treatment Confirm diagnosis Look to see if they have made progress since diagnosis Plan treatment and goals
The purpose of assessment changes by setting. In home care we:
In home care we:
Plan treatment
Functional communication to meet daily needs
Plan treatment to make them functional in that environment
Cautions of assessment:
Don’t rely on test results only (test scores could be low because of depression)
Look for. Other possible reasons patient isnt communicating (sometimes don’t want to interact in front of children, embarrassment)
Observe patient with family and familiar partners
Three approaches to assessment
Impairment oriented
Disability (activity) oriented
Handicap (participation) oriented
In most cases we do a combined approach of all three. All three need to be addressed for a good report.
Impairment oriented assessment
Identify neuropsychological strengths and weaknesses
Standardized neuropsych batteries, aphasia tests, motor speech tests
Disability (activity) oriented assessment
Identify possible effects of neuropsychological problems on real world function
Standardized functional scales-observation of daily activities
Handicap (participation) oriented assessment
Identify limitations on education, vocational, social, or familial participation
Identify environmental modifications to enhance participation
Identify strengths and needs of everyday communication partners
Outline of assessment t
- Detailed case history (premorbid skills)
- Orofacial examination including screening for dysphasia (cranial
Nerve) - Hearing screening
- Assessment of verbal skills
Speech- fluency, voice, articulation
Language- phonological, morphological, semantic, syntactic,
Pragmatic - Assessment of nonverbal communicative skills
- Assessment of cognitive skills
- Intellectual skills (academic abilities in children)
- Assessment of functional execution of daily living skills
- Assessment of visuospatial, visuomotor, visuoconstructional abilities
Assessment of expressive and receptive verbal skills
Repetition Naming Auditory comprehension Oral expression Reading Writing Automatic speech Singing Humming Prosody, intonation, story telling organization
Assessment of nonverbal skills
Expression through gestures/pantomime
Comprehension of gestures/pantomime
Recognition of facial expression and intonation/prosody
Cognitive assessment
Dependent on clients current status
Varies y level of severity for TBI patients and stage of recovery
Is ongoing
May initially consist of observations both direct and indirect until a patient reaches a point of participation
