Assessment Flashcards
Define Assessment.
Assessment is an organised, goal directed evaluation.
Patterson and Chapey, 2008
Purpose of assessment
For diagnosis: Strengths and weaknesses Auditory comprehension Speech production Reading Comprehension Writing Pragmatic, cognition, mood etc. if required
Determine type of aphasia.
Background and medical information should also be gathered.
Informs intervention-areas to focus on
Establish theoretical explanation of what’s gone wrong with reference to PALPA language processing model.
Information for family/carers- strengths and weaknesses, advice on how to facilitate communication.
Prognosis
Measurement of change and monitoring
Helps plan therapy
Ascertain what strategies will support them
Provide information relating to the individual’s capacity- adults with incapacity act 2000- if they are incapable? or just need AAC to convey decisions.
What framework should we consider when assessing?
ICF WHO
What does the ICF WHO consider?
The impact on the individual.
Components: impairment, activity and participation, personal and environmental contextual factors.
Gives us a more hollistic view of the PwA
Impairment Based Assessment.
Comprehensive Diagnostic Batteries
Boston Diagnostic Aphasia Examination
Western Aphasia Battery-Revised
BDAE
- performance across language modalities
- allows diagnosis of aphasia to be made.
- Normally just do little bits of it- quite big.
- does give a comprehensive picture of deficits and retained abilities.
Western Aphasia Battery-Revised
- full battery and bedside screening
- differential diagnosis and aphasia type.
When are comprehensive diagnostic batteries inappropriate?
Innapropriate for acute stage aphasia.
PwA should be neurologiclally stable- this is normally 3 months post stroke.
What should be considered if doing a comprehensive battery?
It takes time and will require several sessions.
Fatigue
Emotional effects
PwA’s performances fluctuate and may change dramatically on a day to day basis- ideally for this reason any assessment should be completed within a week.
What do acute stages refer to?
Aphasia= early days- first 4 to 6 weeks Stroke= first week.
What are used in the acute stages to assess?
Screening tests
Informal assessments.
Name a screening test.
Aphasia Screening Test.
Assessment of aphasia - informal.
It may not always be appropriate to use formal assessments in the hospital environment or in acute stages of recovery.
Instead SLT may use informal techniques or only use certain parts of formal assessments informally.
If we don’t have a lot of information from the referral what should we do?
Over prepare for the assessment. :)
Prepare for multiple possibilities
Screening in hospital- what is important practically?
It has to be practical- you can’t carry loads of stuff around the hospital-, in terms of ease and infection control.
What may help you develop a hypothesis?
If the area of stroke is is provided.
In screening- what should be assessed?
The 4 communication modalities at a basic level:
- Auditory Comprehension
- Reading Comprehension
- Verbal Expression
- Written Expression
In terms of screening what should we prepare for?
A range of impairment severity.
Name comprehension screening in terms of severe aphasia.
picture/object matching
Y/N questions
1-2-3 stage commands
single word level.
Name comprehension screening in terms of mild aphasia.
complex sentence level, conversation level, higher level language abilities.
Name expression screening in terms of severe aphasia.
might have none at all, use of gesture, reliable Y/N
Name expression screening in terms of mild aphasia.
Conversation level expression, higher language.
What is it not necessary to do?
not necessary to start at most basic level and carry on to the highest.
Causes patient distress, harms rapport and waste of time, little benefit.
Instead pitch at a level you think might be appropriate and adjust up or down.
How can medical information be gathered?
From medical notes
getting to know me forms
MDT members
