Assessment and Basic Terminology Flashcards
Exploratory Play
0-10 months
Child looks at toys, mouths objects, and shakes objects
- 0-3 months = visual interest
- 4-5 months = bang and shake objects
- 6 months = object exploration (sits up)
*child is exploring voice during this time
Cause and effect
8-10 months
Understanding that if I do something, something else will happen
ex: shaking the rattle makes noise
- crawl
Relational Play
8/10 - 12 months
Determining how objects relate to one another
ex: put things in container and take them out
Single Functional Play Schemes
12-18 months
Throw a ball, push a car, drink from a cup
Is the child using the object the way its intended to?
- first word / single word - single play scheme
Combination Play Schemes
18-24 months
Putting 2 simple play schemes together
ex: stacking blocks and knocking them down
- 2 word utterances = 2 play schemes
Constructive Play
24 months
Building - using materials to make other objects
ex: building a tower with blocks
Symbolic Play
18/24 - 30 months
Using an object as a symbol for something else
ex: using banana as cellphone
- emblem gestures
Miniature Toy Play
30 months
Playing with little people
- all word classes / able to engage with play
Dramatic Play
3-5 years old
Elaborates story telling, plans out pretend situations
(connects with cooperative play)
ex: dress up
- vary sentence type / increased MLU
Games with Rules
5 years old
Child can play a game that includes rules
- sequencing / play appropriately
Solitary Play
Before age 2, children play on their own
Onlooker Play
No specific age, can occur anytime
Children watch other play
May ask questions but do not attempt / don’t know how to join
Parallel Play
Develops around 2-3 years old
Children play side by side but do not interact
Pay attention to each other and engage in the same activity
Associative Play
3.5 - 4.5 years old
Children are interested in people but NOT playing together
Cooperative Play
4-5 years old
Children share ideas and toys, follow established rules
Interested in people AND the activity
- goes with dramatic/pretend play
INREAL Techniques
- Child led, use an evaluation session (dynamic assessment)
- Valuable to establish rapport with the child and build language
S.O.U.L
Silence, observation, understanding, listening
- Child-centered / based
- Don’t talk just watch / understand what the child is interested in
- Give the child time to process and formulate ideas to play
Mirroring
Mirroring what the child does to validate them (non-verbal behavior)
VMR
Imitating child’s verbal behavior (gives them confidence)
Self-Talk
Talking about what you are doing through play
Parallel - Talk
Talk about what the child is doing through play
Expansion
Take what the child says and build on it
Modeling
Not saying what the child is saying
ex: child “car” me “red! fast!”
How are language and play related
- Both share cognitive principles
- Play supports development of child’s cognitive skills such as: memory, problem solving, play performance
What information do we need to look at to determine if an assessment is appropriate for our client?
Case history, child’s level of attention, frustration tolerance, age range that it is normed on, and presenting concerns
Standard score
Mean = 100
SD = 15
SD below the mean = 85
Scaled score
Mean = 10
SD = 3
SD below the mean = 7
Primary Language Impairment
- Language is the root of the cause
- Does not arise from an underlying condition
Secondary Language Impairment
- Attributed to another condition (ASD, DS, etc.)
- diagnosis came first … language impairment is second
Dynamic Assessment
NOT a standard or norm-referenced measure
(test-teach-retest, informal language sample, stimulability)
Language Delay
Development is typical in all areas except language (cut off - 3 years)
Language Deviance
Language development is not just slower than typical development, but also different from the trajectory we’d expect (very slow in development)
Language Difference
Rule-governed language (dialect) that deviates from the standard language used by mainstream culture
When do you want to complete a dynamic assessment?
During initial eval and after formal testing because that is when you are coming up with trial treatment
Components of a formal assessment
- Test
- Subtest
- Index
How to pick an objective
start with case history, look at language sample, formal assessments, take all components of assessment into account to make objectives
Long-term goals
End goal of treatment, do not need to be measurable
Short-term goals
Have to be SMART, measurable, achievable, realistic, time bound
what is a session objective?
- what you are doing in a specific session
- can not be broken down any more
- the most basic skill that you want the child to perform to meet the short term goal
- needs to be SMART
Language sample
- Assesses use of functional language skills for communication
- Can be formal or informal when observing for play
- Helpful to determine MLU
- limitations: time consuming
SMART goal
- who
- will do what
- under what conditions
- how well
- over what time
Informal measures
Oral mech exam, dynamic assessment, not standard or norm-referenced (observation)
Formal/standard measures
Uniform, include scaled and standard scores, child’s performance is compared to same-age peers (standardized)
Language Disorder
Difficulties with language become persistent and do not fall within normal range
AFTER 3 years old it is a language disorder - before it is a language delay
Earliest developing phonemes
/p/, /b/, /w/, /h/, /m/, /n/
Components of an assessment
Case history, language sample, standardized assessments, informal assessments, oral mech exam, counseling
Why is play important?
Play tells us additional information about the child’s development
Etiology
The cause of a disease / condition
How might etiologies impact assessment and treatment?
If there is a known diagnosis, there may be a certain hallmark (speech/language/feeding) impairment that is associated with that diagnosis
* helps formulate treatment plan
Functional communication
How strong a child’s ability to use each language domain to communicate in everyday experiences
Why do we have to look at language and cognition?
To determine the capacity for language learning, determine our own scaffolds for the child, and improve our assessment and intervention
Long term memory
Where we store information for a long time
Working memory
- Similar to short term
- Active processing of information
- Temporary storage of information while it is being manipulated or processed
- Limited capacity
- Determines what we want to go to long term
Working Memory Model
1) Central Executive
2) Phonological loop
3) Visuospatial sketchpad
4) Episodic Buffer
Central Executive
*command center boss - what goes where and how we use it
- stores information and processes it
- flexible but limited in capacity
- helps us regulate and coordinate the flow of information in our working memory
- more effort is requires to store information when capacity gets smaller
Visuospatial sketchpad
- visual information
- plays a role in reading tasks
- helps with encoding - deals with letters and words, helps us backtrack and find out place again
Episodic Buffer
- Handles visual AND speech-based information
- Puts visual and verbal information together (improves semantic information stored and processed in our working memory
Phonological loop
- Processes verbal and acoustic input during language learning
- Vocabulary acquisition
- Sound sequencing
- Facilitates the acquisition of a language
What if one of the components of working memory is impaired?
The person is going to have difficulties processing information accurately
Short term memory
- Short term storage of verbal information in the phonological loop
- If weak = difficulty with vocabulary acquisition
- more repetitions of a word are required before it goes to long term
Processing speed
- Rate that information can be processed in our brains
- Improves with development
- processing speed improves = working memory and other areas of cognition improve
Why do we use nonword repetition tasks on assessments?
If we are not repeating the word it will test phonological short term memory
What does number memory reversed tasks measure?
Verbal working memory
Why do we use word memory tasks?
To measure phonological short term memory
Language mapping
- How we process, learn, and use new vocabulary
- Experiencing with actual objects when learning new words helps establish lexical-semantic representation
Fast mapping
the initial association made between the word and the referent
- first/ early exposure
Slow mapping
How we enrich lexical-semantic representations that have been put in our memory
* more exposure to the word = richer quality exposure
** Repetition of target word, gestures, organizing objects by category
Stages of slow mapping
1) trigger = heard word can’t use it in a sentence (fast mapping)
2) configuration = understand how to use it in a sentence (slow mapping)
3) engagement = fully understands and is apart of your lexicon (slow mapping)
Cause of word retrieval deficits
Visual and phonological loop have a breakdown - the child will never make it to the engagement stage and will struggle in the classroom
word retrieval deficit examples
- um..uh
- “what’s the word I can’t think of it”
- “the word is on the tip of my tongue”
Naming errors
Phonological = sound mix up ex: chicken for kitchen
Semantic = similar word but not the correct word ex: cup for bowl
Perseverative = repeating same word to male multiple objects
Visual misperception = look similar ex: lollipop for balloon
What domain is affected in word retrieval deficits?
semantics
where are the EF centralized?
within the frontal lobe
lack of ___ can lead to EF difficulties
Sleep
What do children with EF and language impairments have in common?
they both benefit from repetition
why is the power of choice so important?
- to be able to pick a task thats on the to do list for the session it allows them to decide what they want to do first which is going to give them motivation and improve there chance of success
how was mindfulness found to be beneficial for children with EF?
- helps with self monitoring
- teach kids how to regulate there emotions
what does executive function go hand in hand with?
Language!
- these can not be looked at separately
- we must look at them as a direct influence on one another
important factors to consider when identifying an executive function impairment
- need to determine if a child has a language impairment because of an executive function impairment or is it a true primary lang impairment
- how the child presents on the outside is usually what is happening on the inside
what will a child with EF struggle with?
a child will struggle with language if they struggle with EF
- just because a child struggles with language does not mean they also have EF deficits
what roles does EF play in language abilities?
- if a child cant attend ~ they are not learning
- pragmatics ~ the child won’t think before they speak
- organizing their thoughts is hard - cant catch up/ regulate
- struggle with communication when emotional
- forget hw/book ~ can’t practice
an individual with EF inhibition deficit will struggle with…
- the ability to control impulses and keep yourself from doing the first thing that comes to mind
examples = waiting our turn to speak, waiting at cross walk, drinking, drugs
what are some ways to improve EF inhibition?
- frequent breaks
- fidgets
- timers
- make rules
an individual with EF working memory deficit will struggle with…
- not being able to keep things in mind
- remembering directions
- taking notes
- reading comprehension
what are some ways to improve EF working memory?
- reduce distraction
- reduce background noise
- memory strategies
- focus on study skills - timer
- use visual written support - schedule
- the goal is to reduce the info in the child’s mind = the more we put in front of them the better
- visualization strategy
an individual with EF Flexibility deficit will struggle with…
- adapting to change
- problem-solving and reasoning
- they are only seeing their perspective and don’t understand why we are asking them to do something
*help the child recognize when they need to bend and teach them calming strategies
* need to be flexible in order to consider viewpoints other than their own
what are some ways to improve EF flexible thinking?
- present expectations ~ give rules
- define the end goal ~ what are u working towards
- give series of steps that help the child get to that end goal
- give warnings before a transition - timer
- use visual support to show how things will change
why is the EF emotional control so important? and what does it look like?
- when we can help kids manage their emotions = more empowerment
- children aren’t bad, their emotions are always communicating something with us and we can use this to help support them further
- this involves positive and negative emotions
- labeling emotions can help improve vocab
what are some ways to improve EF emotional control?
- prepare the child for a situation where flexible thinking might be required
- teach zones of regulations
- identify tools that can help the child when they are having a hard time managing emotions
- prepare the child for new situations
- provide positive reinforcement and feedback when the child does something well with regard to emotional control
The EF self monitoring goes hand in hand with focus, what does this look like?
- ask the child: what does focus look like to you?
- help the child see moments where they are focused vs not focused
- children need to be able to monitor their focus to initiate, execute, and complete tasks
- need to monitor focus to do anything
what does the EF self monitoring impact?
reading = predicting, making connections, visualizing
writing = outlining, need a model to follow, rubric to show expectations
math = breakdown of word problems, problem solving
what are some ways to improve EF self monitoring?
- ask a child to reflect on his/her performance
- have a schedule & post directions - this will allows the child to monitor where they are at
what are some ways to improve EF Planning/prioritizing?
- review the process for the assignement
- break larger projects into small chunks
- get ready, Do, Done, Planner
what are some ways to improve EF Organizing?
- color coded folders
- agendas
- to do list
- check list
- read do done planner
*let the child pick = they will take owner ship of it will use it more since they had a say in it - graphic organizers
Task initiation
beginning a task
* a lot goes into it before we actually begin and task
language to improve those with EF task initiation deficit?
- in order to start a new task we must have to stop another which can be difficult for some kids, so give them a heads up
- use first then language
- use visual schedules/supports
- as time gets closer give them another reminder
- timer
- validate that its hard but you will help them
- provide positive reinforcement
Scaffold
the type and way you are supporting the child to meet his/her objective
Differential Diagnosis
look at whole child not at one part, be thorough in evaluation don’t just focus on language
Receptive and Expressive language
- Always treat receptive language first
- if you assess a child and their expressive language is higher, we should be concerned
When assessing a child under 3 what information do we go off of to determine their baseline
informal assessment, play, using milestones to tell if they are progressing
Why is understanding milestones so important to assessment and treatment
we can not treat them properly if we do not know the milestones. We need to know what is normal to know when something is wrong
What should the environment look like for a play assessment?
A comfortable environment with age appropriate toys
How do we use play as a means of assessment?
We can use play milestones to see where they are developmentally
