Clinical Exam 3 Flashcards
professional ethics
they establish right and wrong actions in serving clients in the workplace. The common core values and collective obligations shared by people in a particular discipline.
Evidence based practice (EBP)
The integration of research evidence with practitioner expertise and client preferences and values into the process of making clinical decisions.
basic research
adds knowledge about a fundamental process (e.g., how toddlers develop language)
applied research
Studies individual or specific cases without
the objective to generalize
section 504 (PL 93-112)
civil rights legislation to provide accommodations for children and adults
diagnosis
identification of a disease of disorder based on symptoms presented
prognosis
a forecast of the likely course of a disease or ailment potential benefit from therapy or medical treatment.
factors influencing prognosis include:
-age
-severity of communication disorder
-family support
-ongoing medical conditions
norm-referenced tests:
comparing a client’s performance to a sample of individuals who are similar to the client. (always a standardized test)
criterion-referenced tests:
comparing client’s skills to a certain predetermined expectation.
standardization
in order for a test to be fair, everyone should take it under the same conditions.
validity
the extent to which a test measures what it claims to measure.
reliability
when a test score remains stable, or similar, regardless of who gives the test or when the client takes it, the test is considered reliable.
purposes for communication sampling
-functional assessment
-helps us understand the impact of someone’s communication disorder
-helpful for culturally diverse populations
-used for all ages and all areas of speech and language problems
-can demonstrate progress
nonverbal clients
-children who don’t yet have a symbolic language.
-older children, adolescents, or adults with developmental disabilities
-clients who previously were typical but lost their skills due to injury or illness
collecting communication samples
-very young clients: a play session with developmentally appropriate toys and a familiar person
-children, adults: clinician needs to be especially careful to provide opportunities for the child to express wants, needs, intents.
-older adults w/ developmental or acquired disorders: choose developmentally appropriate materials and arrange for a sampling context where communication is a large part of the activity.
Sampling procedures: language
-audio and/or video recording is recommended.
-transcribing is recommended
-open ended questions, parallel talk, story telling
-all 5 areas of language analyzed
what skills are you looking for in a speech sample?
-determine the # of articulation errors and patterns of errors
-providing a description of a child’s phonetic inventory
-determine intelligibility
-determine stimulability for speech sound production
-screening voice and fluency
determine speech performance in a naturalistic context
sampling procedure:
Play (nonverbal communication)
gestures, facial expressions, intonation, body language
sampling procedure: speech
articulation/motor speech production/intelligibility, fluency, and voice
intervention
designed to teach strategies for improving overall communication.
MLU
mean length of utterances
public policy
any action taken by local, state, or federal officials to address a problem.
PL 108-446 IDEA
ensures all children with disabilities have access to a free appropriate public education (FAPE) in a least restrictive environment (LRE)
Medicare
is administered by a federal agency called the centers for Medicare and medical services (CMS) for individuals who turn 65 years of age or those younger who have a qualifying disability.
Medicaid
Pay medical bills for persons of low socioeconomic status who have no other financial means to pay for medical care.
discharge summary/report
a written report of a client’s cumulative progress from the initiation of therapy to his or her discharge
Long-term goals (LTG)
covers the full period of time that therapy intervention has been assigned
short-term goals (STG)
hierarchical small goals working towards LTG
Behavioral objective
do statement: identifies the action the client is to perform.
the condition: identifies the situation in which the target behavior is to be performed.
the criterion: specifies how well the target must be performed for the objective to be achieved.
Purposes of intervention
-eliminate the underlying cause of the disorder.
-compensatory strategies to improve functional communication.
-modify the disorder by teaching specific speech, language, cognitive, or swallowing skills that enable an individual to become more effective with their goal skill.
Normative approach
goals target age-appropriate norms
Continuum of naturalness
intervention activities vary in their degree of naturalness.
Clinician-directed (CD) approaches
clinician controls all aspects of the intervention
client-centered (CC) approach
approaches emphasize therapy in authentic settings. clinician follows client direction.
Indirect vs. direct service delivery
Direct- clinician works face to face with an individual patient or group of patients with clinical model.
Indirect- Clinician works indirectly with patient by providing guidance and teaching to the clients family members and professional colleagues
Consultative/ collaborative model
When members of an intervention team work together to share responsibility for client outcomes or when clinician provides guidance by teaching to clients family members
Individual vs group therapy
Individual-Intense and one-to-one therapy session aimed at teaching a client a specific communication skill
Group- Include two or more patients who are usually working on similar speech language skills or who need to practice the generalization of learned skills to additional communication partners
Multidisciplinary, interdisciplinary, transdisciplinary models
Multi- Each discipline conducts own assessment and develops discipline-specific goals. Each discipline has its own plan. (Works separate plans separate)
Inter- Each discipline conducts own assessment but communicates with other disciplines regarding results. (Tests separate but plans together)
Trans- Team members have an ongoing dialogue, sharing of information, knowledge and skills to develop and implement a single integrated service plan for the client. (Works together)
Define culturally and linguistically diverse client
a culturally and linguistically diverse client is an individual who comes from a home environment where a language other than your own is spoken and whose cultural values and background may differ from yourself
Define bilingualism, sequential and simultaneous learners
Bilingualism: individuals who speak more than one language
Sequential learners: acquired one language after another
simultaneous: speak both languages from birth
Who does IDEA (2004) mandate about a child’s native language
(PL 108-446): Ensures all children with disabilities have access to a free appropriate public education (FAPE) in a least restrictive environment (LRE)
The 8 testing guidelines to decrease the possibility of misdiagnosis of children who are culturally or linguistically diverse
- Do not use norm-referenced tests only.
- Do not use only a language sample to qualify someone for
services. - Do not use multiple assessments in order to get low scores so
that someone will be qualified for services. - Do not use translations of tests.
- Do not use only one elicitation technique.
- Do not use tests administered in English only.
- Do not assume that features of a second language or a dialect
of English are characteristics of a disorder. - Do not assume that support personnel are automatically
trained to aid in the diagnostic process.
Define assistive technology
any item, piece of equipment, or
system used to improve functional capabilities of individuals with
disabilities.
Define assistive learning device (ALD)
commonly used in schools to amplify the teacher’s voice above background noise levels
Define ACC
Provides a means of communication for those individuals who have not
acquired functional language or those who have lost language.
Define low-tech and know examples
Sign language, picture exchange
Define mid-tech and know examples
Speech-generating devices with fixed displays that use digitized speech (e.g., voice output switches)
Define high-tech and know examples
Speech-generating devices with computer-like screens that use synthesized speech
What are some of the sources of family diversity that present particular challenges for the clinician
-ethnic, cultural, and linguistic differences
-different family structures
-the impact of poverty on disability
What does IDEA(2004) require for clinicians to do for families
Infants and toddlers receive services under an individualized family service plan (IFSP).
* IFSPs provide family-centered care.
* Development of IFSPs include the family in the decision-making process.
Family centered assumptions and attitudes
- any circumstance that affects one family member affects other members.
- The family has a right to establish its own priorities.
- The family must be accepted as being the experts concerning their
family member. - The clinician must collaborate with family members to obtain
assessment information and in developing intervention goals. - The family must be acknowledged as having the right to form
their own approach to raising their child or caring for an older
family member, as long as health and safety are not an issue. - The clinician must acknowledge any personal bias regarding
preconceived notions of expected role behavior in approaching a
family and must place these notions aside in order to assess
function of the specific family and client. - In situations in which a family report appears to differ significantly
from a clinician’s observation, it is the responsibility of the
clinician to explore with the family situations
What does ASHA’s preferred practice patterns include in its list of what should be included in the focus of intervention
The focus of intervention should include training of
communication partners, caregivers, family members, peers, and educators.
What does SOAP stand for
Subjective, objective, assessment, plan
Identify statements that should be in each section S.O.A.P.
S- clients mom reported the client was in a good mood all morning
O- client followed 13/25 auditory commands. Client demonstrated joint attention in 26/29 opportunities.
A- CLIENT DEMONSTRATED IMPROVEMENTS IN AUDITORY COMPREHENSION AND JOINT ATTENTION. CLIENT WAS MORE ENGAGED IN THE ACTIVITIES AND APPEARED TO ENJOY THE ACTIVITIES WITH MORE PHYSICAL MOVEMENT.
P- adapt activities to encourage more verbalization
Define basic research
Adds knowledge about fundamental process (how toddlers develop language)
Define applied research and differentiate from basic research
Applied:Studies individual or specific cases without
the objective to generalize
Basic: fundamental or pure research
