CP 7 Flashcards
SLP’s have two major clinical tasks:
- Increase desirable communication behaviors
- Decrease or eliminate undesirable behaviors and replace them with more positive and appropriate behaviors
The client typically exhibits 2 sets of behaviors that need to be decreased…
- Inappropriate Communication Behaviors
- Interfering Behaviors
What are Inappropriate Communication Behaviors?
Typical undesirable behaviors clients give in place of desirable or appropriate speech-language behaviors
Examples:
Misarticulation of sounds
Stuttering
Inappropriate pitch
What are Interfering Behaviors?
Extraneous non-speech behaviors that interrupt the treatment process
Example:
crying
wiggling in chair
interruptive talking
crawling under the table
True or False: Most undesirable behaviors are maintained because they have been reinforced in some way
True
What are the Four Direct Behavior Reduction Procedures?
- Extinction
- Stimulus Presentation
- Stimulus Withdrawal
- Imposition of work
Describe the Extinction direct behavior reduction procedure..
The reinforcer is terminated, and the response is allowed to be made
◦ Extinction is similar to IGNORING
◦ Gradual process
◦ Educating the client’s significant others about extinction
◦ It is important to educate the parents of young children about what you are doing
◦ Parents may get upset when the see the clinician ignoring their crying child
◦ Limitations of Extinction
◦ Once extinction is initiated, the clinician should not reinforce the client until signs of the desirable behavior occur
True or False: Extinction is also called Punishment
False: Stimulus Presentation is also called Punishment
Describe the Stimulus Presentation direct behavior reduction procedure..
When a stimulus is presented immediately after the occurrence of the undesirable behavior to reduce this behavior
◦ Also called punishment
◦ In therapy, clinicians typically use corrective feedback after an undesirable behavior is presented
What is Corrective Feedback?
Immediately after the client provides an undesirable behavior, the clinician gives feedback telling the client that their response is incorrect
What are the three types of Corrective Feedback?
- Verbal Corrective Feedback
- Nonverbal Corrective Feedback
- Mechanical Feedback
What is Verbal Corrective Feedback?
The clinician verbally tells the client that their response is incorrect
What is Nonverbal Corrective Feedback?
The clinician uses nonverbal signs (gestures, raising a hand…) when an incorrect response is made
What is Mechanical Feedback?
Using a computer program to provide feedback
Describe the Stimulus Withdrawal direct behavior reduction procedure..
A stimulus or event is withdrawn immediately after the undesirable response is made
What are the 2 kinds of stimulus withdrawal procedures?
- Time Out
- Response Cost
What is the Time Out stimulus withdrawal procedure?
After the client makes an undesirable response, the client has a time-out period where all reinforcing event are suspended
What are the 3 major types of Time Out?
- Isolation Time Out
- Exclusion Time Out
- Non-exclusion Time Out
What is Isolation Time Out?
The person is removed from the environment. This is the most extreme form
What is Exclusion Time Out?
The misbehaving person is excluded from normally reinforcing activities
What is Non-exclusion Time Out?
There is a brief period of no reinforcement that follows the undesirable response.
What is a Response Cost?
Each wrong response costs the client a reinforcer
What are the advantages of a Response Cost?
-It is easy to use
-It is effective to use in the clinic, school, or home
-It is not as restrictive as time out
What are the two types of Response Cost?
- Earn and Lose
- Lose Only
What is the Earn and Lose type of Response Cost?
The procedure of losing only reinforcers that the client earns.
Example: The client may be given tokens, and each incorrect response costs the child a reinforcer
What is the Lose Only type of Response Cost?
The client’s tokens are taken away for incorrect responses.
Example: The clinician gives the client a certain number of tokens at the beginning of the session and takes them away as the client exhibits incorrect responses
True or False: In extinction, the clinician does nothing specific each time the behavior occurs
True
In ___ ___ and ______ ______, the clinician does something each time the behavior occurs
Time Out and Response Cost
True or False: In Response Cost, the clinician arranges a brief duration of no reinforcement
False: Time Out
True or False: In Time Out, a reinforcer to which the client has access to is taken away
False: Response Cost
True or False: Imposition of Work is also called Overcorrection
True
Describe Imposition of Work
This requires the person to eliminate the effects of the misbehavior and then practice an appropriate behavior
What are Indirect Method of Response Reduction?
The clinician places no response reducing contingencies on the behavior to be reduced
◦ Indirect methods reduce problem behaviors by reinforcing desirable behaviors that replace undesirable behaviors
◦ Basically, the clinician is reinforcing the desirable behavior
Describe Differential Reinforcement
One behavior increases, and another behavior decreases
What are the 4 Types of Differential Reinforcement?
- Differential Reinforcement of Other Behavior (DRO)
- Differential Reinforcement of Incompatible Behavior (DRI)
- Differential Reinforcement of Alternative Behavior (DRA)
- Differential Reinforcement of Low Rate of Responding (DRL)
What is Differential Reinforcement of Other Behavior (DRO)?
DRO specifies which behavior will not be reinforced
◦ Example: During therapy, you say that you will not provide reinforcement when the client produces an undesirable pitch level. The clinician reinforces the client as long as they are providing an appropriate pitch. As soon as they make an inappropriate pitch, the reinforcement is stopped.
What is Differential Reinforcement of Incompatible Behavior (DRI)?
DRI the clinician reinforces the opposite of the undesirable behavior.
◦ Most effective in controlling physical behaviors (ie wiggling, looking away…)
◦ Example: A child cannot simultaneously wiggle in his chair and sit quietly. Therefore, the clinician reinforces when the client when they are sitting quietly (the opposite of wiggling)
What is Differential Reinforcement of Alternative Behavior (DRA)?
DRA the clinician reinforces a behavior that is a personally and socially more desirable alternative to an undesirable behavior
◦ Example: There is a child that chews on his shirt during therapy. If the client does something more socially appropriate like plays with a stress ball they will be reinforced. But as soon as the child starts chewing on his shirt, the reinforcement is stopped.
What is Differential Reinforcement of Low Rates of Responding (DRL)?
DRL the clinician gradually reduced the frequency of a problem behavior to a more manageable level
◦ Some clients exhibit undesirable behaviors at high frequencies; therefore, it is best to reduce their frequency gradually
What are the Two different ways to perform DRL?
- The clinician allows the client to perform the less undesirable behavior one time during a predetermined amount of time and gradually increases the amount of time
- The clinician allows the client to perform the undesirable behavior a certain number of times during a therapy session and then gradually decreases that number.
True or False: In DRO, any desirable behavior is reinforced, none are specified
True
True or False: In DRA, a behavior that is physically incompatible with the undesirable behavior is reinforced
False: DRI
True or False: In DRI, an alternative and appropriate behavior is reinforced
False: DRA
True or False: In DRL, a reduced frequency of the undesirable behavior is reinforced
True
What are the two functions of reports?
- Document the status of a client and thus provide a basis for future comparison
- Provide communication to other professionals
What are the Writing Guidelines of Report Writing?
- Write in complete sentences
- Use correct spelling and punctuation
- Information should be in chronological order
- Avoid using technical jargon without explanation
- Use complete words, avoid abbreviations
- Avoid using “I”, refer to yourself as “the clinician”
- Proofread
- Write in past tense
- Use accurate data that can be supported by fact
True or False: With Medicare patients, the plan of care needs to be certified by the patient’s physician within 30 days and recertified by the physician every 90 days
True
Lesson plans/treatment plans typically contain 2 things:
- Treatment objectives: the goal for your session
Example: The production of /s/ in the initial position of words with 90% accuracy. - Procedures and Materials for obtaining the objectives: how will you implement the treatment objectives
Example: /s/ picture card will be presented to the client. The client will be required to name each picture
Progress notes do 2 things:
- Gives you means to communicate information to other professionals
- Gives enough information for another clinician to serve your client if you are unable to do so.
What type of progress note is used in medical settings or private clinics?
Periodic Progress Notes
What to include in a Periodic Progress Note?
- Client’s identifying information
- The dates of therapy
- Brief summary of the client’s status at the beginning of the treatment period
- Describe the treatment objectives/goals
- Describe the client’s performance on the objectives/goals
- Summarize your conclusions and recommendations
Discharge Reports should include:
- Treatment period: Beginning treatment date to discharge date
- Client’s level of performance and improvement
- Reason why the client was discharged
-No longer needs treatment
-Met all therapy goals
-Client dismissed themselves
-Poor attendance - Discuss conclusions and recommendations
