Day 2 Flashcards
1st step of diagnostic process based on the scientific model
Definition and delineation of problem- constituent analysis
2nd step of diagnostic process based on the scientific model.
Develop hypothesis- clinical hypothesis
3rd step of diagnostic process based on scientific model
Research design- clinical design
4th step of diagnostic process based on the scientific model
Collection of data- clinical testing
5th step of diagnostic process based on the scientific model
Analysis of data- clinical data analysis
6th step of diagnostic process based on the scientific model
Interpretation of data- Clinical interpretation
7th step of diagnostic process based on the scientific model
Conclusions- recommendations for patient management
Define constituent analysis
Defining the problem through thorough and systematic analysis of information
2 avenues patient information is available through in performing constituent analysis
Case history form and patient interview
Define and explain: case history form
Starting point for understanding clients and
their communication problems
Typically completed by the client or parent Ideally reviewed by the clinician before initial
meeting
Enables the clinician to anticipate areas that
will require assessment, identify topics requiring further clarification and preselect appropriate test materials
Importance of the initial interview
To explore the nature and history of the patient’s presenting symptoms To establish initial contact and the patient/caregiver/clinician relationship May be the foundation for future success in therapy
3 phases of the initial interview
Opening phase, body phase, closing phase
Opening phase of interview
Introductions ¡ Describe the purpose of meeting
Body phase of interview
Discuss “statement of problem”
Client’s history and current status in depth Clarify information on case history form
Closing phase of interview
Summarize major points of discussion
Express appreciation for interviewee’s help
Indicate what will take place and the approximate length of the
session
What a good interviewer needs
Common sense
Basic knowledge of the disorder
Counseling skills
In an interview, the clinician
Assumes responsibility for conducting the interview Should not intimidate the client Should stay focused Should maintain flexibility Should be sensitive Should not express subjective personal feelings Should remain open even if the patient is hostile or
uncooperative
Should be a listener, not a talker
What the patient brings to the interview process
Anxiety
Past and present problems Previous contact with health professionals
Previous contact with educational professionals Education Personal needs Cultural background
4 types of questions
Open-ended, closed-ended, neutral, leading
Clinician’s responses to answers
Summary statements
Reflections Clarifications
Repetitions Pauses Nonverbal behaviors: head nodding, body
posturing, eye contact, touching
9 things to avoid during an interview
Yes/no questions
Either-or questions Inhibitive phrasing
Sudden shifts in the line of questioning Talking too much Stereotypical verbal habits Forgetting client’s feelings, attitudes in view of
symptoms/etiology
Providing too much information too soon Accepting superficial answers
7 pieces of info you should have by the end of the interview
Etiological factors
Previous clinical findings Developmental history
Current health status Educational/vocational history Emotional/social adjustment Family concerns
Define and explain: clinical hypothesis
Theory that could explain presenting behavior
or facts
The purpose is to guide current assessment
and intervention
3 steps to form a clinical hypothesis
Think about the causal factors based on the
constituent analysis
Narrow down possible explanations for the
clinical problem
Form priorities among the potential cause-
and-effect relationships until you have derived the most likely explanation and its causes
4 functions of the clinical hypothesis
Attempts to clarify the clinical problem
Implies a level of understanding Offers a tentative explanation to the speech
and language problem
Derives a dynamic cause-and-effect
relationship used for exploring the patient’s problem
State an example hypothesis: George (3.6 years) was reported by his mother and
pediatrician to have age appropriate skills in all areas of development except language. Information gathered at the
initial interview suggested a significant language delay. During initial play with the child, it was noted that he used only one-word utterances, but seemed to be able to follow directions
Hypothesis: George has a significant expressive language delay.
State an example hypothesis: Ann (7.5 years) has significant difficulty following
directions, using proper sentence structure and learning sight words.
Ann has a broad-based language learning disability that affects both her oral and written language skills.
State an example hypothesis: Standardized testing indicates that Evan (6.6
years) has a significant language delay. It is not clear yet whether this is part of a general global
delay, but his teacher reports that he completes some non-verbal tasks as well as his peers
Evan has a specific language impairment
State an example hypothesis: Jane had a moderate expressive language delay when
she was referred 6 months ago. Jane has been attending weekly therapy sessions and her mother
reports that she is no longer concerned with her language. You suspect that Jane now has age-appropriate language skills and want to check this out with a standardized assessment.
Jane’s language skills are now age appropriate
5 principles of good assessments
Thorough ¡ uses a variety of assessment modalities ¡ Valid ¡ Reliable
¡ Tailored to the individual client
Psychometric principles: definition and 3 things they include
Refers to the measurement of human traits, abilities,
and certain processes
Includes:
¡ Test Validity ¡ Reliability ¡ Standardization
Define: test validity
The extent to which a test measures what it is constructed to measure.
2 types of test validity
Content and construct
Define and explain content validity
Means that a test includes items that are relevant to assessing the
purported skill.
Requires an expert’s critical examination of each item’s relevance and
ability to sample the behavior under observation
3 major criteria of content validity
Appropriateness of the items included Completeness of the items sampled Way in which the test items assess the content
Define and explain construct validity
Degree to which a test measures a predetermined theoretical construct
Ex. Studies of language acquisition show that expressive vocabulary
increases with age. Therefore, a test of expressive vocabulary should yield scores that show progressive improvement with age.
Define: test reliability
Reliability means that the results are replicable
It is preferable for tests to have correlation coefficients of:
.90 or above
The closer a coefficient of reliability is to _____(
1.0, reliable
3 types of reliability
test-retest, split-half, rater
Define test-retest reliability
Refers to a test’s stability over time (over several administrations)
Define split-half reliability
Refers to a test’s internal consistency; scores from one half of the test
correlate with results from the other half of the test…comparing odd
number questions to even number questions
Define rater reliability
Refers to the level of agreement among individuals rating a test
Define: standardized tests
Standardized tests provide standard procedures for the
administration and scoring of the test
Purpose of standardized tests
Standardization is completed so that test-giver bias and
other extraneous influences do not affect the client’s performance and so that results from different people are comparable
The majority of standardized test clinicians use are _______, but _______ is NOT synonymous with ________.
norm referenced, standardized, norm referenced
Any test can be standardized as long as what 2 things are used?
uniform test
administration and scoring are used
2 general testing guidelines
Study administration and scoring directions thoroughly, practice administering the test
6 things to consider when practicing administering a test
Testing Environment ¡ Rest Periods/Breaks ¡ Encouragement and Reinforcement ¡ Repetitions ¡ Cultural Diversity ¡ Dialectal Variation
3 of Many factors that have a negative impact on test administration and
interpretation for individuals from culturally and/or linguistically
diverse backgrounds
Differences between your communication style and that of the student ÷ Lack of familiarity with item contexts (e.g., pictures, vocabulary,
topics)
÷ Items that reflect values and beliefs that are culturally specific
6 Ways to minimize potential cultural diversity problems that may require non-standardized administration
Allow extra time ÷ Increase number of practice trials ÷ Reword test instructions ÷ Continue testing beyond ceiling ÷ Ask student to explain incorrect responses ÷ Use alternative scoring procedures
Define: dialectal variation
Responses may contain regional and cultural
patterns or variations that reflect dialectical differences from mainstream American English
2 things to do when there is dialectal variation
Count variations correct if it is appropriate given the student’s
language background
¡ You must be familiar with the student’s home language
environment to determine whether a response is appropriate
Define: assessment
The process of collecting valid and reliable information,
integrating it, and interpreting it to make a judgment or a decision about something.
Assessment = _______
Evaluation
Outcome of assessment is usually a ______
Diagnosis
Define diagnosis
Clinical decision regarding the presence or absence of a
disorder and the assessment of a diagnostic label (e.g.,
expressive language disorder; childhood apraxia of speech)
6 things SLP’s do with assessment info
Make professional diagnoses and conclusions
¡ Identify the need for referral to other professionals ¡ Identify the need for treatment
¡ Determine the focus of treatment ¡ Determine the frequency and length of treatment ¡ Make decisions about the structure of treatment
4 potential structures of treatment
individual sessions, group sessions, treatment with caregivers, treatment without caregivers
2 types of tests commonly used by SLP’s
Norm-referenced, criterion-referenced
Definition and goal of norm-referenced tests
Standardized tests that compare an individual’s performance
to that of age-matched peers
¡ The goal is to rank the individual so that decisions can be
made about their opportunity for success (e.g., SAT)
Definition and goal of criterion-referenced tests
Individual’s performance is compared to a pre-defined set of
criteria or a standard
¡ The goal is to determine whether or not the individual has
mastery of a certain skill set
¡ These results are usually “pass” or “fail”
3 typical scores used with norm-referenced tests
Standard scores, percentiles, age/grade equivalent