Diagnostics Exam 1 Flashcards
What is assessment?
A. The process
8. SLP’s use of assessment
Why do we complete an evaluation?
A. To determine: Is there a disorder?
B. To compare with norms
C. To share with others
If there is a communication disorder, you will need to:
~ Describe the problem
~ Judge severity
~ Deal with the etiology
~ Prognostic statement
~ Make recommendations
~ Write goals/ objectives
For an assessment to have foundational integrity it needs to adhere to these 5 principles:
~ thorough
~ uses a variety of modalities
~ valid
~ reliable
~ tailored to the individual client
Typical Assessment Includes:
~ Case history
~ Interview
~ Evaluate oral-facial mechanism
~ Sample the client’s speech and language abilities
~ Screen hearing
~ Evaluate assessment information
~ Share findings
May need to make referrals to other professionals
True
Possible other referrals:
~ Psychologist/psychiatrist
~ OT, PT
~ Audiologist
~ Physician
~ Another SLP
Each assessment will differ slightly
True
Some have extensive case histories, clients have different communication difficulties, some cases involve extensive interviewing, some cases require detailed written reports.
Differences in Evaluation
What environment factors do you need to consider while doing a diagnostic?
~ Privacy/confidentiality
~ Room consideration
~ Recording consideration
~ Stimulus consideration
~ Time
~ Seating
~ Distance
~ Appearance
measurement of human traits, abilities, and certain processes
psychometrics
a test measures what it claims to measure
test validity
results are replicable
reliability
provides standard procedures for the administration and scoring of the test
standardization
a test measures predetermined theoretical construct, which is an explanation of a behavior or attribute based on empirical observation
construct validity
validity that is established by an external criterion
criterion validity
a tests validity in comparison to a widely accepted standard
concurrent validity
a tests ability to predict performance in another situation or at a later time
predictive validity
refers to a tests stability over time
test-retest reliability
refers to a tests internal consistency
split-half reliability
refers to the level of agreement among individuals rating the test
rater reliability
results are consistent when the same person rates the test on more than one occasion
intra-rater reliability
results are consistent when more than one person rates the test
inter-rater reliability
refers to a test’s correlation coefficient with a similar test determined by administering Test A and Test B to the same group of people and comparing the results to determine the test’s alternate form reliability
alternate form reliability
standardized tests = ______ tests
formal
_______________ provides standard procedures for the administration and scoring of the test
standardization
standardization helps to eliminate ___-_____ bias and other extraneous influences so they do not affect the client’s performance
test-giver
majority of standardizes tests are ____-__________, but not ALL standardized tests are ____-________
norm-referenced
any test may be standardized as long as uniform test administration and scoring are used
true
consecutive test items that must be correct prior to continuing testing
basal standardization
number of test items incorrect prior to discontinuing testing
ceiling standardization
exact age of child at the date tested
chronological age
adjustment made in age of child if born prematurely
adjusted age
the initial score obtained from test results, but must be converted to interpret test results
raw score
each test should include information about:
- the purpose of the test
- test construction and development
- administration and scoring procedures
- the normative sample group and statistical information derived from it
- test reliability
- test validity
most tests available to SLP’s are ____-________
norm-referenced
norm-referenced tests are often used for evaluating articulation and language disorders
true
norm referenced tests are always ____________
standardized
norm-referenced tests compare an individuals performance of a _____ _____
larger group
normal distribution is often depicted using a ____-______ curve
bell-shaped
normal range on bell shaped curve
-1 to +1
mild range on bell shaped curve
-1 to -1.5
moderate range on bell shaped curve
-1.5 to -2
severe range on bell shaped curve
-2 or lower
scores from norm-referenced tests may include:
standard score, percentile rank, stanine
tells how many standard deviation the raw score is away from the mean
standard score
tells the percentage of people scoring at or below a particular score
percentile rank
based on a 9-unit scale where 5 is average performance. each stanine unit is equally distributed across the curve.
stanine
- tests are objective
- skills of an individual can be compared to a large group of similar individuals
- efficient testing
- widely recognized
-do not need a high level of experience - insurance companies and school districts prefer known test entities
norm-referenced test advantages
- Do not allow for
individualization - Generally static
- Evaluates isolated skills
- Must be administered EXACTLY
as instructed - Test materials may not always
be appropriate for all
populations/cultures
norm-referenced test disadvantages
- Do not compare individual’s performance to anyone else
- Identify what a client can and cannot do
- Help answer the question, “How does a client’s performance
compare to an expected level of performance?” - Often used when assessing clients for neurogenic disorders,
fluency disorders, and voice disorders - May or may not be standardized
criterion-referenced tests
–Usually objective
–Usually efficient
–Many are widely recognized
–Insurance companies and school systems may prefer
known tests
–With non-standardized criterion-referenced tests, there is
some opportunity for individualization
criterion-referenced test advantages
- Testing situation may be
unnatural - Approach evaluates isolated
skills - Standardized CR tests do not
allow for individualization - Standardized CR tests must be
administered EXACTLY as
instructed
criterion-referenced test disadvantages
- Identifies what the client can and cannot do
- Emphasizes contextualized test stimuli
- Test environment is a realistic situation
- Authentic assessment is ongoing
- Requires more clinical skill, experience and
creativity than formal assessment - Strategies recommended for evaluating clients
using authentic assessment
authentic assessment approach
- Natural and similar to real world
- Clients participate in self-evaluation, self-monitoring
- Allows for individualization
- Offers flexibility
authentic assessment approach advantages
–May lack objectivity
–Reliability and validity are less assured
–Requires a high level of clinical experience and skill
–Requires a lot of planning and interpretation time
–May be impractical
–Insurance companies and school districts prefer known
test entities
authentic assessment approach disadvantages
Basal is the ________ point for administration
starting
ceiling is the ______ point
ending
associated with a particular region, social class, or ethnic group
dialects
clinicians need special expertise in assessing children who speak:
- A language other than English
- English as a second language
- A dialectal variation of American English (AAE)
- A different form of English (Australian English)
the scientific study of a culture
ethnography
you will gather information from:
- written case history
- interview
- information from professionals
Gathers information about the client’s
difficulties
Helps plan for the assessment
Allows you to identify information that
needs clarification
case hiystory
Take notes or record it
Develop trust
Stress
Be accommodating
Share your knowledge clearly
Use good communication skills
Strong commitment to people
interviewing tips
Sensitivity
Respect
Empathy
Objectivity
Listening skills
Motivation
Rapport
Facilitating good communication
subjective notes (SOAP notes)
nonmeasureable
objective notes (SOAP notes)
measureable findings
Assessment (SOAP notes)
synthesis of information/analysis
Plan (SOAP notes)
-how to the findings affect the future
-outline recommendations for future action and course of treatment
- birth through age 2
- identifies current levels of
development - Includes family as recipients of
services - supports transition to preschool
program upon reaching age 3 - services coordinated through a
county regional center - plan is reviewed at least every 6 mo
IFSP (individualized Family Service Plan)
- For special education of preschool
and school-age children ages 3- 21 - identifies special education services
necessary to achieve goals - services are coordinated through a
local educational agency - Does not include provisions for the
family - Supports transition to adulthood
upon or before reaching age 21 - plan is reviewed at least every 12 mo
IEP (Individualized Education Plan)
abbreviation for “with”:
c with line over it
abbreviation for “Activity of Daily Living”
ADL
abbreviation for “complaining of”
c/o
abbreviation for “diagnosis”
dx
abbreviation for “Did Not Test”
DNT
abbreviation for “history” and “family history”
hx, f/h
abbreviation for “independent”
a circle with a capital i in it
abbreviation for “within normal limits”
WNL
abbreviation for “no known allergies”
NKA
abbreviation for “medical history”
m/h
abbreviation for “left” and “right”
circle with a capital L in it and circle with a capital R in it
abbreviation for “prognosis”
prog
abbreviation for “quality of life”
QOL
abbreviation for “patient”
pt
abbreviation for “range of motion”
ROM
abbreviation for “speech therapy’
ST
abbreviation for “treatment”
tx
abbreviation for “change”
a triangle
abbreviation for “signs and symptoms”
s/s
for a speech language sample you need a minimum of 50-100 __________
utterances
average rate of speech for an adult
220-410 words per minute
average rate of speech for a 1st grader
125 wpm
average rate of speech for a 5th grader
142 wpm
- number of errors
- Types of errors
- Inconsistency of errors
- Vowel errors
- Rate of speech
- Atypical prosody
- Length and linguistic complexity of words/utterances
- Insufficient vocal intensity, voice disorders
- Disfluencies
- Lack of gestures
- Testing environment
- Client anxiety/fatigue
- Client lack of familiarity with materials
- Clinician’s ability to understand “less intelligible” speech
- Clinician’s familiarity with client
factors that negatively influence speech intelligibility
- Correct/incorrect productions
- Frequency of disfluency types
- Specific language features
- Circumlocutions or word-finding difficulties
- Correct phonatory behaviors
- Inappropriate behaviors
- Ability of client to stay on task
- Incorrect/correct behaviors/productions (+/-)
- Each time a behavior is exhibited
- Behaviors according to preselected criteria
what to chart when charting
