evidenced based practice: assessment and treatment

Question 1

what is a multidisciplinary team

Answer 1

team members represent different disciplines, each member conducts their own eval and write separate reports. There is little interaction

Question 2

what is a transdisciplinary team

Answer 2

multiple specialists work together in the initial assessment but only one or two provide services

Question 3

what is an interdisciplinary team

Answer 3

tem members from multiple disciplines collaborate write an evaluation and intervention plan

Question 4

what percentage of a sample will have scores within 1 standard deviation

Answer 4

68%

Question 5

what are percentile ranks

Answer 5

show the percentage of subjects who scores at or below a specific raw score.

Question 6

what does a score at the 25th percentile mean

Answer 6

75% scored better

Question 7

why are SLPs turning to functional assessment

Answer 7

reimbursers are requiring documentation of functional outcomes of treatment

Question 8

how does a clinician target functional communication during as assessment

Answer 8

1. observe client with amily and peers
2. arrange a child-caretaker interaction
3. arrange for peer interactions
4. talk with 2 or 3 peers about how the child interacts
5. observe in classroom, cafeteria, playground with
   peers
6. observe patient interaction with health care providers and family while assessing in medical settings
7. emphasize conversational interaction. Do no make clinical judgments based solely on imitative or picture naming
8. observe and record conversation in naturalistic situation
9. create meaningful tasks
10. use sentences that include names of family members, activities the client enjoys
11. document variations in the disorder in natural settings
12. examine the effect the client produces when he or she attempts to communicate

Question 9

what are client specific assessments

Answer 9

alternative to standardized test

2. generate data that are helpful in developing client specific treatment
3. evoke speech-language samples over time by use of culturally appropriate client specific materials instead of standard stimuli

Question 10

how do you establish a baseline for client specific assessment

Answer 10

establish baselines of targeted behaviors just before they are taught

Question 11

what is criterion referenced assessment

Answer 11

performance is evaluated against a standard of performance called a criterion

2. may be helpful when the norms of standardized tests do not apply to a particular client.
3. they allow for more in depth evaluation of the patient

Question 12

what is authentic assessment

Answer 12

speech and language samples in everyday settings

Question 13

what is minimal competency core

Answer 13

a variation of authentic assessment
it takes age and specific context into account
the least amount of skill a typical speaker is expected to display

Question 14

what is contrastive analysis

Answer 14

used to establish whether a speech pattern is part of a speaker’s cultural background or is a disorder
2. requiresknowledge of dialect

Question 15

what is dynamic assessment

Answer 15

evaluates a child/s ability to earn when provided with istruction

2. test-teach-retest
3. demonstrates the modifiability of deficient skills

Question 16

describe a comprehensive and integrated assessment

Answer 16

1. clinician retains necessary elements of the traditional approach (cases history, interview, language sample, orofacial exam, and hearing screening)
2. standardized tests may be used
3. clinician uses a client-specific stimulus material, sample communication in natural settings, and evaluate each skill in depth
4. targets are functional and meaningful
5. clinician may expand data to include reading and writing samples, copies of academic records, reports from teacher or other professionals, video of conversation with others

Question 17

what is the directmethod of response reduction

Answer 17

reducing behaviors by immediately providing a corrective feedback

Question 18

what are discrete trials

Answer 18

each opportunity to produce a response is counted separately. They are more efficient in establishing target behaviors but are less efficient than naturalistic methods

Question 19

what is escape

Answer 19

a behavior that reduces or terminates an aversive event after having come in contact with that event

Question 20

what is an evoked trial

Answer 20

no modeling is given. Pictures, questions and other stimuli are used to provoke a response. Evoked trials follow modeled trails

Question 21

what is an exemplay

Answer 21

specific target response that illustrates a broader target behavior. Individual items trained in therapy sessions: /s/ is an exemplar of the word soup

Question 22

what is extinction

Answer 22

withholding reinforcers to reduce a response: appropriate in reducing behaviors as crying

Question 23

what is fading

Answer 23

when the controlling power of a stimulus is gradually reduced while the response is maintained (making modeling less and less audible to client until withdrawn)

Question 24

what are functional outcomes

Answer 24

effects of treatment that are generalized and personally meaningful to clients. They are qualitative. Related to quality of life

Question 25

what are indirect methods of response reduction

Answer 25

reducing undesirable behaviors by positively reinforcing and thus increasing desirable behaviors

Question 26

what are probes

Answer 26

procedures to assess generalized production of responses without reinforcing them. Involve a criterion to be met before shifting training to a more complex level

Question 27

what are prompts

Answer 27

additional verbal or nonverbal that increase the probability of a target response (the word start with a t...)

Question 28

what is punishment

Answer 28

reducing undesirable behaviors by withdrawal of stimuli. Includes corrective feedback, time-out and response cost

Question 29

what is response cost

Answer 29

reducing responses by withdrawing reinforcers contingent on each response (take token away for every incorrect production)

Question 30

what is shaping

Answer 30

a method of teaching nonexistent responses that are not even imitated. The target response is broken down into initial, intermediate, and terminal components and those are taught in an ascending sequence

Question 31

what is time out

Answer 31

a brief period of silence, inactivity, averted eye contact, and lack of reinforcement imposed on a response to be reduced (cancellation)

Question 32

what is continuous reinforcement

Answer 32

all correct responses are reinforced

Question 33

what is intermittent reinforcement

Answer 33

reinforcing some responses and not others

Question 34

what is differential reinforcement

Answer 34

teaching the client to give different responses to different stimuli (plural response to plural stimuli)

Question 35

what is differential reinforcement of alternative behaviors

Answer 35

reinforcing a desirable behavior as an alternative to an undesirable one. (teaching a child to verbally request instead of whining)

Question 36

what is differential reinforcement of low rates of responding

Answer 36

decreasing undesirable behavior gradually by reinforcing progressively lower frequencies of that behavior (reinforcing a child for asking fewer interfering questions during treatment)

Question 37

what is differential reinforcement of incompatable behaviors

Answer 37

reinforcing a desirable behavior that cannot coexist with an undesirable behavior

Question 38

what is differential reinforcement of other behaviors

Answer 38

specifying one behavior that will not be reinforced while reinforcing many unspecified desirable behaviors

Question 39

what is an automatic reinforcer

Answer 39

sensory consequence of a behavior that reinforce that behavior (sensation for autistic kid who bangs their head against the wall)

Question 40

what is backup reinforcer

Answer 40

given at end of treatment in exchange for tokens earned in session

Question 41

what is a conditioned generalized reinforcer

Answer 41

reinforcer whose effect does not depend on motivational state of the client

Question 42

what are secondary reinforcers

Answer 42

praise, smiles, and approval that strengthen response because of past experience

Question 43

what are negative reinforcers

Answer 43

events that are aversive and reinforce a response that terminates, avoids, or postpones them

Question 44

what are positive reinforcers

Answer 44

events that follow a response and strengthen them

Question 45

what are primary reinforcers

Answer 45

effects that do not depend on past learning or conditioning. Biologically determined because of survival value useful in teaching infants, and toddlers with severe ID response to verbal mands

Question 46

what is the normative strategy for treatment

Answer 46

age-based norms that dictate the selection of speech and language targets.

Question 47

what is the client specific strategy for treatment

Answer 47

behaviors that improve communication and meet the social, academic, and other demands made on the clinet will be targeted

Question 48

what is the functional communication strategy

Answer 48

target behaviors are selected that are the most useful to enhance demands of daily living

Question 49

what is the integrated approach to target behavior selection

Answer 49

targets are appropriate or the client's age, ethnocultural background, individual uniqueness, and communication requirements places more emphasis on the client and less on age-appropriateness

Question 50

that is the treatment sequence

Answer 50

1 response complexity: starts at simple level and grows more complex 2. degree of structure: treatment is more structured in initial stages 3. response modes: starts with imitation of modeled: modeling then withdrawn; progresses to spontaneous production in less structured environment 4. multiple targets: multiple phonemes may be taught in a certain sequence; gentle onset and airflow management and slow speech for fluency 5. training and maintenance: 6. shifts in treatment contingencies: initially client reinforced for every correct response. Schedule changes to intermittent

Question 51

how do you increase maintenance

Answer 51

1. select targets that are more likely to be produced in natural settings 2. use a variety of stimuli 3. give sufficient treatment with varied exemplars 4. before dismissal, reinforce the skills in naturalistic conversation 5. teach self-monitoring 6. fade initial continuous reinforcement to intermittent and last use only social reinforcers 7. teach family members to stimulate, prompt, and reinforce correct responses 8. teach the client to prime others for reinforcement 9. follow up with booster treatment if needed

Question 52

what is the procedure for follow up treatment

Answer 52

1. record extended conversation to analyze continued production of treated behaviors 2. determine a follow up schedule

Question 53

what is a follow up schedule timeline

Answer 53

first follow up at 3 months second at 6 months third at 1 year subsequent assessments as necessary

Question 54

what is a booster treatment

Answer 54

treatment offered any time after initial dismissal may be identical to the original treatment may be a modified version may be a different form know to be more effective may be much less extended

Question 55

what are the 7 steps of all treatment programs

Answer 55

1. select functional targets. Select short and long term goals. Make these objective, measurable, functional, and ethnoculturally relevant 2. establish baselines 3. plan a comprehensive treatment that specifies what the client will be required to do, what the clinician will do 4. imprelemtn program wile managing behavioral contingencies that decrease undesirable responses 5. implement a maintenance program. Teach client to self monitor and train key people. Arrange for booster 6. follow up with client to assess maintenance over time 7. conduct booster treatment if necessary