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Clinical Procedures For Speech Lang Pathology > Exam 2 > Flashcards

Exam 2 Flashcards

0
Q

Define Evidence based practice.

A

research evidence is integrated with practitioner expertise and client preferences and values.

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1
Q

Evidenced Based Practice

A

Combines research and clinical practice.
Research purpose is to add to existing knowledge base.
Clinical practice purpose is to change behavior.

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2
Q

What are the 3 types of evidenced based practice?

A
  1. Literature reviews/theory based.
  2. Research based.
  3. Practiced based.
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3
Q

Describe the path to effective intervention?

A

Diagnosis
Selection of therapy targets
Training to facilitate desired behavior
Follow-ups (if needed)

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4
Q

When is intervention complete?

A

When target behaviors have been mastered.

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5
Q

Effective treatment uses this scientific schema:

A
  1. Identification of problem
  2. Review of existing knowledge
  3. Formulation of hypothesis
  4. Manipulation of independent variable.
  5. Collection & analysis of data.
  6. Formulation of conclusions.
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6
Q

Principles of intervention

A
  1. Dynamic
  2. Occurs in realistic environment.
  3. Provide opportunities to engage in meaningful communicative interactions.
  4. Individually oriented.
  5. Designed for client’s consistent success.
  6. Tailors goals to promote client’s knowledge one step beyond the current level. (challenge but not frustrate).
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7
Q

Essential building blocks of speech and language therapy are: hint (PBKSD)

A
  • programming
  • behavior modification
  • key teaching strategies
  • session design
  • data collection
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8
Q

Programming steps

A

Selection
Sequencing
Generalization

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9
Q

Programming - selection of targets involves:

A
  • identification of behaviors client is trying to acquire.

- long and short term objectives.

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10
Q

Programming: selection of targets. What is the clinician required to do?

A
  • identify client’s errors during testing.
  • determine extent and authenticity of errors.
  • assess errors by pretreatment baselining.
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11
Q

Why pretreatment baselining?

A

Provides numerous opportunities for a client

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12
Q

Pretreatment baselining: What is the general rule?

A

If client performs with 75% accuracy or less, target should be considered for therapy.

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13
Q

Factors to consider when selecting targets:

A
  • Client’s cultural and linguistic background.
  • Intelligibility level
  • Age
  • Cognitive level
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14
Q

Two approaches used in selecting targets:

A
  1. Normative approach.

2. Client specific approach.

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15
Q

Normative approach

A
  • developmental approach.
  • therapy targets taught as they should emerge in normally developing individuals.
  • therapy targets that occur earliest is selected as initial targets.
16
Q

Who/what is the normative approach best suited for?

A

speech sound errors and language deficits with children.

not well suited for adults or voice and fluency disorders. There is no hierarch for those disorders; you either have the or you don’t.

17
Q

Factors to consider with the Normative Approach:

A
  • sample population. Too small, not culturally diverse.
  • characteristics of people on which standardization was completed (ethnicity, gender, socioeconomic status). May not be properly represented. Diagnostic validity can be skewed.
18
Q

Client specific approach:

A
  • targets the individual’s specific needs, not the developmental norms.
  • focuses on function.
19
Q

Who is the client specific approach best for?

A

Children and adults.

20
Q

What 3 factors should be considered when using the client-specific approach?

A
  1. Frequency of the behavior in daily activities.
  2. Importance of the behavior to the client.
  3. Stimulability - client’s potential to master the new skill.
21
Q

In the sequencing of therapy targets, what 3 factors determine the progression?

A
  1. Stimulus type
  2. Task mode
  3. Response level
22
Q

What is “stimulus type?”

A

type of input used to elicit a response:

  • direct physical manipulation/hands on
  • concrete symbols, eg picture cards
  • abstract symbols, eg spoken or written language; contextual cues like “This something you bounce, it is a _______”. Ct. says, “ball.”
23
Q

In sequencing, what is TASK MODE?

A
  • amount of clinician support provided to obtain the desired response. This includes:
    imitation - maximal support;
    cues/prompts - mild-maximum;
    spontaneous - least amount of assistance.
24
Q

What is RESPONSE LEVEL in Sequencing?

A 
- determined by knowing where to begin on the hierarchy of performance difficulty. For example, 
isolation
syllable
word
carrier phrase
phrase
sentence
text
25
Q

What is IMITATION?

A
  • maximal support provided by the clinician.

- Clinician directly models the target, eg, “ Say ball,” and client says ball.

26
Q

What are CUES/PROMPTS?

A
  • mild-moderate clinician support.

- Clinician says, “This is round and it bounces, it is a _____.”

27
Q

What is SPONTANEOUS level task mode?

A
  • Clinician provides little or no support.

- Clinician says, “What is this?” Client says, “Ball.”

28
Q

How are RESPONSE LEVELS determined?

A

By knowing where to begin on the hierarch of performance difficulty, eg, isolation, word, carrier phrase, phrase, sentence or text.

29
Q

Guidelines for determining the RESPONSE LEVEL

A
  • if baseline scores are below 50% accuracy, begin treatment one step below baselined response level.
  • If the client performed between 50-75%, begin treatment at the same response level.
30
Q

Melissa’s baseline procedures at word level had the following results, where should treatment response levels begin?

  1. initial k - 60% accuracy
  2. medial k - 20% accuracy
  3. final k - 90% accuracy
  4. initial v - 10% accuracy
  5. medial v - 100% accuracy
A
  1. word level
  2. syllable level
  3. phrase level
  4. syllable level
  5. phrase level
31
Q

Melissa’s baseline procedures at word level had the following results, where should treatment response levels begin?

  1. final v - 50% accuracy
  2. initial and final f - 66% accuracy
  3. medial f - 100% accuracy
  4. initial “sh” - 25% accuracy
  5. medial and final “sh” - 75% accuracy
A
  1. word level
  2. word level
  3. phrase level
  4. syllable level
  5. word level (or phrase level, per Mrs. Ross)
32
Q

What is branching?

A
  • A technique used to determine Response Level.
  • Increasing or decreasing the difficulty by one step.
  • use if client’s performance in treatment does not reflect baseline results. Tasks are modified immediately to keep client from getting frustrated.
33
Q

What 3 things should change as the client improves?

A
  1. stimulus type
  2. task mode
  3. response level

Must increase or change until the criterion level is met - generally 90% accuracy.

34
Q

Example of a CONCRETE STIMULUS

A

The client will imitatively produce s in the initial position of single words with 90% accuracy while naming 20 photographs.

Clinical Procedures For Speech Lang Pathology (2 decks)

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