Foundations of Assessment Flashcards
What is assessment?
Process of collecting valid and reliable information
Then integrating and interpreting it to make a judgement or a decision about something
What is the outcome of assessment?
Diagnosis
Assignment of a diagnostic label
What makes good assessment?
Variety
Reliable
Thorough
Valid
Tailored
What does it mean if an assessment has variety?
Use different assessment modalities, interview, history, formal testing, informal testing, observations
What does it mean if an assessment is reliable?
Accurately reflect communicative abilities of the client
Reevaluation would give similar results
What does it mean if an assessment is thorough?
Incorporates all relevant information and yields accurate diagnosis/recommendations
What does it mean if an assessment is valid?
Evaluates the skills that it intends to evaluate
What does it mean if an assessment is tailored?
Appropriate for the age, gender, skill levels, ethnocultural background, etc.
Overview of the assessment process
Case history
Interview
Orofacial mechanism
All areas assessed
Hearing
Analyze
Share findings
What is the case history?
Historical information about the client and their family/caregivers
What is the interview?
Interviewing client, family/caregivers, or both
What is the interview?
Interviewing client, family/caregivers, or both
What is the orofacial mechanism?
Oral mech
Structural and functional integrity of orofacial mechanism
What are all the areas assessed as part of the assessment process?
Articulation, language, fluency, voice, resonance, and/or cognition
Dysphagia: assess chewing/swallowing
What does the hearing component of the assessment process?
Screen or obtain hearing evaluation information
What is the analyze portion of the assessment process?
Analyze information and determine appropriate diagnosis/conclusion, prognosis and recommendations
What is the share findings portion of the assessment process?
Formal written record (report) and a meeting with client and/or caregiver
May also meet with other professionals
Evaluations refers to ____ in time
One point
Evaluation implies that
We are comparing the client’s performance to some “typical” or “expected” level
What are the purposes of assessment?
Draw a conclusion about an individual’s communicative abilities
AND
Describe the client’s strengths and weaknesses (needs)
Assessment is ongoing or static? Will be used with?
Ongoing
Will be used with clients to assess current level, progress, evaluate generalization, etc.
What is static assessment? What assessments does this include?
-Provides information about how a client’s performance compares to a group and/or standard
-Standardized or norm-referenced tests
What is dynamic assessment?
-Provides information about the types of support that improve client performance
-Test-retest-test
-Uses standardized or non-standardized measures that help identify prompts/cues that facilitate performance
-Trial therapy tasks
What is authentic assessment?
-Provides information about how a client functions in their “natural environment”
-Example: home, daycare, etc
-Testing ability to generalize skills to different environments
Norm-referenced tests are…
Standardized
Compared to a normative group (large representative sample group)
How does the client compare to the average
Normal distribution is often depicted over a
Bell shaped curve
Pros of norm referenced tests
-Objective
-Compare to a large group of similar individuals
-Efficient
-Commonly known and understood in the profession
-Does not require a high level of skill
-Useful for 3rd party payment/qualification of services
Cons of norm-referenced tests
-Don’t allow for individualization
-Static- what do they know NOW vs how they learn best
-Skills are evaluated in isolation
-Testing is unnatural - doesn’t represent real life or other factors
-May not be appropriate for culturally/linguistically diverse clients
-Must be administered exactly as instructed or results aren’t valid/reliable
What are criterion-referenced tests?
-May or may not be standardized
-DO NOT compare to a normative group
-Identify WHAT a client can and cannot do (compared predefined criterion/expected level of performance)
Criterion referenced tests are great for use with which type of population?
-Neurogenic disorders
-Fluency disorders
-Voice disorders
-CLD (culturally and linguistically diverse children)
Pros of criterion referenced tests
Objective
Efficient
Commonly known and understood in the profession
If well-known, can be acceptable for 3rd party payment or qualification of services
If non-standardized, some opportunity for individualization
Cons of criterion referenced tests
Skills are evaluation in isolation
Testing is unnatural - doesn’t represent real life or other factors
If standardized, don’t allow for individualization and must be administered exactly as instructed or results aren’t valid or reliable
What is authentic assessment?
-Identifies what a client can and cannot do
-Contextualized: test environment is more realistic and natural
-Ongoing: testing occurs during assessment and treatment
Authentic assessment requires
More clinical skills/creativity/experience
Need to review portfolio regularly to review/add/change
What are some strategies for authentic assessment?
Systematic observations: use charts and scales
Real-life simulations
Language sample
Structured symbolic play
Self-monitoring
Anecdotal notes
Short answer or extended answer responses
Audiotaping
Videotaping
Checklists
Caregivers
Pros of authentic assessment
Natural
Most like the real world/environment
Self eval/monitoring
Individualization
Beneficial for culturally diverse clients
Flexible
Cons of authentic assessment
Lacks objectivity
Not standardized
Reliability/validity not assured
Not efficient - LOTS of planning
Impractical (sometimes)
May not work for 3rd part payment/qualification of services
What is dynamic assessment?
Type of authentic assessment
Use test-reteach-test
Allows to compare pretest and post-test scores to see learning abilities
Use strategies like cueing, prompting, environmental adjustment, etc.
What are psychometric principles?
What makes a test an assessment
Psychometric principles: What are the different types of validity?
Face: test appears to test what it says it will test
Content: test contents represent the contain domain of the skill
Construct: test measure the theoretical construct it claims to measure
Criterion: test is related to an external criterion in a predictive or congruent way
Psychometric principles: What are the different types of reliability?
Test-retest: test is stable over time, scores are similar each time the person is tested
Split-half: internal consistency based on each half of the test correlating with one another
Rater: level of agreement among those rating the test (same score no matter who administers the test)
Alternate form: test’s correlation coefficient with a similar test
What is standardization?
Standard procedure for administration and scoring
Done through purpose of test, age, construction/development, administration/scoring procedures, normative sample group/statistical information, reliability, validity
ALL info contained in the manual
A part of standardization is determining the ___ age of a patient based on the day that the test was administered
Chronological
What are basals?
Starting point testing/scoring
Typically based on age
What are ceilings?
Ending point for testing/scoring
Typically based on number of consecutive incorrect responses
Why are basals and ceilings used?
Efficient
Standardized administration: what is involved in formulaic administration?
Repetition of stimulus
Time
Standardized administration: what are accommodations and what does that include?
Minor adjustments to the testing situation that do NOT compromise standardization
Example: providing the test in large print
Standardized administration: what are modifications?
Adjustments that do change the standardized administration
Example: rewording, repetitions
What is HIPAA?
Health insurance portability and accountability act
Protect patient’s health information
Who dictates the code of ethics for SLPs? What is part of the code?
ASHA
Integrity, competence, continued learning, fight against prejudices and biases, best interest of clients always kept in mind
What is case history?
Starting point for evaluation
Completed by the caregiver/client and reviewed by the clinician prior to services
What limits the value of case history?
Terminology on the forms, rushed responses, elapsed time between onset and evaluation, life events/circumstances, cultural differences
What is the intake interview?
Conducted with client/caregiver at start of eval/assessment
What types of questions are used during the intake interview?
Closed-ended: answered with yes/no
Open-ended: get short and direct responses
As part of the intake process, clinicians obtain information from other professionals. What does this mean?
Getting notes and health history from other SLPs, AuD, physicians, dentists, educators, etc.
Need written auth for this
Why is information from other healthcare professionals important?
Helps with further understanding about the issues a client is presenting with
