Principles Of Assessment

Question 1

What is assessment?

Answer 1

Process of collecting valid and reliable information, and then integrating and interpreting it to make a judgment or a decision about something

Question 2

What is reassessment?

Answer 2

Appropriate when the patient exhibits a change in functional speech and language communication skills.

Question 3

What is discharge?

Answer 3

Ideally occurs when the individual, family, or designate guardian, and speech-language pathologist as a team conclude that the communication or feeding and swallowing disorder is remediated or when compensatory strategies are successfully established.

Question 4

What is management? Also known as? What is its correct progression?

Answer 4

AKA treatment or intervention
It is a dynamic process that follows a systematic progression
Diagnosis → selection of appropriate therapy targets → training procedures → mastery of behaviors

Question 5

What is screening? Where does it most commonly occur?

Answer 5

Purpose: To quickly identify those individuals who communicate WNL vs comm dsco
Latter: Referred for a complete evaluation
It is not in-depth assessment and should not take more than a few minutes
Most commonly occur in schools

Question 6

What is diagnosis?

Answer 6

Clinical decision regarding the presence or absence of a disorder and, often, the assignment of a diagnostic label

Question 7

What is the purpose of assessment?

Answer 7

Assessing, describing, and interpreting an individual’s communication ability (ASHA)

Question 8

What is a good assessment?

Answer 8

• A good assessment is thorough
• A good assessment uses a variety of assessment modalities
• A good assessment is valid
• A good assessment is reliable
• A good assessment is tailored to the individual client

Question 9

According to this model, the PWDs or viewed as victims or as the problem–sees them as their disorder. Attitudes: pit, sympathy, charity

Answer 9

Charity Model

Question 10

What is the medical model?

Answer 10

• Focuses solely on diagnosing and treating the health condition itself, often ignoring broader social or environmental factors
• PWDs need to be cured and they are passive recipients of care. The aim is to make them “normal”, implying that they are abnormal.

It is a framework for understanding and treating health and illness, primarily focusing on the biological and physiological factors that contribute to a patient’s condition. It operates on the assumption that health issues are rooted in physical causes—such as genetics, infections, biochemical imbalances, or physical injuries—and that treatment should aim to correct these biological abnormalities

Question 11

What is the social model?

Answer 11

Emphasizes that societal barriers create disability
It is a framework for understanding a wide range of social issues, particularly focused on how society and its structures affect individuals, especially in relation to disability, health, and well-being. Unlike models that emphasize individual pathology or biological determinism (like the medical model), the social model centers on how external, societal factors contribute to challenges people face and how societal changes can improve individual outcomes

Question 12

What is a rights-based model?

Answer 12

Focus: Fulfillment of basic human rights

This framework emphasizes the importance of recognizing, protecting, and promoting the rights of individuals and communities as a fundamental aspect of addressing social, economic, and political issues. It is often applied in fields like development, human rights, healthcare, disability advocacy, and education. Unlike other models that may focus on needs or charity, the rights-based model focuses on individuals as rights holders with entitlements, and governments or institutions as duty bearers responsible for fulfilling those rights. The model is grounded in the idea that all people are born with certain rights that are inherent, universal, and non-negotiable These rights cannot be given or taken away and apply to all people, regardless of nationality, race, gender, or economic status.

Question 13

ICF Model (Difference of activities and participation)

Answer 13

Activity is the skill or activity itself, participation is applying that skill to be able to participate in society.

Question 14

This model is used across multi-disciplinary care. It helps healthcare professionals develop personalized care plans that focus on improving a person’s functioning, rather than just treating the medical condition. The ICF is essentially a biopsychosocial model, integrating biological, psychological, and social factors in understanding health and disability. It takes into account not just the health condition but also the broader context of a person’s life, including environmental and personal factors. The focus on participation encourages social inclusion and the removal of societal barriers.

Answer 14

ICF Model

Question 15

What are the three different barriers to participation?

Answer 15

Attitudinal, environmental and institutional

Question 16

What are the basic components of a rights-based model?

Answer 16

Empowerment of PWDs and accountability of the government and other institutions

Question 17

What are the factors of the ICF Model?

Answer 17

Body function/body structure
Activities
Participation
Environment factors
Personal factors

Question 18

These tests are always standardized. It allows a comparison of an individual’s performance to the performance of a larger group, called a normative group. Ask the question, “how does my client compare to the average?”

Answer 18

Norm-referenced tests

Question 19

What are the advantages of norm-referenced tests?

Answer 19

Objective; comparison to a large group of similar individuals, test administration is usually efficient, widely recognized, common ground of discussion with other professionals, clinicians are not required to have a high level of clinical experience and skill (guidelines in manual). Preferred for insurance, schools

Question 20

What are the disadvantages of norm-referenced tests?

Answer 20

It is static and does not allow individualization. It tells what a person knows, not how a person learns. Testing situation may be unnatural and not representative of real life. It also evaluates isolated skills without considering other contributing factors. Considerations for culturally and linguistically diverse clients. Must be administered exactly as instructed for the results to be considered valid and reliable.

Question 21

What are criterion-referenced tests?

Answer 21

Identifies what a client can and cannot do compared to a predefined criterion. It answers the questions, “How does my client’s performance compare to an expected level of performance?” It assumes that there is a level of performance that must be met for a behavior to be acceptable; any performance below that level is considered deviated. This may or may not be standardized. Furthermore, it is used most often when assessing client for neurogenic disorders, fluency disorders, and voice disorders; some aspects of articulation or language

Question 22

What are the advantages of criterion-referenced tests?

Answer 22

Usually objective, test administration is usually efficient. It is widely recognized; common ground of discussion with other professionals. Preferred for insurance, schools. With non-standardized criterion-referenced tests, there is some opportunity for individualization

Question 23

What are the disadvantages?

Answer 23

Standardized criterion-referenced tests do not allow for individualization, and must be administered exactly as instructed for the results to be considered valid and reliable. It evaluates isolated skills without comparing other contributing factors. Testing stimulation may be unnatural and not representative of real life.

Question 24

How to know if a test is norm- vs. criterion-referenced tests?

Answer 24

Test purpose and scoring
Norm-referenced tests use percentile, while criterion-referenced tests uses scoring systems such as pass or fail or mastery levels
Test content and administration
**Criterion-referenced tests it’s more likely to focus on specific skill sets **
Test manuals and resources
Check publisher websites and professional association

Question 25

Also known as alternative assessment or nontraditional assessment. Also identifies what a client can and cannot do; differentiating aspect: emphasis on contextualizing testing, so the test environment is more realistic and natural (e.g., client with social comm disorder: clinic vs. real life situations). This is ongoing as it evaluates the child’s performance during diagnostic and treatment phases.

Answer 25

Authentic assessment approach

Question 26

What strategies can you use in an authentic assessment approach?

Answer 26

Systematic observation, real-life simulations, language sampling, structured symbolic play, short-answer and extended-answer responses. Self-monitoring and self-assessment. Involvement of caregivers and other professionals.

Question 27

What are the advantages of an authentic assessment approach?

Answer 27

It is more natural; most like the real world Clients participate in self-evaluation and self-monitoring Allows for individualization Particularly beneficial with culturally diverse clients or special needs clients Offers flexibility

Question 28

Disadvantage of authentic assessment approach?

Answer 28

May lack objectivity Procedures are not usually standardized; thus, reliability and validity are less assured Implementation requires a high level of clinical experience and skill. Approach is not efficient, requiring a lot of planning time. May be impractical in some situations. Insurance companies and school districts prefer known tests entities for third-party payment and qualification for services

Question 29

True or False. Dynamic assessment is a form of authentic assessment?

Answer 29

True

Question 30

What is the purpose of dynamic assessment?

Answer 30

Purpose is to evaluate a client’s **learning potential based on their ability to modify response after the clinician provides assistance.** Especially appropriate when assessing clients with cognitive communication disorders, clients from culturally and linguistically diverse backgrounds (language disorder vs language difference)

Question 31

What is language disorder?

Answer 31

Difficulties in all of the client’s languages. There is significant difficulty in acquiring or using language skills compared to others of the same age and background.

Question 32

What is language difference?

Answer 32

Difficulties only while speaking one language. It is not a deficit. In most settings, clinicians cannot recommend therapy for clients who exhibit only communicative differences, but acceptable to provide therapy to clients who are electively receiving therapy for them (example: to modify a foreign accent)

Question 33

What is language delay?

Answer 33

Slower than expected development of language skills compared to age-appropriate milestones. It doesn't necessarily indicate a permanent issue. Can have various causes, including environmental factors, developmental delays, etc.,

Question 34

What is language impairment?

Answer 34

Language impairment is an umbrella term that can encompass both language delays and disorders. Any limitation or difficulty with language skills

Question 35

In dynamic assessment, clinician pays particular attention to teaching strategies that were effective at improving the client’s success; may include use of:

Answer 35

- Cueing, - graduated prompting, - environment adjustments, - conversational teaching

Question 36

Dynamic assessment allows the clinician to determine __________________________

Answer 36

**Baselines ability** and identify appropriate goals and strategies for intervention

Question 37

If the problem is language difference, the child will demonstrate ____________________

Answer 37

Improvement following teaching

Question 38

If the problem of the child is language impairment, the chill will ____________________

Answer 38

Not demonstrate improvement following teaching

Question 39

The emphasis of the authentic assessment approach is on

Answer 39

Contextualize testing

Question 40

True or false. The authentic assessment approach only occurs in the initial evaluation stage

Answer 40

False. It is an ongoing process

Question 41

What is the raw score?

Answer 41

Initial score obtained based on the number of correct or incorrect responses

Question 42

The raw score is not meaningful until it is ________

Answer 42

Converted to other scores or ratings

Question 43

What is the standard score?

Answer 43

- Reflects performance **compared to average and the normal distribution** Used to determine whether a test taker’s performance is: average, above average, below average

Question 44

Test developers calculate the __________ of the normative sample and assign it a value

Answer 44

Statistical average

Question 45

The most common standard score average value is ________ with an SD of?

Answer 45

100 (with a standard deviation of 15)

Question 46

This reflects the variation within the normal distribution; how spread out the values are. This determines what is average, below, average.

Answer 46

Standard deviation

Question 47

____ to ____ below the mean is usually considered significantly below average and is clinically a cause for concern

Answer 47

-1.5 to -2 SD

Question 48

This tells the percentage of people scoring at or below a given score.

Answer 48

Percentile rank

Question 49

Usually cause for concern if a client performs near ________ of the normal distribution

Answer 49

Near the bottom 7%

Question 50

This is the degree of certainty of the test developer that statistical values obtained are true. It allows the clinician to obtain a range of possible scores in which the true value of the score exists 95% of the time. The higher the better. This allows for natural human variability.

Answer 50

Confidence interval

Question 51

Standard nine. Method of ranking an individual’s test performance. Score based on a 9-unit scale.

Answer 51

Stanine

Question 52

This reflects the average raw score for a particular age (or grade). Least useful and most misleading scores obtained from a standardized test. Not considered a reliable measure and should generally not be used.

Answer 52

Age equivalence / grade equivalence

Question 53

The higher the confidence interval the less likely the score of the client will fall within that range. True or False

Question 54

Things to know or consider for assessment

Answer 54

- Know the culture of the client - Know the history of the client - Know the normal communicative patterns of the client’s dominant language - Know the client’s cognitive level, and information about sensory integration

Question 55

Who is part of our team when we do an assessment?

Answer 55

SLP, parents, SPED teacher, Psychologist, Occupational therapist, Physical therapist, Nutritionist, Neurologist, Developmental Pediatrician

Question 56

How to choose appropriate assessment tools for age and skills?

Answer 56

- Formal test manuals - Clinical judgment: Dynamic assessment

Question 57

Which assessment procedures to do first and last?

Answer 57

Consider: rapport, invasiveness, comprehensiveness of test, priority regarding: chief complaint, merging/getting information about multiple areas in a singular test, usually do case history first

Question 58

Assessment procedures common to most communicative disorders

Answer 58

Orofacial examination

Question 59

Why do we assess the child’s OPM structures?

Answer 59

To identify any structural issues that could potentially impact their speech, feeding, and communication.

Question 60

This is to measure a client’s ability to make rapidly alternating speech movements

Answer 60

Diadochokinetic (DDK) syllable rate

Question 61

Alternating motion rate

Answer 61

Single syllable /pa/

Question 62

Sequential motion rate

Answer 62

Sequence of syllable /pa-ta-ka/

Question 63

Why do we assess the DDK?

Answer 63

Provides information about a client’s **motor and speech-planning** ability: ability to sequence same and different syllables, accuracy of productions, fluency, rhythm, voicing, rate, coordination of respiration, phonation, and articulation

Question 64

There are two ways to measure DDK. What are they?

Answer 64

Counting the syllables produced within a predetermined number of seconds Measuring the seconds it takes to produce a predetermined number of syllables.

Question 65

What is speech and language sampling?

Answer 65

- Provide important information about speech and language abilities in a narrative or conversation context - Most time consuming components of a speech-language evaluation

Question 66

Purpose of speech and language sampling

Answer 66

Identifying sound errors in connected speech Comparing sound errors from an articulation test and connected speech Determining intelligibility Assessing imitation Evaluating rate of speech Determining the mean length of utterance Assessing comprehension Assessing semantic, syntactic, and morphologic skills, and combined linguistic complexity Assess narrative skills Assessing vocal quality and resonance Assessing pragmatic skills such as eye contact, topic maintenance, turn taking, perspective taking, and gauging partner interest

Question 67

A truly representative sample is a minimum of __ to __ distinct utterance, if possible, continue until 200

Answer 67

50 - 100 distinct utterances

Question 68

Strategies on how to get speech and language sampling

Answer 68

Establish a positive relationship before collecting a sample Be as unobtrusive as possible; minimize interruption and distractions Be willing to wait for the client to talk. Do not talk to fill the sentence Preselect materials and topics that will be interesting to the client, and follow the client’s lead in elaborating or changing topics Vary the subject matter of the sample Seek out multiple environments (e.g., clinic, playground, home, workplace) Alter the contexts (e.g., conversation, narratives, responses to pictures) Avoiding yes/no questions or other questions that can be answered with only a few words Ask questions that elicit lengthy responses, such as “tell me about…” “what happened” “why?” Make natural contributions to the conversation Consider the client’s age and cultural background; avoid questions that could be considered demeaning or offensive

Question 69

Conversation starters for elicit a speech-language sample

Answer 69

- Sample conversation prompts - Pictures - Narratives

Question 70

Reading passages allows the clinician to

Answer 70

Observe the client’s articulation, voice, fluency, and reading abilities Compare oral reading results with single-word, short-phrase, conversational speech samples Rainbow Passage, Grandfather passage, other passages appropriate to specific age ranges

Question 71

This can directly affect articulation, intelligibility, voice production, and fluency

Answer 71

Speech rate

Question 72

May be necessary as a measure of improvement over time (e.g., fluency) or deterioration (e.g., myasthenia gravis)

Answer 72

Evaluating rates of speech

Question 73

Purpose of evaluating the rate of speech

Answer 73

Allows the clinician to evaluate rate’s effect on client’s communicative abilities

Question 74

What are the steps to evaluate the rating of speech?

Answer 74

Record a sample of connected speech (devoid of significant pausing) in: Oral reading, conversational speech, or both Count the number of words produced and divide by number of minutes Time the sample (e.g., 20 seconds) Count the number of words produced (e.g., 62 words) Divide the number of seconds in a minute (60) by the number of seconds the sample (20 seconds in the sample): 60 / 20 = 3 Multiply the number of words in the sample (62 in the example) by the number in Step 3 (3 in the example): 62 x 3 = 186. The wpm (words per minute) is 186.

Question 75

The more samples you get the greater the reliability. True or False

Answer 75

True

Question 76

Steps when evaluating rates of speech when you have several samples

Answer 76

Example: Three samples are 20, 25, and 30 seconds, which equals a total of 75 seconds The number of words in the respective samples are 15, 20, and 25 which equals a total of 60 words. The number of seconds in 3 minutes (60 seconds per minute times three samples) is 180 seconds. Divide the number of seconds (180) by the number of seconds in the three samples. 75: 180 / 75 = 24 Multiply the number of words in the sample (60) by the number in Step 3 (2.4): 60 x 2.4 = 144. The wpm is 144

Question 77

Speech sample used must be an adequate, representative sample of the client’s speech to obtain a valid intelligibility rating. True or False

Answer 77

t

Question 78

Factors that can negatively influence intelligibility

Answer 78

The number of sound errors The types of sound errors Inconsistency of errors Vowel errors The rate of speech, especially if it is excessively slow or fast Atypical prosodic characteristics of speech, such as abnormal intonation or stress The length and and linguistic complexity of the words and utterances used Insufficient vocal intensity, dysphonia, hypernasality, or hyponasality Disfluencies particularly severe disfluencies that disrupt context Laco of gestures or other paralinguistics cues that assist understanding The testing environment (such as at home vs in the clinic) The child's anxiety about the testing situation The client’s lack of familiarity with the stimulus materials The client’s level of fatigue Very young children Elderly clients Clients with certain neurological disorders The clinician’s ability to understand “less intelligible” speech

Question 79

This is especially valuable for: evaluating stimulability, assessing the maintenance of newly learned target behaviors in the clinical setting, determining the client’s maximum phrase length for primal speech production. Versatile and can be used with different disorders: articulation, rate, prosody, inflection, and intonation.

Answer 79

Syllable by syllable stimulus phrases

Question 80

Clinical questions to ask in syllable by syllable stimulus phrases?

Answer 80

Can fluency be maintained in increasingly longer phrases?

Question 81

Assessment of SSD

Answer 81

Screening Formal tests Sound error analysis Descriptive features of phonemes Distinctive features of consonants Frequency of occurrence of consonants Developmental norms for phonemes and consonant clusters Phonological processes Stimulability Childhood apraxia of speech

Question 82

Assessment for spoken language in children

Answer 82

Review: Assessment approaches Components of language Normal language development Language disorder categories Screening Assessment of early intervention Assessment of school-age children Language sampling analysis