Study Guide Flashcards
(121 cards)
1
Q
What are the major goals of assessment?
A
- providing a diagnostic level is the LEAST important part
- accurately describing the complex language systems of the individual child is the MOST important part
- to recommend treatment, follow up, or referral
2
Q
What does the SLP need to determine during an assessment?
A
- whether or not a problem exists
- the causal-related factors
- the overal intervention plan (if one is warranted)
- recommendations for caregivers and teachers
3
Q
What are the reasons to assess?
A
.
4
Q
Why is a parent interview important?
A
- it gives you a perspective of the child’s language in the home
- gives you parents goals and concerns
- gives information on possible causal factors for language impairment
- Parent response gives indication of where to start and what to look for
5
Q
What are the types of testing?
A
Standardized (psychometric procedures) and non-standardized testing
6
Q
What are the different types of standardized tests?
A
- criterion-referenced (neutralist philosophy)
- norm referenced (normalist philosophy)
7
Q
What is criterion-referenced testing?
A
- compares the child’s present performance to past performance and/or is descriptive in nature
- performance is summarized meaningfully with raw scores
8
Q
What is Norm-referenced testing?
A
- based on norm or average performance level
- this is often a score that society considers typical of normal functioning
- main purpose is to rank individuals
- performance is summarized using standard scores and percentiles
9
Q
What are different informal approaches to testing?
A
- language sampling
- observation
10
Q
What is the best indicator of the child’s abilities when obtaining an informal language sample?
A
spontaneous speech
11
Q
Is conversational language sampling valuable?
A
-requires probing, but still can be valuable
12
Q
What are the types of language sampling?
A
- spontaneous
- conversational
13
Q
What is the qualifying standard score and percentile in a public agency?
A
- 1.5 standard deviations below the mean
- this is 77.5-which is approximately the 7th percentile
- (100-15-7.5=77.5)
- It must be found on two measures!
14
Q
explain what is involved in descriptive approaches and why it’s important
A
- language sampling
- observation
- gut level is important
- reporting these things highlights the individualistic nature of a child’s communication abilities
- normative testing does measure isolated skills, but it imposes group criteria on the individual student. A complete assessment needs to assess the INDIVIDUAL. Normative testing by itself cannot do this
15
Q
What does descriptive approaches in general allow for?
A
- flexibility
- allows for notation of pragmatic behaviors
- allows us to note different behaviors in different environments
16
Q
What is the gold standard for obtaining a language sample?
A
-observing the client in three different environments
17
Q
What do we observe during a language sample?
A
- use (pragmatics)
- Content (semantics)
- form (syntax and morphology)
18
Q
what are the disadvantages of language sampling?
A
- level of expertise needed by SLP for analysis
- time needed to collect
- reliability and validity of the sample is often subjective (protocols do exist to help with collection for standardized testing)
19
Q
What is the most natural way to assess a child? and how do we do it?
A
- through observation
- we observe caregivers and peers with the child in everyday settings (home and classroom)
20
Q
How do we observe in more clinical settings?
A
- toys and both structured and non-structured conversational activities with the caregiver or others and items from home. As typical as possible.
- SLP can observe from camera or corner
- Take notes. Descriptions should detail as closely as possible what has observed–tape record or video.
- infer and make hypotheses only later (this doesn’t always happen. infer the whole time your watching–it’s probably the most appropriate thing to do)
- refer to developmental language charts
21
Q
what do we observe during informal assessment observation?
A
- form of language
- understanding of semantic intent
- language use
- rate of speech
- sequencing
22
Q
what do we observe when observing form of language?
A
single words, phrases, sentences? negatives, interrogatives, passives? elaborations?
23
Q
what do we observe when observing the understanding of semantic intent?
A
does the child respond appropriately to various question form-the wh’s? does the child confuse words from different semantic classes?
24
Q
What do we observe when observing language use?
A
- look for a range of functions:
- asking for information and help, replying, statements, conversational turns, introduction of topics and maintenance of them through turns, repairs?
25
what do we observe when observing rate of speech?
- too slow?
- too fast?
- pauses between turns or before words or utterances?
- fillers used frequently (um's)?
- word substitutions?
26
What do we observe when observing sequencing?
- can he/she relate events in a sequential fashion based on order of occurrence?
- can he/she discuss recent past events or recount stories-narratives?
27
Should you go formal/standardized or informal/descriptive?
a combined approach is recommended
28
Why should we do a combined approach of assessment?
- no single measure or session is adequate
- multiple assessment of language features and behaviors in a variety of contexts
- allows for alternation of structured and non-structured tasks (attention)
- adapt methods to the child
- the result is the most thorough individualized method of evaluation possible
29
what are the parts of a combined approach?
1. questionnnaire and/or caregiver interview
2. environmental observation
3. SLP directed formal standardized assessment (psychometric)
4. Child-directed informal assessment (conversational sample)
* Components, of course, vary by child and work setting but each step becomes more focused!
(think about the picture of the upside down triangle)
30
What are some other things to assess in terms of pre-literacy skills?
- obtain a reading sample. particularly if dyslexia or LD (LLD) is suspected.
- Choose age-appropriate text. Note fluency. ask comprehension questions. read a story to the student and ask them comprehension questions. Compare results.
- ask about school performance in language arts curriculum. particularly w/ regard to reading fluency scores and reading comprehension scores.
- phonemic awareness
- rapid automatic naming
31
For what population is it particularly important to assess written language? What do we look for in the language sample?
- written language sample-particularly if dyslexia or LD/LLD is suspected
- evaluate for phonological and linguisitic awareness, word boundaries, vocabulary and use, ability to communicate thoughts precisely, sequentially, and systematically. Generation and organization of ideas, morpheme use, syntactic use, semantic awareness, word associations, and handwriting.
32
What does a well-designed, thorough assessment of communication skills and deficits help you with?
the diagnostic process
33
What must we keep in mind about assessing and therapy?
assessment and measurement are ongoing throughout therapy
34
What assessment questions should we remember?
-why a child is being assessed (purpose of assessment)
leads to->
-what behaviors to assess
leads to->
-(how)the best evaluative methods to use
35
What does 100 mean on a bell curve?
exactly average
36
How many points is one standard deviation from the mean? and what does this indicate?
- 15 points
| - one standard deviation below or above the mean is within normal range
37
What does standardized mean?
a consistent manner of presenting testing items
38
What can modifications of a standardized test affect? and what must we do if anything has been modified during a standardized test?
-modifications or deviations of a standardized test can affect normative data and should be reported in your written evaluation report
39
what does normed mean?
given to a group of children that supposedly represent all children for whom the test was designed.
40
Once the score has been determined what can be attached and what is it associated with?
a verbal level can be attached that describes associated levels of severity
41
What does a standardized test assume about the "average" score?
that the "average" score for a sample population is the "normal" score for the larger population
42
how much of the population falls within 1 standard deviation above or below the mean?
2/3
43
What can standard scores be converted into?
age and grade equivalent scores (these aren't very strong, though)
44
What kind of scores do we generally try to stick to because they are more accurate?
-Standard scores and percentiles
45
Check Becky's notes to go over the standard score chart! we need to be able to interpret the scores, their importance, and where it falls, and if the child qualifies for the public agency. We need to explain why!
--
46
What must we avoid diagnosing?
a difference vs. a disorder
47
Describe the a difference vs. a disorder.
.
48
What are some test selection variables?
- is the test appropriate for the child's age/functioning level?
- is the norming population large and varied?
- does the manner of presentation of the test match the optimal conditions for testing for your client?
- are you familiar enough with the test procedures?
- is the test reliable
49
what is high internal consistency?
students who score well overall get the same items correct, those who score low also perform similarly
50
what is interjudge reliability?
the probability that two judges will score the test in the same way
51
What are three measures of validity?
- criterion validity
- content validity
- construct validity
52
other than just assessing the systems of language, what are some other things that are important to assess?
- written language
- play
- pre-literacy skills
- information processing
53
Why should we assess play?
-although particular cognitive skills are not necessarily prerequisites for language development in general, certain behaviors that can be observe in child's play and gestural behavior tend to go along with particular communicative developments
54
Why should we assess information processing?
- children with a variety of disorders have difficulties processing verbal information
- it can answer questions and suggest alternative methods of intervention
55
How do you assess memory?
with both verbal and nonverbal tasks--digit repetition and nonword repetition, etc.
56
How do we assess pragmatics in terms of receptive vocabulary?
receptive vocabulary: point to a picture when given a label or description
57
What can assessing semantics be complicated by?
-word retrieval and word finding difficulties
58
What is facilitative play?
a technique for encouraging maximal talking from a younger child/toddler.
- it helps encourage output from children for use with the collection of ongoing language samples
- it provides low structured modeling of language structures and conversational strategies and it can help outwit some resistant children!
59
What are the two key factors of facilitative play?
1. topic of immediate interest to the child
| 2. power relationships between the child and the adult de-emphasize the adults image as one of power and authority
60
What are three important aspects that are combined to create facilitative play?
- shared reference
- feedback and responsiveness
- appropriate models
61
what is shared reference during facilitative play?
both the child and the adult are attending to the same thing @ the same time. in this way it is clear what the words are referring to.
62
In terms of facilitative play, what does feedback and responsiveness refer to?
the child generates feedback with the utterances and above all the adult is responsive to the child
63
In terms of facilitative play, what does appropriate model refer to?
the adult provides models of language and behavior that are appropriate to the child
64
What are some facilitative play techniques?
- appealing activities
- follow the child's lead
- avoid directing the child
- talk about what the child is doing
- use language of appropriate level for the child
65
what should general intervention definitely be?
- be fun
- be challenging
- involve conversational exchanges between the child and partners
- whenever possible, be FUNCTIONAL
- address language holistically, much as it is used in communication
- be evidence based
66
What does RAVE-O stand for?
retrieval, automaticity, vocabulary, elaboration, and orthography
67
What is RAVE-O?
- This is a multi-component program that targets all systems of language and underscores literacy
- Several components of the program can be adopted into our work as SLPs
68
What population of children benefit from RAVE-O?
-dyslexic & "garden variety" reading problems
69
Why do both dyslexics and children who have "garden variety" reading problems benefit from RAVE-O?
- dyslexics don't need to comprehension or the oral narratives, but they benefit from the other pieces of RAVE-O
- RAVE-O is functional b/c it uses materials from the classroom
70
Draw and label the brain as we did in class
.
71
For intervention to be functional what do we need to promote?
transfer/generalization of skills into real-life situations
72
How can we engage young children?
- encourage more output
| - model the next level
73
To facilitate effective communication, what must we often promote?
- theory of mind development
| - social emotional learning
74
Describe Superflex
- targets elementary, school-aged students
- engaging comic book format w/ a focus on self-awareness, self-monitoring of own behavior, and flexible thinking.
- Review over and over, supplementing w/ real life comparisons and discussions
- whole body listening
- trying to get kids @ the table-( this is done early on, earlier than the school years)
- functional approach to therapy
75
Programs such as Kimochis: TOM & SEL promote what?
- self awareness
- social awareness
- self management
- relationship skills
- responsible decision making
76
Describe Michelle G. Winner's Center for Social thinking, Inc.
- you are a social detective: explaining social thinking to kids
- engaging comic book format w/ a focus on "social smarts"
- review over and over, supplementing with real-life comparisons and discussions
* is your brain part of the group?
* is your body part of the group?
* are behaviors expected or unexpected?
- targeted for elementary, school-aged students!
- functional approach to therapy
77
What is an important element that underlies referential skills?
topic
78
In terms of referential skills, specifically topic, what are some things we can work on with our young clients?
- topic initiation
- topic maintenance
- duration of topic
- conversational repairs
79
what three things contribute jointly to literacy learning (decoding & comprehension)?
-Phonological Awarenes, Morphological Awareness, Orthographic Awareness
80
What can we teach when working on semantic categories and relational words?
- semantic classes
- quantitative and qualitative words
- spatial and temporal terms
- conjunctions
81
what two sources does word finding difficulties result from?
- lack of elaboration or thorough representation in the internal dictionary
- difficulty with retrieval
82
What is extremely vital for us to be working on?
-we must be working to connect language to developing literacy
83
Discuss your 1st grade children's book.
1. someone (character)
2. Somewhere (setting)
3. Wanted
4. first
5. but
6. next
7. but
8. next
9. but
10. next
11. solution
12. feelings
make sure there is some connection between wanted, solution, and feelings!
84
Why are oral narratives so vital?
because much of life is an oral narrative: retell events, retell stories
85
How are oral narratives essential for reading?
to comprehend what is read. also, a good sense of this patterning helps to make inferences and predict outcomes and draw conclusions over time and with exposure
86
How are oral narratives essential for writing?
a good sense of this patterning sets the stage for successful planning, organization, and execution of written product
87
What is the goal for retrieval intervention?
to improve access
88
What is a stroke/cerebrovascular accident?
-the temporary or permanent disturbance of brain function due to vascular disruptions caused by a lack of blood or by bleeding
89
How do symptoms develop following a stroke?
- the onset of communication disorders is almost dramatic.
- symptoms develop rapidly and become maximally expressed within a few minutes to a few hours
- during the first few days, parts of the brain that are not actually damaged or destroyed may also be functionally impaired.
90
What are the types of stroke?
- ischemic (deprived of blood)
| - hemorrhagic (caused by bleeding)
91
What are the two major neurological causes of adult language disorders?
- aphasia: a disorder that affects comprehension and/or production of spoken, written, or gestured verbal materials
- right hemisphere damage and associated pragmatic communicative impairments
92
What aspect of language is often overlooked?
narratives
93
what is the medical term for the death/loss of tissue?
infarct
94
Describe ischemic strokes.
- higher occurrence
- this type of stroke is also called occlusive, caused by a blocked after/blood clot.
- consequent loss of blood supply
- prolonged occlusion (3-5 minutes) causes death of tissue
95
Describe Hemorrhagic strokes:
- caused by bleeding
- lower occurrence.
- cerebral hemorrhage caused by a rupture of a cerebral blood vessel
- the rupture is caused by weakness of vessel wall, traumatic injury to a vessel or (rarely) extreme fluctuation in blood pressure
96
What is the brain remarkably intolerant to?
-sudden changes in oxygen & glucose
97
What is the periSylvian region in the left frontal lobe is called? and what "area" is associated with it?
- anterior language zone
| - Broca's area
98
What is the periSylvian region?
the area surrounding the Sylvian fissure
99
what are the three types of ischemic strokes?
- thrombotic ischemic strokes-materials build up
- embolitic ischemic stroke-sudden blockage by materials moving through them
- transient ischemic attacks (TIAs): <24 hours, temporary!
100
what does permanent damage in the periSylvian region almost always cause?
language impairment
101
Describe the 1-2-3-4 circle
1. The posterior language zone/wernicke's area is important for comprehending and recalling (storage and retrieval of MEANING) linguistic material. During Spontaneous speech, this area searches the lexicon for words needed to express a message and constructs a sentence that complies with PHONOLOGIC, SYNTACTIC, and SEMANTIC rules. It then sends the neurally coded sentence on to Broca's area
2. The anterior language zone/ Broca's area is important for planning and executing language behavior/ movements (speech, writing, gesture--the output) it translates the received code into an action plan and sends it oil to the primary motor cortex.
3. Once it has done this, the primary motor cortex completes the plan transmits these commands and control information downward to the cranial and spinal nerves which set the speech muscles into motion.
4. Wernicke's then monitors what is said to be sure it is correct
102
What is the periSylvian region in the left temporal and parietal lobes called? and what "area" is associated with it?
- posterior language zone
| - Wernicke's Area
103
What can damage to the angular gyrus cause?
-damage to this region usually produces severe impairments in reading (alexia) and severe writing impairments (agraphia)
104
What is aphasia generally defined as?
a language disorder related to injury to the left hemisphere of the brain
105
what are the three most common aphasia syndromes?
- broca's aphasia (damage to broca's area)
- wernicke's aphasia (damage to wernicke's area)
- global aphasia (massive damage throughout the periSylvian region)
106
What are some "aliases" of broca's aphasia?
- expressive aphasia
- motor aphasia
- anterior aphasia
107
What is broca's aphasia usually associated with?
right sided hemiplegia
108
How does somebody with broca's aphasia speak?
- as if their motor plans for speech have gone awry
- words come out slow, laboriously, haltingly. Unusually long pauses between and sometimes within words.
- intonation and stress patterns are diminished: monotonous quality to speech
- misarticulations are prominent
- short utterances, consisting mostly of content words (nouns, verbs, adjectives) function words are missing (conjunctions, articles, prepositions).
- Described as agrammatic or telegraphic
- these patients write as they talk: slow and laboriously
- These patients comprehend spoken and written language better than they speak or write, but they read slowly
109
Describe Global Aphasia
- Massive affects
- severe impairments of all language functions
- even the simplest test of listening comprehension and answering of yes/no questions are difficult
- speech is severely limited and usually consists of few single words, stereotypical utterances ('how-de-doo') or expletives
- Over time can become efficient @ communicating in a limited way with a combination of intoned stereotypical utterances, gestures, and facial expression, but verbal communication remains mostly unfunctional
110
Describe Wernicke's aphasia:
- Aliases: sensory aphasia, receptive aphasia, posterior aphasia
- impaired comprehension of spoken and printed verbal materials, even simple materials
- may get the overall point if mild/moderate, but will miss specifics
- sometimes cannot discriminate between phonologically valid non-words (spome) and real words (spoon)
- Blurring of semantic distinctions among words may exist (good vs. wonderful)
- lost sense of semantic typicality in some patients (carrot is a more typical vegetable than artichoke)
- impaired short term retention and recall of verbal material. Poor short term memory
- often speak smoothly, effortlessly, and copiously (lots of words) long syntactically well-formed sentences with normal intonation and stress patterns, but will pause when having word retrieval difficulties (often)
111
What is the speech often littered with, for a person with wernicke's aphasia?
- verbal paraphasias (substitute one word for another)
- literal paraphasias (substitute or transpose sounds i words)
- neologisms (non-word like carabis)
112
If wernicke's aphasia is severe enough, what may the patient produce?
- patient may simply produce jargon (strings of neologisms with a springkling of connecting words)
- handwriting resembles speech
113
What fraction of adults who sustain right-hemisphere damage develop communication impairments?
-1/2
114
Who may be more susceptible to developing communication impairments when they sustain right-hemisphere damage?
-patients with cortical lesions, a history of familial left handedness
115
What impairments occur when somebody has a right CVA?
- perceptual (recognition) and attentional impairments
- impairments in recognition and expression of emotion, diminished speech prosody, confabulatory speech (content and organization problems)
- impaired comprehension of narratives and conversations
- impairments may be associated with right-sided damage
116
What must we keep in mind about aphasia therapy? Dumb this down! A lot!
- not all aphasic patients should receive treatment for communication impairments
- patients with very mild aphasia are likely to recover all premorbid communication abilities without treatment..
- patients with very severe aphasia following neurologic recovery may not recover functional communication even with treatment.
- speech pathologists may provide support, education, and counseling for these patients and may help them find ways to maximize the effectiveness of the communication abilities the patient is left with.
- for those patients where therapy is indicated, treatment directed towards underlying information processing is usually more efficient and effective than treatment that mimics test tasks which deficient performance is noted
- auditory comprehensive requires a combination of text based (bottom-up) and knowledge based (top down) processes, treatment should include both and infuse knowledge base into therapy
- treatment of impaired speech production often focuses on word-retrieval, usually by means of confrontation naming tasks in which prompts and cues are manipulated to improve word retrieval. Confrontation naming drills alone are not thought to improve word retrieval in social interactions unless generalized through treatment
- using circumlocution to advantage, group treatment, family therapy
117
Go over individual test activity sheet. Celf-4 etc...
...
118
Write out the 1-2-3-4 process, your storyboard, and draw the brain!
..
119
For what population are oral narratives essential for?
Elementary school students
Adolescents
Young adults
Adults
120
When observing phonemic awareness and rapid automatic naming, what are we assessing?
Pre Literacy skills
121
When we are assessing/working on topic initiation, topic maintenance, and duration of topic,what are we assessing?
Pragmatically
