4065 Final Review Assessment Process of collecting and interpreting relevant data for clinical decision making Purposes of assessment 1 Screening 2 Determining a diagnosis or Differential diagnosis type of communication disorder 3 Determine eligibility for services Determine if the client truly has a communication disorder and distinguish the In an educational setting the SLP must show that there is an educational need in order to qualify a child for services 4 Establish a baseline Reference point for measuring progress during treatment 5 Developing intervention targets Stimulability testing can be utilized during an assessment to determine which communication behaviors are elicited with cueing or prompting 6 Tracking and documenting progress Ongoing assessment is crucial to identify if progress is being made towards goals and to determine if the intervention is effective Screening Tool which allows for determination of whether or not further assessment is needed Methods of assessment 1 Norm referenced tests Standardized tools that are utilized to compare and individual s performance to the performance of others with the same age and gender These tests are most useful for identifying if a communication problem is present and to determine if an individual is eligible for services 2 Criterion referenced procedures Procedures allow us to determine if a skill is mastered These do not tell us if an individual s performance differs from the norm Helpful in establishing a baseline developing intervention targets and documenting progress 3 Observational tools Identifying the presence or absence of a behavior How often the behavior occurs What the rate the behavior occurs The length of time the behavior occurs The magnitude of the behavior Situation that the behavior is likely to occur Areas of Assessment 1 Language Form syntax morphology phonology Conent semantics Use pragmatics In four modalities depending on age Speaking Listening Reading Writing 2 Motor Speech 3 Voice 4 Fluency 5 Hearing 6 Collateral Areas Helpful in getting a complete picture of communication status Cognitive status Literacy Social Emotional Behavioral Status Motor Functioning Steps in the Assessment Process 1 Referral for an assessment 2 Data Gathering Gathering case history Conducting an interview 3 Assessment Observation Test administration Informal measures Screen collateral areas Check for stimulability 4 Results Score tests Analyze data Identify strength and needs 5 Recommendations 6 Provide information 7 Complete clinical report Case history Gather case history from medical records case history forms and interviews Helps the clinician understand reason for services presenting complaint client s current communication needs environment factors contributing to the problem resources that the client may or may not be using client family caregiver expectations Case History forms include Biographical Information Description of the problem Medical history Developmental history pediatric Academic history pediatric Social history Previous treatment outcome goals Goals of a client interview 1 Understand the client s perception of the problem 2 Confirm significant information from the case history form 3 Gather information about a client s functional communication needs 4 Define expectations goals 5 Orient client to evaluation procedures 6 Establish rapport Intervention I General principles of intervention Intervention should be individualized to your client Design your intervention so that your client is successful This requires you to give the amount of support needed to ensure success Set therapy goals to promote a client s knowledge one step beyond his her current level Dismiss a client from therapy when all goals are achieved or the client is no longer making progress Intervention is a dynamic process in that the clinician is continuously assessing the client s progress towards goals and modifies them as needed Consider a client s cognitive abilities when selecting therapy objectives The ultimate goal is to teach strategies for facilitating the communication process rather than teaching isolated skills Speech and language abilities should be taught in a communicative context The most optimal situation is for therapy to occur in realistic situations Find opportunities to engage your client in functional communication interactions Five parameters of a treatment program 1 Programming Selection sequencing and generalization of therapy targets 2 Behavior modification Systematic use of stimulus response consequence 3 Key teaching strategies learning Use of training techniques like modeling or shaping to facilitate learning 4 Session design Organization and implementation of therapy sessions 5 Data collection Measurement of client performance and treatment efficacy Approaches to target selection age based norms 1 Normative Approach Developmental Behaviors that are appropriate according to 2 Client Specific Approach Functional Teach behaviors that best serve client s 1 Long Term Goals cover an extended period of therapy intervention amount of time communicative education and social needs Long short term goals depends on the setting 2 Short Term Goals Task analysis toward LTG Lesson plan 1 Specify what should be accomplished during the session 2 Small steps toward STG weekly therapy goals 3 Steps vary according to complexity and context Behavioral objective and components Description of a performance that is stated in terms of behaviors that can be observed and measured 1 Do Statement Specific action the client is expected to perform 2 Condition Situation in which the target behavior is to be performed 3 Criterion How well the target behavior must be performed Three factors which determine therapy sequence Stimulus type Nature of input used to elicit a target response 1 Direct physical manipulation 2 Concrete symbols objects photographs black and white drawings 3 Abstract symbols oral language written language Task Mode Type of clinician support scaffolding provided to obtain desired responses 1 Imitation 2 Cue prompt 3 Spontaneous Response Level Degree of difficulty of target responses Increase length and complexity of response 1 Examples Isolation Syllable Word Carrier Phrase Phrase Sentence Conversation Narrative 2 Decrease latency actual time between stimulus presentation and client response Intervention ii Three Major Methods of Intervention 1 Clinician directed Discrete skills drill drill play meaning using operant