Diagnostics Midterm

mental retardation (MR)

(Intellectual Disability) condition characterized by intellectual function that is significantly below normal. It usually is caused by a biological medical condition or syndrome.

alternate form reliability

(parallel form reliability) - refers to test's correlation coefficient with a similar test. Determined by administering a test (Test A) to a group then administering a parallel form of test (Test B) to the same group. Two sets of test results are compared to determine the test's alternate form reliability. - Two tests that are similar (measuring the same thing). Comparing Test A to Test B - they should have similar scores.

expository genre

- Descriptive/enumerative​ - Persuasive​ - Compare/contrast​ - Procedural​ - Problem/solution​ - Cause/effect

natural genre

- Make up a story about a picture​ - Tell a personal experience story​ - Retell a previously read story​ - Explain how to perform an activity or accomplish a goal​ - Answer open-ended questions based on previously presented text, either spoken or written​

narrative genre

- Recounts (past events in the presence of others present)​ - Event casts (ongoing events)​ - Accounts (experiences not shared with the listener)​ - Stories (fictional narratives)

normal patterns of second language acquisition

1. Interference or transfer 2. Fossilization 3. Interlanguage 4. Silent period 5. Code-switching 6. Language loss

memorize this slide

1. Use culturally appropriate assessment materials. 2. Test in the client's dominant language and in English. 3. Collect multiple speech-language samples. 4. Use narrative assessment. (books/pictures) 5. Focus on the client's ability to learn rather than on what the client already knows. (looking at areas of standardized tests, teaching them, seeing what cues/prompts you noted that work for the client) 6. Be prepared to modify your assessment approach as you learn more about the client's abilities. (note if they needed frequent breaks, schedule, etc.) 7. Consult with other professionals 8. Consult with an interpreter. 9. Be sensitive when meeting with a client or caregiver in an interview situation.

cognitive/language, language/chronolgical, percentile

3 way to define SLI: 1. There is a discrepancy between the child's nonverbal ______ performance and his or her _______ abilities ​ (1 or 1.25 or 1.5 etc. Standard deviations).​ IQ tests by psychologist will fall under avg range, but language assessment scores will be below average 2. Compare ______ age to ______ age (CA)based on the results of comprehension language tests ​ (at least 12 months lower than CA)​ 3. ______ scores (based on language measure) that show what percentage of same-age children would obtain an equivalent or lower score than the client​ (1.25 or 1.5 SD corresponds to the 10th percentile)

one

68% of all outcomes will fall within ______ standard deviation of the mean (34% on each side)

two

95% of all outcomes will fall within _____ standard deviations of the mean (47.5% on each side)

three

99.7% of all outcomes will within ______ standard deviations of the mean (49.95% on each side)

late bloomers

A child who appears delayed prior to age 3, use more communicative and symbolic gestures, but make sufficient developmental gains linguistically by age 4

language learning disability

A condition characterized by significant difficulties acquired and using skills for listening, speaking, reading, writing, reasoning, or mathematics. It is believed to be caused by central nervous system dysfunction.​ Due to primary diagnosis These are the kids with IEPs - have intervention specialists, occupational therapists, etc

cultural competence

A developmental process that requires a life-long commitment to learning and continuous enhancement of: - Knowledge - Skills - Attitudes

ESL/bilingual speakers

A dynamic assessment is usualy given to ______. Evaluate the client in their native language. You will need an interpreter if their native language is not one that you speak May not be a communication disorder but need ESL services (typical in their native tongue but not in English) - this is why you test ALL languages that the client speaks. Teach the skill THEN retest to see if they understood. You may need an interpreter for the reassessment.

psychometrics

A field of study concerned with the theory and technique of psychological measurement. Refers to the measurement of human traits, abilities and certain processes. It is what we as SLP's do when we evaluate a client's communication. For our purpose that would be measuring the communicative status (receptive/expressive skills)

secondary language impairments

A language deficit that is secondary to other disorders. These children are referred to as having language impairment secondary to a disorder such as: Autism Developmental delay Genetic disorder IQ is two standard deviations below typically developing

standard error of measure (SEM)

A measure of precision of the assessment—the smaller the SEM, the more precise the measurement capacity of the instrument. The standard deviation of measurement errors that would be obtained from numerous repeated administrations of a test to an individual. A measure of central tendency How far away is my client from what most people scored? SLPs usually use 90% confidence level. We are exposed to kids that are exposed to different levels/qualities of education.

reliability coefficient

A measure that tells us an estimate of the proportion of variance in a group of observed scores that reflects true individual differences rather than error. The values for reliability coefficients range from 0 to 1.0. A coefficient of 0 means no reliability and 1.0 means perfect reliability. Cronbach's Alpha

stanine

A method of ranking an individuals test performance. A stanine score is based on a nine-unit scale, where a score of 5 describes the average. When they report the scores in percentile, that score is how much better you did than everyone else (90% means you did better than 90% of people who took the test) Many tests use the stanine form of scoring

standard score

A score that indicates the distance between an individual's score and the means of the sample in standard deviation units.

specific language impairment

A seemingly pure language impairment with no obvious cause or co-occurring condition. ​ These children follow the same general sequence of language acquisition as normally developing children only at an impaired rate.​ Show weakness in both receptive and expressive language.​ Many of these children show differences in their cognitive-linguistic profiles and in their motivation to learn. ​ Often used in the schools.​ Don't have a secondary diagnosis, don't have a learning disabiility, no intervnetion specialist​ SLP is the case manager over these kids

culture

A shared framework of meanings within which a population shapes its way of life. It is what one needs to know or believe to function acceptability in a particular group. It is shaped by the population's history and evolves as individuals constantly rework it and add new ideas and behaviors.

raw score

A test score computed by counting the number of correct responses or by allotting points based on how much each test item is worth and then summing the points.

hearing screening

ALWAYS DO A ________- in addition to all other informal assessments

a good assessment is reliable

Accurately reflect the client's communicative abilities and disabilities. Repeated evaluation of the same client should yield similar findings, provided there has been no change in the client's status

270, 160-180

Adults produce an average of _____ words per minute (WPM) index. Adults produce an average of ______ words per minute during oral reading (Calvert and Silverman, 1983). Speaking rate of a normal adult ranges from 220-410 words per minute during uninterrupted discourse (conversation) (Weiner, 1984)

objective, recognized, prefer

Advantages of norm-referenced tests - Tests are ______/ scores are standardized - Scores can be compared to those of a larger group of similar individuals - Test administration is usually efficient - Many norm-referenced tests are widely _____, allowing for a common ground of discussion when other professionals are involved with the same client. - Insurance companies and school districts ______ known test entities for third-party payment and qualification of services.

age 5-14

All areas of language should be assessed ​ Should include reading, writing, and spelling, along with oral discourse​ Various cognitive-linguistic interactions would also need to be examined to understand the influence of attention, working memory, and executive function on language performance (informal - observation)​

estimates

All test scores are estimates of a student's true score. But we can estimate the range in which we think a student's true score likely falls; in general the smaller the range, the greater the precision of the assessment.

reading passages

Allows the clinician to observe the client's articulation, voice, fluency, and reading ability. Compare oral reading results with those from single-word or short phrase evoked utterances and conversational speech samples. Grandfather passage, rainbow passage, passage from a newspaper (which is usually a 3rd grade reading level. Find a basic passage)

standardized tests

Also called formal tests Theses tests provide standard procedures for the administration and scoring of the test Require that all test takers answer the same items/questions in the same way and it is scored in a standard consistent way, thus making it possible to compare the relative performance of individuals or groups of individuals Give us a common language and allows us to compare people across the country and see where they lie

diadochokinesis

Also known as alternating motion rates(AMRs) or sequential motion rates (SMRs) Used to evaluate a client's ability to make rapidly alternating speech movements.

benefits of informal assessments

Alternative assessment or nontraditional assessment It allows for the evaluation of a client's behavior in real life situations and contexts. It allows the clinician to determine whether a client's functional communicative abilities are adequate to meet the demands of the different communication situations. Assessment materials can be tailored to reflect the client's culture. Assessments are completed over time in different environments rather than in one to two sessions in a clinician's office. Data is maintained in an assessment portfolio to allow for ongoing evaluation. Role playing (e.g. get something from the vending machine. Give them money; have them buy something from cafe ah-roma, etc.) Reassessing in the beginning and middle of the semester for informal assessments (starndardized tests should not be done every 6 months or less)

standardized assessment

Always standardized Type of test used most often by SLPs Tests that compare an individual's performance to that of other people from the same population (normative group) Norm-referenced tests Help answer the question "How does a client compare to the average?" They are most commonly used to evaluate clients for articulation or language disorders Normal distribution is often depicted using the bell shaped curve

rapport

An assessment must take into account _________, using clinical intuition, asking questions, clinical insight, integrating/synthesizing information.

case history, observation, direct testing, language sampling

An integrated approach that combines aspects of both (descriptive and psychometric) approaches is recommended.​ Owens (2004), recommends four sequential stages of assessments​: 1. _____ questionnaire and caregiver interviews​ 2. _____ of the client in a variety of NATURALISTIC settings​ 3. ______, including formal assessments​ 4. Conversational _________

known test entities

Another benefit of standardization: Insurance companies and school districts prefer_____ for third party payment and qualification for services

state of service delivery

Approximately one in three SLPs has some bilingual clients, but more than 80 percent of these professionals do not feel confident in their abilities to serve these clients. It is estimated that only 2 percent of certified members of ASHA are able to provide services in languages other than English (Langdon & Cheng, 2002).

basal

Artificial starting point based on client's age.

ceiling

Artificial stopping point

art of active listening

As health professionals we rarely solve the problem by "fixing" the presenting problem Communication problems are behavioral in nature therefore they have complex etiologies Rarely can we offer the resolution to a problem in a few easy steps or though offering some specific advise The competent clinician strives to show (professional empathy) his/her clients that they have an appreciation for their struggles and to see the disorder from their perspective

age equivalents, strengths/weaknesses

As you go over results, don't give _______ but explain the standard score results. Talk about their _______. Indicate their behaviors during the assessment. Talk about these things to the parents and teachers.

learn the history of the client

Ask relevant questions to a particular culture and/or linguistic background, in addition to the traditional case history form. Be sensitive about how you ask and obtain the information. Ask sensitive questions after you have met with the client/family several times and have established a positive rapport. Use an interpreter if necessary.

norm-referenced tests

Assessments that allow a comparison of an individual's performance to the performance of a larger group, called a normative group. Always standardized. Most commonly used tests by SLPs The way the tests are created is taking people who have no HL/communicative difficulties at a certain age group and the results of the tests taken by these individuals

descriptive

Authentic assessment method with a focus on describing behaviors and comparing past performance to current performance. ​ Advantages​ The clinician is allowed to determine whether the presenting problems are affecting the client's day-to-day communicative interactions.​ Limitations​ Reliability and validity of the finds are dependent upon the level of expertise of the clinician and how representative the language samples obtained are. Changes from child to child. Varies.​ Spontaneous speech-language sampling and observation in naturalistic contexts is emphasized. Language is assessed in all of its richness and complexity. ​ Informal assessment component (interview, language sample, etc.)

disposable gloves stopwatch small flashlight tongue depressor

Basic Things Needed for orofacial exam

instructions, orofacial

Before obtaining DDK provide adequate _____ for the task, to keep accurate time say "go" Always pair DDK with the ______ exam!!

strategies, behaviors, support, patterns, style

Behavioral Observations (Collateral Test-Taking) 1. Test taking _____ 2. _____ that can influence results of formal testing 3. ______ that the child required during the session 4. ______ the child demonstrates (e.g. choosing the last option presented) 5. Learning _____ Take note of inattentiveness, the need to be redirected, the need for frequent breaks or reinforcements. Degree of support needed: extra time to respond, impulsivity, repetitions, and visual cues

objectivity, quantification, communication, economy

Benefits of standardized tests

alternative assessment process

Case History Questionnaires Oral-Peripheral Examination Standardized Assessment Tools (norm-referenced and criterion-referenced tests) Accommodations and Modification to Standard Assessments Speech and Language Sample Audiological Assessment IN THAT ORDER

alternative formal assessment procedure

Check the test to see if the person's ethnic or language background is represented in the normative sample. Make adjustments to fit the client's needs. Explain adjustments in your diagnostic report and the test scores cannot be used in an official capacity.

understood by strangers

Child aged 1;0 = 1/4 or 25% intelligible Child aged 2;0 = 2/4 or 50% intelligible Child aged 3;0 = 3/4 or 75% intelligible Child aged 4;0 = 4/4 or 100% intelligible

when to assess intelligibility

Children at 2 years of age who demonstrate limited verbal output with few varying sound productions

late talkers

Children who demonstrate delays in the early stages of language development, and whose deficits persist past the age of 4 (Rescorla & Schwartz, 1990) ​

clinically significant information

Clinicians should remember that scores are only meaningful when interpreted judiciously in context of other ________ pertaining to the client's personal history and present level of functioning

interference/transfer

Communication behaviors from the first language are transferred to the second language.

use

Communicative intentions Eye contact/physical proximity and body language Topic initiation, maintenance, conclusion Turn taking skills Language use in context is partner dependent and is best assessed via informal, careful observation

content validity

Completeness of test Does the content actually match the objective of this test? Does this look like things that would measure fluency, for example? - Poor - test that measured the knowledge of the last two weeks of class as opposed to the entire class. Does this test measure all aspects of receptive language?

conversational children assess

Conversational speech Narrative ability Ability to understand humor Response to complex commands

open-ended, interests, different, explanation

Conversational starters to elicit language sample: Use ______ stimuli ("Tell me about") Ask specific questions about the client's ______ (hobbies, occupation, sports, family, current event) Children: Introduce ______ activities, objects, or toys. Play matching games Puppets Ask questions about events/tasks that require an ________ (Do you have a pet? Tell me about it., Tell me how to make popcorn, Tell me about you favorite movie.

desirable behaviors

Corrective sound productions, fluent speech - objective charting

cronbach's alpha

Correlation between two tests or a comparison of scores between ½ of two different tests

expected level

Criterion-referenced tests help answer the question, "How does my client's performance compare to an ____ of performance?" Any performance below that is considered deviant. Criterion-referenced tests are used most often when assessing clients for neurogenic communication disorders, fluency and voice disorders.

predefined, don't compare, standardized

Criterion-referenced tests: Identify what a client can and cannot do compared to a ________ criterion. They _________ an individual's performance to anyone else. Criterion Referenced Tests Help to answer the question "How does a client compare to an expected level of performance?". They assume that there is a level of performance that must be met for a behavior to be acceptable, any level below that is considered deviant. Criterion referenced tests may or may not be ______

alternative objects, score twice, culturally relevant

Cultural adjustments of assessments include: Providing additional prompts. Giving more time to respond to answers Giving breaks Testing over multiple days Practice the test items several times before you begin the test Use _______ or pictures that are familiar to the client; ask him the function of familiar items around the testing room Formal assessment: ______; once as the scoring manual directs and then with the nontraditional adjustments made. Oral-Peripheral - are they stimulable for certain sounds? What sounds are they missing? This eval may take a little bit longer than the others Do the assessments in English AND their native language Speech and language sample: can be as simple as showing them a picture (that is _______to the client) and having them talk about it as much as they can

language loss

Decline in a speaker's first language proficiency while a second language is being learned.

making a diagnosis

Delayed onset of language Limited amount of language Deficiencies in syntactic, semantic, and morphological components Deficient cognitive skills Limited language comprehension Poor listening skills Limited conversational skills Limited ability to narrate experiences A general inappropriate use of language

mean

Determines the peak, it represents the average performance.

difference

Difference or disorder? If the child gets a concept as soon as you teach it They will make significant progress over a shorter period of time. I want you to find all the cats - morphological structures - theyll get it right after you teach it to them. It CAN have an impact on their academic performance. That is when you need to address it.

individualization, static, unnatural, biased

Disadvantages of standardized tests: Do not allow for ______ Generally _____ Testing situation is _______ and not representative of real life Evaluate isolated skills without considering other contributing factors In most cases of Culturally & Linguistically Diverse clients, formal assessments are not effective and in certain cases may be detrimental Standardized tests are usually culturally and linguistically ______, favoring the mainstream, white culture

strengths and weaknesses

Discoure examines: Appropriateness and diversity of vocabulary​ Syntactic, morphological and phonological structure​ Text cohesion and referencing​ Overall hierarchical organization or macrostructure and its relationship to individual detail and linguistic structure or microstructure​ Spelling ​ Application of written conventions​ Look for _______ of all of these things

asd

Disorder characterized by impairment in communication and social skills and stereotyped and restricted behavioral patterns.​

disadvantages of norm-referenced tests

Do not allow for individualization Generally static, tell what a person knows not how a person learns Testing situation is unnatural and not representative of real life Evaluates isolated skills without considering other contributing factors Must be considered exactly as instructed for results to be considered valid and reliable Test materials may not be appropriate for certain populations

criterion-referenced tests

Do not attempt to compare an individual's performance to anyone else's (as opposed to norm referenced tests) rather they identify what a client can and cannot do compared to a predefined criterion - Trying to determine if they can/cannot do a certain task/criteria - You are allowed to use a raw score for this type of test May or may not be standardized Determine mastery of a skill or content Address concern in a specific area Performance can be presented in raw scores for meaningful interpretation

interact, wants/needs, school

Do the areas of difficulty determined by the assessment impair the child's ability to: ______ with family and peers? Express________? Do well in ______-?

test-teach-reteach

Dynamic assessment approach follows a test-teach-retest method 1. A test is administered without prompts or cues to determine current performance (to see where they are) 2. Clinician teaches strategies specific to skills being evaluated (clients who are culturally/linguistically different) 3. Clinician observes client's response to instruction and adjusts teaching accordingly (mediated learning experience) 4. Re-administer the test and results from pre- and post-test are compared Pay particular attention to teaching strategies that were effective at improving client's success (i.e. cues, graduated prompting, environment adjustments, conversational teaching) DA helps to determine baseline ability and identify appropriate goals and strategies for intervention

language delay

Early language skills are developing late; however, the term implies that there is potential for the child to "catch up" to their peers. Typically used for children age 4 and younger.​

linguistic rule system, language-related

Essential Components of Language Assessments​: - Comprehension and production of the 5 parameters of language (_______) - Cognitive-Linguistic interactions - ______ skills (reading,​ writing,​ spelling,​ text comprehension and reformulation across subject areas)​ - collateral test-taking behavior - analysis of error patterns - background information

inter-rater reliability

Established if test results are consistent when more than one person administers the test.

intra-rater reliability

Established if test results are consistent when same person administers test.

fluency, myasthenia gravis

Establishing speech rate is necessary as a measure of IMPROVEMENT (________), or DETERIORATION (intelligibility associated with _______).

communication

Exchange of assessment results among professionals

change

Expectations of language performance ______ across time.​ Speakers of any given language are not a homogeneous group. ​ Due to individual variability, there is no "best" approach for the assessment of language with all clients.​

dynamic assessment

Form of authentic assessment Used to evaluate a client's learning potential based on the ability to modify responses after teaching or other assistance has been provided Most appropriate when assessing clients with cognitive communication disorders or those from culturally and linguistically diverse backgrounds

case history, observation, standardized, informal

Four sequential stages of assessment of preschoolers: 1. _______ questionnaire & Caregiver interview 2. _______ of the client 3. Norm-referenced & criterion referenced assessments (_________ tests) 4. ________ assessments (play skills, conversational language sampling , pragmatic language skills, & narratives)

2 sd

Generally, when a score is greater than _____ (either above or below the mean, the score is significantly different (e.g., an Standard Score of 70 or lower). The score can be significant if it is 2 SD below OR 2 SD above the mean

z-score

Has a mean of 0 and a SD of 1. Range from -3 to +3.

informal assessment considerations

Have materials that reflect the client's culture. (e.g. language sample [at least 400 utterances] for hispanic family) Systematic observation (a period of time where you just observe the client and write what you see). Asking the client how they would respond based on certain situations (familiar and unfamiliar) Talk to the family about how the client interacts with family and others in the community

culture embodies

History Societal Roles Family Structure Education Religious Beliefs Standards for Health Appearance and Dress Diet Perception of Time & Space Definition of Work and Play Artistic & Musical Values Life Expectations Aspirations Communication & Language Use

developmental norms

Hodson Assessment of Phonological Patterns, Rossetti Infant-Toddler Language Scale, Voice Assessment Protocol for Children and Adults Criterion referenced tests are based on _________ as opposed to the average person.

reading, conversational speech

How to determine speech rate: - Tape record a sample of connected speech in oral _______, in __________, or both. - In a 60 second interval, count the number of words produced and divide by 60 (or 120 for a two-minute sample, 180 for a three-minute sample, etc.) The best way to check speech rate. Good to do it at the beginning of the assessment, then treat, then re-assess midway (once you have developed the plan of treatment) This tell us if their rate of speech is changing with therapy

25, 50-75, 75-100

How well words can be understood by parents By 18 months ~___% intelligible By 24 months ~______% intelligible By 36 months ~______% intelligible

language disorders

Impairment of comprehension and production in the modalities of oral, written, or sign system, can affect any of the 5 areas of language.

informal assessment

In most cases of CLD clients, formal assessments are not effective and in certain cases may be detrimental. A thorough assessment will include traditional and elements of creative and nontraditional methods. Standardized tests are usually culturally and linguistically biased, favoring the mainstream, white culture. This is why a ______ is necessary for bilingual children

alternatives to therapy

In some cases, the client may not benefit from therapy, but many benefit from other programs: English as a Second Language (ESL) Bilingual Assistance Tutoring Counseling Parent or Family Education Program

analysis of error patterns

Influence of modality of input (auditory, visual, tactile)​ Relationship of error response to correct response​ Self monitoring and self correction Visual supports aid in comprehension, how does the demand to hold in memory and manage more than one piece of information at a time influence response accuracy. Does the child monitor and self correct his own responses, are errors somewhat related to the correct response or are they completely irrelevant.​ Are they self-correcting?​ GOOD ASSESSMENT FOR READING ABILITY - "Expressive one-word" test​ "Receptive one-word" test - looking at ability to put things into categories, etc.​ "Bracken" - how well can they follow directions?​ Test of language develeopment - narrows on younger children​ Cater to the needs of the client. What does the child need?

non-standardized tests

Informal assessment that is used to see where strengths and abilities lie Can be used to highlight difficulties to target during therapy

all, request

Integrate all of the data obtained to determine a diagnosis. Once your assessment is complete, it necessary to determine whether the client is experiencing difficulty in his or her predominant language(s). Legally and ethically, a disorder can be diagnosed only when the client demonstrates difficulties in ____ of his or her languages. In most settings clinicians can not offer services for those who exhibit communicative differences. However, it is acceptable to provide services to those who electively ______ treatment for communicative differences.

natal, medical, developmental, language, social

Interview questions should consist of the following: Pre-, peri, and post _____ questions _______ history ______ history ______ history _____/family history In addition, gather information regarding the child's life style, expectations from family, culture, and the degree of interference in daily living.

assessment portfolio

It allows for the evaluation of a client's behavior in real life situations and contexts. It allows the clinician to determine whether a client's functional communicative abilities are adequate to meet the demands of the different communication situations. Assessment materials can be tailored to reflect the client's culture. Assessments are completed over time in different environments rather than in one to two sessions in a clinician's office. Data is maintained in an __________ to allow for ongoing evaluation. - Represents the beginning before progress. Keep it so you can see progress over time

speech language sample

It can be the basis for determining whether a problem exists, while identifying the client's specific deficiencies and needs. It should be long enough to obtain a true, representative sample of the client's speech and language. Minimum of 50-100 distinct utterances. 200 or more provide a better data set

cognitive, physical, social-emotional development

It is critical that we understand these three aspects during a diagnostic evaluation in order to fully understand the communication behavior Regardless of the referral, CPSED should be kept in mind as you approach every client, these factors influence the course of treatment you prescribe. This can be seen through normative charts, developmental milestones, communication disorder classification systems. As a diagnostician we must uncover the CPSED for ourselves as well as for our clients. This philosophy can be applied during the initial interview.

seeing the whole person

It is important to see the entire person (thoughts, emotions) and not just the behavior in question Competent SLPs must appreciate and consider the client's motivation, personality, and emotional reactivity In addition, familial, historical, and cultural factors need to be considered To maximize therapeutic outcomes the person referred needs to be treated as well as relevant caregiver

recent

It is important to use the most ______ edition of a published test - This is required by insurance and law agencies - People have been in court for this. DON'T USE PHOTOCOPIES OF TEST BOOKLETS - Hang on to protocols. It should only be in the client's file. Do not shred them.

listening

It is paramount because it sets the stage for empowering our clients to help themselves The purpose of the therapeutic process is to help people garner the resources in their lives toward the goals of self-help. Ultimately to take responsibility for their own problem The clinician acts as the knowledgeable sensitive partner who guides, while sometimes taking the lead Provides suggestions Gives direction when in synch with the verbal and nonverbal request of the client

longer processing time

It may appear that a child who is learning two languages is delayed. They are not but they just have a ______ because they are learning two languages at once so it may appear as a delay. The SLP will be able to tell what is a true delay and what is a disorder

disadvantages of authentic assessments

Lack objectivity Procedures are not standardized (may be a little biased because you may cue more) Requires a very high level of clinical experience and skill Not efficient, lots of time is needed to plan (transcribing language samples, thinking of your own questions to ask, etc.) May be impractical in some situations Not always recognized by insurance companies and to qualify for services You must ALWAYS attempt to give a standardized eval. Give a rationale for why an informal assessment was given.

rapport, distractions, preselect, standardized test

Language sample: Strive for a long sample, establish _____, minimize interruptions and _______, wait for the client to speak, ______ materials and topics that are of interest to the client, vary the subject matter, ask questions that elicit lengthier responses. Disfluencies, prosody, voice, code switching, vocabulary level, morphology, syntax, phonology Can take you right to the standardized test you want to give If you can tell the child is nonverbal or you can't get another 100 utterances, you can stop. You can write down any details you observe (e.g. sounds heard, mannerisms, ability to play, etc.)

early indications of a language disorder

Limited phonetic inventory within babble or meaningful speech Limited nonverbal communication in the form of communicative and symbolic gestures after the age of 9 months Delayed onset of first words following 12 to 14 months Delayed onset of two-word combinations after age 18 to 24 months Limited or no eye contact Sudden regression in child's development in cognitive (Piaget's stages of early cognitive development), social, and linguistic skill areas Slow or limited expansion in total number of different words produced following 15 to 18 months Limited comprehension of basic vocabulary and simple directives (receptive)

collateral test-taking behavior

Linguistic and communicative behaviors​ Sustained and controlled attention​ Strategies for managing and coping with challenging tasks​ Effectiveness of management and coping strategies​ Awareness of what he does or doesn't understand, ask for clarification, repeat or rehearse verbal information before responding, do these strategies help or hinder performance. Do they demonstrate sustained and controlled attention, persist at a task even when it is hard, switch from one task to another and maintain goals in active memory​

form

MLU syntactic structures grammatical morphemes complex sentences speech sound production intonation, prosody, inflection

executive function

Maintaining goals​ Inhibiting irrelevant information​ Avoiding distractions​ Problem solving (scenarios, do they recognize that there even is a problem?)​

test taker

Maturation, learner effect, test experiences, memorization, guessing (patterns), short-term learning, forgetting.

test validity

Means that a test truly measures what it claims to measure. A test can be reliable but not valid

reliability

Means that the results can be repeated.

standard deviation

Measure of the average distance of scores from the mean of the scores in the distribution.

mean, median, mode

Measures of Central Tendency _____- average of scores ______ - Middle score _____ - Number obtained the most

face validity

Measures what it claims to measure A purely subjective determination of validity by the examiner. Does this test seem to be measuring what it claims to measure?

cognitive-linguistic interactions

Meta-linguistic knowledge​ Working memory​ Executive functions

undesirable behaviors

Misarticulations, throat clearing- objective charting

temporary

Mood/motivation, health, family issues, light, noise, comfort level, environment.

minimally verball children assess

Naming familiar objects Use of pre-syntactic devices Counting or reciting days of the week Use of simple phrases Use of simple grammatical morphemes (e.g. -ing, -s) Mean length of utterance Comprehension of words and simple phrases Use of simple pragmatics

sample informal tasks

Natural Genres ​ Narrative genre (verbalization) Expository genre

benefits of authentic assessments

Natural and similar to the real world Client participates in self-evaluation and self monitoring Allow for individualization: CLD clients and those who use alternative augmentative communication (AAC) systems Flexible You can send the client home with checklists of what they are supposed to do.

average

Norm referenced tests help answer the question, "How does my client compare to the ______? " It is the responsibility of the test developers to determine normative standards that will identify what average is for a given test.

criterion

Number correct response in a row to establish a basal. All items prior to basal are considered correct.

quantification

Numerical results provided by standardized measured, numerical results summarize performance and ease comparison of results ; not antidotal notes or observation

direct observation

Observe the child's behaviors and skills and the quality of the communicative model provided by the parent/caregiver Take note of the parents/caregiver's communication, is it typical or not? In some instances, it may become apparent that a child is not developing within normal expectations because the parent model is deficient Video record the communication sample, if possible

socioeconomic status

On the other hand, switching between two languages may possibly confer developmental advantages in some bilingual children. (Bialystok, Craik, & Luk, 2008a). Any assessment of children with culturally linguistically diverse (CLD) backgrounds must recognize the relationship between the risk for language impairment and __________(SES). Assessment and intervention with English Language Learners (ELLs) should be conducted in the native language as mandated by federal law (PL 94-142 and Pl 95-561).

calculating the standard score

One method of standardizing each score with reference to each of the scores. Tells how many standard deviations the raw score is away from the mean. (T-score and z-score)

language

One of the most challenging disorder to evaluate.​ Varied and complex​ Development is influenced by other aspects of development such as cognition, motor development and social development.​ Components of _____ (pragmatics, semantic, syntactic, morphologic, and phonologic) do not occur in isolation​

meta-linguistic knowledge

Phonemic awareness​ Definitions​ Synonyms​ Antonyms​ Analogies​ Grammatical judgments​ Literal meanings​ Figurative meanings​

nonverbal children assess

Play behaviors Use of gestures, signs, and symbols (pointing ,directing) Use of non-speech vocalizations Use of meaningful vocalizations Nonverbal responses to verbal stimuli Appropriate use of objects Imitation of words Possible spontaneous production of words Communicative intent

background information

Pregnancy, birth, health, developmental histories​ Language learning history​ Social communicative interactions​ Educational achievements and challenges​

II, V, pre-linguistic, sentences

Preschoolers: Children between 2 and 5 years Language levels between Brown's ____ and _____ stages Have _______ skills including early social knowledge, gestures, and cognitive processes Have begun combining words into ______ Have not acquired all the basic language structures of the language Have not acquired all the basic sounds of the language

charting

Provides a method of scoring a client's responses and objectively identifying the client's communicative abilities and deficits. Desirable and Undesirable behaviors Information provides an assessment BASELINE for diagnostic decisions and demonstrates progress in therapy. Prepare your charts ahead of time

structural, functional

Purpose of an oral facial exam is to identify or rule out ______ or _______ factors that relate to a communicative disorder or dysphagia.

diagnosis, strengths, prognosis, intervention, referral

Purposes of Assessment: ______ the speech, language, cognitive-communication, or swallowing disorder Identify the communication _____/needs Develop a prognostic statement (_______) Recommendations for _______ and support ________ for other assessments and services

bias does not affect

Reasons for standardization: - Test-giver ___ and other extraneous influences ______ the client's performance (if they do that is when informal assessments come into play) - Results of different people are comparable Procedures for administration and scoring of a test are identical for each individual tested

test-retest reliability

Refers to a test's stability over time. If i give this test the same test over and over will I get the same results? DOESN'T MEAN IT IS VALID - if my scale says 99 lbs no matter what it is reliable but not valid.

rater reliability

Refers to degree to which the same person or different people obtain the same or similar test results. - intra-rater reliability - inter-rater reliability

attitudes

Refers to focusing on the kind of professionals we wish to be and the values we wish to embrace as we strive for cultural competence. How does one maintain a healthy attitude towards those of different cultures?

knowledge

Refers to information that we need to know to become culturally competent. What are some ways to interact with culturally and linguistically diverse populations?

skills

Refers to what we should be able to do with our knowledge and how we should apply it in our practice of the profession. How does one apply their knowledge about other cultures to the therapy setting?

assessment considerations

Remember there is no one answer Be careful not to mislead clients Success in treatment always depends on many factors Try not to offer canned advise, be sure to review all the factors involved with the client Allow your opinion to be based on information gathered in the interview, performing procedures, and administering tests By offering your honest opinion you set the stage for the respect and trust that will help shape all future therapeutic interactions.

age and grade equivalent

Represent the mean raw score achieved by a standardization sample for a particular age group or grade level. More deceptive, less common in speech-language pathology tools. Not as accurate. Hurtful when you have to report these scores to parents. Theres a lot of variance in age and grades.

multiword combos assess

Response to simple commands Use of syntactic structures Use of various semantic relations Use of more advanced grammatical morphemes Phonological processes Use of more advanced pragmatics Comprehension of conversational speech

85-115

SLP average standard scores

economy

Save clinicians time and resources that would be needed to subjectively evaluate individuals

administrator/examiner

Script/administration of test, knowledge of test, style of examiner, environment, experience, dialect.

fossilization

Second language errors become ingrained even after the speaker has achieved a high level of second language proficiency.

history, frequency, proficiency, environment

Selecting the language of intervention is dependent on unique factors for each individual: 1. Including language _____ and relative experience with each language 2. ______ of use for each language 3. ______ in each language, including how well the individual understands and produces each language 4. _______, including where and with whom the child uses each language Family considerations and goals (Goldstein & Fabiano, 2007).

a good assessment uses a variety of modalities

Should include a combination of interview and case history information, formal and informal testing, and client observation

a good assessment is thorough

Should incorporate as much relevant information as possible so that an accurate diagnosis and appropriate recommendation can be made.

strengths of standardized tests

Standardized tests have been historically promoted as "objective" in the sense that the examiner's biases would not influence the results. Some school districts may have a policy of qualifying children for services based only on the results of standardized tests, although the federal special education laws do not require that the decisions be based on the results of standardized tests. The concept that deviation from a statistical norm suggests a disorder in need of remediation is entrenched in the U.S. educational and clinical establishment. Easy to grasp the concept of a standardized test than such alternative views as skill deficiency or mastery levels that do not match the social and academic demands the child faces. A variety of speech and language skills may be sampled in a relatively short duration, regardless of the problem that each behavior is only sampled superficially. Test constructors now follow widely accepted ethical guidelines in standardizing tests. Authors of tests have been making and continue to make systematic efforts to eliminate biased stimuli, culturally loaded instructions, stereotypic characterization of diverse people, and so forth. Test developers are making significant efforts to sample diverse populations.

deafness

State of having minimal to no hearing. Causes may be biological or environmental. The impact of deafness on language is profound.

working memory

Storage and manipulation of information needed to carry out a task​ Attention switching​ Monitoring behaviors Remembering sentences to repeat

test design

Subjective items, clarity of directions, trials, stimulus: interest level, repetitions, complexity, number of test items, scoring, environment, is cheating possible?

language differences

Such as dialects or the influence of a first language on a second are not disorders. These are valid rule-governed linguistic systems in and of themselves

types of alternative assessments

Systematic observations Real-life simulations Language sampling Structured, symbolic play Short answer and extended answer responses Self-monitoring and self-assessment Use of anecdotal notes and checklists Videotaping Audiotaping Involvement of caregivers and other professionals

percentile rank

Tells the percentage of people scoring at or below a given score. Mean represents the 50th percentile. Scores above 50% are above average, scores below 50% are below average.

benefits of norm-referenced tests

Test are objective Skills of an individual can be compared to those of a large group of similar individuals Administration is usually efficient Tests are widely recognized Do not require a high level of clinical experience and skill to administer and score They are preferred by insurance companies and school districts for third-party payment and qualification for services

normative sample

Test developers administer the test to a representative sample to establish a range of normative scores by which others scores are judged when they take the same test. The individuals tested are collectively referred to as the standardization, or ________ and should represent the people for whom the test is intended.

objectivity

Test findings are verified by other testers rather than based on one tester's perception or guesswork

construct validity

Test's ability to measure predetermined theoretical construct. Your theoretical knowledge about the disorder that is being examined. Deaf child will not have the same language skills as a hearing child

disadvantages of criterion-referenced tests

Testing situation may be unnatural, not representative of real life Evaluates isolated skills without considering other contributing factors Standardized criterion referenced tests do not allow for individualization Must be administered exactly as instructed for results to be valid and reliable

predictive validity

Tests ability to predict performance to another situation or over time. (ex: GRE scores predict future academic performance.

prognosis

The ______ depends on: Client motivation Degree of impairment Preliminary results of procedures Human and material resources available Support system Individual experience/knowledge of the clinician Explore handout

slp as a health professional

The ability to make accurate referrals to other health care professionals is an essential part of our profession Even if speech-language treatment is solely recommend, in this era of specialty, it is important to know when to refer The SLP creates a diagnostic modesty that recognizes that disorders of communication might need to be treated by multiple health professionals of varying training or disciplines Professionals who deal primarily with factors of CPSED may play an equal or primary role in the treatment process

criterion validity

The degree to which a newly developed measure of a particular ability is correlated with an independent measure of the same ability. How do the 3rd graders compare on a reading test to all other 3rd graders in the state?

normal distribution curve

The distribution of a set of data that clusters around the mean, resembling a bell-shaped curve.

communicative status

The end goal of assessment is to draw a conclusion about an individual's ________ Several methods and approaches are appropriate valid and reliable assessment data collection

limitations of standardized tests

The highly structured and standardized formality of most standardized tests do not allow for a sampling of natural social interactions inherent to communication Most standardized tests sample behaviors may not represent the client's functional communication skills in social situations. Most standardized tests provide limited opportunity for the child to initiate interaction. Test items evoke responses, but do not allow for much spontaneous communication. - If you are testing functional skills, you should do an informal assessment in combination with the standardized test and report that this is the SLP's objective findings and indicate why an informal assessment was needed. - You can also use a standardized test and alter it to fit the needs of the client, as long as you report how you modified it. Many tests artificially isolate individual aspects of communication (e.g., expressive syntactic skills or receptive vocabulary). Test items do not help assess language skills that are integrative of different structural aspects Speech and language tests generally are less efficient in assessing more global conversational skills and abstract language production than they are in assessing the production of discrete words and grammatical morphemes. Most standardized tests sample verbal language and overlook preverbal or nonverbal communication. The standardized formats and protocols allow for little individual variation in communication across children. Most standardized tests limit the role of family members in the assessment process and intervention planning. Few standardized tests of early language skills have good predictability of language Standardized tests are designed only to determine whether or not a problem exists compared with a sample of the general population. Therefore, they may not identify a child's overall strengths and weaknesses.

diagnosis

The outcome of an assessment is the _______. What you learned from the assessment.

assessment

The process of collecting valid and reliable information, integrating it, and interpreting it to make a judgement or decision about something. The process of determining whether a communication problem exists and the nature of the problem.

less input

There is a strong link between language experience and language development in young children. When comparing monolingual children to bilingual children, bilinguals receive _______ in each language being learned.

speech rate

This can directly affect articulation, intelligibility, voice production, and fluency. It allows the clinician to evaluate its effect on the client's communicative abilities. Necessary as a measure of IMPROVEMENT (fluency), or DETERIORATION (intelligibility associated with myasthenia gravis). Checking for stimulability (are you able to teach this client? What cues work?) Visual supports, verbal directions, etc. Informal assessment is a great time to do teaching, prompting and stimulability!!

learn normal communication patterns in client's dominant language

This is crucial in order to determine whether a client is demonstrating a communicative disorder or a communicative difference. There are many languages where there is no published data that help identify normal verses delayed or disordered communication. The SLP must then investigate the language by interviewing others such as other professionals, interpreters, teachers, and community members.

content, construct, criterion

Three kinds of validity to ensure that test results are valid

content

Topics discussed (here/now; past, present, future events) Appropriateness of language to context vs tangential or echolalic language Perseverative language (continue to stay on one topic) Semantic relations Vocabulary Narrative skills

psychometric

Traditional language assessment approach with an emphasis on ranking individuals according to norms.​ Advantages​: - A broad content area is usually assessed with a high degree of objectivity, reliability, and validity.​ - Helps determine whether a problem exists and help identify specific problem areas​ Limitations​ - Do not adequately assess the complex, multidimensional aspects of language ​ - Profiles of the clients do not match the profiles of the sample group on which the norms are based​ Performance is summarized by using percentile ranks and standard scores. The use of standardized, norm-referenced tests is emphasized. ​ Doesn't allow for dialectal differences - informal assessments

a good assessment is valid

Truly evaluate the intended skills

psychometric, descriptive

Two Approaches for Assessing Language

reliability and validity

Two of the most critical gauges of a test's quality YOU CAN'T HAVE ONE OR THE OTHER- YOU NEED TO HAVE BOTH

concurrent and predictive

Two types of criterion validity:

number of syllable repetitions, how many seconds

Two ways to obtain measurements: 1. Counting the _______ a client produces within a predetermined number of seconds.- what the stopwatch is for 2. Timing ________-it takes the client to repeat a predetermined number of syllables.

Conversational ​ Question & Answer​ Narrative​ Expository

Types of discourse

at least 2

Typically childhood language impairment is diagnosed if the child shows difficulties in ______components of language.​ Phonology​ Morphology​ Syntax​ Semantics​ Pragmatics​

believe, value

Understanding cultural diversity requires a thorough look at what you have come to _____ about the world and what you have come to _____

t-score

Used to avoid using negative numbers and decimal point in standard scores. Have a mean of 50 and a SD of 10.

confidence levels

Used to construct confidence intervals depending on the desired level of certainty in the precision of the test. (68%, 90%, 95)

confidence interval

Used to estimate the likelihood that the person's true score falls within a range of the observed score.

retell

Using a narrative to elicit a language sample: A narrative (story) production requires the client to use certain rules of cognitive organization and language sequencing to relay events that have a beginning, middle, and end. Have the client _____ a story.

context, natural

Using pictures to elicit a language sample: The use of pictures often provide a known _______, which may be helpful when assessing clients with significantly impaired intelligibility. Use pictures that illustrate a variety of activities. Use pictures to transition to more _______ dialogue, when possible ("Has that ever happened to you?"). Use your judgment to decide what pictures to use Ranger rick magazines, TIME magazines, etc. What's happening here? Talk about what you see.

benefits of criterion-referenced tests

Usually objective Administration is usually efficient Tests are widely recognized Insurance companies and school districts prefer known test entities for third party payment and qualification for services Opportunity for individualization if unstandardized

anatomic, function, experience, relationship

Valid interpretation of findings from an oral-motor examination requires ; Understanding of ______, physiologic, and neurologic bases of the oral-facial structures _______ of the structures ______ in performing the examination - WATCH VIDEOS Assessing the _______ between oral-facial integrity and communicative function Beginning clinicians will need to relay on class notes, anatomy, physiology, and neurology textbooks, and chapters on oral examinations in diagnostic textbooks.

concurrent validity

Validity in comparison to a widely accepted standard.

syllable by syllable stimulus phrases

Verbal phrases can be used for a variety of sampling tasks. They are especially valuable for: - evaluating stimulability - assessing maintenance of newly learned target behaviors in the clinical setting - determining the client's maximum phrase length for optimal speech production Articulation, rate, prosody, inflection, and intonation can all be sampled across a variety of disorders using phrase lists. Using syllables and stimulus phrases Have then imitate these phrases (clinician models, client repeats it)

tenses, decontextualized, MLU, sequence

What other things can a language sample (using a narrative) tell us? - Use of past/present/future _____ - How much ______ information do they have? Can be a made up story or something that they actually have done in their past - Retelling stories can tell use the client's ability to: ______ - Morphology usage - Adverbs, nouns, verbs, etc. - Ability to _____ (first, next, last)

silent period

When a second language learner is actively listening and learning but speaking little.

interlanguage

When a speaker develops a personal linguistic system while attempting to produce the target language.

code switching

When a speaker unknowingly alternates between two language.

primary language impairment

Where language deficits represent the primary concern, there may also be underlying weaknesses in working memory, executive functions, attentional processes, and motor coordination. Previously called specific language impairment. Not necessarily delayed in academics, or in special education classrooms.

delay/impairment, diagnosis, intervention

Why do assess preschoolers? To identify whether or not a ______ is present To accurately _______ the problem To determine an _______ approach based on results

match

You must consider test scores within the context of what the child is actually doing with communication. Do the scores and what you see the child doing ______? If they don't, why not? You must determine if the data collected supports one another. If they are discrepant, you must ask yourself "Why?" You will need to try to figure out why and talk about it in the report. - ASD, culturally and linguistically diverse children

measurement error

You should always practice scoring. Take time to get to know the instrument. You're not supposed to reinforce at all. Take into account temporary factors because it may indiciate that they need to be retested another time when these factors are not a problem.

norm, criterion

______ referenced: takes a child's score and weighs it against the performance of other age-matched peers _____ referenced: enables the clinician to explore a specific area of a child's development in depth

calculating intelligibility

________ is necessary when: - Considering the need for treatment - Identifying factors that contribute to poor intelligibility - Selecting treatment goals - Recording baseline information - Monitoring the effects of treatment over time Audio taping or video the sample is helpful for analysis and future comparison. Obtain samples from several environments. Also remember there are things that can negatively effect the sample. Number of sound errors, type of errors, inconsistency of errors, rate of speech, etc.

narratives

between the ages of 2 and 3, children begin to tell short narratives that are linked to a central event Provide information on a child's ability to organize information, his or her attention to relevant details, and morphological and syntactic abilities

play skills

highly correlated with language ability and provide information on how children interpret the world Children's play progresses through stages (Westby's Play Scale)

pragmatic language skills

joint attention, eye contact, attention seeking, protesting, greetings, informing, turn-taking

language sampling

used to assess form, content, and use Samples should be transcribed and analyzed using developmental norms (Brown's Stages of Development)

smaller, greater

we can estimate the range in which we think a student's true score likely falls; in general the _____ the range, the _______ the precision of the assessment.