Quiz 2

Issues that create different considerations between family-centered service delivery for adults and family-centered service delivery for children

-role of patient within the family, prior life experience, financial considerations

Contemporary factors affecting SLP service provision in the b-3, public school, and medical settings.

-service delivery historically 1:1 or small group intervention approaches -significant changes to service delivery models reflect evolving government, health care, and educational systems -many issues effect service delivery approaches - like policy -functional communication, assistive technology, evidence-based practice, multicultural issues, transition services, regulations and accreditation

Components of a comprehensive assistive technology assessment

-vary based on client and their needs -1st: comprehensive record review (determines next steps) -direct observation -interview -formal assessment of functioning -technology assessment --> synthesizing and disseminating the data collected to the clients caregivers

Family Systems Theory

4 sources of diversity that pose a challenge for clinicians 1) growing # of families whose ethnic/cultural backgrounds differ from service providers 2) differences in family structures 3) impact of poverty on disability 4) increase in number of families that have parents or adults with disabilities

Cognitive Communication Evals

MMSE-2 RIPA-2 RIPA-G CLQT FAVRES ALFA

How are voice quality, resonance, and prosody typically assessed during communication sampling?

all 3 generally assessed perceptually during a speech sample -voice: consensus auditory-perceptual eval of voice -impact voice has: client report assessments like the VIH -instrumental analysis gives clinician voice data to monitor client's progress (they become acclimated so perceiving small changes becomes more difficult)

In addition to syntax, what other areas need to be examined in com samples of adults with acquired language disorders?

analysis of phonological errors, syntax, morphology, semantics, and pragmatics

What must a clinician do prior to recording to make sure that the recording will be successful?

-noise free environment -client fully visible (especially for nonverbal clients)

what does PICO stand for? how is it used in evidence based decision making?

-patient, patient group, or problem -intervention being considered -comparison treatment -outcome desired -used to form the clinical question

Collecting a patient history

-perform a chart review -conduct patient interview

Parameters that contribute to patient's progression through SLP in school setting?

-preschool and school based require child to be identified as having a language impairment or educational diagnosis t -identification --> assessment --> intervention --> consultation --> counseling --> referral

How may an SLP and AuD use assistive technology in their clinical practice?

-AAC -teach specific skill -create optimal listening environments through the use of ALDs

Compare/contrast low-tech, mid-tech, and high-tech AAC devices.

-all want to provide user with a means of communication -main difference: amount of technology utilized -low tech, no technology -mid tech- fixed displays/voice output switches (communicate through prerecorded messages) -high-tech devices are those with dynamic displays and synthesized speech (computers, tablets)

What sampling contexts are appropriate for preschoolers, school aged children, and adults?

-any natural context is fine as long as its a context in which the client has a need to function

Who might benefit from assistive listening devices?

-anyone with even minimal hearing loss -children in schools with hearing impairments -elderly population

What role does collaboration have in family-centered practice?

-anything that effects 1 family member affects all -family has right to establish their own priorities -family = experts on their family member -clinician must listen to family -utilizing family interviews and observing family-client interactions are important aspects

Memory Strategy Training

-based on explicit memory and self-instructional routines association techniques: -visual-verbal -visual imagery -visual peg method -method of loci organizational techniques: -acronyms -categorization -PQRST -story telling and elaboration

How monolingual SLPs assess and treat bilingual individuals

-establish contacts -hiring bilingual SLP consultants -establish cooperative groups -recruit bilingual speakers -team mono and bilingual SLPs together

How is family centered practice different than traditional practice?

-family is considered a primary partner in selecting approaches and making decisions regarding goals rather than a preselected set of conditions used for every patient

sociolinguistic factors that influence clinician's interaction with client

1) child socialization practices 2) family chacteristics 3) individual differences in clients from culturally and linguistically diverse pops

5 Characteristics of Effective Communication

1) clarity 2) succinctness 3) redundancy 4) respect 5) genuineness

Four alternative methods of assessment in the diagonsis of communication disorders of individuals from culturally and linguistically diverse pops?

1) criterion referenced tests - specify what will be tested, establish criteria, don't compare client's response against a standard 2) portfolio assessment - client's work over time 3) ethnographic assessment - observe client in many contexts with different conversational partners, learn more about their culture 4) dynamic assessment: determine how client learns, what is needed for them to learn, how they generalize a task 3 factors: -client responsiveness -examiner effort -transfer

6 steps to making evidence based clinical decisions

1) develop a 4 part clinical question (PICO) 2) find the internal evidence and answer question based on this evidence. includes: -attention to client/family values -clinician's knowledge of the condition, client, past experience 3) find published evidence 4) critically evaluate the external evidence 5) integrate the internal and external evidence 6) apply and evaluate the outcome

types of evidence

1) external - published research 2) internal/client based - client characteristics, preferences 3) internal/clinician based - clinician's preferences, competencies, values

Issues with mobile technology in population with com disorders?

1) not considered medical equipment --> not covered by medicare 2) not as durable as traditional AAC systems 3) no tech support for 3rd party apps like there is with traditional AAC

Discuss 2 methods of speech intelligibility in children and adults

1)-look at # of consonant errors in relation to # of consonants produced -100 word sample, with x for any unintelligible word. Divides unintelligible words by 100, then multiplies by 100 to get intelligibility %. -overall measure, does not give info about what types of errors cause the decreased intelligibility 2) PCC (percent consonants correct) -phonemic transcription of 100 word speech sample using IPA -for each consonant: gloss or intended phoneme -PCC=# of consonants that agree with their gloss/# of consonants glossed x 100 -can be misleading if the child produces few consonant sounds

Disorders of Langauge

Aphasia - loss of language subsystems, characterized by paraphasia (decreased naming) Dyslexia Agraphia Anomia

Internal Memory Strategies

CRAM AVW categorize repeat association mnemonics attentional visualization write it down WRAP wrap repeat associate picture

Why is communication sampling an important part of assessment?

LSA allows for increased sensitivity in diagnosing disorders -allows for assessment of difficult to test clients -provides guidance for treatment planning -supplements std test results

Multi-, inter-, and trans-disciplinary services

Multi: each invidiual discipline conducts it's own assessment and develops discipline specific goals with minimal integration of these goals across disciplines Inter: each discipline conducts it's own assessment, but always communicates with other disciplines Trans: team members have an ongoing dialogue in which they share info, knowledge, and skills in order to implement a single integrated service planner client. Since assessment completed in unison by the professionals.

basic vs. applied research

adds knowledge about a fundamental process (how toddlers develop language) applied: addresses the impact of intervention approaches (specific intervention improves a specific skill) **helpful in EBP decisions

Motor Speech Evals

RUSH CDS Oral Motor Checklist AIDS ABA-2 SSI-4

What is family centered practice?

Taking the family's goals, dynamics, circumstances, and point of view into consideration during assessment and intervention.

Language Eval Tools

WAB-R BDAE-3 BNT-2 CAT

What specific questions does an assessment of nonverbal communication answer?

What can the client respond to? What are the client's functional comprehension levels like? What types of communicative intentions can the client express? Is a range of intentions available, or is the range limited? How frequently does the client attempt to communicate? -Can client initiate/respond?

How can assessment and intervention be provided in a family centered manner?

birth-3: parents direct contents of IFSP, goals, family needs/resources --> all interventions are designed around this 3-12: family input is required to assess and to target what to assess. family's work with other team members to develop IEP -adults: patient bill of rights ensure family notification and patient/family input or attendance at all case conferences

How is evidence based decision making used to inform decision when choosing technology for a client?

incorporate clinical knowledge, scientific evidence, and client values into decision making process -SETT framework ensure that clinicians utilize their clinical expertise, evaluate scientific evidence, and include their client's values during technology assessment process

language sampling provides

info on client's vocab, syntax, and pragmatics Elicitation: preschoolers: play interactions school-aged: open ended questions adults with ALD: engage in convo about a familiar topic

define evidence based practice

integrating clinical experience, scientific research, and client's priorities in choosing the best intervention

What is the relationship b/w child socialization practices and language development? How might you determine that a child's linguistic performance was due to socialization and not the result of a com disorder?

child socialization practices affect child-directed speech, mother-child interaction, amount of talk, type of talk, pragmatics, appropriate conversational partners, etc. in an assessment - you would utilize a DYNAMIC assessment, obersvation, testing beyond the ceiling, criterion-referenced testing, parent report, and teacher report

Advantages and disadvantages of computer-assisted analysis methods? Of manual methods?

computer +: perform multiple analyses on same transcript computer -: clinician still has to elicit a representative sample and transcribe manual +: may be performed during the evaluation, don't always require transcription manual -: complex analysis still needs to be done using a transcribed sample

Cultural Considerations

customs revolving around: -food -holidays -religious obeservences roles of men, women, children verbal and nonverbal pragmatic behaviors

dysfluency

interruptions in smooth, fluid speech (ex: stuttering)

prosody

intonations in speech

Service delivery features of the SLP. What are the relative strengths and weaknesses? Direct vs. indirect?

direct: work face to face w/ patient indirect: no hands on contact, but consults with family members, teachers, or medical personnel

How is SLP role in 0-3 services different that of a school based clinician?

family is recipient of services - services provided in family's environment rather than in a clinic or school

How has mobile technology effected the way people w/ and w/out disorders interact?

portability and connectivity enable the user to communicate through a range of modalities -can be used as dedicated communication systems

Goals of Speech Sampling

preschoolers: phonetic inventory, articulation errors, intelligibility, and stimulability school-aged: same as preschool as well as prosody and fluency adults: dysarthria, apraxia, voice, resonance

How are utterances segmented in transcription of preschool language samples? School-aged samples? Adult samples?

preschoolers: rising/falling intonations children + adults: t-units

SETT framework

provides clinicians with a way to organize pertinent info as part of the AT decision making process

Situations that might pose challenges to providing family-centered services?

public schools: -family access to classrooms -availability of activities to working families -school accessibility to parents w/out transportation -sometimes patients are not wiling to have the family be highly involved in treatment planning

3 clinical features that must be considered when critically appraising external evidence to assist in a decision about a new SLP intervention approach

research design: identifying which design was used for a particular study b/c each design answers different types of questions and varies according to level of evidence methodological quality: determining whether the researcher took adequate steps to avoid bias and subjectivity consistency and strength of observed effects: examining the statistical significant, effect-size estimates, and consistency of study effects on identified outcomes

dialect

rule-governed variety of a language characterized by social, ethnic, and geographical differences in speakers

What 3 settings do audiologists practice in?

schools, hospitals, private practice

How is communication sampling used in conjunction with formal tests of communication performance (standardized tests)?

std tests give info about nature of the disorder these tests alone will not give any idea of how the communication function is affected by the presence of a disorder communication sampling is necessary to discern this

Difference between cluttering and stuttering? How are each analyzed? Why is this important?

stuttering: high frequency of involuntary interruptions of speech -characterized by a loss of control cluttering: 1) rapid and/or irregular articulatory rate 2) high avg of disfluencies 3) reduced intelligibility due to exaggerated coarticulation both are assessed with a speech sample difference: video recordings used for stuttering due to the secondary behaviors associated whereas analysis of cluttering has more of an emphasis on articulation errors

External Compensations

various techniques designed to enhance memory organization - written planning systems, electronic planners, auditory/visual systems, task specific aids orientation notebook electronic device memory notebook