Assessment Protocols

AAC assessment

Assessment of Specific Capabilities Overall approaches to assessment participation & communicative competence -circles of communication participation needs/assessment -money -social networks -access barriers -attitude assessment -partner skills -capabilities profile -motor (capability for direct selection, switch activation, manual sign) cog (communication matrix, CSBS--- ability to use AAC tool: aware, world knowledge, symbols, metacog ) -linguistic (est. yes/no first) -symbolic -literacy (spelling,first letter of word) -sensory perceptual assessment predictive assessment and feature matching =Comparison between what client wants and their skills how does client... request reject socialize play

non-prelinguistic communicators

(Maata et al., 2012) The developmental trajectories of pre-linguistic communication and early language development that predict later language struggles include: joint attention gestures, early vocalizations, symbolic play, language comprehension, vocabulary size, intentionality, and background of language-related problems in child's family, SES Protocol: OSMSE-3 Hearing test Informally observe vocalizations and gestures- (Paul & Norbury, 2012) Rosetting Infant-Toddler Language Scale (Rossetti, 1990) Ages 0-3 collecting sample of behavior to assess and track development over time. Can use 3 different times 6 domains: interaction/attachment (relationship with parent pragmatics (how child uses language to communicate with others) gestures (to express thoughts or intents) play (changes that reflect representational thought) Language expression (both preverbal/verbal) Language comprehension Child is considered to have a behavior if it is observed, elicited, or reported base goals off of developmental milestones Preschool Language Scales-5th (PLS-5; Zimmerman, Steiner, & Pond, 2011) ages 0-7.11 Considered a tool to use with linguistically and culturally diverse populations (ASHA, 2007) Assesses PLAY SKILLS, PERSPECTIVE TAKING, and EMERGENT LITERACY Scoring rules for 5 dialect patterns: AAE, Appalachian English, southern English, Spanish and Chinese influences Has guidelines for kids with severe developmental delays, physical impairments, hearing impairments, ASL users, visual impairments, and ASD

Woodcock Reading Mastery Test by Woodcock, 2011

4;6-79;11 (K-12) Evaluates struggling readers and identifies specific strengths and weaknesses in reading skills to plan targeted remediation -Screens for reading readiness and determines reading strategies for students with special needs 9 subtests (Phonological Awareness, Listening Comprehension, Letter Identification, Word Identification-real words, Rapid Automatic Naming, Oral Reading Fluency, Word Attack-nonwords, Word Comprehension, Passage Comprehension) Cluster Scores (Total Reading, Readiness, Basic Skills, Reading Comprehension) Materials: stimulus book, CD, stimulus cards for rapid automatic naming, 2 record books (same but different) -Organized hierarchically -Error Analysis on some subtests To assess a child's overall reading readiness or ability and where the breakdown is happening. Good because can be administered to a large age range and assesses basic skills up to complex reading abilities Hierarchically organized, breakdown in various areas (comprehension or decoding)

Reading disability

-test BOTH listening comp and decoding, in order to target deficit

autism spectrum disorder protocol

ADD protocol (CDC Screening Information, 2017) Two steps to make diagnosis:developmental screening and comprehensive diagnostic evaluation. Comprehensive diagnostic evaluation:may include hearing, vision, genetic, neurological testing. Can do this evaluation: developmental pediatricians, child neurologist, child psychologists or psychiatrists, well-child doctor visits that include screening for ASD at 24 months. If a relative has ASD, this puts child at high-risk and should be monitored SLP assessment for pragmatics and language impairment:

WAB-R subtest breakdown

Aphasia Quotient - severity Spontaneous Speech Fluency, Grammar, Paraphasia Information Content Auditory Verbal Comprehension Y/N Auditory Word Recognition Sequential Commands Repetition Repetition Naming and Word Finding Object Naming Word Fluency Sentence Completion Responsive Speech Aphasia Classification Criteria Fluency, Grammar, Paraphasia subtest (do not include Information Content subtest) Auditory Verbal Comprehension Repetition Naming and Word Finding Spontaneous speech Conversational questions: How are you today: 'wood' Have you been here: says 'yes' shakes head 'no' Phonemic paraphasias when given last name Full address- can't say (jargon)- motions to ask for pencil- off the record, wrote jargon but with process approach, found she could pick address from array of three addresses Occupation? Gestures driving/ neologisms /press of speech "fuss for 12 caddy hours eat tirew yeller" Why are you here- shakes head, points to head, press of speech "The thing is the terrible shed afterwards then falk...taak...yellow..."(conduite d'approche) Picture description- what's happening in the pic? Try to talk in sentences. "That gloyer is phlaying but the pantic piknak picnic yum and afterwards, oh you know, ply tye sky... um... afterwards them want peat... um.. Eat.. oh, you know. The bool is on the wake. He run it with the pail, you know" -appropriate use of syntax, prosody, no content words (verbs nouns)- sometimes information words- but can be phonemic paraphasias, or random words *place picture towards left visual field* scoring content: used conduit d'approach to say sky, picnic, eat. Incomprehensible due to phonemic paraphasias and jargon. 1/10 Scoring fluency: normal syntax, significant word finding, phonemic jargon 7/10 40% overall on spontaneous speech 70% on fluency subtest Auditory verbal comprehension yes/no questions Is your name smith?- shakes head no Is you name brown? Yes- shakes head no Is you name patricia? 'Yes' and shakes head yes Are you a woman? 'Yes' and shakes head yes Results: 42/60 does better with simple biographical questions than abstract questions lacking personal significance/context like "will paper burn in fire?" "Do you cut the grass with an ax?" Established reliable Y/N with head shake - Verbal response unreliable!!! Auditory word recognition "Show me..." -real objects -objects in pile in intact visual field -contextual, has visual cues, is able to point (cup matches, pencil, flower..etc) -pictured objects, shapes, letters, numbers, colors, furniture, body parts, fingers, -weakness with numbers, colors -confuses ring/index finger, gets the rest -point to obj in room- ok with "chair, desk" -trouble with picking out right/left body parts, proprioceptive issues (maybe not aware of self in space due to pontine stroke)- can point to objects around her, harder time with body parts. Can see fingers, so that's good. -Right-left on body (side and body part must be correct to get points) Sequential commands Raise your hand- does it Shut your eyes- does it (automatic) Point to the chair- does it Point to the window then to the chair- does it Point to the pen and the book - Put the pen on top of the book then give it to me- cannot do this -notice as apart of process approach, issues due more to proprioception than comprehension which brought her down into wernicke's area (mainly had trouble with pointing to self than at objects around her) Repetition: 50/100 Slp says "can you say..." and pt repeats word Client has progressively more trouble with repetition as it becomes more complex -scored on Bed-good Nose- good Pipe-good Window Banana "nana" Snowball "slowball" Forty-five Ninety-five percent "ninney fibe perlent" the pastry cook was satisfied Pack my box with five dozen jugs of liquid detergent Overall score 60/100 Naming and word finding Object naming - physical objects 20 seconds to name each item Can give pts if phonemic paraphasia Can give pts with cue ( tactile-pt holds object, semantic, phonemic) Book Ball Knife Cup Safety pin Pencil Paper clip Comb Tape Fork Matches Word fluency "name as many animals as you can in one minute" -press of speech, random words/empty speech, circumlocution, paraphasias Sentence completion "The grass is" Responsive speech "what do you write with?" Score: 5/10. Press of speech, phonemic paraphasias, required tactile cues Aphasia Quotient: Severity rating of severe (score of fifty) Aphasia classification criteria: Scored as wernicke's but would have scored as conduction if not for proprioceptive difficulties

ABA-2

Apraxia battery for adults- Second edition (ABA-2; Dabul, 2000) Only standardized apraxia test for adults Good points: Quick (can give in one session), flexible, if there is impairment or not/ and mild, moderate or severe -assess acquired apraxia of speech -mild moderate or severe apraxia (or no evidence) -determine therapeutic approaches for tx of apraxia: see where they are breaking down, where to start -criterion referenced, no percentile rank -pick and choose subtests to get raw score/severity per subtest -need stopwatch (two subtests are timed) -will need to discern between aphasia and co occurring apraxia Description of ABA-2: 6 subtests Diadochokinetic rate (DDk is on this test too- can skip on oral mech and then do on ABA, since you get severity rating here (don't need to do twice) Increasing word length: Laura likes this one. Looks at monosyllabic, bisyllabic, trisyllabic (jab, jabber, jabbering). This tells you where the breakdown is where you start treatment. (forward chaining, backward chaining). Increasing word length part b is more complex: would not give to someone who is very impaired. Limb apraxia and oral apraxia: salute, hitchhike, whistle, kiss a baby, etc (can use a demo if needed) Latency time and utterance time for polysyllabic words: Joanne//laura do not like this test. From picture, name of the thing you see, need to say as soon as they see. Have to time it from the second you show picture... then time from when they attempt to say it to when they actually say it, but only have 10 sec total. hard to know if they couldn't name object b/c of co-occurrent aphasia. Subtest 5: Repeated trials: tracking how client name a picture each time (three trials of word like 'telephone). Across three trials, are they 1. Getting closer to target (might respond better to drill situations like MLG approach) 2. Getting farther from target (deteriorating)... for tx, repetition will not benefit as a tx approach. Inventory of articulation characteristics of apraxia: show an action picture (circus), have client read "my grandfather passage" aloud. Challenging passage for people with apraxia, count to 30 and back down; record all of this (audio)... go back and do analysis of speech later. Test administration: Can be administered in approximately 20 minutes (but may take longer) Entire battery should be completed in one session but have option of administering individual subtests Need a watch/stopwatch—two tests are timed Specific directions are provided for each subtest in test booklet Specific scoring instructions are provided for each subtest in booklet No basal or ceiling—need to administer entire subtest/test (may need to discontinue and note that) Obtain raw score and then can compare to normals and/or other persons with apraxia but is considered a criterion-referenced test

dementia

Arizona Battery for Communication Disorders of Dementia (ABCD; Bayles & Tomoeda, 1993) -Only assessing language, memory, and some visuoperceptual skills -would not administer alone: would also administer ALFA or CADL-2 -Idenitify and quanitify linguistic communication deficits associated with Alzheimer's Dementia. can also administer to lewy body- maybe not first choice for someone with PPA- would want to do Aphasia testing first. -use to understand client's ability to complete everyday tasks -"everyday tasks" include: reading comprehension confrontation naming (Hallmark is anomia) describing (if stronger may consider using semantic feature analysis in Tx) defining repeating answering comparative questions follow commands retell a story (retell a story immediately and then with delay) recall/recognize words (learn a list with 16 words) Word learning subtest:important to see how well client learns new information. I tells you if they have free recall or benefit from use of a prompt to remember words. using cued recall of naming an item just seen based on a clue, when client misses items, present the missed items again. then see if they can remember the item after learning have up to three opportunities to learn the word that goes with each description. after this, distract client by having them count to 20 then have the client say as many items as they can from the past four pages in 2 min. check the order- more likely to remember the items from beginning or from end? lost items farther back in space or remembered at the beginning and then couldn't hold later words? when client can't do free recall on all items, for the ones not remembered give cues (cued recall) copy figures (see if they can use drawing as form of communication) drawing; clock, bucket (i.e. looking to see if drawing can be a compensatory reasoning. also assesses visuo-spatial perceptual skills. Note: does address reading/drawing but not writing Looking for what skills are preserved to work on and keep those skills for as long as possible with the understanding they will decline over time. Three ways to use test Use as screener for deficits ( newly diagnosed or mild) can pick and choose subtests but then can only get raw score can administer the whole test-must do in order- can take two hours (at least 90 min) would not administer to someone severe Materials manual response form stimulus books A and B one-page laminated scoring guide nail/envelope (to describe)

ALFA

Assessment of Language-Related Functional Activities (ALFA; Anderson Baines, McMartin Heeringa, Martin, 1999) Use to assess functional skills (cognitive linguistic impairment) -good test for aphasia, TBI, dementia, RHD Specifically looks at: Aud comp Verbal expression reading/writing -must have some ability to read, write, comprehend to participate in test Not appropriate if they cannot read/write/comprehend -includes testing about medications, writing down, balancing checkbook, home... can the person function at home? Norming data; 92% of participants age 55+ 645 individuals- quite large Multiple lesions, multiple strokes included in pop Wide range of educational achievement Appropriate for any kind of educational background Pick and choose subtests: don't have to do whole test Functional communication Includes observation of cognitive skills Can pick and choose subtests Norming population larger Must have some ability to read, write comprehend Repetitions allowed without penalty Administer for TBI, LHD, RHD, dementia, aphasia. Use this assessment to determine where client goes (go home or to long term care). Can choose not to administer subtests based on clients premorbid abilities (i.e. never balanced check book). Trying to determine an individual's ability to perform skills specifically in the home. Independent functional rating: Done by age above and below 65, because need to determine if it is normal aging an underlying issue (if under 65, may be an undiagnosed problem). This assessment is more for functional living Pretend to call emergency vehicle

Assess or document in every case

Behavioral observation Swallowing Hearing Oral Speech Mechanism Screening Exam - 3 (OSMSE-3; St. Louis & Ruscello, 2000) pragmatics fluency articulation voice vision

CELF-P2

Clinical Evaluation of Language Fundamentals-P2 (CELF-P2; Wiig, Secord, & Semel, 2004) 3-6;11 -To identify, diagnose, and complete follow-up evaluations for children with language deficits; -Designed as downward extension to CELF-4 9 subtests sentence structure word structure expressive vocabulary concepts & following directions recalling sentences basic concepts word classes recalling sentences in context phonological awareness +Pre-Literacy Rating Scale +Pragmatics Profile Can use item analysis to compare scores. Can give just core subtests or more. Does not look at play, pragmatics, etc. More language-based probably for a higher-level language problem in a higher-developed kid.

BASA

Boston Assessment for Severe Aphasia (Helm-Estabrooks et al., 1989) Not comprehensive Get credit for accuracy/quality of gestural or verbal response. Could administer BNT is addition verbal/gestural More Qualitative assessment vs. quantitative Have to be severe or global to administer ------------- Used with those with severe impairment, purpose is to identify and quantify preserved abilities in severely aphasic patients. Test is shorter than BDAE and WAB. What is unique about the scoring of the BASA? Person can receive credit for both gestural and verbal response for the same item. Whatever person can communicate, that is what is scored. Why would emotional content be relevant on a test for aphasia ? -trying to get client to attend: emotional material may help to get a response, any response. --------------------- Design of test: o Natural context o Emotionality o Preservation of facial expression and tone of voice o Humor o Use of drawing for communication o Non-verbal vs. verbal skills o Orientation o Apraxia o Perseveration _______ No basal/ceiling --------- Why would emotional content be relevant on a test for aphasia ? -trying to get client to attend: emotional material may help to get a response, any response.

BDAE-3

Boston Diagnostic Aphasia Examination—3rd edition (BDAE-3) (Goodglass, Kaplan, & Barresi, 2000) Boston Naming Test (Goodglass, Kaplan, & Weintraub, 2000) Boston diagnostic aphasia exam Section 1 Conversational and expository speech assesses verbal expression (and conversational). Based on interview -Clinician add personal question. Needs to be something to analyze after. Length of utterance? Able to answer question? Strugglin with word finding? Taking general feel for how well communicating. Fluent or non fluent? Do answers make sense? -cookie theft- phonetically transcribe (look for word finding, length of utterance, grammaticality, paraphasias) Skip Aseop's fables (culturally bias) Auditory comprehension The person's ability to comprehend at: Word level Sentence level Narrative level (paragraph) Administer the three auditory comp tests below: Basic word discrimination (page 9) Commands (page 13) -lots of info on how someone follows directions Complex ideational material (14-15) Oral expression: Automatized sequences recitation/melody/rhythm Repetition important to diagnosing type of aphasia and to see if client is stimulable for tx with repetition Repetition of single words Repetition of sentences Responsive naming test- Ask question w/ finite answers Not on assessment but throw in generative naming task (how many items can they name, perseverative?) --------------------------------------------------- BDAE-3 suggested sections to administer 1) verbal expression Conversational and expository speech (cookie theft and interview) Oral agility / verbal agility Automatized sequences Repetition: words, sentences 2) Auditory comprehension Single word comprehension Commands Complex ideational 3) Reading comprehension P. 24-25 letters, words (comp) P. 28-29 oral reading - words and sentences P. 30 Silent reading comp 4) written expression p. 31 Mechanics Dictated words p. 33 Written picture naming p. 36 Narrative writing (cookie theft) BDAE is used to determine: type and severity -can convert raw score to percentile rank for each subsection -this is a go-to comprehensive test

BNT-2

Boston Naming Test-2nd edition (Goodglass, Kaplan, & Weintraub, 2000) Bias of Boston Naming test (BNT) -geographically distinct -educational level -socio-economic status -statistical difference in scoring based on educational level. To interpret BNT scores: -Does client have anomia? -error pattern? Solely to assess naming Have to administer with BDAE. don't administer with WAB-R Could administer with BASA (not comprehensive)

Mean Length of Utterance (MLU)

From speech sample of 50-100 words MLU= total # morphemes/total number utterances Brown, 1973 MLU stages Stage I: MLU 1.0-2.0 age 12-26 mo Stage II: MLU 2.0-2.5 Age 27-30 Stage III: MLU 2.5-3.0 Age 31-34 Stage IV: MLU 3.0-3.75 age 35-40 Stage V: MLU 3.75-4.5 age 41-46 Stage VI: MLU 4.5+ age 47+ Each word a child produces is broken down into morphemes. A morpheme is the smallest, indivisible unit of meaning. For example, the word "walk" is one morpheme, while "walked" is two morphemes: "Walk" carries its own meaning and "ed" signifies past tense.

CELF-5

Clinical Evaluation of Language Fundamentals-Fifth Edition (CELF-5; Wiig, Semel, and Secord 2013) Word Classes (WC) 5-21 years The individual's ability to understand relationships between words based on semantic class features, function, or place or time of occurrence The individual chooses two of the three or four orally-presented words that are related Word Structure (WS) 5-8 years The individual's ability to apply word structure rules, mark inflections, known derivation of nouns, comparisons The individual looks at a visual stimulus and completes an orally presented sentence (cloze procedure) with the targeted structure(s) Linguistic Concepts (LC) 5-8 years The individual's ability to understand spoken directions that contain concepts of logical operations (e.g., inclusion, exclusion, orientation, and timing). The individual points to objects in the Stimulus Book in response to oral directions that contain embedded concepts Sentence Comprehension (SC) 5-8 years The individual's ability to understand spoken language at the sentence level. The individual points to a picture in the Stimulus Book that illustrates the orally presented sentence Word Structure (WS) 5-8 years The individual's ability to apply word structure rules, mark inflections, known derivation of nouns, comparisons. The individual looks at a visual stimulus and completes an orally presented sentence (cloze procedure) with the targeted structure(s) Word Classes (WC) 5-21 years The individual's ability to understand relationships between words based on semantic class features, function, or place or time of occurrence. The individual chooses two of the three or four orally-presented words that are related Following Directions (FD) 5-21 years The individual's ability to follow single or multistep verbal directions related to varying characteristics (e.g., color, size, or location). The individual points to shapes in the Stimulus Book in response to oral directions of increasing length and complexity Formulated Sentences (FS) 5-21 years The individual's ability to use a given word to formulate complete, semantically, grammatically correct, spoken sentences. Using a visual stimulus as a reference, the individual formulates a sentence about the picture using one or two targeted words presented orally by the examiner Recalling Sentences (RS) 5-21 years The individual's ability to listen and repeat spoken sentences without changing content, word structure, or sentence structure. The individual imitates sentences presented orally by the examiner. Understanding Spoken Paragraphs (USP) 5-21 years The individual's ability to sustain attention while listening to spoken paragraphs, create meaning from oral narratives, answer questions about content, and use critical thinking strategies to make inferences The individual responds questions about a paragraph presented orally by the examiner; the questions target the paragraph's main idea, details, and sequencing as well as inferential and predictive information Word Definitions (WD) 9-21 years The individual's ability to analyze and define words for their meanings and relationships; describe meanings that are unique to the reference The individual defines a word that is named and used in a sentence Sentence Assembly (SA) 9-21 years The individual's ability to formulate sentences by manipulating given words The individual produces two semantically and grammatically correct sentences from words or groups of words presented visually and orally by the examiner Semantic Relationships (SR) 9-21 years The individual's ability to interpret sentences that are expressed in passive voice, make comparisons, identify location or direction, specify time relationships, and include serial order After listening to a sentence, the individual selects the two correct choices from four visually and orally presented options that answer a target question Reading Comprehension (RC) 8-21 years The individual's ability to sustain attention and focus while reading paragraphs, creaming meaning from written narratives, answer questions about the content, and use critical thinking to make inferences. The individual responds to orally presented questions about passages he or she reads. The questions target the paragraph's main idea, details, and sequencing as well as inferential and predictive information Structured Writing (SW) 8-21 years The individual's ability to use situational information given by a story title, an introductory sentence, and an incomplete sentence to create and write a thematic, structured narrative. The individual writes a short story by completing a sentence and writing one or more additional sentence(s) Observation Rating Scale (ORS) 5-21 years Parent/caregiver, teacher, and individual each rate the student's classroom and home interaction and communication skills Pragmatic Profile (PP) 5-21 years The examiner records information about the individual's social language skills, eliciting information from a parent or teacher if needed. If you are unsure how to rate a skill or behavior, ask the individual's teachers, parents, or other informants who know the student for their input. Note to examinee: complete all 50 items Pragmatic Activities Checklist 5-21years The examiner and individual interact during 3 selected activities (e.g., make a paper airplane, have a snack, etc.) with the purpose of eliciting authentic communication. Complete this checklist (32 items) after completing three activities with the individual

CELF-5 META

Clinical evaluation of language fundamentals- Metalinguistic (CELF-5 META; Wiig & Secord, 2014) Metalinguistics: need to understand abstract context, multiple meanings, figurative language to use language -what strategies does client use while taking test? Taking notes on the strategies to get answer important information. Age range: 9-21:11 30-45 min to administer Have to look b/t record form/examiner's manual and using stimulus book at same time 5 subtests (item analysis for each subtest) basal/ceiling differs by subtest -metalinguistic profile: questionnaire gather info about edu and social context. Ex: makes inferences from public opinion, do they know when they are experiencing communication breakdown -making inferences- make logical inferences about situation (four options)... 15 sec response time. After answering, have to self-generate an answer of why something happened. Old version of test: give situation "what do you think?" and then show them the options... in new version, it's flipped. -conversational skills; evaluates students ability to intiate conversation, relevant, pragmatically appropriate, semantically correct. Stimulus= picture w/ 2-3 words to give conversational context. -multiple meanings: assesses student's ability to recognize/interpret diff meanings/lexical and structural ambiguities..."flowers are sold by interesting people" making pple interested, or people who are interested. -figurative knowledge: short dialogue with an idiom in in it... no all answers are figurative language... give four options CELF-5 Metalinguistic normed on english speakers, but included diff. Dialects and bilingual, as well as diff. Disorders. Reliable for testing ESL, ASD, and LD students (testing what students don't know instead of what they do know.. Maybe not best way to use this test. For example, someone who is ESL may have higher order language skills but maybe not in english) Not just multiple choice, additional open line for every item -pictures now in color/pictures updated -important part of pic is in color, rest of pic in black and white -updated idioms -measures ability for students to make inferences, construct conversationally appropriate sentences, understand messages w/ words that have multiple meaning

CLQT

Cognitive-Linguistic Quick Test (CLQT; Helm-Estabrooks, 2001) -came out with this because most cog tests are heavy language based. To measure cognitive skills without being language heavy - comprehensive test that assesses a lot cog-linguistic skills -easy to administer/score -relatively fast (within an hour) performance based better than asking for verbal answer, may know the answer conceptually but may not be able to follow through with the task. -includes behavioral observation, unlike SCATBI Measures these 5 areas with ten subtests; Attention Memory Language Executive functions Visuospatial skills -Identify strengths/weaknesses, help ID areas for tx -can use with Aphasia, TBI, RHD, LHD, and dementia (but not recommended by Laura) Administration -for acquired neuro disorders- 18-89 -must be able to use pen (drawing, not writing) -can be administered in 15-20 min (can take a lot longer) -felt tip pen (write in any direction) -timer -english or spanish 10 subtests (can choose subtests that assess specific skills) personal facts when/where born Age Current address -qualifiers: latency, perseveration, etc... not just right or wrong, looks at how answer is given symbol cancellation -planning, neglect Confrontation naming -vague outlines of common objects (i.e. tie, cow, banana) Clock drawing spatial/planning Story retelling Symbol trails -connect circle-to-triangle-circle, etc -memory, attention, visuo-spatial, self-monitoring, executive function Generative naming Anomia, memory, perseveration Design memory -non linguistic task that can provide info about visual discrimination, analysis, attention, visual memory, Mazes Executive function Timed- 2 minutes Design generation "Connect each set of dots using four lines- make each design different" -3 min-timed -executive function -memory -Attention -visuo-spatial (possible to perseverate) Scoring...can get: Cognitive domain score Severity rating scale-assessed by age Composite severity rating Clock drawing severity rating Can provide qualitative observations Severity rating is by age Need to account for normal aging Two ratings: 18-69 yrs, 70-89 yrs ---------------------------------------------------------------

CADL-2

Communication Activities of Daily Living—second edition (CADL-2) (Holland, Frattali, & Fromm, 1999 ) -use for stroke (LHD or RHD (not first choice with RHD)), TBI, brain tumors (don't use with dementia) -qualitative measure: doesn't need to be a precise response- needs to communicate the info. -gets 2 pts for response "I have to wear the umbrella because it was rain" because although not well formulated, communicated content. -client gets 1 pt needs repetition, 2 pts if answers questions verbal/gestural Functional communication assessment This is a complimentary/supplemental test. WAB or BDAE used for assessment of type and severity... same, WAB and BDAE should not be used to assess functional communication. -good for a client who can use any modality to communicate. Structure -no subtests- 50-60 questions. Have to administer all questions to get standardized score, categories are scattered throughout assessment -looks at ability to read, write, use numbers -social interaction -contextual communication -nonverbal communication -Sequential relationships -humor, metaphor, absurdity Looks at: Using the telephone navigating grocery store (locating correct aisle) determining which picture is funny pressing correct button in elevator getting drink from vending machine choosing correct restroom Does not assess cognitive skills: assesses functional skills Test uses functional objects -client has to show some ability to write (can be non dominant hand) Administered interview style and asks client to respond to various situations of daily living. Looking for practical observation of communicative acts in a simulated natural environment. How can client use the communicative ability they have in these situations?

CASL-2

Comprehensive Assessment of Spoken Language Second Edition (CASL-2; Carrow-Woolfolk, 2017) Administration ● 14 subtests ○ Subtests are stand-alone; any or all of them can be administered. ○ Each subtest takes between 5-10 minutes. ○ Specific instructions for prompting in each subtest are included in the test easels. ● The test kit includes three test stimuli easels and two sets of record forms: ○ A form including 10 subtests: to be used with children aged 3-6. ○ A form including all subtests: to be used for all examinees. ● General Language Ability Index is calculated using a combination of several subtests, which differ by grade and age. Administration takes 30-45 minutes for ages 3-6 years and 45-60 minutes for ages 7-21. =============================================== Receptive Vocabulary (3-21 years) Auditory comprehension for perceptual and conceptual relations. Includes spoken prompts and multiple-choice pictures for all items. Point to the sleeping dog. ===================================== Antonyms (5-21 years) Test of word knowledge, retrieval, and oral expression of opposites. Items presented verbally, without pictures. Tell me a word that is the opposite of start. If it's not start, it's ____. ================================================= Synonyms (5-21 years) Test of ability to recognize words with similar meanings. Items presented verbally with multiple-choice responses. Which word means the same as simple? ========================================== Expressive Vocabulary (3-21 years) Test of word knowledge, retrieval, and ability to complete sentences. Items presented verbally. Earlier items include pictures; later items do not. Examinee responds verbally. One day when Abby went out, she took her umbrella because of the _____. Idiomatic Language (9-21 years) Test of knowledge, retrieval, and oral expression of idioms. Items presented and responded to verbally. Jackie went to the fancy party dressed to ____. ============================================= Sentence Expression (3-21 years) Test of oral expression of accurate syntax, word order, and grammatical morphemes. Items presented verbally with pictures; examinee responds verbally. What do you see going on in this picture? ===================================== Grammatical Morphemes (3-21 years) Test of knowledge, retrieval, and oral expression of inflections and function words. Items presented verbally. Earlier items include pictures; later items do not. Examinee responds verbally. Here, the backpack is the boy's. But here, the backpack is the ____. ============================================== Sentence Comprehension (3-21 years) Test of the ability to recognize the meaning of sentences with similar words/structures. Item presentation and answers are given verbally; no pictures. Point to the one picture that goes best with the sentence I say. The box has a ball within it. =========================================== Grammaticality Judgement (5-21 years) Test of the ability to construct sentences that are grammatically correct and to accurately identify whether or not syntax is correct. Item presentation and answers are given verbally; no pictures. Try to fix the sentence by adding, changing, or taking out only one word to make it sound right. The crowd were in the street. ====================================== Nonliteral Language (7-21 years) Test of ability to understand the meaning of words depending on context, rather than on literal meaning. Item presentation and answers are given verbally; no pictures. She runs like lightning. What do you think that means? ================================== Meaning from Context (7-21 years) Test of ability to use context clues to recognize the meaning of an unknown word. Item presentation and answers are given verbally; no pictures. Sam sat in the doll's chair and he got stuck because the chair was so diminutive. ======================= Inference (3-21 years) Test of the ability to infer meaning and draw conclusions through the use of past knowledge. Earlier items include pictures; later items do not. Answers are given verbally. Three-year- old Billy wanted to wear his dad's shoes, but when he tried them on, he was unhappy. Why do you think he was unhappy? ==================== Double Meaning (9-21 years) Test of the ability to express two potential meanings for a word or phrase that is subject to interpretation. Item presentation and answers are given verbally; no pictures. Mother told Susie to get her dress to the cleaners. ===================== Pragmatic Language (8-21 years) Test of understanding and application of pragmatic language rules in specific contexts. Initially, items include pictures. Later items are presented verbally without pictures. Answers are given verbally. You want to go out to play. How should you ask your parent?

CTOPP-2

Comprehensive Test of Phonological Processing-2nd ed (CTOPP-2; Torgesen, Rashotte, and Pearson 2013) Having a CD standardizes the test, since all non-words sounds the same, number repetition is not broken into groups. Previous version of CTOPP didn't have all subtests with CD available. -Helpful to know how client is motivated when taking: if you give feedback "that is not quite right" may lose them. Ages 4-24 Two booklets: age 4-6 and 7-24 Takes about 40 min to administer (need to learn to use CDs, administer test smoothly) -Most subtests overlap between age groups but some do not overlap. -No basal and ceiling is 3 incorrect -rapid naming subtests are timed Subtests -Elision: can give feedback. "Say sunshine, now say it w/o sun"... only give feedback on first 14 items -blending words: first half of test, put together syllables, second half you combine phonemes. Done using a CD. Can prompt; "try saying the sounds all together again and can give feedback about whether correct or not) -Sound matching (only ages 4-6): matching a word from a series to a picture. Can give feedback, if it is right or wrong "sa and sun start with the same sound" -Phoneme isolation: isolate intial, medial, final phonemes in the word -Memory for digit: repeat digits in the same order they are presented. Can't give feedback beyond saying the right answer -Nonword repetition: repeat nonword words as they are presented. No repetitions are allowed. Rapid naming subtests: only ages 4-6. Name as many digits, letters, color naming, object naming... timed test and also checking if child was correct. CELF used to have rapid naming. This task is very much like reading... must understand conventions of reading (start in this corner and move across) Blending nonwords: blending syllables or phonemes into nonwords, requires CD Composite scores from CTOPP: combos of subtests can measure: Composite scores separate out phonological tests Phonological awareness Phonological memory Rapid symbolic naming and rapid non-symbolic naming (if kids don't know letters/numbers yet)... use auditory mem Pros: Wide age range Feedback allowed (really helpful for phoneme segmentation, to help explain what task is) All directions in booklet Not all subtests need to be administered Cons: Recorded tracks can sound unnatural/robotic Clinician needs to be familiar with tech Considerations: -must be in quiet environment (need to hear child on phonemic level) Know when to give repetition, and when to not -set up materials beforehand

Childhood apraxia of speech

Differential diagnosis: Dysarthria SSD CAS Chain: Idea to convey→ language formulation→ speech motor planning/programming→ execute speech motor program→ speech output→ auditory feedback loop(any adjustments to make? Phonological disorders: Lie in the area of Language formation (problem with phonological pattern, underlying idea of how sounds are made) Dysarthria: speech motor execution part of chain (disorder of muscular distribution) CAS: In chair, Speech motor planning and programming Making differential diagnosis Consistent vs. Inconsistent errors To assess this: -standardized articulation test twice in a row -children w/o CAS will improve or show consistent errors across administrations -children w/ CAS will show inconsistency -Word inconsistency assessment from the DEAP (Diagnostic eval of artic and phono) Consideration: two types of inconsistency -token-to-token: words inconsistent -phonemic inconsistency (phoneme inconsistent across words) Co-articulatory Transitions -obtain diadochokinetic rate (DDK) -difficulty w/ both artic changes and w/ same place of artic w. Dysarthria -CAS show weakness where artic changes, do better on shorter phrases Prosody -evaluate conversational/spontaneous speech (25-30 utterances minimum) -inappropriate use of stress -inappropriate use of intonation/affect -abnormal rate? Obtain case History -neurological insult? -family history of speech/language impairments? -history of difficulty chewing/swallowing -determine overall intelligibbility (conversational speech) Percent of errored productions (POE) -Percent of consonants correct and percent of vowels correct (not ocmmon but will help w/ understanding vowels -obtain phonetic inventory (may show full phonetic inventory) -psychosocial issues? May have apraxia of limbs as well.. How much is child feeling inhibited, interfering with quality of life. Features associated with CAS -comorbid language disorders -comorbid fine and gross motor disorders -comorbid reading difficulties -delayed babbling -speech perception task: children w/ just CAS show no deficits in speech perception (clear idea of boundaries between syllables) while those with comorbidities and CAS have more difficulty discriminating between two sounds. -Theory that groping feature of CAS is associated with too much therapy. That child is aware that articulation is incorrect and trying to correct. -Differential diagnosis important b/c differs in how we treat.

FDA-2

Frenchay Dysarthria Assessment- 2nd edition (FDA-2; Enderby & Palmer, 2008) -can administer for ages 15-97 -determines type/severity of dysarthria Description of test: Assess patient's performance on 7 functions (divided into sections) Note: has additional Influencing Factors section (looking at hearing, sight, teeth,language, mood, posture, rate, and sensation) Determine type based on pattern (coloring in column based on severity A through E (E is the most severe and A is the least severe) If all A and B's more mild, C, D, E more severe 7 sections: Reflexes Example: Ask person if they cough/choke when eating/drinking or clearing throat Respiration Lips Palate Laryngeal Tongue Basically doing Oral mech with above Intelligibility Single word, sentence, conversation "Two for one"- includes oral mech Shorter to administer: For someone w/ less endurance- more acute setting- fatigue- not a lot of time Assesses single words, sentences, conversation Can get type and severity of dysarthria Type is from shading in columns and comparing to pattern at the end. More severe means more C's, D's, E's Informally give rating from A to E for intelligibility based on 3-5 min conversation sample (E least intelligible) Don't need a judge- you do interpretation Only score second attempt on each task ( Give target/warm up- see if second attempt to closer than first)... may want to note if speech gets worse with fatigue Only english Sentences are 3-5 word

functional communication measures

Functional independence measures (FIM) Scale used to measure one's ability to function with independence Utilized in rehabilitation units (not used in acute care because its too soon- just there to become medically stable) Collect scores upon admission to rehab (within 72 hours) and just prior to discharge (within 72 hours) FIM score may go down because... Client doesn't cooperate Client gets sick (pneumonia) Team may be grading client too high (based on clinician skill) Always shoot lower at baseline to chart improvement later on Who collects scores?? Anyone trained in FIM (including PT, OT, SLP, nurses, psychologists, social workers). SLP would complete section that is relevant to field FIM evaluates the following areas of daily functioning (know a few examples) PT/OT/Nursing Eating-cutting, use utensil, open carton, getting food to mouth (not swallowing) Grooming- brushing hair/teeth Bathing- how you get clean (shower, tub bath) Toileting-ability to get to/on/off toilet, bedpan, commode Bladder management- diaper, catheter? Locomotion- stairs, moving in a wheelchair, how you're ambulating (walking, walk with single point cane or a four point cane, a walker (lift and go and step, or with wheels). SLP Also looks at the following cog-comm areas: Comprehension Expression Social interaction Problem solving- infers safety Memory- season, date, schedule Scoring system for FIM: ranges from 1-7 *know range- 7 is the highest independence and 1 is total assist. You get a FIM score on each item- 1-7 on dressing, 1-7 on memory, etc* Know that FIM 1 is total assistance, FIM 5 is supervision/set up, FIM 7 is independent (no help)

GFTA

Goldman-Fristoe 2 Test of Articulation (Goldman & Fristoe, 2000) sounds in words sounds in sentences Based on John Quincy's responses on the GFTA-2, nine phonological processes were identified. An explanation of each process identified and an example of John Quincy's usage follows: Stopping is a process in which a sound that is made with a restricted air stream is replaced with a sound made by stopping and releasing the air stream (e.g. /haʊs/→/haʊt/). Fronting occurs when a consonant made in the back of the mouth is moved forward (e.g. /dʌk/→/dʌt/). Gliding occurs when /r/ and /l/ are replaced by /w/ or /j/ (e.g. /tri/→/twi/). Prevocalic Voicing occurs when a consonant that is made without using the vocal cords is replaced with a consonant that is made by producing sound with the vocal cords (e.g. /kwæk/→/gwæk/). Cluster Reduction occurs when one or more sounds is left out of a grouping of consonants (e.g. /swɪmɪŋ/→/wɪmɪŋ/). Labial Assimilation occurs when a consonant made with the lips influences another consonant in the same word, causing it to be made with the lips as well (e.g. /wɪndoʊ/→/wɪwoʊ/). Weak Syllable Deletion occurs when an unstressed syllable is deleted in a multisyllabic word (e.g. /bənænə/→/nænə/). Vocalization occurs when a final /r/, sounds that have an /r/ quality (i.e. /ɝ/ and /ɚ/), or /l/ are replaced with a vowel (e.g./bɔl/→/bɔ/). Final Consonant Deletion occurs when the consonant following a vowel in a syllable or the final consonant in a word is deleted, leaving only a vowel at the end of the word or syllable (e.g. /bæθtəb/→/bæːtəb/).

language and literacy disorders

Hearing / OSMSE / Vision → all ruled out Nonverbal IQ → WNL Speech & language sample Dyslexia & Poor comp → good speech (there's a chance that dyslexia kids could have SSD comorbidity if they have weak phonological representation, but if there's no mention of that in the case, they don't have to), good pragmatics, voice WNL, fluency WNL, MLU WNL (poor comprehenders could have lower MLU if they haven't understood as much receptively, it might be shown expressively in length of utterance/simpler language), possibly limited expressive vocab Writing sample → Spelling errors → Limited vocab → Vague, ambiguous use of words (especially poor comp) → immature syntax CELF Core Lang Dyslexia → WNL (but semantics may possibly be low end of normal b/c of Matthew's Effect) Poor comp → below normal or low end of normal because working memory and listening comprehension are implicated (for children over 2nd grade) ====================== WRMT-III Word identification: dyslexia → below normal; poor comp → WNL Word attack: dyslexia → below normal; poor comp → WNL Passage comprehension: dyslexia → below normal (actually, I'm not sure about this. Would they maybe have the low scores because of poorer vocab and the choppiness at which they read the words makes it hard to follow a thread while reading? I think you could argue that. I also think you could say it's low end of normal. Either one, probably); poor comp → below normal Listening comprehension: dyslexia →WNL; poor comp → below normal (children over 2nd grade who didn't do well on WRMT-III decoding portions): CTOPP → poor phonological awareness (use where they break down as a starting point for tx) (for children under 2nd grade) WRMT-III Letter Identification → below normal (for children under 2nd grade) CTOPP → poor phonological awareness Classroom observation → Poor participation in reading activity → Spelling errors (especially poor comprehender) → poor comprehension of stories (presented orally or written)

speech sound disorders

Hearing / OSMSE / Vision → all ruled out Nonverbal IQ → WNL Speech & language sample Phono → some pattern Artic → no clear pattern, only a few sounds affected Delay → typical processes showing up later than they should Disorder → atypical processes showing up Percent Consonants Correct Severe → < 49% Moderate → 50-64% Mild-Mod → 65%-84% Mild → 85-100% Writing sample → Possible spelling errors → Possible omission of morphological endings (if so, language impairment implicated) GFTA-2 Sounds in words → Sounds in sentences → Contextual (initial/medial/final) → Stimulabitlity → CELF Core Lang → WNL unless comorbid language impairment is implicated

Specific language impairment

Hearing / OSMSE / Vision → all ruled out Nonverbal IQ → WNL Speech & language sample → good speech (they may have a comorbid SSD, but if there's no mention of it in the case, they don't have to), good pragmatics, voice WNL, fluency WNL, low MLU, difficulty with morphosyntax Classroom observation → Difficulty following directions → Vague words in expressive language → Omission of morphological endings → Limited vocabulary Formal assessment of expressive and receptive language: CELF-P2 or CELF-5 (for children < 5 yo) CELF-P2 → overall poor performance in core lang. Sentence Structure → low end of normal (depending on how severe you want them to be, they can be below normal also. Especially if you want them to work on following directions) Word Structure → below normal Expressive Vocabulary → below normal (for children between 5 and 8) CELF-5 → overall poor performance in core lang. Sentence Comprehension → low end of normal Word Structure → below normal Formulated Sentences → below normal Recalling Sentences → below normal (for children between 9 and 12) CELF-5 → overall poor performance in core lang. Word Classes → low end of normal Formulated Sentences → below normal Recalling Sentences → below normal Semantic Relationships → below normal / low end of normal (for children over 13) CELF-5 → overall poor performance in core lang. Formulated Sentences → low end of normal Recalling Sentences → below normal Understanding Spoken Paragraph → below normal / low end of normal Semantic Relationships → below normal / low end of normal

Goals for client with wernicke's who can't write and can't repeat.

Long term remediation goal: Improve auditory comprehension at discourse level Semester remediation goal: Improve auditory comp at sentence level (commands, directions, and/or questions?) "Mr. S. will comprehend multi-step directions with clinician cues in 80% of opportunities" If working on auditory comprehension, use alerting cue to see what is coming, written cues, paired gestural cues (i.e. "close your eyes (point to eyes) and point to ceiling (point up). Compensatory goals: "Mr. S. will comprehend multi-step directions using compensatory strategies with clinician cues in 80% of opportunities" "Mr. S. will use self-advocacy to increase auditory comprehension at the discourse level independently. -Has to recognize that he did not comprehend- first step -ask people to slow down, say it again -Does better with written material -can advocate for himself by asking for information to be written down. (can write down key words--Written choice)... repeat directions with words written down. ----------------------- Goals for client who comprehends but uses lots of gestures, not able to say what he means (i.e. conduction aphasia) Sample format: "Mr. R will verbally express (formulate, communicate) (basic wants and needs, functional communication, or thoughts and ideas) at the discourse level with familiar listeners (i.e. at home in the community). "Mr. R will verbally communicate functional information in mock real-life scenarios (or picture description, story retell) with 80% accuracy (or use a rating scale- client can self-rate or slp can rate...Likert Scale (3= fully communicative, 1= max cues).

MIRBI

Mini Inventory of Right Brain Injury-2nd Ed (MIRBI-2; Pimental & Knight, 1999) -this test is only for RHD: not other cog-ling issues -screener, not a stand alone with test then move from there -15-30 min -good test if tight on time -if really impaired, can't sustain attention, good bedside screener -four sections: -visuospatial/scanning -on response sheet, cancellation task (looking for left neglect) -with letter a and with reading Would not tx but confirms presence/absence of RHD: -finger gnosis, point to fingers and have pt. Name -stereognosis: give quarter, see if they know what it was -use caliper to see if client can feel one point or two -language processing nosis; -visual verbal processing: read aloud to see if they read to left, ask question because assessing comprehension -looking for slant in writing sample, disorganization (can't see left?) and coherence of writing (verbose and wordy or short) -emotion/affect/behavior -look for prosody in happy and sad voice (pt. Has to say it) -show something funny, see if pt can see what -proverbs (culturally sensitivity= idioms/proverbs pull on specialized knowledge)) -eye contact, tangential speech? Organize? Test materials: -caliper -pencil -blank sheets of paper -quarter Administration -move quickly, screening (if doesn't respond in 20 sec, score and move) -result in percentile rank/stanine

How to assess cognition in the blind

MoCA Blind -assess EF in addition: ask how to make peanut butter and jelly sandwich, how do you put your shoes on, what do you do if your car is out of gas

RICE-R

RIC Evaluation of Communication Problems in Right Hemisphere-Revised (RICE-R; Halper, Cherney, Burns, and Mogil, 1996) Purpose: evaluate secondary sequelae following Right Hemisphere Damage Admin: 6 subtests Behavioral observation profile Interview questions for orientation purposes Five minute conversation on topic of interest Tasks to determine topographical orientation I.e. find way to nursing station, elevator, or bathroom Client is graded on rating scale for attention/awareness/orientation, etc pragmatic communication skills Evaluating areas of pragmatics Gestures, intonation, eye contact, etc Looking at intiatin, turn taking Client graded on rating scale for amount of time behavior/pragmatics appropriate Narrative discourse Story retell Rated on how well she recalls piece Visual scanning/tracking Like Mirbi, letter/word cancellation (cross out the a's) Tasks hierarchical, become more complex Start on left, cross out the items in the row Assessment and analysis of writing Use line paper with left sided margin, directly in front of patient Copy sentence Writing to dictation Write description of event (or action paper) Target is to get 50 words Looking for evidence of left neglect Also looking to see if description is cohesive/organized Metaphorical language Looking to see if language is interpreted in a concrete manner Notes: Can choose which subtests to use. Each subtest is individually administered and scored. Can discern a raw score and a severity rating for each subtest

Can be used to assess cognition, memory, EF in Aphasia

Raven's colored progressive matrices(no verbal output and no grapho-motor skills) CLQT (need grapho-motor skills) Rey Osterith complex figure test

Example of PLS-5 breakdown: receptive/expressive/pragmatics+ language sample

Receptive Language: This section looked at what --- understands, such as his ability to follow directions, identify pictures, and identify a variety of language concepts. -- received a standard score of 90 (Percentile rank=25). This score is in the low average range of developmental functioning. -- demonstrated an understanding of sentences with post-noun elaboration given an affirmative sentence (i.e. Point to the small black kitten in the box) but demonstrated difficulty understanding a negative sentence with post-noun elaboration (i.e. Point to a kitten that is not black). -- demonstrated a knowledge of pronouns and spatial concepts including under the table, next to you, and in back of you but had difficulty identifying in front of me. ---demonstrated a knowledge of pronouns including his, her, and they. He had difficulty with the quantitative concepts of more and most. He was able to identify Who has more crayons, but had difficulty identifying who had more and who had the most crayons when they were redistributed so that ---, the clinician, and a toy bear each had crayons. ---demonstrated difficulty following directions that contained the quantitative concept of all. When asked, Show me all the things that look like a ______, --- correctly identified one or two shapes in the picture, but even with the prompt, Is that all?, he did not pick out all of the shapes. --- correctly identified letters in the alphabet when asked, Show me the letter____. Expressive Language: This section looked at what --- can say, as well as his vocabulary, grammar, and language use. ---received a standard score of 88 (Percentile rank=21). This score is in the low average range of developmental functioning. -- demonstrated emerging abilities to answer questions logically. When asked, What do you do when you are tired? He said, "I'm go to sleep." However, he had difficulty answering the question, What do you do if your hands are dirty. --- pointed at his hand, and said, "I got play doh."--- demonstrated his knowledge of possessives, correctly identifying a picture by saying, "The girl's cat" and "The cat's." --- demonstrated an emerging understanding of how to explain an object's use. When asked, What do you do with a coat, --- answered, "You wear a coat." However, when asked, What do you do with a towel, --- said, "You put it in the water." --- also demonstrated an emerging understanding of how to answer questions about hypothetical events. When asked, What would you do if you felt sick, --- answered, "You spit it out." When asked, What would you do if you got food on your shirt, -- pointed to his shirt and said "Look." --- demonstrated an emerging understanding of using the words in, on, and under. When asked to identify where a spoon was, he pointed to the spoon and said "Right here." He identified the spoon on top by pointing and saying, "Up there." -- verbally identified "under" verbally, without pointing.-- demonstrated difficulty using the possessive pronouns hers and his. When asked to fill in the phrase, This is her picture, this is ______, -- responded "Boy picture" rather than the target, his picture. --demonstrated an emerging understanding of categories. -- was able to identify cereal, oranges, mashed potatoes and pizza, as "foods" but identified blocks, doll, ball, and puzzle as "animals," and water, milk, juice, and soda as "foods" as well. -- demonstrated difficulty answering a question about what the people in a picture should do. When given the prompt, Darlene wants a cookie, what should she ask her mother, -- responded "She's getting the cookies." When given the prompt, Christopher wants the cereal. What should he ask his mother, -- pointed to the cereal box and said, "He wants this." Pragmatics and Social Language: Throughout both assessment periods, -- frequently said "I don't know" when asked a question. When prompted (i.e. Just take a guess), --- generated an original response. Although -- often used "I don't know" as an initial response, he sometimes gave the correct answer after a pause, even without a prompt. When obtaining a language sample, -- engaged with the student clinician in symbolic play with a farm set. -- gave animals rides in the tractor and incorporated clinician suggestions into his play. He asked for help and responded to questions appropriately.---used a variety of nouns (i.e. Tractor, chair, bunny, chicken, water) and verbs (i.e. Driving, going, dropped, push). He combined words to form sentences between four and six words in length (i.e. "I dropped the bunny," "You go in the tractor," "I need to push my chair").

Rosetti Infant-Toddler Language Scale

Rosetti Infant-Toddler Language Scale (Rosetti, 1990) 0-36 months Interaction/attachement, pragmatics, gesture, play, language comprehension, language expression, parent questionnaire -criterion-referenced -data is collected from parent report, observation, & elicitation Subtests Interaction Attachment—This subtest assesses the cues and responses that reflect a reciprocal relationship between the caregiver and the child. Pragmatics—Assess the way the child uses language to communicate with and affect others in a social manner in this subtest. Gesture—This subtest assesses the child's use of gesture to express thought and intent prior to the consistent use of spoken language. Play—Assess the changes in a child's play that reflect the development of representational thought with this subtest. Language Comprehension—This subtest assesses the child's understanding of verbal language with and without linguistic cues. Language Expression—Assess the child's use of preverbal and verbal behaviors to communicate with others. --------------------------- Developmental milestones 0-36 mo Newborn Primitive reflexes - step, place, Moro, Babinski, ATNR Flexor posture Primitive reflexes - grasp Primitive reflexes - root, suck Alerts to sound Startles to loud sounds Variable cries Visual focal length ~10" Fix & follow slow horizontal arc Prefers contrast, colours, face Prefers high pitched voice Bonding (parent child) Self-regulation/soothing ---------------------- 2 mos Head steady when held Head up 45o prone Hands open half of time Bats at objects Turns to voice Cooing Prefers usual caregiver Attends to moderate novelty Follows past midline Attachment (child parent) Social smile ----------------------------------------- 4 mos Sits with support Head up 90o prone, arms out Rolls front back Palmar grasp Reaches and obtains items Brings objects to midline Laugh, razz, "ga", squeal Anticipates routines Purposeful sensory exploration of objects (eyes, hands, mouth) Turn-taking conversations Explores parent's face ---------------------------------------- 6 mos Postural reflexes Sits tripod Rolls both ways Raking grasp Transfers hand to hand Babble (nonspecific) Stranger anxiety Looks for dropped or partially hidden object Expresses emotions: happy, sad, mad Memory lasts ~24 hrs ------------------------------------------------ 9 mos Gets from all 4s sitting Sits well with hands free Pulls to stand Creeps on hands and knees Inferior pincer grasp Pokes at objects "Mama", "dada" (specific) Gestures "bye bye", "up" Gesture games ("pattycake") Object permanence Uncovers toy "Peek-a-boo" Separation anxiety -------------------------------------------- 12 mos Walks a few steps Wide-based gait Fine pincer (fingertips) Voluntary release Throws objects Finger-feeds self cheerios 1 word with meaning (besides mama, dada) Inhibits with "no!" Responds to own name 1-step command with gesture Cause & effect Trial & error Imitates gestures and sounds Uses objects functionally, eg rolls toy car Explore from secure base Points at wanted items Narrative memory begins --------------------------------------------- 15 mos Walks well Uses spoon, open top cup Tower of 2 blocks Points to 1 body part 1-step command no gesture 5 words Jargoning Looks for moved hidden object if saw it being moved Experiments with toys to make them work Shared attention: points at interesting items to show to parent Brings toys to parent ------------------------------------------ 18 mos Stoops and recovers Runs Carries toys while walking Removes clothing Tower of 4 blocks Scribbles, fisted pencil grasp Points to object, 3 body parts 10-25 words Embedded jargoning Labels familiar objects Imitates housework Symbolic play with doll or bear, eg "Give teddy a drink" Increased independence Parallel play --------------------------------------- 2 yr Jumps on two feet Up & down stairs "marking time" Handedness established Uses fork Tower of 6 blocks Imitates vertical stroke Follows 2-step command 50+ words, 50% intelligible 2 word phrases "I", "me", "you", plurals New problem-solving strategies without rehearsal Searches for hidden object after multiple displacements Testing limits, tantrums Negativism ("no!") Possessive ("mine!") ------------------------------------ 3 yr Pedals trike Up stairs alternating feet Undresses Toilet trained (2 1⁄2 - 3 1⁄2 yrs) Draws circle, cross + Turns pages of books 3-step commands 200 words, 75% intelligible 3-4 word phrases W questions ("why?") States full name, age, gender Simple time concepts Identifies shapes Compares 2 items (eg "bigger") Counts to 3 Separates easily Sharing, empathy Cooperative play Role play ("pretending")

RIPA

Ross Information Processing assessment-2nd edition (RIPA; Ross-Swain, 1996) Test purpose: Identify and quantify information processing deficits Assist in establishing treatment goals Measure and document progress Identify and quantify information processing deficits Assist in establishing treatment goals Measure and document progress Complete in 45 min Have to administer subtests in order (delayed recall task, brought up during later subtests...for example, remember "rose, sweater, hamburger") One subtest is timed: need watch Record pt. Answers if possible. Test of orientation is very redundant (e.g. "what did you do before you saw me?") 1 for correct, 0 for incorrect. Not percentile rank; its based on percentage *don't need to know severity rating* Administer at RLA 5 because all tasks are presented verbally and all responses are verbal. Can't participate in confused/agitated state) Subtest 7: requires specific knowledge: declarative/fact based asking if you know who the governor was, war between north and south (civil war), who is helen keller. No performance component. Cons: May be passable for someone with TBI, verbal responses may be ok if they have specialized knowledge Diacritical marks that describe behaviors exhibited during testing Pro: can administer this if person can only give verbal response but no ability to hold/use pen. If TBI and motorically impaired, or blind, the RIPA can be given

TBI protocol

SCATBI is for RLA-R 4 & above Glasgow Coma Scale Time post-onset Injury details (what TYPE of TBI→ diffuse/focal) Secondary Complications (edema, skull fractures) Previous services (acute care, acute rehabilitation) Current Services (OT, PT) Additional medical concerns (high blood pressure, prior surgeries) Handedness (right, left) Can they participate in assessments that require writing/using a pen and paper? Vision/Hearing Status Feeding/Swallowing Status Educational: Highest level of education obtained Major/minor in college (area of focus) Vocational: Previous job Special skills Caregivers: Primary caregivers Living situation (home, assisted living, PCA) How well can you understand them? D. What issues related to the various aspects of diversity will you take into account in your planning and how? I. Assessment A. Given the case description, your diagnostic hypothesis, and the information you would have gathered prior to your assessment, describe your assessment protocol, including both standardized and nonstandardized procedures. Bill was determined to be a RLS 5 (Confused & Inappropriate). Informal Interview (Client/Caregiver): What are your current concerns/symptoms? Important to administer assessments based on clinician observations AND client/caregiver report They are the "expert" What does a typical day look like for you? ADLs What kind of activities do you participate in? Integrated into therapy (functional) Hints about social interactions What do you hope to get from therapy/future goals? Get idea about how realistic he is/awareness levels How well can you understand Bill? Fluency, voice, speech/language Observations about orientation levels... Confirm representativeness of client's performance on assessments ("Is this what they look like typically?) Include a questionnaire Mini Mental State Examination (MMSE) or GOAT -------------------------------------------- Standardized Assessments: Cognitive-Linguistic Quick Test (CLQT) (Helm-Estabrooks, 2001) Assess major cognitive areas and language: attention, memory, language, executive functioning, visuospatial Identifies strengths and weaknesses Targets for intervention Quick, 15-20 minutes (almost a screening), lots of helpful information in short period of time Able to use a pen (connecting dots, circling, maze) Available in English AND Spanish Includes Response Pattern: delayed response, self-correction, unintelligible, no response, perseveration Clinician is able to SEE client perform task (look for compensatory strategies used, functionality) Assesses behavior! Subtests: Personal Facts: Orientation to self ("Where were you born?"), place, time Behavioral Measure: perseveration, self-correction, probing, latency) Symbol Cancellation (memory: remember symbol, attention: focus on task, visuospatial: neglect, executive functioning: look for where they start to cross out symbols) Confrontation Naming (anomia, visuospatial: can they perceive a simple line drawing?) Clock Drawing Attention, memory, visuospatial Story Retelling Look to see if providing prompting questions helps them (could be helpful for therapy) Memory Symbol Trails Attention, memory, problem solving Generative Naming Look for a pattern or random (farm animals), perseveration Design Memory Mazes Design Generation Severity Ratings: Normal Mild Moderate Severe ----------------------------------------------- Scales of Cognitive Ability for Traumatic Brain Injury (SCATBI) (Adamovich & Henderson, 1992) Documents progress overtime Assess major cognitive-linguistic areas Helps to determine WHERE to begin in therapy Test items are ordered easy-hard (cognitive processes hierarchy) Tasks increase in difficulty If client cannot complete earlier items then they will not be able to do the later ones (save them aggravation) → discontinue if they are continuing to fail MUST be administered to clients with RLA-R Level of 4 (Agitated) or above! Takes 2 hours to administer* MUST be considered Requires a lot of focus, time-consuming Does not assess visuospatial OR behaviors! Subtests: Perception and Discrimination (Includes Attention) Orientation (Person, Place, Time) Organization (Includes Categorization & Sequencing) Recall (Verbal, Visual Memory) Reasoning Severity Score: Lower Score → More Impaired Severe: 3-6 Moderate: 7-9 Mild: 10-12 --------------------------------------- Ross Information Processing Assessment (RIPA) (Ross-Swain, 1996) Identify and quantify information processing deficits Assist in establishing treatment goals Document progress overtime Subtest organized from simple to complex Description of/quantify behaviors included* Normed for RLA-R Level 5 & above Great for clients with limited motor skills → ONLY verbal responses Heavy on orientation and memory Longer test → 45 minutes Subtests: Delayed Recall Task (before subtest #1) "What are the two objects that I asked you to remember at the beginning of the test?" Temporal Orientation Age, days in a week Spatial Orientation Problem Solving: Scenario Auditory Processing Severity Rating: Mild: 14-20 Moderate: 11-12 Marked: 8-10 Severe: 1-7 Language Sample: Cookie Theft Picture Description Information about... Discourse Cohesion ("flow" of sentences) Topic Maintenance Verbose, tangential Pragmatics Gestures Affect

SCATBI

Scales of Cognitive Ability for Traumatic Brain Injury (SCATBI; Adamovich & Henderson, 1992) -SCATBI SEVERITY SCORE: overall severity across sections (mean: 10 SD:3) -severe 3-6 -moderate 7-9 -mild 10-12 -borderline normal: 13-15 -average: 16 and above -covers cog-ling areas for TBI (attention, orientation, memory, EF) -specifically for TBI (pros and cons to administering to other cog-ling disorders) -comparing a person with brain injury to another person with a brain injury -Can administer in acute, rehab, or long term care -while this is an in depth test, very time consuming cons: -unlike CLQT no structured way to account for behaviors -test takes two hours -pt won't be able to sustain attention -may be better for out pt (RLA 8-10) -Can attempt at RLA 4, but may try CLQT (faster test admin, not as taxing but not as in depth) SCATBI is based upon "hierarchy of cognitive processes" (5 different scales): Perception and discrimination (includes attention) Assessing attention: have to pay attention to verbally presented (i.e. tapping when person reads the word "to" and visually presented (i.e. "point to all the yellow ones, different visual stimuli asked to pay attention to, point to item, pt has to say outloud). Orientation Biographical questions Organization (includes categorization and sequencing) If pt fails 1-3, don't continue with section Not just looking at categorization, look at how they approached card sorting task (working memory regarding rule, attention, executive functioning-planning) Recall (memory—verbal and visual) Read a short passage and ask fact-based/inference questions (pickles and icecream passage assumes background cultural knowledge- that pregnant women like this) Reasoning idiom/proverb questions culturally specific, requires specific background knowledge Deductive reasoning task (e.g. ilene smith cadillac, donna hood ferrari + three families/1-3 children/different kinds of boats) cadillac /ferrari task requires inference/background knowledge (cultural bias) Have to hold on to the info (with TBI may not write down, if they do, may not be organized) It's about looking at the process the pt. Uses. not supposed to slow down rate of speech. SCATBI administration -provide pen/pencil and paper- not mandated but there if pt. Wants -administered to pt. At RLA 4 (i.e. agitated and confused) or above. -within each section is a subtest "testlet"... if pt. Doesn't get three right in a row, move to next section since tasks increase in difficulty as they progress -1 or correct, 0 for incorrect -percentile rank or standard score- mean of 100 with SD of 15.

Social language development test

Social language development test (adolescent and elementary versions) -'gets at some of the harder things to get at' -includes picture stimuli book and sample answers manual -elementary ages 6-11.11 -stimuli no repetitions Adolescent 12-17.11 No hierarchy of stimuli difficulty, b/c who to say what is more difficult? Both tests take about 45 min to administer No basal or ceiling Can use the prompt "what else can you tell me" Score is based on relevancy and quality...a score of 0 would be for a hurtful, irrelevant vague response. Elementary subtests: Making inferences: have to take on character of picture, and speak in the third person, then needs to show a clue (body language or facial expression) that made student think of answer Interpersonal negotiation student needs to pretend they are in conflict and state the problem, state a solution, and justify solution Multiple interpretations: provide two interpretations of a situation in the photograph (boy sitting with backpack, what's he doing?) Supporting peers... students assume role of a main character in a situation and make a comment that supports/pleases a friend even if it's not honest. Adolescent subtests: Two questions per item: need to get both right to get credit Making inferences: have to say what chacater is thinking Interpreting social language: asks for interpretation of idiom, show action (i.e. show me a posture that sends a message) etc.. Problem solving: need solution and justification to get question... both questions are asked at once. Social interaction: students listen to situation about what you would do and say. Looking for how you would respond, socially appropriately. Interpreting ironic statements asks students to understand intention of speaker and reject literal meeting...look at ironic statements -remediation strategies related to each subtest, so if student is weak in one area, book includes strategies -some scenarios are uncomfortable (i.e. "your friend's mom has cancer, what would you say to her?).

fluency protocol

Stuttering severity instrument Need some standardized assessment (SSI-4) for any assessment of fluency... -can include qualitative analysis when giving SSI-4 -analyze disfluncy type -characteristics of: syllable repetition, sound prolongations, description of respiration, quality of response Concealment strategies -swallowing, covering mouth, coughing, acting 'spacy' (i.e. "I don't know, you're talking to me?) Case History Information • Developmental, speech/language history an adult with a stutter may have a traumatic brain injury, may confronting just, could be psychological, have some trauma, psychogenic. Ig tip off is age of onset. Situations that make them stutter more or less Neurogenic/psychogenic stutterer will not be fluent in the same ways that someone with stutter will be (stutterer fluent during rote tasks, choral singing) • Previous testing •Input from significant others: family, teachers, etc. Assessment of Overt Features of Stuttering • Stuttering Severity Instrument (SSI-4) (score tapes twice, to get intrarater reliability) -can be used as diagnostic tool, prepare tx plan, document change pre/post tx Sound/syllable repetitions (stuttering behavior is narrowly defined) Easy to use/effective in assessing the surface features Severity of stuttering determined by: Frequency of stuttered syllables Both in conversation and oral reading tasks Cound 300-400 syllables for speaking task, syllables are only counted once Count disfluencies Syllables are counted as disfluent only one Multisyllabic words may have more than one MOS Phrase repetition is not counted [my mother x3]... pay attention to word after repetition, this word may be blocked, keep coming back to previous words to try again. Average duration of 3 longest MOS Concomitant struggle behaviors (grimacing/mouth muscles jaw tensions/widening eye movements, squinting, movement of hands, arms, legs, as long as it occurs during stutter, forced swallow, head movements (after seeing client do a behavior, can see how it feels)... counted every word after forced swallow as stutter (pple do all sorts of things that people think facilitates fluency) w-w-w>>>>>what-what (two types of disfluencies but only counted once)g • Speaking and reading samples videotape during oral reading tasks, speech samples should be 300 to 400 syllables. Ask client if it is typical of their speech... can get stutter that is not representative, have them come back, videotape at home, go into classroom and observe child in school Child brings materials of interest • Extra clinical samples when needed Assessment of Covert Features OASES (OASES Yaruss; Quesal. 2010 Pearson Publisher) Overall Assessment of the Speaker's Experience of Stuttering (OASES) -three versions: school aged, teens and adult versions (more questions as you go up in age) -can be used as diagnostic tool, prepare tx plan, document change pre/post tx -to score, add up numbers (not just number of 2's, 3's, etc). -info used in program planning: to determine ratio of working on motor vs. emotional aspects of stuttering -self-report so may not be accurate (if client wants to please you, if they are board, etc may not get accurate response (or denial) -getting a sense of what issues are... when coming up with program planning, quantifying changes -always look at what client has to say: these tests help to document progress pre and post tx -higher score means perception of stuttering impacte worse - • Erickson Scale of Communication Attitudes S-24 -higher the score the poorer the communication attitude -prognostic indicator... indicates if pple need to work more on cognitive area. w/o shift in attitude, will continue to relapse • The Behavior Assessment Battery • Speech, Language, Hearing Testing When Appropriate

Ravens colored progressive matrices (RCPM; Raven, 1995)

nonverbal IQ- pattern matching test from stanine score (best is 9, worst is 1) to determine high or low functioning. if eyesight may be an issue, screen first to see if pt can do the assessment by showing her a page with images/colors/numbers (want to see if she can process) to see if pt can scan spontaneously to find information

TACL

Test for auditory comprehension of language-4th edition (Carrow-Woolfolk, 2014) 3-9;11 -Identify children with receptive language disorders -Guides clinicians toward specific areas of grammar that need additional testing -Provides means of measuring change in grammatical comprehension 3 subtests (Vocabulary, Grammatical Morphemes, Elaborated Phrases & Sentences) Could use this test for non-verbal child. Quick and used with broad range... if child not following along in class. Might use with child with expressive language issues.... Gives insight into language deficit. Remember: what is the question, that will dictate which test to use. For each item, say "show me____". For under five: Can repeat after 10 sec if no response... score of 0 if not. If fail first three practice questions, don't do test... good for non-verbal child to find out comprehension abilities. Grammatical morphemes subtest. Standardized test that can be administered to children ages 3 to 12 years old. If you don't administer test in proscribed way, report. If outside rigid structure of test administration, use test to get the information that you need. Pro: All of test instructions are in front of test booklet. Pictures are brightly colored.. Give you a lot of info on receptive language. Good with non-verbal child. Straightforward to administer and score. Con: Not much room: three and three is basal and ceiling (small margin for error)... few opportunities to show if they can do it. Prompts are long and you can't repeat. Same prompt for every question "show me" some images not very current (old TV that isn't used any more).

TNL-2

Test of Narrative language (TNL-2; Gillam & Pearson, ) -identify child with narrative language probs or pragmatics -document progress/language gap between expressive/receptive TNL can be used to test ages 4-15;11 Every task has a picture No basal or ceiling Six tasks. Two tests: comprehension or production -script-like story: includes commonly followed routine -fictional story -personal-like story For comprehension tests, cannot repeat any questions -doing comprehension and production dubtests together, can combine into narrative language ability index (NLA) -limited use of prompts (what happened to boy) but can only give prompt once Mcdonald's story -comprehension subtest begins with the question asking if child has ever eaten at mcdonalds or burger king, child listens to story and looks at picture, then asks inferential and literal questions. You score for grammar as well as inferences and literal questions. Shipwreck story -child listens to the story looks at pictures and answers mix of inferential and literal questions. Treasure task Comprehension -child listens to story of two children Task six: aliens... child create story based on picture of aliens Pros Alternating test admin of comprehension and production allows adult to model narratives Recording allows for efficient process so double check responses Gives prompts to child to preface the story Giving comprehension info actually primes child for telling the story., remember certain types of knowledge. Con Surprising that they kept the mcdonald's story Depends on how kid uses pictures Include visuals but same from TNL-1 May depend on cultural exposure (maybe never been to mcdonalds) Some comprehension questions might be too specific/knowledge based (why does your mom get a salad? May lack exposure to know how to answer). May not appropriate for 4 year old, where only getting a few items can be within range of normal.. Older kids may benefit more.

TOPL-2

Test of Pragmatic Language-second edition (TOPL-2; Phelps-Terasaki & Phelps-Gunn, 2007) Pictures new: first TOPL had no pictures -6;0-8;11 or 8-18 -45-60 minutes 6-8 year olds, focus on the first 17 items, but all the way up to 43... -Have to start administration for item 1 Must administer whole test. No basal or ceiling Can repeat directions and point to picture Intensive scoring process, but easy to administer (Good item analysis) Prompts are long: easy to become distracted Extensive writing: examiner must write everything down -con of test: most of the test asks you to apologize, and then give response.. Won't do well if you're not an apologizer. -examine different aspects of social communication and documents progress Subtests... all embedded w/in each prompt Physical context: attend to setting/event/context characteristics... has to answer about what boy's body language says Audience: adjusting to audience/turn taking/point of view Topic: have to be able to introduce topic, change topic, maintain topic, repair communicative breakdown Purpose: informing, explaining, requesting, persuading, negotiating, describing, warning, regulating, objecting... focusing on communication breakdown, explaining what they did and why Visual gesture: reading and monitoring facial expressions, body language, gesture Abstractions: explaining a proverb or metaphor in a way that is relevant, makes sense, and explains symbolic ,message Pragmatic evaluation: must justify why someone would give a certain response

PLS-5

Zimmerman, Steiner, & Pond (2011) developed Preschool Language Scales Fifth edition (PLS-5). auditory/receptive: Evaluates a child's comprehension of language: Items for infants & toddlers reflect precursors to language development (e.g. attention to speaker, object play, etc.) Items for preschoolers assess vocabulary, concepts, morphology & syntax Item for school aged children evaluate comprehension of complex sentences, use of language to make comparisons & inferences, emergent literacy skills expressive: To determine how well a child communicates with others: Assesses vocal development & social communication in infants Preschoolers are asked to name common objects (expressive vocabulary), use concepts that describe objects & express quantity, prepositions, grammatical markers, and sentence structures For older children emergent literacy skills are assessed by tasks of phonological awareness & ability to re-tell a short story in sequence, and integrative skills are evaluated by use of similes, synonyms, and language to classify words Language Sample Checklist provides an overview of content & structure in spontaneous speech, MLU (part of test protocol form) Articulation Screener is for children 2.6 through 7.11 to determine if further testing is necessary (part of test protocol form) and is criterion-referenced measure Home Communication Questionnaire is for children birth - 2.11 and provides the caregiver's perspective of the child's communication behaviors and yields information about the child's communication strengths and challenges (separate form) language Skills Analysis This is a reproducible form found in the Administration & Scoring Manual. It shows all the items on both scales by age level and allows for a quick scan to look for patterns PLS-5 Profile This is the final section within the test protocol form & provides another analysis of the child's error patterns, divided into type of skill within each scale (e.g. spatial concepts, syntax, etc.)

apraxia of speech (adult)

To see if client shows symptoms of dysarthria (weakness) or apraxia (groping): Oral Speech Mechanism Screening Exam - 3 (OSMSE-3; St. Louis & Ruscello, 2000) Apraxia Battery for Adults-2nd (ABA-2) (Dabul, 2000) determine severity of apraxia determine potential treatment approaches 6 subtests diadochokinetic rate increasing word length limb apraxia and oral apraxia latency time utterance time for polysyllabic words repeated trials ****To see if pt gets better or worse with repeated trials: if they get BETTER, then MLG is an appropriate treatment option.

TTFC-2

Token Test for Children-2 (TTFC-2;McGhee, Ehrler, & DiSimoni, 2007) 3-12;11 Assesses listening comprehension and ability to follow multiple step verbal directions to further probe child's receptive language skills Practice Section (must get all 3 right) Parts 1-3: tasks increase in length b/w and maintain difficulty within Part 4: increasingly complex within 15-20 minutes -20 tokens that vary in shape, size & color -No ceiling -Basal: correct on all practice items Not functional, hard for the clinician to administer. Good if the child needs manipulatives to help them. Subtests I. PRACTICE SECTION Basal-Child correctly answers all 3 practice items correctly II. PARTS 1-3: The tasks get longer in each part but level of difficulty remains the same within each part Part 1 Use all tokens Example: "Touch the small yellow circle" Part 2 Use the large tokens Example: "Touch the yellow circle and the red square" Part 3 Use all tokens Example: "Touch the small yellow circle and large green square" Part 4: Level of difficulty increases within this part Use the large tokens Example: "After picking up the green square, touch the white circle"

WAB-R

Western Aphasia Battery-Revised (WAB-R; Kertesz, 2007) -Determine presence, severity, and type of aphasia -Measure patient's level of performance over time -Provide a comprehensive assessment of patient's strengths and areas of impairment (language) to guide treatment -Better for more severe—slightly easier (Y/N questions, objects) -Oral Portion (Information Content, Fluency, Auditory Comprehension, Repetition, Naming) -Nonverbal Portion--OPTIONAL (Language Comprehension, Written Expression, Praxis, Construction [drawing, block design, calculation, Raven's score]) -Oral Portion: Aphasia Quotient -Language Comp & Written Exp.: Language Quotient -Praxis, Construction: Cortical Quotient -Need objects -Oral portion can be administered in 1 hour -Subtests organized by language area and hierarchically Need to complete entire test to get AQ or CQ Comprehensive test of aphasia that is better for someone more impaired because there are manipulatives and questions are a bit easier. Have to administer entire test and answers can only be given verbally. Generative naming section (name as many animals as you can). Test directions given- interrater reliability Prepackaged but need to administer whole thing Oral portion most important on test: (all the verbal expression and auditory comp tasks) Have to administer all subtests in oral portion to get aphasia quotient ---------------- Scoring: Cortical quotient: praxis, construction Language quotient: reading comp, written expression Aphasia quotient: reliable measure of severity of language impairment. Scored based on verbal/auditory section -need to assign severity... Assesses using verbal/aud and not written/ Some relationship between AQ and type of aphasia (e.g., Global aphasia scores below 25) Differs from BDAE-3 in terms of determining severity Cut off score to have aphasia or not is 93.8... if above this number, no aphasia. Below 93.8 suspicion is that you have aphasia AQ severity rating: Very severe: AQ 0-25 (global) Severe: AQ 26-50 Moderate: AQ 51-75 Mild: AQ 76 and above (up to 93.8) classification chart Type of Aphasia is determined using this chart (based on subtest scores) --------------------------------------------- WAB: lower score is more impaired and higher score is less impaired. On WAB page 10, look at WAB-R aphasia Classification criteria... look at how scores in fluency, auditory verbal comp, repetition, and naming/word finding match up wiith type of aphasia. If you circle all four boxes across one line, that is your type (global, Broca's isolation, transcortical motor, wernicke's transcortical sensory, conduction, Anomic) -About 80% fit into a specific type, 20% do not... subcortical types (site of lesion) impacts how type looks. - Hemisphere dominance can also impact how symptoms appear. -comorbidities can also confound things -etiology: what caused the aphasia The tests are normed on people with aphasia that had a focal site of lesion- if someone has TBI, could be focal/diffuse or brain tumor. ------------------------- WAB Subtests advantages of objects as stimuli -Good for pts with visual perceptual / visual acuity problem -Good for more moderate-severe cases (more tangible) -If imitating object use helps, candidate for Visual Action Therapy ==================================== Oral Sections Spontaneous Speech Auditory Verbal Comprehension Repetition Naming and Word Finding Spontaneous Speech Subtests Information Content Fluency, Grammar and Paraphasias Auditory Verbal Comprehension Subtests Y/N Questions (fantastic) Auditory Word Recognition Sequential Commands Naming and Word Finding Subtests Object Naming Word Fluency Sentence Completion Responsive Speech Oral Sections: -spontaneous speech-Fluency, grammatical competencend paraphasias -Auditory Verbal Comprehension -Repetition -Naming and Word Finding Apraxia items Upper limb Facial Instrumental Complex ___________________________________ Helps determine type Aphasia Quotient Reliable measure of severity of language impairment Oral Sections: SSP, AVC, R, N&WF ○ Very severe: AQ 0-25 (Global) ○ Severe: AQ 26-50 (Broca's and Wernicke's) ○ Moderate: AQ 51-75 (Transcorticals, Conduction) ○ Mild: AQ 76-93.8 (Anomic) Aphasia Quotient - severity uses subtests: Spontaneous Speech (whole section: information content +fluency, grammar, paraphasias) Auditory Verbal Comprehension Repetition Naming and Word Finding Aphasia Classification Criteria Fluency, Grammar, Paraphasia subtest (NOT Information Content) Auditory Verbal Comprehension Repetition Naming and Word Finding

Values cards + life interest

determine what client wants to work on and is important to the client

Swallow eval

first screen by asking pt/caregiver about cough/ what food do you like- self-limiting (soft solid only), what about steak? fatiguing while masticating regular solids bedside eval (if no prior issues-unrestricted diet) involve- cough, lip seal, wet vocal quality. observe during meal- time to eat/ pocketing

SEE

ocial Emotional Evaluation (SEE) Age 6-12;11 Admin time: 20-25 Criterion referenced Measures emotional and social awareness as well as social-emotional competence Includes social-emotional questionnaire Criterion referenced test: Z scores: basic standard score, how far they are from mean (1 means they are 1 above the mean, and -2 means they are 2 standard scores below the mean) Percentile ranks No reinforcement allowed "you're working hard" is ok Breaks allowed No basal or ceiling Repetitions are allowed subtests Identifying common emotions: match picture of 6 basic emotions Identifying emotional reactions: which picture makes the person feel that way (child sees toys) Understanding social gaffes: identifying an unexpected behavior... identifying situations that would result in conflict with peer Understanding conflicting measures: looking for inconsistencies between verbal and nonverbal aspects. Did the person in the CD mean what they said? There is a social emotional questionnaire. Caregiver and examiner fill out form, can infer comparisons between what perceived social abilities are perceived at home vs. at school. Also helps to see if test results are consistent with what is observed at home/school. -Can't get a score w/o doing all the subtests -must have accessible CD player