CSDS 110 Exam #1 Study Guide

Define confidentiality and list information considered to be confidential

don’t yap about your client to other people #hippa

Name, family, address, medical history, educational history, diagnosis, treatment plan, etc.

Knowledge of the responsibilities of a student observer

Arrive on time

Introduce self and request permission to observe

Observe entire session

Respect client’s right to confidentiality

Discuss a client privately with clinician/clincial educator

Do not interrupt session/waste clinician’s time

Do not remove clinical information from the clinical area

Increase observational skills

Present self as professional

Complete observation report forms for each client/have clinical education sign

List the observation guidelines/questions the student should be asking regarding the treatment session

What type of severity and commnuicative disorder did the client exhibit?

What were the objectives of the session?

How were the target behaviors?

How was the session structured?

How was the room arranged?

How were the client and clinician seated in relation to ach other?

What types of materials and activities were used?

What did the clinician do to train the target behaviors?

What types of cues were used?

What types of reinforcers were used and on what schedule?

How were undesirable behaviors decreased?

How were responses charted?

What activities seemed to bemost effective?

What activities seemed to be least effective?

If you were the clinician, what changes might you make for the next session?

Basic Assessment

Background and presenting complaint

Observation and Test Results

Summary and Prognosis

Recommendations

Background and presenting complaint

case history

Interview

info from other professionals

Determines if the client’s communication difficulties might be part of other problems

Observation and Test Results

Hearing screening

Oral-preipheral examination/speech mechanism exam

Spontaneous Speech and language sample

Other “informal” or “alternative” measures of speech and language, as needed

“Scales” and/or “inventories,” as needed

Standardized Tests, as appropriate

Stimulability testing

Explain the importance of Case History form and potential reliability problems

completed by the child’s caregiver, family member, or by the client

Understand both the past and the present history of the child

Serves as a guide for the clinical interview

Frequently filled with reliability problems like caregiver memory, faking

Understand the guidelines a clinician should follow during clinical interviews

Conducted with those who accompany the client to the clinic to provide additional information

Review the written case history form

Establish rapport

Overview of what is planned for the session

Specific interview questions will vary

Interview guidelines 3 phases: Opening phase, content phase, closing phase

Describe the hearing screening procedure

Typically administered at 20-25 dB for the frequencies of 500, 1000, 2000, and 4000 Hz

Administered in a quiet environment using a well maintained and calibrated audiometer

“Play audiometry” may need to the used with a young child

Referral to an audiologist, if appropriate

Pure tone hearing screening procedures

Pure tone hearing screening procedures

Positioning

Verbal instructions prior to placing the earphones

Condition the child to respond appropriately

Present pure tones

Testing limits

If the child does not respond to one or more frequencies, may reinstruct, reposition headphones, or rescreen

Describe the purpose of the orofacial examination

Evaluates the structural and functional adequacy of the oral mechanism

Structural adequacy

the normal development of the orofacial structures and their relationship to each other

Functional adequacy

how these structures move and perform during speech production

Implications of Irregular facial symmetry

muscle weakness, nerve damage, stroke, neurological involvement

Implications of Unusual facial features

fetal alcohol syndrome, down syndrome

Implications of Clavicular breathing

poor respiratory support, could be neurological (check medical record)

Implications of Mouth breathing

lip weakness, enlarged adenoids/tonsils, velopharyngeal insufficiency, forward tongue carriage

Implications of Irregular breathing

may affect speech prosody/neagative effect on vocal quality

Lips Implications

discoloration=poor respiratory support,

scars=repaired cleft lip/palate

muscle weakness=neuro involvement

Can’t sustain air pressure=weakness/velopharyngeal insufficiency

Sequencing problems=apraxia

Tongue Implications

with neuro issue tongue with deviate to the weak side,

tongue tie=can’t stick tongue out past lips, heart-shaped tonue

weakness, sequencing=apraxia

Teeth Implications

discoloration=poor dental hygeine/nutrition/medications/medical conditions

poorly developed teeth=medical condition/syndrome

poorly aligned=various craniofacial anomalies/syndromes

Severe malocclusion/dental alignment=interfere with articulation

Open bite/overjet=tongue thrust or forward tongue carriage

Hard palate Implications

discoloration/scarring=palatal fistula, repaired, unrepaired or submucosal cleft (bifid uvula)

Significantly high/narrow palate=forward tongue carriage, articulation problems

Pronounced rugae=tongue thrust/forward tongue carriage; often co-occurs with high/narrow/low palate or large tongue

Soft palate Implications

Bifid uvula=submucosal cleft or velopharyngeal insufficiency

Asymmetry of faucial arches/deviation of uvula to one side=neuro involvement, arches droop on weak side, uvula deviates to strong side

Change in vocal quality=VPI

Enlarged tonsils=general health, resonance, hearing problems, forward tongue carriage; could affect speech, but not usually

Weak/absent gag reflex=velopharyngeal weakness/neuro impairment

Hyperactive gag reflex=hypersensitivity

Describe the purpose of diadochokinetic tasks

Assesses the child’s production of rapidly alternating speech sounds

Helpful in the differential diagnosis of apraxia of speech

How to perform the diadochokinetic task

Consists of the production of the following sounds continuously and as quickly as possible /p^ /, /t ^ /, /k^ /, /p^ tə/, and /p^ tə kə / (looking for rate, accuracy, and consistency)

Typically calculated as “repetitions per second”

Rate of repetitions may be recorded on the Protocol and compared against Fletcher’s (1972) norms

Explain stimulability testing and why it is important

Responsiveness to trial treatment strategies

It is a good prognostic indicator (how well or if treatment will work)

Describe the components of a summary statement

Estimate level of severity

State diagnosis if appropriate

Provide characteristics of the given diagnosis

Describe the components of a prognostic statement

Area of imporvement

Judgement of improvement

Judgement of client motivation

Judgement of family support

Client stimulability

Describe the components of a recommendations statement

Treatment recommendations

Therapy goals

Areas where more assessment is needed

Referrals to other professionals or services

Standardized Assessment strengths

Convenience and Ease of Administration

Interpretation of Results

Qualifying and Paying for Services

Objectivity

Standardized Assessment Limitations

Test structure does not allow for naturalistic language

Limited sampling of responses

Test norms

Clinical limitations

Basal Level

entry level (starting point)

Ceiling level

test terminating score

Diagnosis in speech-language pathology

naming a disorder and differentiating from a similar disorder (not a medical diagnosis)

Equivalent scores

suggests that a given score is representative of a particular age group or educational grade

gives an age equivalence but still might not meet the requirement for services

Evaluation

Multidisciplinary team (nurse, occupational therapy, physical therapy, psychologist, SLP)

Must be comprehensive

Assess all areas of suspected disability

Address educational and behavioral concerns

Determines eligibility for services

Normal distribution of scores

represented by a bell-shaped curve with the range of scores or values measured on the horizontal axis and the number of participants receiving a particular score on the vertical axis. The peak of the bell-shaped curve will represent the mean or median score, the average performance on the test, or the 50th percentile.

Norm-referenced

compares the client’s performance to the performance of a normative group

Percentiles

Represent the percentage of individuals in the standardization sample scoring at or below a given raw score

50th percentile represents the mean or median score

Score above the 50th percentile are “above average” in the tested skill

Score below the 50th percentile are “below average” in the tested skill

Questionnaires and developmental inventories

not standardized tests

supplement other assessment data

used to obtain additional information from parents/caregivers

Raw score

Represents the initial scores based on the number of correct responses to test items

Screening assessment

Quickly identifies individuals who communicate within normal limits and those who may have a communication disorder

Consultation, Observation, Formal standardized screening assessment, Non-standardized tasks

Stardard deviation

Represents the extent to which an individual’s score deviates away from the mean

Scores that fall below 1 ½ to 2 standard deviations from the mean are considered clinically significant

Standard scores

Represent the degree to which a child’s score deviates from the mean

Two common types of standard scores: Z score (average is 0, SD 1), T score (normalized standard scores, average is 50, SD 10)

Standardization

a research process that includes careful selection of test items, administration of the items to a representative sample drawn from a defined population, statistical analysis of results, established age-based norms, and development of instructions and response scoring procedures

Stanine

Based on a nine-unit scale with a mean of 5 (representing the average performance) and the SD that approximates 2

Created out of standard and nine

Score only ranges from 1 to 9, all raw scores are converted to one for the single digits within that range

Knowledge of test construction

Test purpose

Stimulus tests

Administration and scoring procedures

Normative sample

Statistical analysis

Validity and reliability

Test manual

Know and understand reliability

= repeatability

Consistency across repeated measures of the same phenomenon with the same instrument

Types of reliability

Interobserver reliability (AKA: interjudge reliability)

Intrajudge reliability (AKA: intraobserver reliability)

Test-retest reliability

Alternate- or parallel-form reliability

Split-half reliability

Interobserver reliability

consistency fo test scores recorded by two or more examiners administering the same test to the same individuals

Intrajudge reliability

the consistency of scores that the same individuals obtain when the same examiner re-adminsters a test or repeats a naturalistic observation

Test-retest reliability

in the construct of standardized tests only

Alternate/parallel form reliability

consistency of measures when two forms of the same test are administered to th same person or group of people, requires two versions of the same test

Split-half reliability

measure of internal consistency of a test, correlates the scores from one-half of the test with those from the other half of the test

Know and understand validity

=truthfulness

Does the test measure what it is designed to measure?

Types of validity

Content validity

Construct validity

Criterion validity

Concurrent validity

Predictive validity

Content validity

demonstrated by expert judgement that the test includes items that are relevant to assessing the stated skill

Criteria Validity

appropriateness of items includes, completeness of the items sampled, ways in which the test items assess the content

Construct Validity

the degree to which a test measures a predetermined theoretical construct, supported by prior empirical observations/experimental data, should produce test scores that reflect the theoretical statement

Criterion Validity

the assurance that the test measures what it states it measures because it is correlated with another meaningful variable, external variable to validate a new test

Two forms: concurrent validity and predictive validity

Concurrent validity

the degree to which a new test correlates with an established test that is already regarded as valid for measuring the same skill or behavior

Predictive validity

the degree to which a test predicts future performance on a related task, takes time to establish/may not be reported in first edition of test

Understand how to determine the most appropriate standardized test to administer

detailed and comprehensive test manual

based on a large and diverse normative sample

samples skills adequately

recently been revised and provides current normative data

strong reliability and validity

appropriate stimulus items

you are well trained to administer

will yield useful diagnostic information and help design treatment goals/procedures