Studied by 4 people
which evidence based factors are associated with external evidence?
empirical evidence- basic and applied, practice guidelines
which evidence based factors are associated with internal evidence?
patient/contextual factors, clinical knowledge and experience
describe the 6 steps to EBP.
develop PICO question (allows us to take clinical question into something that is easily searchable)
find and evaluate internal evidence (can help identify biases)
find external evidence
critically evaluate external evidence
integrate internal and external evidence
apply and evaluate outcome of decision
D FEI FE EE IIE AE
Be able to list and identify the 4 PICO components if given PICO question.
P: problem or population
I: Intervention
C: Comparison
O: Outcome
Why is it important to assess research design when evaluating external evidence?
understand credibility of study and determine which study you might rely on more to gain accurate information
What is the difference between experimental and non-experimental research studies?
experimental: when researcher has manipulated something in order to see an effect
non-experimental: when researcher has not done something but still want to see an effect
what does it mean if an article has been peer reviewed?
journal receives an article and sends it out to other clinicians/professionals who also do similar types of research. These peers read article and validate research design and judge different qualities. The article in turn improves and authors can fix mistakes.
Name this study: level IV report that uses data from other studies to answer PICO questions with what experts think about the topic.
Expert Report
may contain bias
is an expert report experimental/non-experimental, group/no group, control/no control?
non-experimental, no control, no group
just opinions
which level of research design can you draw a definitive conclusion from?
RCT and systematic reviews
name this study: Level III study that is an in-depth and detailed individualized examination of one person/situation
case study
just recording
is a case study experimental/non-experimental, group/no group, control/no control?
non-experimental, no control, no group
name this study: Level III study that examines a situation and reports how that situation is working.
cross-sectional
mostly interview and observation
is a cross sectional study experimental/non-experimental, group/no group, control/no control?
non-experimental, no control, groups
name this study: level IIb study that establishes a baseline, makes a change and constantly observes effects of that change.
single case experimental design (SCED)
has phases, called ABA design, has repeated measures
is a SCED experimental/non-experimental, group/no group, control/no control?
experimental, control within participant, no group
individual participants change not whole group change
name this study: level IIb study that uses a test, teach, retest design and measures change in outcomes (mean scores).
quasi-experimental
one measure in time compared to another measure in time
is a quasi-experimental study experimental/non-experimental, group/no group, control/no control?
experimental, no control, one group
name this study: level Ib study that randomizes participants, does an experiment and compares groups to see which group produces better outcomes.
Randomized control trial (RCT)
is an RCT study experimental/non-experimental, group/no group, control/no control?
experimental, controlled, groups, randomized
name this study: level Ia study that is a review of experimental/control studies.
systematic review
is a systematic review study experimental/non-experimental, group/no group, control/no control?
depends but usually experimental, groups, controlled, randomized
name the studies from least to greatest credibility.
expert report
case studies and cross sectional
quasi experimental or SCED
RCT
systematic review
why is randomization important for group design studies?
ensures all groups in group design are equal and will continue to be equal throughout the study. The only difference between the two groups is the variable you are wanting to change
what is lost if you don’t randomize in group design studies?
equality between groups
How is the control different in SCED and RCT research studies?
SCED: control within participant. participant is compared to themselves before vs after treatment
RCT: control is another group of participants that have not undergone treatment
what is the difference between statistical and clinical significance?
statistical: statistics in relation to means that show that one group is different than the other based on what you are measuring (looking for effect size).
clinical: whether treatment is beneficial enough and makes a big enough impact in patient’s life for amount of money, time, energy the treatment/experiment took.
what is an example of statistical vs clinical significance?
In a study on MLU, the control group may have increased their MLU by .1 compared to the experiment group who increased they MLU by .2. This might be statistically significant for the experiment but in the eyes of a parent/client, this would not be significant because of the time, money and energy put into this therapy.
what are two barriers to evidence-based practice?
lack of time to search, read, analyze published research evidence
lack of competent abilities to efficiently search and find relevant evidence
why is it important to consider quality of research study, in addition to study design?
there can be a high level research design that has a lot of evidence but was conducted poorly. the level of research design does not automatically assign credibility.
what is the ICF-FY framework?
International Classification of Functioning, Disability and Health: Children and Youth Version by the World Health Organization
why is the ICF-FY framework helpful when considering client factors, values and preferences?
holistic perspective and includes considerations of physical body and its structure, person’s activity level and participation. also includes environmental and personal factors. does not solely focus on impairment
what could make generating a clinical decision after weighing all internal/external evidence more difficult?
there is really no one intervention approach or target selection strategy that is better than all the rest for every single type of client. can be difficult to take in all three sources of evidence and make a decision.
what is the difference between inductive and deductive reasoning?
deductive: move from general assumption to something specific (fact)
inductive: going from specific instance to general conclusion
which type of reasoning is based on fact- inductive or deductive?
deductive
inductive is based on what you’ve observed and your general conclusion- not always right
define cumulative treatment intensity
whole amount of therapy client will receive, including practice at home
define treatment strategy
methods we use to teach
define antecedent
prompt or instruction, what clinician does to set up a situation
define consequence
feedback from clinician
why is it important to write treatment goals?
more likely to achieve your goals because you have a plan and can keep yourself accountable. you will know exactly what the outcome should be and how to get there. stay on the path!
how do you determine what goals are best for a client?
look at assessment outcomes, client’s values and challenges, clinical evidence, progression from the pass
determine what is attainable and SMART
what is the zone of proximal development?
difference between child’s current level of independent performance on task and how they succeed at same task with assistance
how does the ZPD relate to writing goals?
make sure goals are within ZPD and break down steps, treatment should occur between what student can do on their own and what they need full support with.
what are long term goals?
big benchmark goal that is achieved during course of therapy over longer course of time
what are short-term objectives?
smaller goals that lead to achieving an LTG, monitor progress of that path
what are session objectives?
goal for the session, leads to an LTG, might be an STO
what are additive objectives?
working on STOs all at once and working on them all together will add up to LTG
what are sequential objectives?
sequenced steps of STOs, must mark off previous STO before you move on, think of a pathway
define the SMART criteria
Specific: detailed enough to be understood by others
Measurable: need to know when you reach goal
Attainable: belief about whether person can actually meet goal
Relevant: should be working toward something that is meaningful for client’s life
Timely: need to have timeline of when you think client will achieve goal
what is the difference between continuous dosage vs sprint/variable dosage?
continuous: see client regularly within specific amount of time with normal intensity
sprint/variable: see client for blocked out amount of time with high intensity and then take a break
how does an SLP shape behavior through antecedents and consequences?
SLP changes antecedents and consequences in hopes of getting the right behavior.
what are examples of antecedents?
gestures, explanations, questions, hand over hand
what are examples of consequences?
high five, candy, point system, verbal praise
what are step up clinical strategies?
when client is doing well and clinician makes it harder- step up expectations and give more independence
what are step down clinical strategies?
client is struggling and clinician makes it easier- step down expectations
what are contextual supports?
environment, proximity, noise level
what are intervention materials?
materials used to support strategies
client self monitoring, intermittent feedback and others providing feedback are all supports that help a client to do what?
generalize their skills outside of therapy room
what is client self monitoring?
skill SLP can teach where client self monitors to see if they are accomplishing their tasks correctly outside of therapy
what is intermittent feedback?
giving less feedback/consequence as student excels and learns so they are able to complete task without your constant support and feedback
helps with motivation
why do we take data during treatment?
know if client is making progress toward long term goals and short term objectives
make changes during session based on the data
what is qualitative data?
descriptive data, journaling or observing, interview or reported info
what is frequency data?
how often behavior occurred, percentage, needs demoninator
what is duration data?
how long behavior occurred
what is interval data?
if behavior occurred during set amount of time
Categorize this information into SOAP: after this session, client with continue to practice minimal pairs with her parent during bathtime.
plan
Categorize this information into SOAP: client’s mean length of utterance during the session was 4.75.
objective
Categorize this information into SOAP: Client’s parent reported that the client’s distinction between minimal pairs has increased and the practice seems to help her understand to listen to the sounds in a word.
subjective
Categorize this information into SOAP: client’s progress is likely due to a lot of listening practice at home.
analysis
Categorize this information into SOAP: answering questions should continue to be targeted next week.
plan
Categorize this information into SOAP: client’s parents reported client was having trouble staying awake in class.
subjective
Categorize this information into SOAP: client identified a distinction between minimal pairs with 60% accuracy.
objective
Categorize this information into SOAP: client improved her ability to distinguish minimal pairs by 6%, as compared to last session.
analysis
Categorize this information into SOAP: client arrive to therapy session with parents but one parent left midway through.
subjective
Note 
Flashcard (64)