CSAD 147 - Exam 1

Assessment is...

-Process of collecting valid and reliable information

-Integrating the information

-Interpreting the information

-Making a judgment

Overview of Assessment - A good assessment is...

thorough, uses variety of modalities, valid, reliable, tailored to the individual client

Ethical assessments - expectations

-Maintain professional integrity

-Maintain the highest level of professional expertise

-Practice in their area of expertise

Assessment outcomes are...

- A diagnosis or diagnostic label

- A clinical decision regarding the presence or absence of a disorder

Assessments are used to...

-Make further assessment decisions

-Make diagnoses

-Draw conclusions

-Identify the need for outside referral to other professionals

-Identify the need for treatment

-Determine eligibility

-Determine the focus of treatment

-Determine the frequency and duration of treatment

-Determine structure of therapy

-Determine severity

-Make therapy recommendation

-Determine progress

Eligibility: CA dept of Ed- to qualify for language therapy you need __ tests in the same area, below ___ percentile, below ___ standard deviations from mean.

2, 7th, 1.5

What are the components of an assessment?

RIOT

Records review

Interview

Observations

Testing

Where we start:

Concern communicated by parent, caregiver, teacher, allied professional

Where we go:

-Related area

-Poor grades/history/diagnosis (child find)

Speech- related areas

articulation, phonological processes, motor planning, intelligibility

Language- related areas

semantics, morphology, syntax, receptive vs expressive

Oral motor- related areas

structure, function, DDK

Other areas we might look at

- Cognition

- Pragmatics

- Chewing/swallowing

- Resonance

- AAC

- Written/Reading

- Voice

- Fluency

- Hearing

Why records review matters

- provides background context

- saves time during assessment

- identifies red flags or areas needing attention

- helps tailor evaluation to client needs

What are some examples of records?

medical reports, educational records, therapy notes, family/social history forms, standardized test results

What are the goals of records review?

- understand case history before meeting client

- recognize patterns across reports

- identify previous diagnoses or concerns

- note strengths and supports already in place

- guide hypotheses for current assessment

Step-by-step process for records review

1. gather all available documentation

2. organize chronologically

3. highlight key medical, developmental, or educational info

4. note discrepancies or missing information

5. prepare targeted questions for interview or evaluation

When looking at records, what are we looking for?

- birth and developmental history

- medical conditions

- educational performance

- previous SLP assessments

- intervention history

What questions should you be asking during review?

- What does this information suggest about possible speech/language needs?

- How reliable is the source?

- Does the information align with presenting concerns?

What are the red flags in records review?

- unexplained regression in skills

- repeated mentions of attention or memory issues

- hearing loss or recurrent ear infections

- limited progress despite intervention

- significant discrepancies between reports

Why does interview matter?

- provides first-hand client/family perspective

- builds rapport and trust

- clarifies concerns and priorities

-fills gaps from records review

- guides assessment focus

Who do we interview?

clients, parents, teachers, healthcare providers, other professionals on team

What are the goals of interview?

- understand communication concerns in daily life

- gather case history

- learn about strengths and interests

- identify environmental supports/barriers

- prioritize client and family goals

What are the types of interview?

structured, semi-structured, unstructured, combination

What are some key topics that should be covered in interview?

- medical history

- speech, language, hearing concerns

- educational and social participation

- family observations

- previous services

- clients perspective

What are effective interviewing skills?

- use open ended questions

- active listening

- show empathy and respect

- use clear language

- be culturally responsive

Red flags during interview:

- inconsistent reports

- concerns about safety

- signs of regression

- emotional distress

- unrealistic expectations

Pitfalls to avoid in interview

- asking only yes/no questions

- rushing

- not clarifying vague answers

- making assumptions

- ignoring family priorities

Why does observation matter?

- provides real world view of communication

- compliments records and interviews

- captures spontaneous skills

- highlights impact of environment

- reveals strengths not seen in testing

What are the goals of observation?

- identify communication skills

- note interaction patterns

- see how environment affects communication

- verify reports from caregivers

- gather baseline info

What is a naturalistic observation?

observing and recording behavior in naturally occurring situations without trying to manipulate and control the situation

What is a systematic observation?

a planned observation guided by specific goals

What are simulated and structured play observations?

clinician sets up scenarios to elicit specific skills

What are the key behaviors to observe?

- speech clarity and fluency

- use of vocabulary and grammar

- nonverbal communication

- social interactions

- attention and engagement

- behavioral/emotional regulation

Red flags in observation:

- limited initiation of communication

- frequent frustration

- lack of response

- very limited vocab use

- difficulty maintaining social interaction

What are the parts to a test?

manual, easel, protocol, test materials

What should the manual of a standardized test include?

- purpose of the test

- test construction

- administration and scoring procedures

- normative sample group

- test reliability and validity

Validity

the test truly measures what it claims to measure

Face Validity

does this test appear to test what it claims to test?

Content validity

Is the test content representative of the content it claims to assess?

Construct validity

Is the test structure representative of known and verified structure?

Reliability

the results are replicable; consistent results on repeated administrations

test-retest reliability

test stability over time and repetitive administrations

Split half reliability

scores from one half of the test correlate with results of the other half of the test

Intrarater reliability

does the same tester get the same results over multiple administrations

Interrater reliability

do multiple test administers get the same results?

What do sensitivity and specificity measure?

diagnostic accuracy

What is sensitivity in a test?

% of true positives, how well a test identifies a disorder

What is specificity in a test?

% of true negatives, how well a test identifies a normal

True/False Positive and High/Low Sensitivity

Child with a SSD is correctly identified as having a SSD

True positive, high sensitivity

True/False Positive and High/Low Sensitivity

Child WITHOUT a SSD is incorrectly identified as having a SSD

False positive, low sensitivity

True/False Negative and High/Low Specificity

Child WITHOUT a SSD is correctly identified as NOT having a SSD

True negative, high specificity

True/False Negative and High/Low Specificity

Child with a SSD is incorrectly identified as NOT having a SSD

False negative, low specificity

Item bias

individual test item favors one group

Intrinsic test bias

test generally favors one group over another

Extrinsic test bias

test is not biased but the outcomes result from societal differences not the test itself

Test administration considerations

- strict adherence to protocols

- testing environment

- examiner behavior

- recording and scoring

- ethical and professional responsibilities

Accommodations to testing

- minor changes

- do not compromise standardization

Modifications to testing

changes to the test administration protocol

What is chronological age?

exact age of a person in years, months and days

What is adjusted age/ corrected age?

considers missing gestational period and adjusts expected milestones for premature babies

Chronological Age Practice:

Today: Sep. 18, 2025

DOB: Jul. 15, 2024

1 year, 2 months, 3 days

Chronological Age Practice:

Today: Sep. 18, 2025

DOB: Mar. 10, 2018

7 years, 6 months, 8 days

Chronological Age Practice:

Today: Sep. 18, 2025

DOB: Sep. 20, 2007

17 years, 11 months, 28 days

Chronological Age Practice:

Today: Sep. 18, 2025

DOB: Jan. 5, 1990

35 years, 8 months, 13 days

Chronological Age Practice:

Today: Sep. 18, 2025

DOB: Jun. 25, 1975

50 years, 2 months, 23 days

Chronological Age Practice:

Today: Sep. 18, 2025

DOB: Nov. 30, 1945

79 years, 9 months, 18 days