Practice and Reflection Weeks 1-2

Biopsychosocial models of disability contain three key components. Define each of the three components in no more than 1 sentence. In one sentence, why is it important for us to consider biopsychosocial models in our approach to clinical practice?

communication skills: impairment—> what is the structural impairment? (structure function) and activity—> what can the client actually do (usually thinking in the therapy room)

environment: social (attitudes, laws, regulations) and physical (ramps, elevators, subtitles)

personal perspective: things cannot change (race, age), beliefs, wishes

AK:

bio= physical function of the body; the physical impairment

psycho=refers to the psychological/emotional coping and perspectives of the client

social= refers to the environment surrounding the person and the impact it has on health

It is important for us to consider all of these factors in our assessment and treatment so that we can provide holistic care for clients. If we only pay attention to one or two of these factors, we may miss important factors contributing to our client’s challenges with communication in daily life and we may fail to address all the needed areas where the client needs support.

Define or give one example that demonstrates understanding of anti-ableism or anti-ableist care in our profession.

-respecting diverse forms of communication

-not pushing someone to communicate typically or follow the norms (don’t need to conform)

-prioritize what is important to them and where they want their communication to take them

AK:

Ableism refers to having a perspective in which everyone is expected to conform to the norm of “typical function,” and diversity in terms of how people function is not recognized or respected. Anti-ableism counters that perspective by purporting that diversity in how people function should be respected without pressure to conform to norms. This is important in our profession particularly for our clients with chronic disabilities. In an anti-ableist view we respect the person for how they function and do not put undue pressure or stigma on a person for functioning in ways that differ from the typical norm. Our focus is on helping clients to communicate in ways that fulfill their needs and wishes, not necessary compelling clients to function “typically.”

List 3 tips for working effectively with an interpreter for our sessions.

-meet with them ahead of time to go over expectations and purpose

-try to get the same interpreter each session (if possible)

-tell them what we are looking for and not to gloss over errors or fill in the blank for client

-speak directly to client NOT interpreter

-allow ample time

-remember all stages of the encounter because it will all need to be interpreted as well

AK:

1.Speak directly to the patient during conversations – not the interpreter

2. Allow sufficient time for the interpreter to interpret

3. Remember everything will be interpreted. Do not make any side comments or conversation you do not want interpreted

4. Always use a professional interpreter – not family or friends of the client

5. Remember an interpreter will not automatically help you as a cultural broker or do written material translation

6. Avoid figures or speech or other aspects of communication that might not translate well culturally

List two reasons why agenda setting at the beginning of a session is important.

-gives client clear idea of what to expect (help relieve some anxiety)

-clear plan of action during session

-allows client and clinician to collaborate on what to cover based on priorities of client

AK:

1. This helps the client to feel welcome and relax a bit to understand what will happen in the session.

2. This helps to ensure you know the client’s key questions or concerns so you can be sure to address them in the session.

3. This helps to establish a personal yet professional relationship with the client by demonstrating your respect for them

 

Give an example of one open ended question for an intake interview and one closed question (label each)

-Tell more more about your communication? How has your swallowing been? (open)

-What symptoms are you experiencing from your stroke? (closed)

AK:

Open ended: What has been happening with your speech recently?

Close question: What are the prescription medications you are taking right now?

Is the following true or false? If false, how would you correct it?

“screenings are an essential part of diagnostic assessments to compare your client to norm-referenced data”

FALSE

screenings are quick and brief assessments that give us a binary answer as to if they “passed” or “failed” and if a full in depth evaluation is warranted

cannot compare anything

AK:

False. Screenings are not always done so they are not essential. They do not always have comparisons to norm-referenced data. They are a way to identify people who may warrant a full diagnostic eval vs. those who do not based on level of concern raised in the screening.

What do we mean by “least biased assessment” and why is this important?

-keeping in mind your client when choosing assessments. Are they well represented in the assessment of choice (from same cultural/linguistic background)

-does the test manual provide guidance on scoring adjustments for things like dialect?

WANT TO GET RID OF CULTURAL TOUCHPOINTS

we want to use a tool with out clients that can be representative of them and their background

AK:

This pertains to cultural and linguistic responsivity in assessment. We need to be sure that our assessment tools, tests, and practices do not introduce confounds based on cultural and linguistic background, for example a client not knowing a vocabulary word because that word or concept is not used in their preferred language. This is important so we do not confuse or mislabel a cultural speech or language variation as a disorder.

Give an example of event-based type of data vs duration-based type of data

event based data

-tally: counting the number of times it occurs ex: how many times they incorrectly produced the target sound in 3 minutes

-percentage: the proportion of correct responses over the total number of opportunities

ex: correctly produced target sound 5 times out of 10

Duration based:

-How long client can sustain target behavior

AK:

Event based: Counting the number of correct /r/ sounds the client produces in an assessment task.

 

Duration based: Counting how long a client can sustain health resonant voice quality in a speaking task