719 Exam 1

T/F: Assessment and evaluation can be used interchangeably.

True

The identification of difference or disorder found through assessment or evaluation

Diagnosis

A systematic effort to change an existing condition

Treatment

The first step to determine what needs to be changed, and if possible, why

Assessment

The ongoing procedures used by qualified personnel to identify the child's unique strengths and needs and the early intervention services appropriate to meet those needs throughout the period of the child's eligibility and includes the assessment of the child and the child's family

IDEA definition of assessment

A complex process that requires the integration of a variety of information gathered during the evaluation

ASHA definition of assesmsent

Diagnosis of disease precedes treatment; identification

Medicine model

Not only are we identifying the disorder; but we are using our assessment to understand the nature of the problems - all of which precede treatment

Communication disorders model

What all is included in written case history?

Basic identifying information, referral source, other specialists who have seen the child, statement of the problem, developmental history, medical history, family and social background, educational backround

This section includes the client's name, date of birth, age, address, and phone number as well as the caregiver's information as well as - generally the physician's information may also be listed here

Basic identifying information

What to remember with basic identifying information

Make most of foster care or custody dispute and be educated on the matter at hand

Documentation of the _______________________ is imperative as they will be a source for further information on the child and may also be required for payer documentation.

Referral sources

________ the referral comes from is also indicative of information about the client

Who

T/F: Knowing if other specialists are involved is not a key component to determining whether your diagnosis is primary or secondary to other issues.

False

This section provides the caregiver a space to state their concerns or problems. This can help you prepare for what type of assessment you might need to administer.

Statement of the problem

An area for the caregiver to report ages and skill achieved related to development - this will assist you in looking at the child as a whole to determine if the communication difficulties are isolated or potentially part of a more global issue with development

Developmental history

This area is where the caregiver will report any illnesses, accidents, or hospitalizations. In some cases, you may have a list of diseases or disorders that can check off or it may be an open ended area for them to write in the information.

Medical history

What section is a good area to obtain any medications the child might currently be on as sometimes medications can have influence on communication?

Medical history

What section allows you to collect information on caregivers/parents educational and occupational background, siblings, family unit and dynamic - this is also as great area to have them identify their language spoken in the home and any other information that might be pertinent to culturally responsive area

Family and social background

Utilize this section of the case history to identify any type of education or socialization time the child might have - for instance, if they are school age, you'll want all the details of where they go to school, their performance and most importantly if they are receiving services

Educational background

For younger children, identifying if they are in a ______________________ will be helpful for you to know with regards to exposure to language.

Daycare setting

What are some case history limitations?

Reliability and limitations of understanding

What is the goal of caregiver/client interview?

Building comfort and trust with the family

List some tips for initial clinical interview

Be prepared, take your time, record your interview, avoid talking too much, use open ended questions, summarize your discussion, same question different way, share the next step

What does a hearing screening look like in a school?

MDE has a screening form that is specific to what they require. Screen, screen, refer.

What does a hearing screening look like in a medical setting?

You may encounter a variety of tools or procedures for hearing screening.

T/F: Sometimes children will get screened for hearing and vision at various pediatrician appointments

True

Typically you should screen child at _____ dB. Some schools will screen at _____ do due to environmental noise.

20, 25

What frequency should you screen hearing at?

1000 Hz, 2000 Hz, 4000 Hz - on occasion you may choose to add 500 Hz but this should be at 25 dB

T/F: Always try to ensure the quietest environment possible

True

Orofacial areas of examination

Strength, range, coordination, consistency of movements

T/F: You may find that pure tone screening is not possible and nonbehavioral screenings are necessary via tympanometry.

True

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

Structural adequacy

How the structures move and perform during speech production

Functional adequacy

T/F: Each sound targets a different muscle group in push tuh kuh

True

Puh requires _________________ activity

Labial

Tuh requires ?

Tongue tip elevation at the alveolar ridge

Kuh requires ?

Posterior tongue elevation at the velum

Why do we take a speech and language sample?

To obtain a child's most naturalistic communication that is representative of their skills

How to obtain speech and language sample

Obtain samples in and outside of clinical setting

Refers to child's responsiveness to trial treatment strategies

Stimulability

Thought that Stimulability results can actually assist a clinician in determining a prognosis for treatment

Prognostic function

The development of invariable procedures of measurement and interpretation of measured values

Standardization

Standardization includes what in the research process

- careful selection of test item

- administration of the test items to a representative sample drawn from a defined population

- statistical analysis of results

- establishment of age-based norms

- development of instructions and response scoring procedures

All items needed to effectively administer the assessment should be included

Self contained

Any materials used in the tasks for measurement - this could be a book or manipulative

Stimulus materials

Sometimes called protocols - these items are where you record the responses from the client and score the test

Record forms

This is used by the examiner to obtain scores for the standardized test

Examiner's manual

The performance measure of a normative group on a tested skill

Norm

Usually a representative sample of the individuals of the same age and possibly the same sex as the client

Normative group

Helps compare a client's performance to the performance of another group of individuals called the normative group

Norm-referenced test

T/F: Most standardized tests are norm referenced.

True

T/F: Norm referenced tests are not always standardized

False

What is the minimum size of sample

100

Meeting only the minimum sample size will result in a test with extremely limited _____________

Applicability

If the goal is to differentiate or identify the disorder then _______________________ is chosen

Typical sample

The greater variety of variables and the more adequate the different subsamples, the wider the ________________ of the test

Applicability

The more varied the geographical distribution, the wider the ______________ of the test

Applicability

A typical normal distribution of scores results in a ___________________ with the ranges of scores plotted on the horizontal access and the number of participants receiving a particular score on vertical access

Bell curve

Represents the statistical average of the individual performance

Mean

The individual's score may not correspond to the mean; it might deviate and the extent to which it does is called the ____________________

Standard deviation

The ___________ for the test is the initial score given based on the number of correct responses to test items

Raw score

T/F: Typically raw scores of individuals are not meaningful compared to each other

True

How to look at raw scores for a picture of growth

Test and retest capacity

Scores derived from the raw score that allows different individuals to be compared to determine strengths and limitations

Scales or derived scores

What are the more frequently encountered transformed scores?

Percentile ranks, standard scores, stanines

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

Percentiles or percentile rank

What percentile represents the mean score

50th

Represents the degree to which a child's score deviates from the mean

Standard score

Two common types of standard scores

Z scores and t scores

Based on a range of 9 numbers with a percentage of tested individuals connected to each number

Stanine

Types of equivalent scores

Age equivalent and grade equivalent

Entry level or initial score - certain number of correct responses

Basal scores

Test-terminating score - usually a certain number of incorrect responses

Ceiling score

States the rationale and purpose of test. Holds key information including examiner's qualifications

Test manual

Should provide you with uniform test administration procedures and scoring directives

Administration and scoring procedures

Items that evoke a targeted skill and generally include verbal instructions, photographs, drawings, objects, and written information

Stimulus items

Sample of people smaller than normal population, but large enough to represent the population

Normative sample

Manual should provide a range of raw scores as well a s derived scores - Should include conversion tables for many of the components mentioned

Statistical analysis

Two most important components of standardized testing

Validity and reliability

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

Reliability

Types of reliability

1. Interobserver reliablity

2. Intraobserver/ test-restest reliability

3. Alternate or parallel reliability

4. Split half reliability

Consistence of test scores recorded by two or more examiners administering the same test to to the same individuals

Interobserver reliability

Consistency of scores the same indidvuals obtain when the same examiner readministers the test or repeats a naturalistic observation

Intraobserver reliablity

The consistency of measures when two forms of the same test are administered to the same persons

Alternate/parallel form

A measure of internal consistency - corrrelates scores from one half of the exam and compares them to the other - even/odd this can be harder to do depending on the test

Split-half

The extent to which a test measures what it is constructed to measure - it reflects the truthfulness of the measure

Validity

When an expert exams the test items and concludes that the items assess the purported skill

Content validity

The degree to which a test's measures are consistent with a known theoretical construct

Construct validity

Theoretical statement supported by prior empirical evidence

Construct

The assurance that a test measures what it purports to measure because it is correlated with an external variable called a criterion

Criterion validity

Purpose of questionnaires and inventories

Obtain information about a child's speech and language skills from their parents or caregivers

Strengths of standardized tests

Convenience and ease, interpretation, qualifying and paying, objectivity

Limitations of standardized tests

Test structure, test norms, sampling of responses, clinical limitations

Criteria for selection of standardized tests

1. Detailed and comprehensive test manual

2. Large and diverse normative sample

3. Samples skills adequately

4. Recently revised and updated normative data

5. Strong reliability and validity

6. Appropriate stimulus items

7. Well trained to administer

8. Yield useful diagnostic information

Tests that could be administered to individuals who came from varied cultural backgrounds and spoke different languages

Culture free or cross cultural assessment

Example of potentially culture free assessments

Non verbal IQ tests

Refers to a verbal behavior that is firmly rooted in an individual's culture

Language

How to assess language culture free

Processing-dependent skills

Rather than testing language, the examiner would test the underlying cognitive components that support language

Processing - dependent skills