Module 4 CSD 464

We need to make clinical decisions that are what?

accurate

defensible

responsive

what clinical decision is grounded in enough relevant information

accurate

what clinical decision is supported by the best available evidence

defensible

what clinical evidence is adjusted when the learner or context changes

responsive

when making decisions for assessment and intervention what should we ask about our information before making a decision

• Who supplied it and in what context

• what does th measure assess or sample well

• what important language demands are missing

• do reports, observations, samples ,and test converge

what making decision for assessment and intervention what should we ask about the person before making a decision

• Strengths, priorities, identity, and preferences

• Cultural and linguistic experiences

• Communication partners and environmental supports

• Participation across home, school, and community

evaluating evidence requires us to look at what

efficacy

effectiveness

efficiency

what is “can the intervention produce benefit under ideal or controlled conditions"?”

efficacy

what is “does it produce meaningful benefit in routine practice/real-world context

effectiveness

what is are the gains worth the time,effort,resources, and opportunity cost

efficiency

when should you stay the course and not change a plan in intervention

• progress matches the predicted trajectory

• skills transfer to new people, materials, and settings

• the intervention remains meaningful and feasible

when should you adapt and change plan in intervention

• Progress stalls or varies unpredictably

• Supports are not fading or outcomes are not generalizing

• Priorities, environments, or demands change

• New evidence challenges the original hypothesis

flexibility without data is

drift

what makes a reasoning visible, to see what clinicina should do?

decision trees

what is MTSS

Multi-tiered system of supports

what is tier one of mtss

1. universal, classroom-based instruction

what is the support intensity ot need and response of tier 1

broad prevention

monitor performance for all learnes

what is tier 2 of mtss

targeted, often small-group support

what is the support intensity to need and respond for tier 2

increase intensity, use reponse data to refine support

what is tier 3

intensive individualized support

what is support intensity to need and respond for tier 3

specialized planning, frequent monitoring

movement across tiers should be informed by ___- not waiting for failure

data

curriculum-based language assessment focuses on what

real demands

what are the curriculum based language assessment demands

curriculum demand

student performance

instructional response

what does the curricum demand ask

what language does this task require

what does student performance dmand ask

where does performance break down

what does instructionaol reposne demand ask

what modification,strategy, or target improves access

the curriculum helps define both what

• the assessment task

• intervention outcome

routine based interviews uncover what

natural priorities and opportunities

what questions can be asked during routine-based interviews

Walk me through a typical day.

Which routines are easiest—and hardest—for communication?

When does the child initiate, participate, repair, or withdraw?

What would make one routine more successful for the family

what do you do with the answers from the routine based interviews

• to choose meaningful targets

• to identify practice opportunities

• to fit strategies into daily life

intervention priorities shift with what

development and participation

what are intervention priorities of infants+toddlers

• caregiver interaction

• engagement and intentional communication

• modeling and imitation within routines

what are intervention priorities of preschoolers

• play and peer interaction

• early language and literacy

• ?modeling recasts and embedded learning

what are intervention priorities of school age

• spoken-written language connections

• curriculum access and discourse

• self-monitoring and strategic learning

developmental expectation informs _____;functional impact determines ____

decisions, priority

Instructional supports shape the ____- and should what

response, change over time

what are the instructional supports

• antecedent

• behavior

• consequences

what is apart of antecedent

choose materials and context

model

,prompt

,cue

, and wait

what is apart of behavior

learner attempts the target communication behavior

what is a part of the consequences

respond contingently

acknowledge

,recast

,request

repair

what are the three critical thinking parameters to clinical decision making

• accurate

• defensible

• responsive

what should we take into consideration when intervention planning

• MTSS

• curriculum

• routines

• culture

• context

What are some clinical reasoning prompts when trying to reason what to focus on

• which communication domains appear most affected

• what evidence would conform or challenge your hypothesis

• what functional target might have more immediate impact

What should you plan to do with instructional supports

plan to fade support

vary examples

probe independent use

what is an example of a progress-monitoring protocol

• Define one observable target’

. • Choose spoken and/or written elicitation tasks.

• Specify frequency, sample size, scoring, and support level.

• Include an untreated context to examine generalization.

• State the decision rule for adapting intervention

a progress-monitoring protocol should be ___ to the change the intervention is designed to produce

sensitive