EXAM #2 STUDY GUIDE

October 21

When was evidence based pratice adopted?

ASHA 2005

What does PICO stand for?

• P: particular problem or patient population of interest

• I: intervention of interest

• C: comparison or alternative to the intervention of interest

• O: outcome of the evidence

Examples of PICO (preschool-age children)

• developmental language disorder who use Spanish at home and English at school [P] (problem)

• how greater vocabulary improvement in English [O] (outcome)

• following bilingual [I]

• or English-only [C] training? (comparison)

Examples of PICO (adults)

• a primary acquired aphasia: [P] (problem)

• does lexical-semantic treatment in one [I] (intervention)

• or two languages [C] (comparison)

• result in the greatest functional outcomes [O]? (outcome)

3 sources of information serves as the basis for decision making within the EBP framework

1. external empirical evidence (clinical decisions MUST be based on the highest quality of external evidence available)

2. internal evidence developed by the clinician

3. client characteristics

2 general types of internal evidence

• Objective measures of progress include clinician observations of various communication skills such as the length or grammatical accuracy of sentences, the
  number of words produced or understood, or the types and frequency of communicative attempts.

• Subjective measures consist of evidence from the client’s perspective (e.g., patient-reported outcomes)

T or F

Both objective and subjective measures are important.

True

The ultimate goal of EBP is to provide optimal _______ service to those affected by language or other communication ___________.

• clinical

• disorders

Language development begins at/before birth and continues throughout__________ , language milestones are simply predictable _____________ along the developmental pathway.

• adulthood

• benchmarks

Evidence-Based Practice (EBP) in SLP is an approach to clinical ________ ______ in which different sources of information are integrated into an action plan that best serves the long-term interests of individuals with communication disorders."

decision-making

What are RCT studies?

• gold standard

• randomized controlled trial is a form of scientific experiment used to control factors not under direct experimental control.

• Examples of RCTs are clinical trials that compare the effects of drugs, surgical techniques, medical devices, diagnostic procedures or other medical treatments.

• In RCTs, individuals who are similar in important ways (such as type and severity of disorder, age, language background, and cultural experiences) are randomly assigned to one or more active treatment groups or to a control group in which no treatment or a sham treatment is provided.

• The change in each group’s performance on selected tasks over the course of treatment is used to determine the relative effectiveness of each treatment.

Repeating words overheard in conversation usually occurs at __ years of age

2

Copying sounds and gestures of others usually occurs at ____ months.

9

Why do bilinguals translanguage?

• Some concepts are better expressed in one language over another.

• To satisfy a “linguistic need” with a word or expression in a particular domain.

• To reiterate or report something that was said in a particular language.

• Communicative or social strategy to demonstrate group involvement.

Clinical decisions be based on the highest quality of external (scientific) evidence available, know which the strongest and which is the weakest.

• Strongest: Systematic Reviews/ Meta-Analysis of RCTs

  • examination of data from a number of independent studies (RCTs) of the same subject, in order to determine overall trends

• Weakest: Expert Opinion

Children start responding to sounds by making sounds (listening carefully) at____months.

6

Know which is the systematic review that collects all possible studies related to a given topic and design, and reviews and analyzes their results.

Systematic review/ meta-analysis of RCTs

Using simple gestures that have meaning like waving bye-bye and shaking their head "no" usually occurs at ____months

12

The clinician, the client, & relationship between them, the structure of treatment & the clinician's belief in the approach they are using are examples of __________ factors. A clinical goal is also to identify potential _________factors and ____________ them to the greatest extent possible to ensure optimal outcomes. Clinical actions are informed by internal and external ____________ but embedded in a context of interacting human and structural factors.

• interacting

• Influential and interacting

• exploit

• evidence

3 conventional ways to quantify or qualify language ability, or proficiency, in developing bilinguals **** know underlined and bolded

1. Consider the bilingual child’s abilities in each of his or her languages as compared to those of monolingual same-age peers in each language.

2. Consider the degree or level of language attainment in developing bilinguals by comparing performance to that of age and experience-matched bilingual peers.

3. Describe bilingual language abilities by using within-speaker comparisons, a child’s ability in one language is compared to his or her ability in the other known language

Sequential Bilinguals

• also known as successive bilinguals

• children who acquire a single first language (L1) beginning at birth and begin to acquire a second language (L2) at some point during childhood

  • in some cases, L1 is the majority language of the community

In the United States, children whose primary home language differs from that of the broader community are currently classified in the educational system as _________ __ _____________ __________ or. ___________ ________ .

• English Language Learners (ELLs)

• English Learners

T or F

Simultaneous bilingualism does not cause delays in the attainment of early language milestones.

True

Simultaneous Bilinguals

• a child’s concurrent experience with two different languages beginning at about the same time in his or her life, typically during infancy.

• Two or more languages spoken by parents at home; parents can speak the same languages to the child
  or different languages

• Use language for the same communicative purposes, with the same degree of clarity, as single- language learners

• Similar age of onset and rate of progression of critical early language skills as single-language learners

• Breadth of words known for simultaneous bilingual children from middle-income families is consistent
  with the number of words known by their middle-income monolingual counterparts, (when both
  languages are considered)

• e.g., child might know agua in Spanish for water and doggies in English – part of the single linguistic repertoire of bilinguals

• Overall exposure to each of these languages will be uneven, leading to a bigger vocabulary in one of
  the languages (children with uneven vocabularies also process words faster in their stronger language)

T or F

Bilinguals are two monolinguals in one.

False-dual monolingualism is not possible

T or F

Typically developing simultaneous bilingual children do not meet the same linguistic milestones (similar age of onset and rate of progression of critical early language skills) as single-language learners.

False, they do meet the same milestones

_____________ ___________ are children who receive regular input in two or more languages during the most dynamic period of communication development— somewhere between birth and _______.

• developing bilinguals

• adolescence

Children use plurals (e.g., wheels, cars, dogs) by ____ years of age.

3

Children begin developing figurative language at about ____ years of age.

5

Input, as used here, refers to a child’s cumulative experience with ______ language.

spoken

The majority of children learning two languages are _________, with intact social-emotional, cognitive, neurological, motor, and sensory systems, these children are _______ for the task of acquiring two (or more) languages

• typically developing

• well-equipped

T or F

The relative social prestige and broader community support associated can affect the process and product of language proficiency in developing bilinguals

True

For typically developing _______ bilinguals, attainment of early L1 skills parallels that of monolingual children who share similar socioeconomic circumstances, at least until the introduction of L2

Sequential

• __________ all languages, cultural and linguistic backgrounds Bi/multilingualism is a skill and an asset – not a hinderance to meeting academic, vocational, social demands.

• By the very nature of its name, code switching suggests that _________ possess __________separate linguistic system(s) that they rely on to communicate.

• Translanguaging posits that ________ have ________ linguistic repertoire from which they deliberately select features to communicate effectively.

• Translanguaging places the focus on the _________ speaker, their practices, and the deployment of their linguistic resources as opposed to the _________languages they may be acquiring.

• Respect & celebration for…

• bilingual

• two

• bilingual

• one

• bilingual

• bounded