Diagnostic Methods Midterm SG

What factors should be considered when treating the whole person?

• Familial

• Historical

• Cultural

• Motivations

• Personality

• Emotion

What happens if clinicians fail to understand all contributing factors in a referral?

They fail to fully understand the referral.

Who can be included when considering the “whole person”?

Parents, caregivers, and significant others.

Therapeutic intervention begins with what and includes what in every session after?

Formal evaluation; evaluation elements

Speech and language emerge from what three developmental areas?

Cognitive, physical, and socioemotional development (CPESD)

What is diagnostic modesty?

Recognizing that communication disorders may require treatment by multiple health professionals

If an SLP diagnoses a speech problem, what may occur?

They may not lead treatment for the client

What is the most fundamental clinical activity?

Active listening

What does active listening help empower?

Clients to help themselves

What begins clinical trust?

Professional empathy

What helps build rapport with clients?

Offering honest opinions

Why can labeling disorders be problematic?

It may confuse clients and lead to assumptions

What is the DSM?

Diagnostic and Statistical Manual of Mental Disorders

What is the purpose of the DSM?

To reduce subjectivity in diagnoses

T/F: Diagnostic labels go in and out of acceptance

True

Why might sharing a diagnostic label with families be helpful?

It allows investigation of literature and personal research

What is static assessment?

A required test or battery that follows a specific protocol

What is dynamic assessment?

An investigative approach requiring rapid clinical decision-making and higher clinical skill

What is the process of assessment?

1. Gathering data

2. Testing

3. Diagnosis

What is diagnosis?

The end result of scientific and clinical data gathering

What does diagnosis determine?

If a disorder exists, its type, severity, and etiology

What information is gathered during preassessment?

Case history, agency reports, interviews

What is a diagnostic interview?

A direct conversation used for fact finding, informing, and altering opinions

What is the funnel approach?

Moving from broad questions to more specific questions

What is the inverted funnel approach?

Moving from specific questions to more general questions

What is the tunnel approach?

Asking questions at the same level of specificity

What is a crucial interview technique?

Allowing clients/caregivers to explain their perspective and observing nonverbal responses

What are characteristics of poor tests?

• Inconsistent scoring

• Varied performance

• Irrelevant content

• Vague manuals

What is a standardized test?

A test with consistent administration procedures

Most language and articulation tests are what type?

Standardized tests

What should standardized test manuals include?

• Administration instructions

• Scripts

• Materials

• Scoring procedures

What are norm-referenced tests?

Standardized tests that compare an individual to a normative sample

What is a normative group?

A large comparison group used to establish norms

Advantages of norm-referenced tests?

• Objective

• Widely recognized

• Required by insurance

• Straightforward

Disadvantages of norm-referenced tests?

• Lack individualization

• May be unnatural

• Evaluate isolated skills

What is a criterion-referenced test?

Measures performance against a predefined criterion rather than other individuals

Advantages of criterion-referenced tests?

• Objective

• Efficient

• Some individualization

Disadvantages of criterion-referenced tests?

• Artificial setting

• Limited comprehensiveness

What is a normal distribution?

Scores cluster around the mean forming a bell curve

What is standard deviation?

Average distance of scores from the mean

What is a raw score?

Number of correct answers

What is a standard score?

Distance from the mean expressed in SD units

What is percentile rank?

Percent of individuals scoring at or below a given score

What are the two most critical components of test quality?

Reliability and validity

What is reliability?

Consistency of measurement

What is validity?

Accuracy of measuring what the test intends to measure

Examples of reliability?

Test-retest, alternate forms, split-half, inter-rater

Examples of validity?

Content, criterion-related, concurrent, predictive, construct

What is a language disorder?

Impairment in comprehension or use of spoken, written, or symbolic language

Language disorders may involve what components?

Form, content, and function

What is Specific Language Impairment (SLI)?

Language deficits with no other major impairments

What is Primary Language Impairment?

Language impairment without neurological, emotional, cognitive, or sensory deficits

What early skill predicts later language outcomes?

Early receptive language skills

Children first communicate using what before words?

Gestures

What do early gestures indicate?

Better prognosis for language delay

What disorder involves communication, social, and behavioral impairments?

Autism

What disorder involves IQ below 75?

Intellectual Disability

What category includes Down syndrome and Fragile X?

Genetic disorders

Common signs of language delay?

• Limited phonetic inventory

• Delayed first words

• Delayed word combinations

• Limited eye contact

• Regression

Main objective of assessing toddlers/preschoolers?

Determine if a delay or impairment is present

What assessment methods are used?

• Standardized tests

• Informal measures

• Dynamic assessment

Why should clinicians note the degree of support a child needs?

It helps create an appropriate treatment plan

What is the most common method of assessing language?

Language samples

Purpose of language samples?

Obtain a representative sample of everyday language

Ideal language sample length?

50–100 utterances

Speech sound disorders may be what two types?

1. Organic

2. Functional

What causes organic SSD?

Motor/neurological, structural, or sensory causes

What are functional SSDs?

Idiopathic (unknown cause)

Prevalence of articulation/phonological problems?

10–15% of preschool children

Five SSD etiology subtypes?

1. Unknown origin

2. Otitis media with effusion

3. Special populations

4. Motor speech disorders

5. Psychosocial involvement

What is articulation?

Motor processes for producing speech sounds

What is phonology?

Organization and patterning of phonemes in a language

What is phonetics?

Study of speech sounds and their properties

What is a phoneme?

Basic speech segment

What are minimal pairs?

Words differing by one phoneme feature

What are maximal pairs?

Words differing by multiple phoneme features

What is the CTOPP-2?

• Comprehensive Test of Phonological Processing

• Assesses phonological awareness, phonological memory, rapid naming (Dyslexia)

• Strongest predictor of future skills

Why does the CTOPP-2 have two different subtests?

• Because you can’t do a 24y/o test with a 4y/o

• 4y/os don’t know how to read; 7y/o+ do

PLS-5: Does it include an articulation screener?

Yes, it helps determine if further artic assessment is needed

PLS-5: Why are there so many play-based objects?

Because children at that age learn a lot through play-based activities, so it helps clinician obtain an idea of client’s level

PLS-5: Does it assess pragmatic skills?

Yes

PLS-5: Why do different ages have different basals?

• You don’t want to use inappropriate basal procedures (ex. snapping localization on a 7y/o)

• Clients have different energy levels— you don’t want to waste it

PLS-5: Comprehensive assessment consists of…

• Auditory comprehension

• Receptive language

• Expressive language

• = 100

CELF-5

• Tests receptive & expressive language (NOT SPEECH)

• Key assessment used in clinic

• Standardized

• Age range: 5-21

GORT-5

• Assesses fluency & comprehension

• When testing comprehension, client no longer has the story

• Reading total = fluency + comprehension

• Norm-referenced tests

• Examiner records time, deviations, & comprehension

• Has A & B stories in case retesting needs to be done

SSI-4: How could ethnographic interviewing impact this?

Can impact what they see or how they describe

SSI-4: What considerations should be made for ELL/ESL?

Even if they’re at a certain age, they may read at lower levels

SSI-4: Disfluency factors to measure

• Frequency

• Duration

• Secondary behaviors (if present & not mild → need intervention)