UW SPHSC 405 Final

Client Entry Types

New client (full dx assessment) OR transfer client (quick dx check + review prior goals/data)

Treatment Planning Assessment

Integrate with dx OR review prior SLP data + confirm targets/goals + check changes

Key Assessment Focus

Areas of concern + strengths vs weaknesses (threshold) + non-standardized + client-reported concerns

Good Treatment Target Criteria

Need + baseline + prognosis + client preference + feasibility + EBP + data-driven

Justification 1 Disorder

State diagnosis + severity + symptoms + impact on communication

Disorder Evidence Types

Normative (not WNL) criterion (poor performance/decline) functional needs (WFL) client concern

Justification 2 Baseline

Measure prior performance + stability + trajectory

Baseline Interpretation Stable

No change → needs intervention

Baseline Interpretation Trajectory

Improvement/decline pattern → tx may influence outcomes

Justification 3 Prognosis

Based on dx knowledge + client status predicting success

Prognostic Factors

Diagnosis

Stimulability

Ability to improve with support (dynamic probes

Stimulability Factors

Error awareness + motivation + start with highly stimulable behaviors

Justification 4 Preference

Document client/family goals and preferences

Justification 5 Evidence

Use feasible evidence-based treatment options

Number of Targets

Treat multiple but not too many (usually 3–4)

Long-Term Goal LTG

Distant outcome goal WNL or WFL in real-life environments

LTG Types

Full resolution

Short-Term Goals STG

Observable measurable steps toward LTG

SMART Goals

Specific measurable achievable relevant timely

STG Timeframes

Clinic semester outpatient ~1 month inpatient ~1 week schools IEP-based

STG Do Statement

Specific behavior client will perform (no vague improve/reduce)

STG Condition

Level of help environment partner activity type

STG Criterion

Accuracy frequency duration or rating scale level

Good Goal Test

Another clinician can replicate exactly

Intervention Purposes

Habilitation restoration compensation accommodation

Intervention Focus

Maximize participation in life

Sequential Teaching Program STP

Stepwise progression toward target behavior

STP Structure

Start slightly above current → end at STG

STP Progression Principles

Simple→complex easy→hard support→independent structured→natural clinic→real

Target Number Guideline

3–4 simultaneous targets

Hierarchies Linguistic

Sound→syllable→word→phrase→sentence→conversation

Hierarchies Comprehension

Words→yes/no→1-step→multi-step→paragraph→conversation

Hierarchies Reading/Writing

Word→phrase→sentence→paragraph→functional materials

Hierarchies Support

Model/cue→independent

Hierarchies Environment

Clinic→real life varied settings

Hierarchies Activity

Drill→functional/natural tasks

Shaping

Build components then combine if client cannot perform simplest level

Trial Definition

One practice opportunity in STP

Trial Sequence

Antecedent (stimulus) → client response → clinician feedback

Antecedent Types

Visual auditory tactile cues

Elicitation

Signal to respond always present

Help in STP

Models and cues (not used in independent steps)

Correct Response Feedback

Reinforce (praise rewards age-appropriate)

Incorrect Response Feedback

Provide correction and increase support

Low-Structured Therapy

Naturalistic communication contexts and opportunities

Purpose Low-Structured

Generalization motivation real-life relevance

Use Cases Low-Structured

Mild clients transition phase low tolerance for structure

Clinician Role Low-Structured

Set environment create opportunities provide natural consequences collect data

Coaching

Help clients manage real-life challenges with strategies and problem-solving

Counseling Role

Listen support educate do not solve everything

Reflective Listening

"I hear you saying…" summarize validate

Counseling Do Not

Guarantee outcomes give empty platitudes overshare personal stories

Counseling Principles

Respect autonomy provide info ensure safety stay within scope

Treatment Data

Performance during therapy tasks

Probe Data

Periodic assessment of progress (non-treatment)

Data Types

Accuracy strategy use PROMs client reports qualitative data

Data Collection Tips

Accurate efficient unobtrusive representative

SOAP Notes

Structured format for session documentation

Discharge Criteria

Mastered ≥80%/WFL stable maintained generalized

Plateau

No progress before mastery

Generalization Types

Spontaneous vs programmed

Programmed Generalization

Expand tasks environments partners reduce support increase naturalness

Discharge Reasons

Goals met plateau funding health life changes

Discharge Planning

Start early use data involve client shared decision-making

Withdrawal of Tx

Gradually reduce sessions increase real-life practice monitor maintenance

Ongoing Needs Clients

Stabilize function plan follow-ups document needs

Ethics Purpose

Protect clients practitioners public profession

Ethical Violations Causes

Stress resource limits time lack training culture issues

Ethics Autonomy

Client right to choose treatment with informed consent

Ethics Justice

Fair access no discrimination

Ethics Beneficence

Act in best interest of client

Ethics Nonmaleficence

Do no harm

ASHA Principle Client Welfare

Prioritize client well-being provide competent care no discrimination

ASHA Principle Competence

Maintain skills stay in scope supervise appropriately

ASHA Principle Public Responsibility

Provide accurate info avoid conflicts and fraud

ASHA Principle Professionalism

Collaborate act ethically follow laws no harassment

Ethics Actions in Dilemma

Consult supervisor ethics boards ASHA guidance