Note
Studied by 15 people
Therapeutic Methods Exam 1
- List and explain the 5 components of language.
Tests will be given in class and are cumulative.
Be familiar with the information addressed in “Test Review 1”
Understand strategies for Rapport Building with your client as reviewed weekly in class (Also discussed in the “Adulting” reading).
Know the methods discussed for preventing disruptive behaviors.
Know the methods discussed for responding to disruptive behaviors.
Memorize the 5 steps to complete prior to selecting treatment targets
Know when and how to use client specific and normative strategies for treatment target selection.
Define baseline.
Be familiar with methods used to determine baseline.
Be able to write a baseline statement.
Be familiar with the acronym SMART and its application to the material presented in class.
Be able to write long and short term goals.
Speech vs. Language
Speech: How we say sounds and words, including articulation, phonology, voice, and fluency.
Language: The words we use to share ideas, encompassing receptive and expressive language. Can be verbal, nonverbal, or written.
Components of Speech
Articulation: How we make speech sounds using the mouth, lips, tongue and cheeks.
Voice: Vary in intensity pitch and quality. Can be affected by overuse, yelling, or conditions like viruses or COVID.
Fluency: Rhythm and flow of speech. Variations can result in stuttering or cluttering, influenced by stress or brain injury.
Receptive and Expressive Language
Receptive Language: Understanding verbal, nonverbal, and written language.
Expressive Language: Using verbal, nonverbal, and written methods to share ideas.
Verbal: Spoken words.
Nonverbal: Body language, tone of voice, gestures, facial expressions.
Written: Text.
Semantics
Governs the meaning of words and relationships between them.
Receptive Semantics: Understanding vocabulary.
Expressive Semantics: Choosing vocabulary to communicate.
Example: Describing a dog (Ellie) by category (pet, animal), description (soft, little, adorable), parts (paws, ears, tail), location, antonym, actions, and associations.
Phonology
Receptive: Hearing and deciphering differences between phonemes.
Expressive: Ability to produce correct phonological patterns.
Systematic impairments result in phonological processes. For example:
Changing "dog" to "dot" is fronting.
Changing "frog" to "dog" is stopping.
Cluster reduction in words like "truck"
Morphology
Understanding how word prefixes and endings impact meaning.
Expressive morphology involves using prefixes and endings to change word meaning.
Example: Using morphology to indicate number: one \space coffee versus three \space coffees.
Morphemes are the smallest units of meaning.
Syntax
Refers to overall grammar and sentence structure.
Receptive syntax: Understanding different sentence structures.
Expressive syntax: Using various sentence structures.
Example: Yoda's inverted syntax.
Pragmatics
Focuses on overall communication and context.
Involves understanding the intent and social cues in communication.
Example asking, "Can you get it" versus, "May I get it."
Acquired Brain Injury
Disorder resulting from injury to the brain since birth, either traumatic or non-traumatic.
Types of Brain Injury
Traumatic Brain Injury (TBI): External force to the head (e.g., motor vehicle accidents, falls).
Non-Traumatic Brain Injury: No external force; caused by tumors, stroke, encephalitis, infections, or anoxia.
Signs and Symptoms
Include physical, sensory, behavioral, cognitive, speech-language, pragmatic, and swallowing impairments.
Aphasia
Language disorder caused by stroke, TBI, tumor, or infection.
Two main types discussed:
Broca's Aphasia: Non-fluent language, difficulty verbalizing responses.
Wernicke's Aphasia: Fluent but meaningless utterances, decreased comprehension.
Classified by fluency (fluent vs. non-fluent) and the area of challenge (receptive vs. expressive).
Apraxia
Neurogenic disorder affecting neural pathways between the brain and oral structures.
Results in decreased ability to plan and sequence movements for speech.
Can be caused by stroke, TBI, tumor, infection, or can be congenital.
Childhood Apraxia of Speech
Difficulty connecting the motor part of the brain to the mouth to produce sounds.
Signs and symptoms include halting speech, articulatory groping, inconsistency, and sound distortions.
- List the 7 characteristics of FBI.
7 Characteristics of Family Based Intervention (ASHA, 2020)
Developmentally/Socially supportive
Services are evidence based
Alignment with family situation
Family determines involvement
Honors family values
Culturally and Linguistically responsive
Comprehensive, coordinated services
-List and explain how to write a PICO question.
PICO Process
PICO helps frame clinical questions.
P: Population: Characteristics or conditions of the group (e.g., diagnoses, ages, severity levels).
I: Intervention: Screening, assessment, treatment, or service delivery model (e.g., high-intensity treatment, hearing aids, instrumental swallowing assessment).
C: Comparison: Main alternative to the intervention, assessment, or screening approach (e.g., placebo, different technique, different amount of treatment).
O: Outcome: What you want to accomplish, measure, or improve (e.g., more intelligible speech, better hearing, upgraded diet levels).
A well-constructed PICO question includes elements specific to the client's circumstances and values.
Examples of PICO Questions
Population: Children with severe to profound hearing loss.
Intervention: Cochlear implants.
Comparison: Hearing aids.
Outcome: Speech and language development.
PICO Question: For children with severe to profound hearing loss, what is the effect of cochlear implants compared with hearing aids on speech and language development?
Population: Young adult with a stroke.
Intervention: Cognitive rehab.
Comparison: Not specified in the transcript.
Important Considerations for PICO Questions
Clinical questions should include family values.
It should be specific but not too specific.
A situation may have more than one question and each should be tackled sequentially.
-List the 3 components of EBP
External evidence: Scientific literature.
Internal evidence: Data from observations on the client.
Client perspectives: Personal and cultural factors, values, priorities, and expectations.
Framing a clinical question.
Gathering evidence that supports the question.
Assessing the evidence: Determining what the evidence concludes.
Making a decision.
-Explain the 5 steps of the evidence-based process.
Four Steps of the EVP Process
Framing a clinical question.
Gathering evidence that supports the question.
Assessing the evidence: Determining what the evidence concludes.
Making a decision.
Service Delivery Models
Provider: The person administering the treatment.
SLP (Speech-Language Pathologist).
SLPA (Speech-Language Pathology Assistant).
Trained support personnel.
Intern
Caregiver
Others?
Format: Type of session.
Individual (1-1).
Group.
Concurrent Group
Consultation
Coaching/Training
Others?
Dosage: Frequency, intensity, and episode of care.
Frequency: Number of treatment sessions.
Intensity: Length of each treatment session.
Episode of Care: Length of treatment period.
Setting: Location of treatment.
Home.
Outpatient Clinic.
Classroom vs. Separate Room.
Hospital.
Community-Based.
Others?
Service delivery is a dynamic process where changes are made to the above components.
Format and Service Delivery Models
Direct Service
Indirect Service
Dosage and Service Delivery Models
Dosage: The amount of services described as the combination of frequency, the length of a therapy session, and the length of an episode of care.
Episode of Care: The length of time needed to address a specific problem.
Frequency: The total number of sessions of intervention that occur over the course of a specified time period.
Intensity: Time each session
Example Dosage in Educational Setting:
Episode of Care: The length of the annual IEP (individualized education plan), semester/trimester.
Frequency: Times per week, month, or year. Ex. 1x/week; 4x/month; 30x/year
Intensity: Written in minutes (15, 30, 45)
Example: Services are recommended for 30-minute sessions, 3 times monthly (30 x 3/month) from 9/11/2025 - 9/10/2026, totaling 810 minutes annually.
Example Dosage in Biola Clinic Setting:
Episode of Care: The length of the semester.
Frequency: Times per week. Ex. 1x / week
Intensity: Written in minutes (45 minutes)
Example: Amelia is recommended to attend speech therapy for one 45-minute session per week from 9/9/2024 - 12/16/2024.
Dosage Terminology
Intensive: A highly concentrated dosage of therapy intervention provided over an episode of care.
Example: weekly sessions lasting 45 minutes or more in length or a frequency of 2x or more/week.
Frequent: A moderate dosage of therapy intervention provided at consistent intervals over an episode of care.
Example: weekly or bimonthly sessions lasting less than 45 minutes in length.
Periodic: A lower dosage of therapy intervention provided at regularly scheduled intervals for a specified number of minutes over an episode of care.
Example: 2 to 5x/year for a total of 60 minutes
Intermittent: A low dosage of therapy intervention provided irregularly or when needed over an episode of care. Length of therapy session may vary.
Example: 1 to 2x/quarter for 20 minutes per session.
Setting and Service Delivery Model: The role of the Speech-Language Pathologist (SLP)
Schools: SLPs diagnose and treat children through special education and consult with administrators and educational staff.
Skilled Nursing Facilities: SLPs diagnose and treat adult and geriatric populations to ensure quality of life, including patients with progressive diseases like ALS, Parkinson's, and Dementia.
Private Practices: SLPs work directly with clients and families to treat adults and children with chronic disorders or developmental delays, often in familiar environments (home or school) or a clinic space.
Hospitals: SLPs diagnose and treat children and adults following an acquired or congenital neurological disruption, in both inpatient and outpatient settings.
NICU (Neonatal Intensive Care Unit): SLPs diagnose and treat dysphagia in premature babies to ensure swallow safety in the first few days of life.
Acute Care: SLPs facilitate functional communication and ensure safe swallow while patients are still in the acute phases of injury.