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Flashcards in Clinical Procedures Deck (152):
1

What are four major behavior observations we look for?

1 presence or absence of beh
2 frequency of beh
3 situations of beh
4 duration/magnitude of beh

2

Sustaining attention to a task is an example of a ___ to behavior.

duration

3

Beyond a observing a percentage of the time we have ______. in what ____, and use a ____.

define behaviors we wish to observe; context; system to measure it

4

The guidelines for behavior observations include utilizing ____ skills, avoid comparison to a _____, separate ______, and avoid ______.

observation; predetermined standard; subjective from objective; personal bias or judgment

5

What are 5 applications for behavioral observations

1 assess difficult-to-test beh
2 validate info collected from other tests
3 extend assessment to other settings
4 ID functional rel btw stimuli in environment & behavior
5 monitor the effects of clinical intervention

6

What are the 3 basic principles of intervention?

1 eliminate the cause
2 teach compensatory strategies
3 modify a disorder by teaching specific speech, language, or pragmatic beh

7

What is an example of elimination of a the underlying cause of a disorder?

pe tube instertion

8

What is an example of teaching compensatory strategies?

learning disabilities

9

What is an example of modify a disorder by teaching specific speech, language, or pragmatic beh?

articulation instruction, fluency

10

____ are steps to achieve long term goals.

short term goals/objectives

11

Short term goals are steps to achieve ___.

long term goals

12

Objectives need to be ___ so as to determine materials, procedures and content to assess progress formally or informally to allow the client to participate meaningfully.

clearly defined

13

The client needs to be ___ as to the nature of the task.

informed

14

The client should also (ideally) ____ make goals

help

15

Objectives need to be clearly defined so as to determine ___, ___, and ____ to asess progress.

materials, procedures, and content

16

What is the first part of a behavioral objective?

do/performance statement (ID the action or what the client will actually do or complete)

17

What should we avoid in performance statements? 2

avoid avoid statements (won't have a tantrum)
avoid abstract terms (understand, discover, be aware of)

18

What is the second part of a behavioral objective?

condition (situation in which the target beh is performed)

19

What are examples of conditions? 4

1 with modelling
2 in response (vs. initiation)
3. with picture stimuli/written stimuli/no stimuli
4 in a group (fluency difficulties are harder in group settings) or one on one

20

What is the third part of a behavioral objective

criterion (how well it is performed)

21

What are normal criteria for behavioral objectives?

80 - 95%
90% accuracy
8 out of 10 correct
over three consecutive sessions
in a five minute period

22

How are long term goals different than short term goals/objectives? 3

usually are functional
criteria for discharge from treatment
more general

23

What is task hierarchy? 3

1 when you make decisions for your client
2 usually work least-to-most complex
3 systematic (work towards the goal changing portions as nece)

24

What happens with short term goals that are acheived easily? 4

adjust complexity, change type of stimuli, change accuracy levels, change from receptive vs. expressive to make more challenging

25

What happens with short term goals that are not acheived easily? 4

teach concept (make sure dev approp), use receptive language, work expressive language,

26

What is an example of working least to most complex?

receptive to expressive language

27

What is an example of increasing complexity of task? 3

remove cues, varying targets, changing settings

28

The ____ represents the degree to which intervention contexts correspond to everyday life; how functional or "real" it is.

Continuum of Naturalness

29

The Continuum of Naturalness ranges from ____ to ____ or ___ to ___.

least natural; most natural; clinician directed; client centered

30

What are 3 factors affecting naturalness?

1 intervention activity
2 physical context
3 individuals with whom the client interacts

31

What are 4 examples of intervention activities?

1 drill
2 drill play
3 structured play

32

What are different physical contexts for intervention activities?

therapy room, campus shuttle, picnic, fast food restaurant, store

33

In ___, the clinician controls all aspects of the intervention. Clinician identifies the specific target responses.

clinician directed approaches

34

What are the ABC of clinician directed approaches?

antecedent - model or prompt
behavior - client response
consequence - clinician's reinforcement (not necessary reward/punishment)

35

Are clinician directed approaches naturalistic?

no, but maybe effective in the early stages of therapy

36

____ often uses real setting or simulated real settings.

Client Centered Approaches

37

What is the assumption with client centered approaches?

that generalization will occur more quickly

38

In client centered approaches, you can use ____ or ___ settings.

real or simulated real

39

What is a characteristic of client centered approaches? 2

1 often involves waiting for the client to initiate a comm beh.
2 clinician does not elicit predetermined targets

40

In client centered approach, we can _____ to maximize responses.

manipulate the physical environment

41

What do you when with adults client centered? 2

1 functional therapy
2 conversational group therapy

42

____ are midpoints on the continuum of naturalness.

Hybrid approaches

43

What are the two components of hybrid approaches?

1 use very natural activities
2 clinician maintains ctrl over the treatment

44

What are the 3 main characteristics of hybrid approaches?

1 only one or a small set of gals are targeted during intervention
2 activities that promote spontaneous use are selected
3 clinician models and expands client utterances

45

Four main types of hybrid approaches are

1 focused stimulation
2 milieu teaching
3 script therapy
4 conversational coaching

46

In ___, clinician arranges the verbal and non-verbal environment to increase the likelihood that the client will produce the target. Models are provided in a functional context.

Focused stimulation

47

In ___, this emphasizes the use of ongoing activities. The environment is key (set up the environment to encourage communication) and incorporates operant conditioning principles (imitation, modeling, and reinforcement).

Milieu teaching

48

In ____, we target behaviors are taught with the context of a familiar routine. May be an event like a birthday party, ordering at a restaurant, or going to a restaurant.

script therapy

49

In ___ is developed to facilitate functional communication btw adults with aphasia (simulates real convo w/in structured setting).

conversational coaching

50

____ evidence is from published journals.

External

51

____ evidence is from client or clinician experctations/experiences, preferences/competencies, competencies, values and culture

Internal

52

What is evidence?

what guides our decision for eval & treatment procedures

53

What are two major categories of internal evidence?

- clinician experiences, preferences, competencies, values and culture
- client expectations characteristics, preferences, values and culture

54

What is the 3 of E3BP?

1 published professional evidence
2 clinician experience
3 client expectations

should be integrated!

55

What are the levels of external evidence? 1-4

IA - meta-analysis (systematic review) of multiple well-designed controlled studies
IB - well-designed randomized control study (compare 2 types of treatments (tx))
IIA - well-designed study without randomization (matched by age, play, language ability, etc.).
IIB - well-designed quasi-experimental
III - observation
IV - expert opinion

56

What goes into internal evidence? 3

1 time
2 expertise
3 circumstance

57

____ means maximizing benefit.

Beneficience

58

___ means minimizing harm.

Nonmaleficence

59

____ means means honoring self-determination and functioning independently witout extraneous influence.

Autonomy (client and clinician - clinician needs to determine their own therapy, not the facility, clinic or school district).

60

___ means practicing fairness and equitible distribution of therapy.

Justice

61

What does PICO perspective/question?

person, intervention, contrasting intervention, outcome (desired)

62

What is the person in PICO?

who is the client? what is his/her situation

63

What is the intervention in PICO?

what is one way you can do intervention? what is the dominant intervention or your instinct?

64

What is the contrasting intervention in PICO?

what is a DIFFERENT way you could do the intervention?

65

What is the outcome in PICO?

what constitutes success for an intervention

66

What is the 6 step approach to EBP?

1 develop PICO
2 find internal evidence
3 find external evidence
4 eval external evidence
5 integrate internal and external evidence
6 apply and eval the outcome

67

What are the steps in traditional articulation tx? 4

1 ID the std eng sound and discriminating it from the erred sound
2 approx and refin the approx until correct prod is acheived
3 practicing the new sound in lang segments of incr length and complexity
4 generalizing the sound to all speaking situations

68

What are the steps in phonological process tx? 2

1 concept and discrimination training
2 production training at word level, ch produces the error and "teaches" the adult, use minimal pairs

69

___ is an option available to low-weight or premie infants. This comes from DARS.

Texas Interagency Council on Early Childhood Intervention (ECI)

70

___ is the plan created for infants with their family in mind.

Individualized Family Service Plan (IFSP)

71

What are referral sources for ECI and IFSP?

screened babies at birth
ECI is based on ZIP code (can referred by MD or parent can call ECI)

72

Who administers preschool services?

Texas Education Agency (TEA)

73

Who governs a child's IEP?

ARD (Admissions Review and Dismissal) Committee

74

What are the steps for an Individual Service Provider? 5

1 receive a referral
2 eval the student
3 reveal results
4 provide treatment
5 communicate results of tx to others

75

From date of consent, the SLP has ___ calendar days to evaluate.

60

76

From the date of report (eval report), the SLP has ___ to complete ARD meeting.

30 days

77

From the date of decision, the SLP has ___ to implement the ARD committee decision..

30

78

What is RtI?

the practice of meeting the academic and beh needs of all students thru a variety of services

79

What are the 3 parts RtI?

1 provides high qual instruction & EB intervention for students
2 monitors progress for decision-making
3 assists joint decisions for educational placement

80

What are the payers for adults/geriatric age population? 4

1 insurance
2 medicare
3 medicaid
4 self-pay

81

_____ is insurance for 65 or older (part A), or for end-stage renal disease pts or railroad workers (part B).

Medicare

82

Medicare is administered by ______

social security

83

____ is insurance provided based on income.

Medicaid

84

What is CHIP?

Children's Health Insurance Program (tx of special health needs)

85

What does a lesson plan contain? 2

1 behavioral objectives (Short Term Goal - STG)
2 procedures are what the Clinician will do to assist the client in meetings STGs

86

What are important questions to ask yourself when making STGs? 2

What do I want the client to do?
What am I (the clinician) going to do?

87

What are the 4 lesson plan guidelines?

1 describe the materials, techniques, processes that will be utilized to assist the client in meeting STGs
2 Describe activities that will be conducted during the treatment session in the Procedures section of the Lesson Plan
3 Vary activities based on the client's age interests and goals
4 Use techniques that are evidenced based

88

It tends to be that words are easiest to produce in the initial. T/F

T

89

___ involves chewing, swallowing, and over extension of the tongue.

Tongue thrust

90

What are factors affecting naturalness? 3

1 intervention activity
2 physical context
3 individuals with whom the client interacts

91

____ is a short period of treatment that is used for short term goals especially in schools.

Episode of care

92

What is the purpose of data collection? 3

1 allows the clinician to track client progress
2 provides documentation as to the efficacy of treatment
3 maximizes clinician effectiveness

93

___, if designed correctly, will greatly help data collection.

recording or data collection sheets

94

____ should provide the type of info that is most relevant to a client or disorder.

Notation system (may have to be weird for cognitively adept adults)

95

____ can be used as an alternative to paper/pencil recording of responses.

Reinforcement tokens (or cards face up/down)

96

___ are instruments administered periodically throughout tx to measure a client's progress. They are designed to assess generalization of trained target beh. Novel stim, elicit w/o target instruct and no reinforcement.

probes

97

The purpose of an eval is to determine ___ of a disorder.

presence or absence

98

What is the specific formula for characterizing chronological age?

subtract birthdate from test date
borrow 30 days regardless of the month
borrow 12 months
except premies, who have an adjusted age with two years

99

What are the four parts to evaluation functions?

1 investigate - collect clinicial info
2 analyze - define nature of disorder/ judge severity/describe beh
3 synthesize - use the info/ combo results to a coherent whole
4 prove effectiveness - proof that tx worked/accountability

100

What are some types of diagnostic tools? 5

1 standardized (norm & criterion ref)
2 parent/client interview
3 case history/summary (probe for more info)
4 beh observations
5 informal assessment

101

How do you choose which diag tools? 3

1 know the referral
2 get an idea from bg info
3 if you don't know, prepare basic arsenal

102

____ discerning the clients disorder as compared to other disorders (specificity).

differential diagnosis

103

____ is the starting abilities of the client in the initial session.

baseline

104

___ is an important feature of a std test, which relates to interjudge/intertest scoring is consistency.

reliability

105

____ is that a test is measuring what it supposed to test. (An articulation test should not test literacy).

validity

106

___ is the part of the population that the test was designed for to ensure that a test is not biased towards a region, SES, race and gender.

standardization (norming) sample

107

___ is how far the scores spread out (it should be a bell curve).

normal distribution

108

___ is how far scores deviate from the mean.

standard deviation

109

___ is a range around the score that they get to let you know the true score.

standard error of measurement

110

You can skip certain items for certain age ranges. ____ is an establishment of the clients current level of performance and anything after you assume anything before should be mastered. (the number you have to get correct a row, often 5). It is a starting point.
____ is a place where the test manual tells you to stop (often certain # in a row incorrect, like 8).

basal; ceiling

111

What are the different norm-referenced scores? 3

1 Raw Scores (# or % correct - not report, just used for calculations)
2 Developmental scores (age/grade equiv - not very useful, basically estimates, tempting to parents)
3 Scores of Relative Standing (percentile ranks & std scores)

112

____ is a comparison to others of their age. Older people get lumped in to larger age groups.

Scores of Relative Standing

113

What are 3 types of std scores?

1 z scores (mean = 0)
2 t scores (mean = 50)
3 scaled scores (mean of 100)

114

Medicare part ___ covers doctor services and outpatient care, covers some preventive services to help maintain a person's helath and keep certain illnesses fro mgetting worse and pays 80% of stuff

B

115

Medicare part A is also known as ___

Hospital Insurance

116

What age is the minimum for Medicare coverage?

65

117

What age is the maximum for ECI?

3

118

ECI = ?

early childhood intervention

119

Medicare part __ covers inpatient care in hospitals, and some skilled nursing facility, hospice and home health care.

A

120

Medicare part B is also known as ___

Medical Insurance

121

Medicare part ___ is run by private companies approved by Medicare which can either be Medicare advantage plans or separate Medicare Prescription drug plans and helps voer the cost of Rx. It is also known as __.

D; Prescription Drug Coverage

122

Medicare part ___ is a way to get Medicare benefits through private companies approved by and under contract with Medicare.

C; Medicare Advantage Plans

123

___ is government insurance for low income individuals and families.

Medicaid

124

IEP =

Individualized Education Program

125

IFSP

Individualized Family Service Plan

126

FAPE
LRE
ARD
PPCD

Free Appropriate Public Education
Least Restrictive Environment
Admission Review Dismissal
Preschool Program for Children w/ Disabilities

127

SI
OHI
AU
SNF

Speech Impaired
Other Health Impaired
Autism
Skilled Nursing Facility

128

Dx, Tx, Rx, Hx, s/p, d/c, LOS, OP, OTR

diagnosis, treatment, prescription, history, status post, discharge, length of stay, outpatient, occupational therapist registered.

129

WHO, ICF

world health organization, international classification of functioning, disability and health.

130

____ is a score that indicate the rank of the client compared to others (Same age or same grade) using a hypothetical group of 100 (students). You want to be 50%, there is no 100%.

percentile

131

___ reflects a client's rank compared to others, based on how far above or below the average ("mean") an individual score falls, using a common scale such as one with an average of 100.

Standard scores

132

Standard scores take __ into account, or the degree which scores typically will deviate from the average score.

"variance"

133

____ are essentially groups of percentile ranks with the entire group of scores divided by 9 parts, with the largest number of individuals falling in the middle (3-7) and fewer individuals falling at the extremes.

Stanines

134

What is the usefulness of stanines?

the relative range of a client's performance

135

What is the relative usefulness of standard scores?

compare individuals from different ages groups or grades, because all scores are converted to the same numerical scale.

136

Is a percentile the same as a percent?

NO! you can't get 100% and it isn't an amount of answers correctly answered.

137

How many parts are stanines broken into? Is it popular?

9; no

138

___ indicate that the client has attained the same score (not skills) as an average person of that age or grade.

Age or grade equivalent scores

139

What is the advantage/disadvantage of age/grade equivalent score?

easy to understand/often given too much significance by lay people

140

_____ is where the majority of all people would fall within a small range (or one "standard deviation") of the mean or average score, and where 50% of of all people would fall above and 50% would fall below the average score.

Normal curve or Bell-shaped curve

141

In a normal curve, ___ are above and below the mean.

50%

142

In a normal curve, ___ are found within 1 standard deviation form the mean.

a majority (68%)

143

____ standard deviation(s) is enough to qualify for therapy in school.

1.5

144

___ is the rough IQ for ID (intellectual disability)

~70 (2 standard deviations)

145

Generally SS: ___ and below is below the average range or ___ and below on a subtest, or PR of ___ and below.

84; 6; 16th

146

What are the standard score mean and 1 & 2 standard deviation from the mean?

mean = 100
1 s = 85, 115
2 s = 70, 130

147

what are the scale scores (subtests) mean and 1 & 2 standard deviation from the mean?

mean = 10
1 s = 7, 13
2 s = 4, 16

148

What are the percentile ranks mean, and 1 & 2 standard deviation from the mean?

mean = 50
1 s = 16, 84
2 s = 2, 98

149

When reporting scores, you need to explain both the __ and ___ of a score.

location and severity

150

When reporting severity of score you can say ___, ___ or ____.

average (average (range), below average, above average

151

When reporting location of score you can say ____, ____ or ____.

less/more than one SD, outside/withing/above/ below the average/typical range, between

152

Remember to point out the score is ____.

the result on this test, today.