Day 2 Flashcards

(158 cards)

1
Q

1st step of diagnostic process based on the scientific model

A

Definition and delineation of problem- constituent analysis

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2
Q

2nd step of diagnostic process based on the scientific model.

A

Develop hypothesis- clinical hypothesis

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3
Q

3rd step of diagnostic process based on scientific model

A

Research design- clinical design

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4
Q

4th step of diagnostic process based on the scientific model

A

Collection of data- clinical testing

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5
Q

5th step of diagnostic process based on the scientific model

A

Analysis of data- clinical data analysis

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6
Q

6th step of diagnostic process based on the scientific model

A

Interpretation of data- Clinical interpretation

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7
Q

7th step of diagnostic process based on the scientific model

A

Conclusions- recommendations for patient management

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8
Q

Define constituent analysis

A

Defining the problem through thorough and systematic analysis of information

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9
Q

2 avenues patient information is available through in performing constituent analysis

A

Case history form and patient interview

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10
Q

Define and explain: case history form

A

Starting point for understanding clients and
their communication problems
 Typically completed by the client or parent  Ideally reviewed by the clinician before initial
meeting
 Enables the clinician to anticipate areas that
will require assessment, identify topics requiring further clarification and preselect appropriate test materials

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11
Q

Importance of the initial interview

A
To explore the nature and history of the
patient’s presenting symptoms
 To establish initial contact and the
patient/caregiver/clinician relationship
 May be the foundation for future success in
therapy
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12
Q

3 phases of the initial interview

A

Opening phase, body phase, closing phase

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13
Q

Opening phase of interview

A

Introductions ¡ Describe the purpose of meeting

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14
Q

Body phase of interview

A

Discuss “statement of problem”

Client’s history and current status in depth Clarify information on case history form

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15
Q

Closing phase of interview

A

Summarize major points of discussion
Express appreciation for interviewee’s help
Indicate what will take place and the approximate length of the
session

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16
Q

What a good interviewer needs

A

Common sense
Basic knowledge of the disorder
Counseling skills

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17
Q

In an interview, the clinician

A

Assumes responsibility for conducting the interview  Should not intimidate the client  Should stay focused  Should maintain flexibility  Should be sensitive  Should not express subjective personal feelings  Should remain open even if the patient is hostile or
uncooperative
 Should be a listener, not a talker

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18
Q

What the patient brings to the interview process

A

Anxiety
 Past and present problems  Previous contact with health professionals
 Previous contact with educational professionals  Education  Personal needs  Cultural background

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19
Q

4 types of questions

A

Open-ended, closed-ended, neutral, leading

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20
Q

Clinician’s responses to answers

A

Summary statements
 Reflections  Clarifications
 Repetitions  Pauses  Nonverbal behaviors: head nodding, body
posturing, eye contact, touching

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21
Q

9 things to avoid during an interview

A

Yes/no questions
 Either-or questions  Inhibitive phrasing
 Sudden shifts in the line of questioning  Talking too much  Stereotypical verbal habits  Forgetting client’s feelings, attitudes in view of
symptoms/etiology
 Providing too much information too soon  Accepting superficial answers

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22
Q

7 pieces of info you should have by the end of the interview

A

Etiological factors
 Previous clinical findings  Developmental history
 Current health status  Educational/vocational history  Emotional/social adjustment  Family concerns

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23
Q

Define and explain: clinical hypothesis

A

Theory that could explain presenting behavior
or facts
 The purpose is to guide current assessment
and intervention

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24
Q

3 steps to form a clinical hypothesis

A

Think about the causal factors based on the
constituent analysis
 Narrow down possible explanations for the
clinical problem
 Form priorities among the potential cause-
and-effect relationships until you have derived the most likely explanation and its causes

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25
4 functions of the clinical hypothesis
Attempts to clarify the clinical problem  Implies a level of understanding  Offers a tentative explanation to the speech and language problem  Derives a dynamic cause-and-effect relationship used for exploring the patient’s problem
26
State an example hypothesis: George (3.6 years) was reported by his mother and pediatrician to have age appropriate skills in all areas of development except language. Information gathered at the initial interview suggested a significant language delay. During initial play with the child, it was noted that he used only one-word utterances, but seemed to be able to follow directions
Hypothesis: George has a significant expressive language delay.
27
State an example hypothesis: Ann (7.5 years) has significant difficulty following directions, using proper sentence structure and learning sight words.
Ann has a broad-based language learning disability that affects both her oral and written language skills.
28
State an example hypothesis: Standardized testing indicates that Evan (6.6 years) has a significant language delay. It is not clear yet whether this is part of a general global delay, but his teacher reports that he completes some non-verbal tasks as well as his peers
Evan has a specific language impairment
29
State an example hypothesis: Jane had a moderate expressive language delay when she was referred 6 months ago. Jane has been attending weekly therapy sessions and her mother reports that she is no longer concerned with her language. You suspect that Jane now has age-appropriate language skills and want to check this out with a standardized assessment.
Jane's language skills are now age appropriate
30
5 principles of good assessments
Thorough ¡ uses a variety of assessment modalities ¡ Valid ¡ Reliable ¡ Tailored to the individual client
31
Psychometric principles: definition and 3 things they include
Refers to the measurement of human traits, abilities, and certain processes  Includes: ¡ Test Validity ¡ Reliability ¡ Standardization
32
Define: test validity
The extent to which a test measures what it is constructed to measure.
33
2 types of test validity
Content and construct
34
Define and explain content validity
Means that a test includes items that are relevant to assessing the purported skill.  Requires an expert’s critical examination of each item’s relevance and ability to sample the behavior under observation
35
3 major criteria of content validity
Appropriateness of the items included  Completeness of the items sampled  Way in which the test items assess the content
36
Define and explain construct validity
Degree to which a test measures a predetermined theoretical construct  Ex. Studies of language acquisition show that expressive vocabulary increases with age. Therefore, a test of expressive vocabulary should yield scores that show progressive improvement with age.
37
Define: test reliability
Reliability means that the results are replicable
38
It is preferable for tests to have correlation coefficients of:
.90 or above
39
The closer a coefficient of reliability is to _____(
1.0, reliable
40
3 types of reliability
test-retest, split-half, rater
41
Define test-retest reliability
Refers to a test’s stability over time (over several administrations)
42
Define split-half reliability
Refers to a test’s internal consistency; scores from one half of the test correlate with results from the other half of the test…comparing odd number questions to even number questions
43
Define rater reliability
Refers to the level of agreement among individuals rating a test
44
Define: standardized tests
Standardized tests provide standard procedures for the | administration and scoring of the test
45
Purpose of standardized tests
Standardization is completed so that test-giver bias and other extraneous influences do not affect the client’s performance and so that results from different people are comparable
46
The majority of standardized test clinicians use are _______, but _______ is NOT synonymous with ________.
norm referenced, standardized, norm referenced
47
Any test can be standardized as long as what 2 things are used?
uniform test | administration and scoring are used
48
2 general testing guidelines
Study administration and scoring directions thoroughly, practice administering the test
49
6 things to consider when practicing administering a test
Testing Environment ¡ Rest Periods/Breaks ¡ Encouragement and Reinforcement ¡ Repetitions ¡ Cultural Diversity ¡ Dialectal Variation
50
3 of Many factors that have a negative impact on test administration and interpretation for individuals from culturally and/or linguistically diverse backgrounds
Differences between your communication style and that of the student ÷ Lack of familiarity with item contexts (e.g., pictures, vocabulary, topics) ÷ Items that reflect values and beliefs that are culturally specific
51
6 Ways to minimize potential cultural diversity problems that may require non-standardized administration
Allow extra time ÷ Increase number of practice trials ÷ Reword test instructions ÷ Continue testing beyond ceiling ÷ Ask student to explain incorrect responses ÷ Use alternative scoring procedures
52
Define: dialectal variation
Responses may contain regional and cultural | patterns or variations that reflect dialectical differences from mainstream American English
53
2 things to do when there is dialectal variation
Count variations correct if it is appropriate given the student’s language background ¡ You must be familiar with the student’s home language environment to determine whether a response is appropriate
54
Define: assessment
The process of collecting valid and reliable information, | integrating it, and interpreting it to make a judgment or a decision about something.
55
Assessment = _______
Evaluation
56
Outcome of assessment is usually a ______
Diagnosis
57
Define diagnosis
Clinical decision regarding the presence or absence of a disorder and the assessment of a diagnostic label (e.g., expressive language disorder; childhood apraxia of speech)
58
6 things SLP's do with assessment info
Make professional diagnoses and conclusions ¡ Identify the need for referral to other professionals ¡ Identify the need for treatment ¡ Determine the focus of treatment ¡ Determine the frequency and length of treatment ¡ Make decisions about the structure of treatment
59
4 potential structures of treatment
individual sessions, group sessions, treatment with caregivers, treatment without caregivers
60
2 types of tests commonly used by SLP's
Norm-referenced, criterion-referenced
61
Definition and goal of norm-referenced tests
Standardized tests that compare an individual’s performance to that of age-matched peers ¡ The goal is to rank the individual so that decisions can be made about their opportunity for success (e.g., SAT)
62
Definition and goal of criterion-referenced tests
Individual’s performance is compared to a pre-defined set of criteria or a standard ¡ The goal is to determine whether or not the individual has mastery of a certain skill set ¡ These results are usually “pass” or “fail”
63
3 typical scores used with norm-referenced tests
Standard scores, percentiles, age/grade equivalent
64
Definition of standard scores
¡ Derived from raw scores using the normative information gathered when the test was developed ¡ Indicate how far above or below the average (or “mean”) an individual’s score falls, using a common scale, such as one with an average of 100.
65
Other uses and purposes of standardized scores
Can be used to compare individuals from different grades or age groups because all scores are converted to the same numerical scale ¡ Most intelligence tests and many achievement tests, including tests used by SLPs, use standard scores
66
Define: percentiles
A score that indicates the rank of the student compared to others (same age or grade), using a hypothetical group of 100 students ¡ Derived from raw scores using the norms obtained from testing a large population when the test was developed
67
How do percentiles differ from percents? Explain what a specific percentile score of X% means
Not the same as “percent” – a percentile of 87 does not mean that the student answered 87% of the questions correctly ¡ A percentile of 87 indicates that the individual’s score on a test equals or surpasses 87 out of 100 (or 87%) individuals
68
Define: age/grade equivalent. Frequency of use and understanding?
Indicate that the student has attained the same score (not skills) as an average student of that age or grade ¡ Seem to be easy to understand but are often misunderstood ¡ Not used very often in formal reports
69
Examples of norm-referenced tests
Clinical Evaluation of Language Fundamentals-5 (CELF-5)  Test of Language Development Primary -4 (TOLD:P-4)  Preschool Language Scale-5 (PLS-5)  Test of Word Reading Efficiency-2 (TOWRE-2)  Comprehensive Test of Phonological Processing-2 (CTOPP-2)  Oral and Written Language Scales-II (OWLS-II)  Assessment of Literacy and Language (ALL)
70
5 other uses of criterion-referenced tests
Used to measure mastery of educational objectives or curriculum (absolute performance) ¡ Does not compare one student to another or rank student ¡ Focus on what the child knows or can do, not on how they compare to others ¡ Often used as “end-of-unit” tests or as a “benchmark” to identify areas of strength or weakness ¡ Typically use raw scores and percentages to reflect the level of mastery of a given objective
71
Examples of criterion referenced tests
``` Assessment of Literacy and Language ¡ Specific subtests  Clinical Evaluation of Language Fundamentals-4: Screening Test  Rosetti Infant Toddler Language Scale  Birth to Three ```
72
4 test/subtest administration procedures
1. Record forms, (Fill out all identifying information,Calculate Chronological age) 2. record responses (write out responses, use a tape recorder) 3. score responses (Clearly indicate correct and incorrect responses, Usually indicate with 1 or 0, but varies depending on test 4. start and discontinue rules
73
Most tests have specific _____ and ____ criteria
Starting and ending
74
Define starting point
The starting point is some arbitrary level judged appropriate for the individual, usually based on age. Basal levels are determined from starting level and are the lowest specified number of correct responses
75
Define ending point
The ending point is determined after the individual has missed a specified number of consecutive questions. This is the ceiling level.
76
In order to save time, especially with relatively long tests, _______ and ______ levels are established so that the entire test does not have to be administered.
basal and ceiling
77
All items (above/below) the basal level are counted as correct
below
78
All items (above/below) the ceiling level are counted as incorrect
above
79
Other info about basal and ceiling levels
Basal and Ceiling levels vary by test. You must refer to the examiner’s manual for this information. This information is often on the test response form as well.
80
Standard scores are derived from
raw scores
81
Define raw score
The Raw Score is the total number of points (correct | responses) for a given subtest or test.
82
How to calculate raw score
Add the scores for the items administered ¡ Remember to give credit for unadministered items below the basal ¡ Write this score at the bottom of the subtest ¡ Depending on the test, also write this number on the front of the record form for test or subtest
83
Info about the Bell Curve
Standard scores and percentiles can be compared using the “normal” or bell-shaped curve  Most tests in speech-language pathology are developed in order to yield a standard curve of scores, where the majority of all individuals would fall within a small range (or one “standard deviation”) of the mean or average score and where 50% of all individuals would fall above and 50% would fall below the average score  Some tests do not have such “normal” distributions of scores and these different types of scores may not be comparable
84
A standard score usually has a mean of _____ and a standard deviation of ____
100, 15 Plus one SD from the mean is 115 (above average…84th %ile) ¡ Minus one SD from the mean is 85 (below average…16th %ile))
85
Define subtest or scale score
A Subtest or Scale Score is a score that represents | one score in a battery of subtests to develop a composite score.
86
Many subtest have a mean score of ____ and a standard deviation of ______
10, 3 | Plus one SD from the mean is 13 (above average…84th %ile) ¡ Minus one SD from the mean is 7 (below average…16th %ile)
87
Guidelines for interpreting composite standard scores 1
115- above = above average 86-114 = average 78-85 = below average 71-77 = poor
88
Guidelines for interpreting composite standard scores 2
``` >130 = very superior 121-130 = superior 111-120 = above average 90-110 = average 80-89 = below average 70-79 = poor ```
89
Guidelines for interpreting subtest standard scores
``` 17-20 = very superior 15-16 = superior 13-14 = above average 8-12 = average 6-7 = below average 4-5 = poor 1-3 = very poor ```
90
Speech and language sampling: importance/purpose? Length?
Very important to determine whether a problem exists, and if so, identifying the client’s specific deficiencies  Should be long enough to obtain a true, representative sample of the clients speech and language
91
6 advantages of speech and language sampling
Assess all aspects of language  Determine strengths and weaknesses  Can make descriptive summaries of language behaviors  Can analyze specific utterances  Analyze communication strategies employed by the patient  Consider errors within a communicative context
92
8 ways to obtain a reliable and valid sample
Establish a positive relationship with the client  Minimize interruptions and distractions  Be patient…do not talk to fill silence  Preselect materials and topics that will interest client  Follow client’s lead in changing topics or elaborating  Provide a variety of contexts – conversation, narrative, response to pictures  Ask questions that require lengthier responses  Can use conversation, pictures or narratives
93
Adults: obtaining a speech language sample through conversation
Clinician can use open-ended questions to elicit responses ¡ This may be done during initial interview
94
Children: obtaining a speech language sample through conversation
With very young children, you may need to use different activities, objects or toys to elicit speech or vocalizations ¡ With older children, use stimulus questions and statements to elicit a sample ÷ Tell me what you would do with a million dollars ÷ Do you have a pet? Tell me about him.
95
3 ways to obtain a speech language sample with pictures
Pictures are useful because they provide a known context  Important to use pictures that illustrate a variety of activities because they provide more things to talk about  Use pictures to transition to more natural dialogue
96
3 ways to obtain a speech-language sample through narrative
A narrative is a story  Narrative production differs from conversational production in that the client must use certain rules of organization and language sequencing to relay events that have a beginning, middle and end  One way to do this is by telling the client a story and having the client tell it back
97
3 ways conversation differs from narrative production
Dysfluencies more evident in narratives than in conversations  Longer utterances in narratives than in conversations  More burdens with narrative and expository discourse than with conversation ¡ Require more planning and organization ¡ Need to organize thoughts & sequence events
98
4 types of hard to assess children
Who are extremely shy or quiet ¡ Who are noncompliant ¡ Who are hyperactive or impulsive ¡ With visual or other physical handicaps
99
Define data analysis
Somewhat of an artificial step  “The nonjudgmental organization of the ‘facts’ that have been obtained during clinical testing” (Nation & Aram, 1984, p. 219)  It follows clinical testing (collecting of clinical data) and precedes clinical interpretation of the data
100
3 stages of clinical analysis
Objectify the data  Categorize and order the new data in reference to the clinical hypotheses  Determine the strength or significance of the data for supporting or refuting the clinical hypotheses
101
2 ways to objectify the data
Scoring ¡ Responses and descriptive statements ¡ How the client performed ¡ What the client did ¡ Conditions under which data were obtained  Comparing data to normative information
102
Scoring results in what 2 types of data?
Quantitative (numerical) and descriptive (informational)
103
2 important facts about data analysis
At this stage you are only specifying the degree and extent of the variation  You are NOT judging the absence or presence of a speech/language deficit
104
3 ways to compare data to standards
Compare to normative data  Compare to your own knowledge  Compare to intra-disorder information
105
4 purposes of clinical interpretation
Determine the significance of the findings  Confirm or reject the hypothesis  Suggest other interpretations if rejecting the hypothesis  Set the course for patient management
106
How to determine significance of results
Accumulate all the data and determine what it means in relationship to ¡ your cause-and-effect statement ¡ your purposes for the assessment ¡ your referral’s request ¡ your patient’s statement of the problem
107
How to interpret all the information
Draw reasonable relationships among all the cause-effect data  Must rely heavily on your problem-solving abilities  Meld the information you got from the constituent analysis task with the information from the clinical analysis step
108
4 mistakes in interpretation
``` Overreliance on test scores  Incorrect cause-effect interpretations  Having inadequate knowledge about correlations between the patterns of the disordered speech and language behaviors and the causal factors  Lack of knowledge about the disorders ```
109
Define: statement of diagnosis
Formal, succinct statement of your diagnosis  Conveys the most logical cause-and-effect relationship
110
3 sources of supporting the diagnosis
Literature ¡ Constituent analysis ¡ Clinical data analysis
111
Supporting the diagnosis
Basically presents the diagnostician’s reasoning process for arriving at his diagnostic conclusion (Nation & Aram, 238)  Make good use of your negative results
112
Define: interpretation
The interpretation is your diagnosis and its probable cause  Use all the knowledge you have about the case up to this point, and your knowledge about delays, disorders and differences  Documents how you arrived at the diagnosis
113
4 questions to ask when determining management plan
``` Can the patient change his speech and/or language behavior?  Is therapy necessary to effect this change?  Do you need to make any referrals?  Are the needed services available? ```
114
Recommendations for intervention draw directly from _________
Assessment data
115
3 parts contained in a recommendation
Recommendation as to whether some intervention by an SLP is appropriate ¡ The goals established for intervention based on the assessment data ¡ Suggestions for methods, approaches, activities, reinforcements or any other aspects of the intervention program that the clinician feels is important
116
Why is it important to hold an interpretive conference?
“There is little likelihood that persons will act on | advice if they do not understand and accept the information given them.
117
Aspects/suggestions for
Simple, non-technical information  Review the general processes which support communication, then give assessment results  First describe strengths, then weaknesses  Use samples and analogies to clarify  Avoid superficial reassurances
118
6 basic principles of the post-diagnostic conference
Don’t expect client to understand everything you say  Share options instead of giving advice  Better to be too simple, than too complex  Provide a simple action to be implemented immediately  Be pleasant, but frank  Be aware of and prepared that they may focus their hostility on you
119
3 characteristics of a report
Summary of the information collected  Generally follows a more or less structured format  Language used should be clear and simple, but professional
120
3 characteristics of clear and simple professional language
Avoid qualifiers such as “rather” and “very” ¡ Distinguish between information we gathered or observed ourselves from information reported by the parents or others ¡ Avoid judgmental terms such as “good” and “nicely” in describing the child’s performance
121
4 steps to writing a report
``` Constituent analysis ¡ Identifying Info ¡ Statement of the Problem ¡ Background History  Clinical design/data collection/data analysis ¡ Testing and Observation  Clinical interpretation ¡ Diagnostic Statement  Conclusions ¡ Recommendations ```
122
Define: articulation disorders
Errors in production of individual speech | sounds
123
Therapy for articulation disorders
Therapy is phoneme based, combining | placement technique with sensory-‐perceptual training
124
Define: phonological disorder
Errors in classes of sounds  Recognizes that the sound system is a component of the child’s language system
125
Therapy for phonological disorders
Therapy is focused on reorganizing the | phonological system by first improving ability to process phonological information
126
Define: childhood apraxia of speech
Deficit in motor planning for speech
127
Therapy for Childhood apraxia of speech
Treatment involves helping child learn motor patterns to produce speech, utilize auditory/visual/kinesthetic cueing  Relies heavily on principles of motor learning for training sound combinations (not individual phonemes)
128
Articulation disorders: speech sounds like, therapy focuses on
individual sound errors, teaching individual sound production
129
Phonological disorders: speech sounds like, therapy focuses on
patterns of sound errors, reorganizing phonological system
130
CAS: speech sounds like, therapy focuses on
inconsistent errors due to fluctuations in motor planning, facilitating movement capabilities
131
Define: Goldman Fristoe Test of Articulaiton-3
Norm-‐referenced scores for ages 2:0 through 21:11  Pictures elicit production of sounds in ¡ varying word positions (initial, medial, final, clusters) ¡ single words vs. connected speech
132
4 purposes of Goldman Fristoe Test of Articulation-3
Identify errors and patterns of errors  Compare child’s speech to the speech of age-‐ matched peers  Numerically quantify improvement over time with Growth Scale Values  Develop treatment objectives
133
3 purposes of administration of GFTA-3
Elicit production of words (not direct imitation)  Score child’s production  Give Sounds-‐in-‐Sentences subtest if necessary
134
How to score the GFTA-3
Count errors to calculate Raw Score  Convert Raw Score to Standard Score, Percentile Rank, Growth Scale Value, and Age Equivalent using tables in the back of the manual
135
4 aspects to consider in interpretation of the test
 Standard score  Age-‐equivalent  Look at errors/error patterns  Check stimulability of error sounds
136
5 general clinical considerations in working with children with hearing loss
• Prepare ahead • Keep detailed records • Dress appropriately • Consider all privacy issues • Every parent loves her child
137
5 clinician considerations in working with children with hearing loss
• Hair back • Rate of presentation • Vocal pitch • Your facial expression is important • Visual contact
138
Name of first school of early intervention for children with hearing loss
The McCowen School for Young Deaf Children (1883)
139
Sensorineural hearing loss
Sensorineural hearing loss: • Leads to broadened auditory filters • Reduced dynamic range •
140
Addition of a cochlear implant means
– Spectral resolution is further diminished | – A frequency-place mismatch exists
141
What is oropharyngeal swallowing?
Moving food from mouth to stomach
142
Kahrilas point of view of oropharyngeal swallowing: part 1
Swallowing is reconfiguring the oropharynx from a respiratory tract to a swallowing pathway (alimentary pathway) for a period of less than one second
143
Kahrilas point of view of oropharyngeal swallowing: part 2
Swallowing is moving the bolus into the esophagus | Posterior lingual propulsion, Pharyngeal constriction, Upper Esophageal Sphincter Opening
144
T/F lanryngeal airspace is CONTINUOUS with the pharynx
True
145
Is the velum up or down for swallowing? Why important?
Velum up for swallowing - prevents nasal breathing and nasal regurgitation (food entering nasopharynx)
146
6 hyolaryngeal components
hyoid, epiglottis, aryepiglottic folds, thyroid, cricoid, arytenoids
147
3 steps of hyolaryngeal system closund sure
1. Hyolaryngeal elevation and approximation 2. Epiglottic inversion 3. Aryepiglottic fold "bunching"
148
Define when pharynx and esophagus are contiguous
Closed UES- pharynx and esophagus share a border
149
Define when pharynx and esophagus and continuous
Open UES- no border between pharynx and esophagus
150
The ______ loads the bolus immediately _______ to propelling it into the ________
tongue, prior, pharynx
151
What happens when the UES is open?
posterior lingual propulsion, or posterior lingual propulasion and pharyngeal constriction
152
Swallowing Schematic
respiratory tract ---> swallowing pathway Levers and movement of other structures velum hyo-larynx UES
153
Oropharyngeal swallowing: conspicuous and indisputable ways to think about it
Essential for sustaining life Important for quality of life Disorders may lead to serious illness or death Function is multi-factorial and complex
154
Oropharyngeal swallowing: inconspicuous and disputable ways to think about it
Objective identification of pathophysiologies Objective decision-making about treatment Monitoring progress of prescribed treatments Conclusions about efficacy of treatments
155
The significance of swallowing disorders is overwhelmingly (clear/unclear), but how to define and treat swallowing pathophysiology is insufficiently (clear/unclear).
Clear, clear
156
Define normal swallowing
Moving food from mouth to stomach with ease and without endangering the airway.
157
Define anatomy
Anatomy – The study of the structure of organisms and the relations of their parts
158
Define physiology
Physiology – A science dealing with the functions of living organisms or their parts