Diagnostics Exam 1 Flashcards by Aaliyah Knight

What is assessment?

A. The process
8. SLP’s use of assessment

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Why do we complete an evaluation?

A. To determine: Is there a disorder?
B. To compare with norms
C. To share with others

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If there is a communication disorder, you will need to:

~ Describe the problem
~ Judge severity
~ Deal with the etiology
~ Prognostic statement
~ Make recommendations
~ Write goals/ objectives

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For an assessment to have foundational integrity it needs to adhere to these 5 principles:

~ thorough
~ uses a variety of modalities
~ valid
~ reliable
~ tailored to the individual client

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Typical Assessment Includes:

~ Case history
~ Interview
~ Evaluate oral-facial mechanism
~ Sample the client’s speech and language abilities
~ Screen hearing
~ Evaluate assessment information
~ Share findings

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May need to make referrals to other professionals

True

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Possible other referrals:

~ Psychologist/psychiatrist
~ OT, PT
~ Audiologist
~ Physician
~ Another SLP

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Each assessment will differ slightly

True

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Some have extensive case histories, clients have different communication difficulties, some cases involve extensive interviewing, some cases require detailed written reports.

Differences in Evaluation

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What environment factors do you need to consider while doing a diagnostic?

~ Privacy/confidentiality
~ Room consideration
~ Recording consideration
~ Stimulus consideration
~ Time
~ Seating
~ Distance
~ Appearance

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measurement of human traits, abilities, and certain processes

psychometrics

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a test measures what it claims to measure

test validity

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results are replicable

reliability

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provides standard procedures for the administration and scoring of the test

standardization

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a test measures predetermined theoretical construct, which is an explanation of a behavior or attribute based on empirical observation

construct validity

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validity that is established by an external criterion

criterion validity

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a tests validity in comparison to a widely accepted standard

concurrent validity

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a tests ability to predict performance in another situation or at a later time

predictive validity

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refers to a tests stability over time

test-retest reliability

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refers to a tests internal consistency

split-half reliability

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refers to the level of agreement among individuals rating the test

rater reliability

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results are consistent when the same person rates the test on more than one occasion

intra-rater reliability

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results are consistent when more than one person rates the test

inter-rater reliability

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refers to a test’s correlation coefficient with a similar test determined by administering Test A and Test B to the same group of people and comparing the results to determine the test’s alternate form reliability

alternate form reliability

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standardized tests = ______ tests

formal

_______________ provides standard procedures for the administration and scoring of the test

standardization

standardization helps to eliminate ___-_____ bias and other extraneous influences so they do not affect the client's performance

test-giver

majority of standardizes tests are ____-__________, but not ALL standardized tests are ____-________

norm-referenced

any test may be standardized as long as uniform test administration and scoring are used

true

consecutive test items that must be correct prior to continuing testing

basal standardization

number of test items incorrect prior to discontinuing testing

ceiling standardization

exact age of child at the date tested

chronological age

adjustment made in age of child if born prematurely

adjusted age

the initial score obtained from test results, but must be converted to interpret test results

raw score

each test should include information about:

- the purpose of the test - test construction and development - administration and scoring procedures - the normative sample group and statistical information derived from it - test reliability - test validity

most tests available to SLP's are ____-________

norm-referenced

norm-referenced tests are often used for evaluating articulation and language disorders

true

norm referenced tests are always ____________

standardized

norm-referenced tests compare an individuals performance of a _____ _____

larger group

normal distribution is often depicted using a ____-______ curve

bell-shaped

normal range on bell shaped curve

-1 to +1

mild range on bell shaped curve

-1 to -1.5

moderate range on bell shaped curve

-1.5 to -2

severe range on bell shaped curve

-2 or lower

scores from norm-referenced tests may include:

standard score, percentile rank, stanine

tells how many standard deviation the raw score is away from the mean

standard score

tells the percentage of people scoring at or below a particular score

percentile rank

based on a 9-unit scale where 5 is average performance. each stanine unit is equally distributed across the curve.

stanine

- tests are objective - skills of an individual can be compared to a large group of similar individuals - efficient testing - widely recognized -do not need a high level of experience - insurance companies and school districts prefer known test entities

norm-referenced test advantages

- Do not allow for individualization - Generally static - Evaluates isolated skills - Must be administered EXACTLY as instructed - Test materials may not always be appropriate for all populations/cultures

norm-referenced test disadvantages

* Do not compare individual’s performance to anyone else * Identify what a client can and cannot do * Help answer the question, “How does a client’s performance compare to an expected level of performance?” * Often used when assessing clients for neurogenic disorders, fluency disorders, and voice disorders * May or may not be standardized

criterion-referenced tests

–Usually objective –Usually efficient –Many are widely recognized –Insurance companies and school systems may prefer known tests –With non-standardized criterion-referenced tests, there is some opportunity for individualization

criterion-referenced test advantages

* Testing situation may be unnatural * Approach evaluates isolated skills * Standardized CR tests do not allow for individualization * Standardized CR tests must be administered EXACTLY as instructed

criterion-referenced test disadvantages

* Identifies what the client can and cannot do * Emphasizes contextualized test stimuli * Test environment is a realistic situation * Authentic assessment is ongoing * Requires more clinical skill, experience and creativity than formal assessment * Strategies recommended for evaluating clients using authentic assessment

authentic assessment approach

* Natural and similar to real world * Clients participate in self-evaluation, self-monitoring * Allows for individualization * Offers flexibility

authentic assessment approach advantages

–May lack objectivity –Reliability and validity are less assured –Requires a high level of clinical experience and skill –Requires a lot of planning and interpretation time –May be impractical –Insurance companies and school districts prefer known test entities

authentic assessment approach disadvantages

Basal is the ________ point for administration

starting

ceiling is the ______ point

ending

associated with a particular region, social class, or ethnic group

dialects

clinicians need special expertise in assessing children who speak:

1. A language other than English 2. English as a second language 3. A dialectal variation of American English (AAE) 4. A different form of English (Australian English)

the scientific study of a culture

ethnography

you will gather information from:

- written case history - interview - information from professionals

Gathers information about the client’s difficulties Helps plan for the assessment Allows you to identify information that needs clarification

case hiystory

Take notes or record it Develop trust Stress Be accommodating Share your knowledge clearly Use good communication skills Strong commitment to people

interviewing tips

Sensitivity Respect Empathy Objectivity Listening skills Motivation Rapport

Facilitating good communication

subjective notes (SOAP notes)

nonmeasureable

objective notes (SOAP notes)

measureable findings

Assessment (SOAP notes)

synthesis of information/analysis

Plan (SOAP notes)

-how to the findings affect the future -outline recommendations for future action and course of treatment

- birth through age 2 - identifies current levels of development - Includes family as recipients of services - supports transition to preschool program upon reaching age 3 - services coordinated through a county regional center - plan is reviewed at least every 6 mo

IFSP (individualized Family Service Plan)

- For special education of preschool and school-age children ages 3- 21 - identifies special education services necessary to achieve goals - services are coordinated through a local educational agency - Does not include provisions for the family - Supports transition to adulthood upon or before reaching age 21 - plan is reviewed at least every 12 mo

IEP (Individualized Education Plan)

abbreviation for "with":

c with line over it

abbreviation for "Activity of Daily Living"

ADL

abbreviation for "complaining of"

c/o

abbreviation for "diagnosis"

abbreviation for "Did Not Test"

DNT

abbreviation for "history" and "family history"

hx, f/h

abbreviation for "independent"

a circle with a capital i in it

abbreviation for "within normal limits"

WNL

abbreviation for "no known allergies"

NKA

abbreviation for "medical history"

m/h

abbreviation for "left" and "right"

circle with a capital L in it and circle with a capital R in it

abbreviation for "prognosis"

prog

abbreviation for "quality of life"

QOL

abbreviation for "patient"

abbreviation for "range of motion"

ROM

abbreviation for "speech therapy'

abbreviation for "treatment"

abbreviation for "change"

a triangle

abbreviation for "signs and symptoms"

s/s

for a speech language sample you need a minimum of 50-100 __________

utterances

average rate of speech for an adult

220-410 words per minute

average rate of speech for a 1st grader

125 wpm

average rate of speech for a 5th grader

142 wpm

* number of errors * Types of errors * Inconsistency of errors * Vowel errors * Rate of speech * Atypical prosody * Length and linguistic complexity of words/utterances * Insufficient vocal intensity, voice disorders * Disfluencies * Lack of gestures * Testing environment * Client anxiety/fatigue * Client lack of familiarity with materials * Clinician’s ability to understand “less intelligible” speech * Clinician’s familiarity with client

factors that negatively influence speech intelligibility

* Correct/incorrect productions * Frequency of disfluency types * Specific language features * Circumlocutions or word-finding difficulties * Correct phonatory behaviors * Inappropriate behaviors * Ability of client to stay on task * Incorrect/correct behaviors/productions (+/-) * Each time a behavior is exhibited * Behaviors according to preselected criteria

what to chart when charting