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521 Child Language and Learning > Principles of Pediatric Assessment > Flashcards

Principles of Pediatric Assessment Flashcards

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1
Q

Assessment is part of the overall treatment process in which settings?

A

Early intervention
Preschool
Private practice/outpatient

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2
Q

What are the 3 purposes of assessment?

A
  1. Identify whether there is an impairment in the form, function or use of the child’s language
  2. Describe the deficits in language form, content, and use; compare with developmental expectations
  3. Determine the impact of the deficits on the child’s daily life
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3
Q

The WHO ICF-CY model is used to

A

Determine the impact of the deficits on the child’s daily life
Take a look at environmental factors and personal factors

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4
Q

What is a naturalist perspective of DLD?

A

DLD is an impairment or disease is a process within the individual
Associated with a medical model that appraises and diagnoses

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5
Q

What is a normative perspective of DLD?

A

Look at how the impairment influence the client’s functioning in daily life?
Focused on societal expectations and obstacles
Identify the functional sequelae of the disorder

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6
Q

In practice, do SLPs use the normative or naturalist perspective?

A

We look at both because we want to look at both the disease and the impact on the client’s life

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7
Q

Where can we assess a client’s communicative function?

A

In a standard environment, clinic or classroom
In the client’s actual environment, contextualized

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8
Q

How do we assess a client’s communicative function?

A

Formal testing (standardized test, criterion referenced)
Informal testing (observations, dynamic evals, interviews)

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9
Q

Why do we assess clients?

A

Screening
Establishing a baseline function
Establishing goals for intervention
Measuring change in intervention

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10
Q

Is assessment ongoing or a one-time event?

A

Ongoing

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11
Q

In the words to sentences and sentences to stories stages, what is the best type of assessment?

A

Language sampling
Also used for goal setting and monitoring progress
Thought of as authentic and contextualized

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12
Q

In the sentences to stories stage, what type of assessment is used to determine if a child has a language disorder?

A

Norm referenced tests that are based on psychometric criteria
Not contextualized

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13
Q

In games to words and words to sentences stages, what must SLPs rely on for authentic assessment?

A

Parental reports
These are deemed to be contextualized

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14
Q

What is involved in the screening process?

A

Child is identified by teachers or caregivers as potentially having a language disorder
The screening procedure then depends on the setting

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15
Q

Screenings are typically done for children in

A

Early intervention
Schools

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16
Q

Early intervention screening is typically done with a ____ team

A

Multidisciplinary team
Team based assessment with other professionals like OT, PT, school psychologists, teachers, etc

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17
Q

What is the Arizona IFSP? What language in this description relatesto how we are talking about SLPassessment in general?

A

Individualized family service plan
Functional outcomes, provided in natural environments, built into family’s daily activities and routines

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18
Q

When looking at deviation from the average, we need to choose a reference point. This consists of ….

A

Age-matched peers
Mental age-matched peers
Language matched peers

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19
Q

Who is part of the multidisciplinary/team based assessment?

A

Family/Caregivers
Audiologist
ENT
Geneticist
Learning disabilities/literacy specialist
Neurologist
Nutrition specialist
Occupational therapist
Pediatrician
Physical therapist
Psychiatrist
Classroom/Mainstream teacher
Special education teacher

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20
Q

Why are family/caregivers at the top of the multidisciplinary/team-based assessment?

A

They are the most important team member and the experts on their child
They are also the ones that are going to be doing the teaching at home

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21
Q

What does the beginning of assessment include?

A

Referral: amount of information can be very limited
Case Review: see what tests were administered before and when, what info is there about the child’s daily life
Observation: try to observe in different contexts if the is possible

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22
Q

What is low structure observation?

A

Observation that is used to build rapport if the child will engage with you
Depends on the setting: child with caregiver, child with peers or siblings, video recording from caregiver

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23
Q

What is a language or communication sample?

A

Record of the child’s speech that can be used later
We can also ask the parent to provide a recording if the child can use verbal language but is reluctant

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24
Q

How do you build up a client’s case history?

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A

Caregiver interview and questionnaire: to collect specific information that was not in the case history, confirm/check info
Teacher interview and questionnaire: ask about concerns, how does the client compare to peers? etc.

25
What is ethnographic interviewing?
Interviewing that uses descriptive questions that allow people to detail about their daily lives
26
What are the goals of ethnographic interviewing?
Establish stronger relationships Understand strengths and needs of clients and caregivers from their own perspectives Minimize preexisting biases Better understand the client's communicative needs
27
What are the recommendations for ethnographic interviewing?
Develop a rapport Ask descriptive and structural questions Identify patterns that indicate concerns or other important info
28
How should questions be worded for ethnographic interviewing?
Use open-ended rather than closed-ended Ask one question at a time Avoid leading questions Summarize the client and family's responses to questions (give opportunity to correct misinterpretation)
29
What are funds of knowledge?
Learning about the knowledge and abilities of clients and families and drawing on these life experiences as resources to advance student learning in the classroom
30
What is included in funds of knowledge?
Language Family beliefs and customs Family outings Household responsibilities Instructional activities Family professions
31
What is routine-based interviewing?
Semi-structured interview about the family's day-to-day life, focusing on the child's engagement, independence, and social relationships.
32
What is the purpose of routine-based interviewing?
1. To develop a list of functional out-comes 2. To assess child and family functioning 3. To establish a positive relationship with the family 
33
Planning the formal assessment begins with ...
Mapping the plan
34
Mapping the plan includes
Use evidence from interviews, observations, and case history to hypothesize the problem and choose evaluation tools Establish baseline abilities (hearing, OME, intelligibility, expressive and receptive) Make referrals as needed
35
Mapping the plan: assessment should cover ...
Domains of language: form, content and use Modalities of language: production and comprehension Collateral areas: hearing, oral-motor, nonverbal cognition, and social functioning
36
Mapping the plan, assessment with CLD children should include
1. Identify and reducing a bias 2. Individualise timing of assessment 3. Consider L1 and L2 abilities and needs (past, present and future) 4. Look beyond language dominance 5. Gather data using multiple measures and multiple sources (Review, interview, observe, test RIOT)
37
With CLD children, it is important that you
Learn about the family's culture before you make choices
38
Procedures for assessment: standardized tests features
Most formal Decontextualized Norm-referenced Do not "stand alone" ALWAYS PAIR WITH SOMETHING ELSE
39
Psychometric criteria, standardized tests: What is validity?
Measures what it intends to measure
40
Psychometric criteria, standardized tests: What is reliability?
Consistency with which it measures a particular behavior or attribute
41
Psychometric criteria, standardized tests: Normative sample details
Ages, geographic location, socioeconomic status, linguistic background of the normative sample
42
Psychometric criteria, standardized tests: What are equivalent scores?
Age equivalent scores do not take into account individual differences, possible range of performance, open to misinterpretation
43
Psychometric criteria, standardized tests: Percentile ranks
Indicates the percentage of individuals in the normative group whose test scores fall below a given value
44
Psychometric criteria, standardized tests: standard score
Accounts for average score and variability - the most meaningful comparison
45
Psychometric criteria, standardized tests: sensitivity
Probability that the test correctly identifies individuals who have the diagnosis
46
Psychometric criteria, standardized tests: specificity
Probability that the test does NOT identify an individual as having the diagnosis when they truly do not
47
Should we use standardized test scores to diagnose DLD?
NO, they should never stand alone Clinician judgement is "gold standard" because we consider multiple sources of information not just the test
48
Standardized tests lead to cultural, linguistic and socioeconomic bias due to
Overidentification (DLLs make similar errors in English to children with DLD) Under identification (wait and see approach due to assuming language problems are due to DLL)
49
Criterion-referenced procedures are different than standardized tests in that they are
Looking only the child, not comparing to others Test the child's levels in certain areas (baseline function, determine if met goals) Check in structured and naturalistic situations Useful with CLD kids
50
Criterion referenced procedures look at both ___ and ____
Comprehension and production
51
Behavioral observations are a type of assessment used for
Description, not comparing the child to any preset criteria May be clinician designed Use checklists or rating forms Sometimes are included as an extra part of standardized tests
52
What are examples of behavioral assessment?
1. Dynamic assessment: reporting on the child’s ability to learn the skills vs the skill itself 2. Functional assessment: used with people with developmentally lower communication ability or issues with different areas of form, content, and use List of tasks in different areas of communication 3. Curriculum-based assessment: looking at how child is able to grasp info they learn in school
53
The WHO ICF-CY model helps clinicians focus on how a child's language disorder ....
Impacts their daily life
54
What is a formative assessment?
Informal Provides feedback that leads to behavioral change Embedded into learning process Ongoing
55
What is summative assessment?
Typical for diagnostic measures Used to measure baseline performance and change after a period of intervention Usually more structured or standardized assessment material + systematic administration
56
What are the overall questions we are looking at when conducting an assessment?
Is there a significant deficit in any or all areas of language (form, content, use)? Is there a significant deficit in either or both modalities of language (comprehension, production)? How severe is the deficit? What is the baseline level of functioning? What further information do we need?
57
The clinical decision is based on ...
Parents, teacher and/or clinician concern ratings Standardized speech and language assessment tasks Connected speech and language production Observation of learning
58
Once assessment has been done, how do we put all of the information together?
1. Determine the severity 2. Make a prognosis 3. Make recommendations for the intervention program

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