Processes of Intervention
Define modeling.
Demonstrations that teach various skills/behaviors. It's a highly structured format where the client must listen, process, then imitate the target at a later time.
Define EBP.
EBP is the careful integration of clinical experience, theoretical knowledge, and research literature.
It incorporates client's values & beliefs, clinical expertise, and the best research evidence available.
List the 4 types of assessment tools.
1) Case histories/questionnaires/interviews
2) Observational tools (behavioral observations, interviews, dynamic assessments)
3) norm-referenced tests (formal tests)
4) criterion-referenced tests (informal tools)
What is the goal hierarchy?
long-term goals->short-term goals->session goals
Goals are created in a broad way, and then they are broken down into smaller, more manageable chunks.
Why is the ASHA code of ethics necessary?
They provide objective set of standard against which to compare your own practices. Safeguard professional reputations and protect the profession. Guidelines help ensure rights and welfare of clients.
What is generalization? How can you facilitate it?
Generalization, aka carryover, is the act of using a target behavior in other contexts outside of therapy sessions without the support of a clinician.
More naturalistic therapy environments promote/facilitate generalization. As a clinician, you can manipulate therapy environments, game/activities played in order to promote carryover.
Compare internal evidence with external evidence.
internal: evaluation of client and their family (their preferences/beliefs/characteristics)
external: current best published scientific evidence
List the 3 types of Communication Sampling and detail the benefits/importance of communication sampling.
How do we analyze samples?
-Nonverbal, Language, and Speech. All 3 investigate a wide range of speech/language problems.
-Use of CS is highly recommended with culturally/linguistically diverse populations. There is increased sensitivity for diagnosis, increased ecological validity, and improved client for "hard to test" children. Assessment results guide treatment planning.
-Analyze CS through MLU, NDW, TNW, segmentation into T-units, IPSyn, SALT.
What does S.M.A.R.T stand for in regards to session goals?
S: specific
M: measurable
A: attainable
R: realistic & relevant
T: time-limited
Match the Definition with the Correct Principle:
I, II, III, IV
-honor responsibilities and relationships with colleagues, students, and those in other professions
-honor responsibility to protect welfare of client/research participants
-promote public understanding of the profession and support development of services to meet unmet needs of the public
-honor responsibility to achieve and maintain highest level of competence and service
I: honor responsibility to protect welfare of client/research participants
II: honor responsibility to achieve and maintain highest level of competence and service
III: promote public understanding of the profession and support development of services to meet unmet needs of the public
IV: honor responsibilities and relationships with colleagues, students, and those in other professions
Describe Behaviorist theory as it relates to the clinician-directed approach.
All behaviors occur following an antecedent (stimulus) and is maintained or discouraged by its consequences; facilitate the production of target goals.
stimulus -> behavior -> consequence
This operant conditioning is done through: cue, delayed imitation, direct imitation, fading, prompt, reinforcement, shaping
What is P.I.C.O?
Patient/Problem, Intervention considered, Comparison of other intervention, Outcome of interest
Describe criterion-referenced tests and discuss their strengths and weaknesses.
Tests do not compare the client's performance to others; instead it measures skills to predetermined expectations. Process may or may not be standardized.
pro: can be administered in naturalistic environment and modifications can be made. Determine baseline functioning and help guide intervention plan.
cons: cannot obtain a standardized score, and this could be an issue for determining eligibility of services.
What is baseline functioning and why is it important?
The baseline describes the current level of communication functioning, detailing both its strengths and weaknesses. It's also known as a "pretest" to ensure client cannot already perform target behavior.
It's important because it determines the starting point of intervention and is subsequently used to track progress.
List the steps in the Ethics Calibration Quick Test
(Framework for resolving ethical issues)
1) What is the conflict/dilemma?
2) What values are in conflict?
3) What evidence is provided by those involved?
4) What courses of action can be taken/are recommended?
5) In whose best interest is the decision?
6) How will the decision effect me or others going forward?
List the 7 types of Clinician Support.
modeling, verbal, visual, tactile, kinesthetic, phonemic, orthographic
List the 4 responses to consider when implementing evidence.
1) Implement the approach regardless of conflicts
2) Use an alternative approach to be in line with the family's values
3) Modify the target approach to reduce mismatch
4) Discuss with the client and their family the research supported approaches that may not align with values
List the 4 psychometric properties that pertain to norm-referenced tests and describe them.
1) Representative sample: norming sample test-taker is being compared to; should be large enough to form bell-shaped curve. Is your client represented in this sample?
2) standard scores: normal curve/normal distribution is used to establish the standard score. SD measures distance from average score.
3) validity: does test accurately measure what is claims to?
4) reliability: do test scores remain stable regardless of who gives the test? inter-rater (similarity of scores between takers) and test-retest reliability (consistency over time).
List and describe the 4 components of a session goal.
1) "Do" Statement: identifies target behavior; should be measurable and S.M.A.R.T.
2) Condition: identifies situation in which target is to be performed (when/where it will occur and with what materials?). Should be universally interpretable!
3) Criterion: specifies how well target must be performed in order for the goal to be met. Aids in determining if therapy techniques are successful.
4) Level of support: will the clinician provide minimal (1-25%), moderate (26-50%), or maximum (51-100%) support?
What is a scope of practice and why is it necessary?
-Scope details what SLPs do, where they work, who they work with, intervention approaches, etc.
-helps in identifying procedures and processes one in allowed to execute in the profession (also help in collaborative work). Help deliver services in comprehensive, integrated manner
Define and compare client-centered, hybrid, and clinician-directed approaches and give an example of each.
Be sure to mention continuum of naturalness!
Client-centered: most natural! Focus on providing therapy in the most authentic environments in an attempt to promote generalization. Client leads intervention and determines sequence, activities, etc. (ex: facilitative play)
Hybrid: mid-point of naturalness! Activities are natural, but clinician still maintains control over therapy session. Focus on generalization by attacking one/small set of goals at a time. (ex: script therapy, conversational coaching)
Clinician-Directed: least natural! Clinician controls all aspects of intervention, including activities, reinforcement, etc. Clear reinforcement and deletion of irrelevant stimuli help target behavior to be produced. (ex: drill, drill-play)
List the 6 step approach for EBP in order.
1) Develop clinical question (PICO)
2) Find internal evidence and answer questions
3) Find external evidence
4) Appraise the quality of the external evidence
5) Integrate the internal and external evidence
6) Evaluate the clinical decision
Describe an oral mech exam, list the articulators observed, and detail general appearances we look for.
Look at structural and functional adequacy of the articulators. Findings contribute to etiology, diagnosis, prognosis, and direction of treatment. Exam should be swift and systematic!
Articulators: face, lips, teeth, tongue, hard palate, soft palate, pharyngeal area. In addition we check respiration and DDK rates.
General appearance: size, shape, color, symmetry, scarring, function, movement, etc.
What is S.O.A.P? What does each letter stand for?
SOAP Notes are the universal format in healthcare for notes. They ensure conciseness, accountability, and assist in treatment planning.
S: Subjective; observations of client's behavior
O: Objective; what were session goals and were they accomplished?
A: Assessment; overall impression of the client's status/performance.
P: Plan; what recommendations are suggested for the next session?
List the disorders/areas that SLPs diagnose/treat
-fluency
-speech production
-language
-literacy
-cognition
-feeding/swallowing
-auditory re/habilitation
-voice
-resonance
-auditory processing