Clinical Methods

Front 1

Why take data?

Back 1

Important for documenting change during treatment, giving the clinician accountability for treatment. Allows clinician to understand client's progress and possible generalization.

Front 2

Types of Data (2)

Back 2

Treatment Data: data taken within the treatment paradigm, with the support of treatment.

Probe Data: data taken outside of the treatment paradigm, or with a change in 1 or more conditions.

Front 3

Types of Probes (7)

Back 3

SOUPDIG

STATIC: no feedback/cues/support provided
OUT-OF-CLINIC: change in setting
UNPRACTICED: new stimuli
PURE PROBE: all new stimuli
DYNAMIC: aka treatment, support given in order to elicit the target behavior
INTERMIXED: mixture of familiar and unfamiliar/untrained stimuli
GENERALIZATION/MAINTENANCE: probes used to understand generalization into different contexts (setting or linguistic)

Front 4

Data Collection Times (5)

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Pre and Post Data: before and after treatment
Baseline Phase: prior to treatment
Treatment Phase: within the treatment paradigm
Withdrawal Phase: after treatment
Repeat Measures: taken periodically to determine nature of behavior change relative to treatment paradigm

Front 5

Qualitative Data

Back 5

Data that can be interpreted to give a clinician an overall impression.

Front 6

Quantitative Data

Back 6

Data retrieved from observable behaviors that are countable and measured.

Front 7

Point Behaviors

Back 7

Behaviors that occur at a certain point in time.
Example: correct production of a target sound

Front 8

State Behaviors

Back 8

Behavior that have duration and occur over a period of time.
Example: attention, sitting in seat, fluent speech

Front 9

Trials

Back 9

Used to describe the number of antecedents given to elicit a response during structured tasks.

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Opportunities

Back 10

Used to describe the number of times a client has a chance to produce a target behavior during naturalistic tasks.

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Generalization

Back 11

The expansion of correctly produced target behaviors into new conditions. Applying learned behavior to new circumstances. (stimulus, response, response mode)

Front 12

Stimulus Generalization

Back 12

When a target response is carried over so that it occurs when new/untrained stimulus are present

Front 13

Multiple Stimulus Generalization

Back 13

When a target response is carried over into some combination of new verbal, physical, setting, or audience stimuli.

Front 14

Stimulus Bound

Back 14

When a client is dependent on a stimulus to be able to produce a response when they are expected to be generalizing the behavior

Front 15

Response Generalization

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When learning a target behavior spreads to another related, but untrained behavior.

Front 16

Response Mode Generalization

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Responses produced in one mode are produced in another mode without training.

Front 17

Concurrent Stimulus & Response Generalization

Back 17

A target behavior is carried over to new untrained stimuli and the learning spreads to new responses simultaneously.
Combination of stimulus and response generalization.

Front 18

Why is concurrent stimulus and response generalization ideal for treatment?

Back 18

Makes therapy more efficient.
It is what we want from therapy: to trigger targets by many stimuli, natural stimuli, and by everyday verbal instructions.

Front 19

Near vs. Far Generalization

Back 19

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Front 20

Maintenance

Back 20

When a target behavior is generalized and maintained after the withdrawal of a treatment program for that particular behavior.

Front 21

Sequential Teaching Program (STP)

Back 21

Outlines how the clinician will move the client toward achieving their long-term goal.

Front 22

Immediate Objective

Back 22

The current goal of treatment/current sessions.

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Short-Term Objective

Back 23

A major step that needs to be taken in order to achieve the long term goal.

Front 24

Long-Term Objective

Back 24

The final goal of treatment that would then allow the client to be discharged.

Front 25

Dynamic Assessment

Back 25

Assessment of a child using prompts/cues/support to help the client produce the target behavior. Allows the clinician to understand what level of support is needed.

TESTS ZPD

Front 26

Zone of Proximal Development (ZPD)

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The zone/difference between the clients current level of performance, and the best level of performance demonstrated when provided with support.

THEORY: this is where you should be working with the child

Front 27

Dynamic Assessment Approaches (2)

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"Sandwich" Format: pretest, teach (DA), posttest
"Cake" Format: no pretest, DA (teaching), posttest (or perhaps not) --> dive into treatment

Front 28

Key Elements of DA

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Probes of Target Behavior (no assistance)
Trial Treatment or Mediated Learning (most-to-least, or least-to-most cueing, shaping, and rapid manipulation of ABCs)

Front 29

Advantages of DA

Back 29

Useful for diagnosis and treatment planning
Difference vs. Disorder
Predict rate of change

Front 30

Disadvantages of DA

Back 30

Time consuming
Poor reliability and validity (cannot be standardized)

Front 31

Efficacy

Back 31

External Evidence of EBP
The extent to which an intervention produces favorable outcomes under controlled conditions.
Does the treatment work?

Front 32

Effectiveness

Back 32

Internal Evidence of EBP
The extent to which intervention produces a favorable outcome.
Same as efficacy but INTERNAL

Front 33

Improvement

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Internal Evidence of EBP
How the client's performance improves over time

Front 34

Efficiency

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External Evidence of EBP
Productive of desired effects
Treatment is productive w/out waste

Front 35

Generalization Behaviors

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A behavior that is expected to change as a result of treatment of the target behavior (response generalization)

Front 36

Control Behaviors

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A behavior similar enough to the target behavior that may change due to maturation of recovery but is not expected to be due to treatment.

Front 37

Principles

Back 37

Underlying basis of treatment procedure that is shown through research to have a positive effect on behavior.

Front 38

Procedures

Back 38

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Front 39

Antecedent

Back 39

What happens prior to a behavior to elicit the target behavior.

Front 40

Behavior

Back 40

An observable response that can be viewed in terms of stimulus, behavior, and consequence

Front 41

Consequence

Back 41

What happens after a behavior in order to reduce incorrect behaviors or increase correct behaviors

Front 42

Instructions

Back 42

A set of verbal steps that are given to the client to help them understand how to go about producing the target behavior.

Front 43

Demonstrations

Back 43

A visual representation of a skill that is exhibited without the expectation that the client repeat it.

Front 44

Stimuli

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Synonymous with antecedent.
However, it can be viewed as only the PHYSICAL materials used to elicit a response.

Front 45

Stimulus Modality

Back 45

Visual
Auditory
Tactile

Front 46

Modeling Hierarchy

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SDDEP
Simultaneous
Direct
Delayed
Embedded (She is wearing a hat. What is she wearing?)
Partial

Evoking without a model/Continuum of naturalness

Front 47

Prompts and Cues

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An addition part of an antecedent that is used to support the client in producing the target behavior.

Front 48

Response Modality

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Verbal, gestural, written

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Response Level

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Single word, phrase, sentence, etc.

Front 50

Target Behavior

Back 50

The general communicative act that is being treated or probed in intervention

Front 51

Target Response

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What a client is expected to do after a specific stimulus is presented.

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Reinforcers

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An event that follows a behavior, to increase those behaviors.

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Reinforcement

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PROCEDURE of following a response with a reinforcer.

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Positive Reinforcement

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Reinforcement that is used to increase the behavior.

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Negative Reinforcement

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Aversive events that are escaped or avoided by a behavior, thereby increasing the behavior.

Front 56

Types of Positive Reinforcement (2)

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Primary (biological necessity)
Secondary (learned, cultural)

Front 57

Types of Secondary Reinforcement (4)

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Feedback (Informative)
Premack (work to earn)
Condition Generalized (token economy, depends on previous learning)
Social (verbal praise)

Front 58

Types of Negative Reinforcement (2)

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Escape behaviors
Avoidance behaviors

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Continuous Reinforcement

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Given after every correct response

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Intermittent Reinforcement

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Given only after a certain number of trials, or after a certain interval

Front 61

Ratio Reinforcement

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After a given number of trials.

Front 62

Interval Reinforcement

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A function of time. Given after a certain amount of time.

Front 63

Two Types of Behavior Management

Back 63

Proactive
Reactive

Front 64

Ways to target reduction of behaviors in treatment (2)

Back 64

Indirect Response Reduction
Direct Response Reduction

Front 65

Indirect Response Reduction Methods

Back 65

Differential Reinforcement of Incompatible Behaviors (give the child a physically incompatible behaviors)
Differential Reinforcement of Other Behaviors
(reinforce any other behavior)
Different Reinforcement of Alternative Behaviors
(give the client an alternate behavior that you CAN reinforce)
Differential Reinforcement of Low Rate/Intensity (Reinforce child for fewer disruptions)

Front 66

Direct Response Reduction Methods (Mostly Punishment)

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Imposition of work (punishment)
Stimulus withdrawal (punishment): remove reinforcer
Extinction: ignore behavior (not punishment)
Mild Corrective Feedback (punishment)

Front 67

WHO-ICF Model

Back 67

Health Condition
Body Functions and Structures
Activity Limitations
Participation Restrictions
Contextual Factors
Environmental Factors

Front 68

Minority Model vs. Universal Model

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Minority Model: based on classification of disordered vs. not disorders. Unidemensional, categorical
Universal Model: continuum of abilities for all people

Front 69

Medical Model vs. Social Model

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Medical Model: disability is a medical condition that required individual adaptation
Social Model: social responsibility

Front 70

Biopsychosocial Model

Back 70

Elements of Medical and Social models
WHO-ICF
Reduces tendency to see impairments and disabilities

Front 71

EBP Triangle

Back 71

Best available external evidence
Clinical expertise (internal evidence)
Client values and preferences

ALL ARE EQUAL

Front 72

EBP Hierarchy

Back 72

Multiple randomized control trials (quanitiative)
Well-designed randomized control trial
Well-designed non-randomized group design
Well-designed single-subject experiment
Quantitative Review
Narrative Review
Non-experimental (case reports, etc)
Expert opinion

Front 73

Implicit Teaching

Back 73

Theories
Not openly taught
What you need to know in order to do what is taught explicitly

Front 74

Explicit Teaching

Back 74

Procedures
Openly discussed

Front 75

Standardized Measures

Back 75

Criterion Referenced and Norm Referenced
Very structured tasks
Done the same way every time (scored the same)
Reduces test-giver bias
Compares the client to established norms or to an expected level of performance

Front 76

Non-Standard Measures

Back 76

Still has a formal structure and may have scoring GUIDELINES
No comparison to norms
Typically criterion referenced

Front 77

Norm-Referenced

Back 77

Client compared to established norms

Front 78

Criterion Referenced

Back 78

Client compared to expected level of performance

Front 79

Dynamic Assessment

Back 79

Stimulability
Assessment that provides support to understand how the client performs with support and what types of support the client may need for treatment.

Front 80

Validity

Back 80

The truthfulness of the data. Does the data accurately measure the behavior of interest?

Front 81

Reliability

Back 81

How dependable or consistent the measure is in measuring what it is supposed to be.

Front 82

Client-Specific Strategy

Back 82

Planning intervention using client values and preferences (what does the client want to work on?)

Front 83

Normative Strategy

Back 83

Planning intervention based off of typical development and established norms.