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133 Cards in this Set

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  • Back
evaluation
informal way deter strength and weakness. Pinpoint potential prob areas, need for thearpy
diagnosis
formal way to determine what the problem is
diagnosis process
ongoing, focus on person(not disorder), working on a jigsaw puzzle start with framework, and fill in pieces
Important for therapist
flexible, critical, objective, insightful, professional, rapport
Flexible
important for therapist-change thearpy plan to meet goal. What works one time or with one client not necessarily w/another
Critical
important for therapist-trust education and instinct does therapy idea makes sense
insightful
important for therapist to sense something that is not quite right
Objective
important for therapist-report what you see not what you think about person
professional
important for therapist don't let personal life get in way of therapy.
Rapport
important for therapist-build trust by being sincere and honest
Why do evaluations
Determine reality of prob, determine etiology, determine appro. options, facilitate implementation of plan
Deter. reality of prob.
why evaluate: disorder? difference? treatable?
Difference in speech
different from others, listener distress, speaker disress, interferes w/ msg.
Disordered speech?
age, cognition, cultural norms
Determine etiology
why evaluate: find probable cause of the problem
Determine appro. options
why evaluate: take info from eval to form best plan
Science of diagnosis
Organized
Predictable
Procedural
objective
Inquisitive
Overlaps with art
Art of diagnosis
Flexible
Sensitive
Insightful
Curious
Experience
Overlaps with science
Eligibilty Issues
Educational setting, Medical setting,Why can private practice be different?,Severity Rating Scales
Educational setting
2 measurable test score-fall 1.5 SD below avg., observation by teacher-test must be supported by observation-a lot kids one therapist
Medical Setting
Private practice-anyone can qualify-no issue w/ crowd. Funct. Goals-what can do b4? vs. what can do now? defecit canidate for therapy.
Severtiy rating
rated severity of disorder 1-4 higher points-more involved the case is-results in less clients
Considering young kids
Spend time w/ kids, no what the it thing is, let them teach you, limit choices, play, be flexible
Considering adolescents
Respect, explain what's going on, get know what's popular.
Components of effective eval
informal observation, standardized test, case history, interview w/ responsible person, results of prior testing: one alone can not be appro. eval.
determine and report a prognosis
level of cognition, present level of perform (motivation), severity of prob, support, age, health, previous incidence, length of time since incident, co existing conditions, stimulability
Prognostic statement
ie. Prognosis is judged to be good for recovery of speech to prior level of function due to:
Prep for interview
Getting the environment ready
Know what you want to know
Know why you need to know
Practice asking questions- out loud
Get your behavior under control
Get environment ready
quiet, unclutter, chairs, respectful, arrangement, show your listening, unintimidating.
Know what you want to know
outline before, names of people in interview
Know why you need to know
don't ask personal questions unless they are necessary
Practice asking ?s
out loud conversational phrasing, clear and concise
Getting behavior under control
nervous habits, volume, pitch, semantics(children v. kid), no cursing, stay away from tech jargon, dress, professional presentation
Types of interview questions
open-ended, primary, neutral all questions should be clear, relavent, related to topic, straight forward, accessible to variety of language levels.
Open ended questions
prompts-more than yes/no-tell me about-non-directive-opp. of closed question: good for getting info-both will make up interview
Primary question
First question to set up topic. start w/ a list of primaries, but another one not listed may come up.
Secondary question
Used to clarify and follow up a primary question
Neutral question
thers' no bias opp. of leading
Leading Question
Force the person to answer in a certain way-answer is suggested within question
Interview openers
start w/ ice breakers, Summarize problem
Explain events up to now
Refer to referral source
Ask a question
Combo
Advantage to open ended questions
Rapport-info that may not be exposed otherwise
Problem with open ended
may not share, tell a person what they want to know, rambliong, irrelavant info, time
Advantages of close ended
specific info quickly
disadvantages of close ended
Not in depth info
Patterns of stuctural sequence
funnel, inverted funnel, tunnel
Funnel sequence
start with an open ended question moves to closed ended question
Inverted funnel sequence
Start with a closed ended question move to open ended question
Tunnel
funnel questions together
Types of testing
Screenings
Diagnostic tests
Informal Tests and Descriptive Statistical Analysis
Screening
determine if further testing is needed-efficient-good for large group, filter-if a screening id's too many people it's not appropriate
Flhuarty screening
ten cards w/ difficult blends
diagnostic test
statistical comparison, part of determining eligibility for school, id strength and weakness, guide for futher eval.
informal test
describe behave in natural environ, language sample, determine goals-not appropriate to write goals base on standard test, measure
dynamic assessment
change assessment base on child
Test Selection
Client Characteristics, Test Characteristics
Client Characteristics for test selection
age, cognition, disorder specific, disability.
Test Characteristics for test selection
valid and reliable for client's characteristics
Reliablity
How consistently a test measures what it measures
test/retest reliability
give now and @ a laters date-how much remains the same
split half reliabilty
first half of test and 2nd half are both equally as reliable.
Interjudge reliability
two therapist give the same test-yields same results
internal reliability
ever item is reliable
Validity
the degree to which a testt measure what a test says it's going to measure
Test of language
Must test all aspects of language to be valid
Types of formal tests
normative, criterion reference test
Normative
standardized/norm referenced
Criterion reference test
need to meet a certain criterion to pass.
Common Errors in use of norm. ref test
Determine TX targets, measuring TX progress, overall disorderr from one test, non natural environment, framentation of integrated system.
Interpretation of test
Normal dist., Raw score, range, mean, median mode
Normal distribution of scores
bell curve, distribution of scores
Raw score
Total # minus total errored-meaningless w/o %
Range
lowest score-highest score
Mean
average
Median
numbers in order middle #
Mode
most frequent number
standard score
conversion of raw score which compares one's performance to others
Percentile rank
type of standard score % of people that you scored better than
stanine
divides normal distribution in nine segments-not equal 9 best
50 percentile
always the mean
standard deviation
square root of the variance-to figure out normal range
variance
how much variablility there is in the score dispersion from the mean
average range
within 1 SD of the mean -1-+1 68% of the population
Normal range
within 2 SD of the mean -2-+2 96% of the population
16th percentile
always -1 SD
84th percentile
always +1 SD
98th percentile
always +2 SD
2nd percentile
always -2 SD
z score
mean of zero SD of 1
T score
mean of 50 SD of 10
Transitions
seamless, accented, abrupt
Seamless
type of transition-ideal, no break, move from one topic to another
accentetd
type of transition-bridge from one topic to another, indicate topic movement w/ transition. We've been doing X, lets move on to Y
Abrupt
type of transition-get back to therapy from tangent
Dealing w/ tears
Tissues, stop talking, empathize by validating person's feelings
Facilitation and probes
Uh huh
Nodding
“Tell me more…”
Pregnant pause-stop to allow person to cont.
Possilbe responses to clients comments
support, reassurance, empathy, confrontation, reflection, interpretation,
Support as response to client comments
you're doing the right thing
Reassurance as response to client comments
Remind them of the right thing
Empathy as response to client comments
I know you're going through a difficult time-validate feelings
confrontation as response to client comments
pointing out what you see
reflection as response to client comments
saying back to the person what they said
interpretation as response to client comments
combo of empathy and reflection
Assisted
A with cirlce around it
Activity of Daily living
ADL
twice per day
bid
with
c with a line over it
complaining of
c/o
cerebral vascular accident
CVA
discontinue/discharge
dc
diagnosis
dx
history
hx
independent
I with a circle around it
left
L with a circle around it
liquid
liq
medical/medication
med
nothing by mouth
npo
occupational therapy
OT
Prior level of function
PLF
po
by mouth
everyday
qd
whenever necessary
prn
physical therapy
PT
four times a day
qid
right
R with a circle around it
without
s with a line over it
subjective, objective, assessment, plan
SOAP
speech therapy
ST
treatment
tx
Within normal limites
WNL
Change
triangle
true score
never really know, but use observed score
confidence interval
range within which a person would fall if test again. Range of score that are reported larger % means higher confidence interval
Standard error of measurment
allows for uncontrolled errors and room for error-take observed score and standard error from it and also add standard error to get confidence interval.