Differential Diagnosis Test 1

Front 1

What are five principals of a good assessment

Back 1

1. Is Valid-should truly evaluate the intended skills.

2. Is reliable-should accurately reflect the client's communicative abilities and disabilities

3. Is thorough-should incorporate as much relevant info as possible so an accurate diagnosis and recommendations can be made

4. Is tailored to the individual client-appropriate age, gender, skill level, etc.

5. Uses a variety of assessment modalities. It should include a combination of interview and case history info, formal and informal testing and client observations.

Front 2

What are six (6) things SLP's use assessment info to do?

Back 2

1.Make professional diagnosis and conclusions

2. Identify the need for referral to other professionals.

3. Identify the need for treatment

4. Determine the focus of treatment

5. Determine the frequency and length of treatment

6. Make decisions about the structure of treatment (e.g. group vs. individual)

Front 3

What is the most important diagnostic tool?

Back 3

The diagnostician herself or himself

Front 4

Name six things a diagnosis enables a clinician to do.

Back 4

1. Establish a record of the clinical problem

2. Understand the cause of a communication problem from the perspective of onset, development, and maintenance.

3. Differentiate one patient from another with related or similar problems.

4. Chart a course of intervention

5. Predict future status

6. Establish a record and criteria for progress

Front 5

Name seven (7) forms of recommendations

Back 5

1. No need for concern

2. Reevaluate at a later date, no intervention

3. Further speech and language evaluation info needed

4. Obtain info from other sources (i.e. referrals)

5. Speech-language pathology

6. Family involvement

7. Therapy coordinated with other disciplines

Front 6

Name five (5) parts of a diagnostic statement

Back 6

1. Classification and Severity Statemnt

2. Factors that may influence intervention

3. Recommendations

4. Prognostic statement

5. Etiologic and behavioral considerations

Front 7

In the original Greek diagnosis means

Back 7

"to distinguish"

"to understand thoroughly"

Front 8

Speech and Language diagnosis are made on the basis of careful consideration of

Back 8

1. Historical info

2. Data from direct observation and examination

Front 9

Name (6) six factors may enhance or hinder the chances of changing communication patterns

Back 9

1. Motivation

2. Health

3. Family support

4. Attention problems

5. Hyperactivity

6. Medication

Front 10

What are three aspects to a diagnosis?

Back 10

1. Determine the reality of the problems (Does the problem exist?)

2. Determine the etiology, if possible.

3. Provide a therapy plan (what to do)

Front 11

Severity statements

Back 11

enlarge our understanding of the disorder, plus they provide baseline information. (i.e., mild, moderate, severe, profound)

Front 12

Classification statements

Back 12

promote efficiency of communication among professionals (i.e., language disorder, articulation disorder, mixed hearing loss, etc.)

Front 13

Prognostic statement

Back 13

The clinician's statement concerning the likelihood of change (improvement of decline) of speech and language performance

Front 14

Prognosis

Back 14

is a forecast of what is expected to develop in the future

Front 15

Diagnosis

Back 15

represents the judgment of a clinician about patients and their presenting problems (areas of concern)

Front 16

What two types of services to SLPs and audiologists provide?

Back 16

1. Diagnosis

2. Therapy

Front 17

Reliability

Back 17

means results are predictable

Front 18

What are six disadvantages to norm-referenced tests?

Back 18

1. Do not allow for individualization

2. Tells what person knows but not how a person learns

3. Testing situation may not be representation of real life

4. Evaluates isolated skills

5. Must be administered exactly as instructed

6. May not be appropriate in certain populations

Front 19

Content validity

Back 19

test contents are representative of the content domain of the skill being assessed.

Front 20

Example of content validity

Back 20

A valid articulation test should elicit all phonemes, assessing the spectrum of articulation

Front 21

What does content validity judge?

Back 21

the actual content of the test (rather than just appearance) and is judged by individuals with expert knowledge

Front 22

Four types of validity

Back 22

1. Face validity

2. Content validity

3. Construct validity

4. Criterion validity

Front 23

Four types of reliability

Back 23

1. Test-retest reliability

2. Split-half reliability

3. Rater reliability

4. Alternate form reliability

Front 24

Psychometrics

Back 24

refers to the measurement of human traits, abilities and certain processes

Front 25

What are four ways language can be categorized?

Back 25

1. Typically developing and speaking SAE

2. Typically developing and speaking a non-standard dialect

3. Atypically developing and speaking SAE

4. Atypically developing and speaking a nonstandard dialect

Front 26

_______% of all outcomes will fall within one standard deviations of the means (_____% on each side)

Back 26

68%

34%

Front 27

Mode

Back 27

the most frequently occurring score in the distribution

Front 28

Symmetrical

Back 28

meaning if you divide the curve into two halves they will mirror each other

Front 29

Unimodal

Back 29

meaning one mode

Front 30

Mean

Back 30

is the average of the distribution this score determines the peak of the distribution

Front 31

Median

Back 31

the score that divides the distribution in half

Front 32

What are four (4) disadvantages of criterion-referenced tests?

Back 32

1. May not represent "real life"

2. Evaluation isolated skills without considering contributing factors

3. Standardized CR tests do not allow for individualization

4. Standardized CR tests must be administered exactly as instructed for results to be considered valid and reliable

Front 33

What are five advantages of criterion-referenced tests?

Back 33

1. Tests are objective

2. Administration is efficient

3. Widely recognized

4. Insurance companies and school districts prefer known tests

5.There is opportunity for individualization

Front 34

Name three assessment approaches that can be used by SLP

Back 34

1. Norm-referenced

2. Criterion-referenced

3. Authentic assessment

Front 35

Normal curve

Back 35

It is a symmetrical, unimodal distribution in which the mean, median, and mode are equal

Front 36

Standard/Scale scores

Back 36

are often preferred type of derived score

Front 37

Z-scores

Back 37

are the simplest of standard score formats and indicate how far above or below the mean of the distribution the raw score is in standard deviation units

Front 38

Three (3) of the most common standard/scale scores based on linear transformations

Back 38

1. Z-scores

2. T-scores

3. Celf-5

Front 39

Stanine scores

Back 39

divide the distribution into nine bands (1-9)

x=5 standard deviation=2

Because stanines use only 9 values to represent the full range of scores, they are not a particularly precise score format

Front 40

Predictive validity

Back 40

refers to a test's ability to predict performance (the criterion measure) in another situation or at a later time

Front 41

Normalized standard scores

Back 41

scores that are based on nonlinear transformations

Front 42

Z-scores

Back 42

x=0 Standard deviation=1

All the scores above the mean will be positive and all the scores below the mean will be negative

A score of 1.6 is 1.6 std devs above the mean

A score of -1.6 is 1.6 Std devs below the mean

Front 43

Name three types of normalized standard scores

Back 43

1. Stanine scores

2. Percentile Ranks

3. Grade equivalents

Front 44

What are six advantages to authentic assessment?

Back 44

1. May lack objectivity

2. Not usually standardized (reliability and validity less assured)

3. Implementation requires high level of clinical experience and skill

4. Approach is not efficient

5. May be impractical in some situations

6. Not preferred option for insurance companies and school districts

Front 45

Concurrent validity

Back 45

refers to a test's validity in comparison to a widely accepted standard

Front 46

What are two types of criterion validity?

Back 46

1. Concurrent validity

2. Predictive validity

Front 47

What are four advantages of authentic assessment approach

Back 47

1. Natural/similar treatment

2. Client participate in self-evaluation and self-monitoring

3. Allows for individualization

4. Flexible

Front 48

T-scores

Back 48

x=50 Standard Deviation= 10

Are all positive and do not have decimals

Ex: 66 is 1.6 std devs above mean

Ex: 34 is 1.6 std devs below mean

Front 49

Rapport

Back 49

establishment of a working relationship based on mutual respect and trust

Front 50

Objectivity

Back 50

No undue emotional involvement and know limits of your skills

Front 51

Persistent curiosity

Back 51

causes the clinician to search for explanations

Front 52

Sensitivity

Back 52

to detect subtle physical, psychological, or interactional changes

Front 53

Insight

Back 53

on which to base judgments

Front 54

Evaluative attitude

Back 54

to look at behaviors in terms of their meaning rather than the expected response

Front 55

What seven(7) things must a diagnostician learn?

Back 55

1. Flexibility

2 Sensitivity

3. Insight

4. An evaluative attitude

5. Persistent Curiosity

6. Objectivity

7. Rapport

Front 56

Percentile Rank

Back 56

the typical way of interpreting is as reflecting the percentage of individuals scoring below a given point in a distribution

Front 57

Percentile ranks range from ___ to ____ and a rank of ____ indicates the median perfomance

Back 57

1 to 99

50

Front 58

A percentile rank of ____ indicates that 80% of the individuals in the standardization sample scored below this score.

Back 58

80

Front 59

A percentile rank of ____ indicates that only 20% of the individuals in the standardization sample scored below this score

Back 59

20

Front 60

Criterion-referenced tests are used most often when assessing clients for ______________________, ______________________ and ______________________.

Back 60

1. neurogenic disorders

2. fluency disorders

3. voice disorders

Front 61

Percent correct

Back 61

percentage of items answered correctly

Front 62

What are two other names for authentic assessment?

Back 62

1. Alternative assessment

2. Nontraditional assessment

Front 63

Higher prevalence of stuttering in _______ than ____________

Back 63

males than females

Front 64

Higher prevalence of articulation and phonological disorders in ______ than ________

Back 64

males than females

Front 65

SLP's and audiologists are increasingly interested in the concepts of:

Back 65

1. diversity

2. multiculturalism

3. individual differences and their influence on assessment and service delivery

Front 66

Name four things you need to know prior to assessment of the client

Back 66

1. Know the culture of the client.

2. Every culture has a set of pragmatic social rules that guide their communicative behaviors

3. Within every culture there is individual variation

4. What is true for a culture as a whole may not be true for an individual from that culture

Front 67

Name five (5) things you need to consider when working with interpreters.

Back 67

1. Find someone who is proficient in both SAE and the language of the client

2. The interpreter should respect the cultural customs of both parties

3. Avoid using a child as an interpreter

4. Avoid using the client's family members or friend as interpreters

5. When speaking, look at the client not the interpreter.

Front 68

______________ is one of the most comprehensive and difficult tasks of the clinician.

Back 68

Diagnosis

Front 69

What are two things a prognostic statement does?

Back 69

1. It provides the patient and family with statements of expectation regarding communication improvements

2. It forces the clinician to be accountable.

Front 70

Name six (6) "do's" and "don'ts" that assist clinicians

Back 70

1. Treat all clinical info as confidential.

2. Maintain a professional manner and appearance during the diagnostic evaluation

3. When taking the case history plan the procedure in advance to obtain important information quickly.

4. During the evaluation, try to rule out various disorders

5. After the evaluation make certain decisions.

6. When writing the report, work for clarity and brevity.

Front 71

For an assessment to be meaningful and useful, it must have ___________________

Back 71

foundational integrity

Front 72

Completing an assessment involves:

Back 72

1. gathering relevant information

2. assimilating it

3. drawing conclusions

4. then sharing the findings and recommendations

Front 73

Face validity

Back 73

means that a test looks like it assesses the skill it claims to assess. A lay person can make the judgment.

Front 74

Construct validity

Back 74

means a test measures a predetermined theoretical construct which is an explanation of a behavior or attribute based on empirical observations.

Front 75

Validity

Back 75

does the test measure what it claims to measure. There are several types of validity.

Front 76

Examples of construct validity

Back 76

Ex: the theoretical construct that preschool children's language skills improve with age is based on language development studies.

Therefore, a valid test of early language development will show improved language skills when administered to preschool children of progressively increasing ages.

Front 77

Example of face validity

Back 77

A group of would be pilots may be more ready to accept a mathematics test dealing with wind drift and fuel consumption than they would to accept a test with essentially the same problems but phrased in term of costs of crops or recipes for baking cakes.

Front 78

Factors influencing reliability (10)

Back 78

1. The number of items on a test

2. Test administration length

3. Range of difficulty

4. Objective scoring

5. Probability of success by chance

6. Accuracy of scoring

7. Homogeneity of items

8. Environment

9. "Trick" questions

10. Misinterpretation of items

Front 79

Each test's manual should including information about:

Back 79

1. The purpose of the test

2. Test construction and development

3. Administration and scoring procedures

4. The normative sample group and statistical info derived from it

5. Test reliability

6. Test validity

Front 80

Norm-referenced scores

Back 80

the client's performance is compared to the performance of other people (a reference group)

Front 81

Examples of norm-referenced score interpretations

Back 81

1. If an examinee has a Core Lng Score of 100, this indicates that he/she scored higher than 50% of the people in the standardization sample.

2. It might be reported that an examinee scored higher than 98% of the standardization sample on vocabulary.

Front 82

Criterion-referenced score interpretations

Back 82

the client's performance is not compared to that of other people; instead it is compared to a specified level of performance (i.e. a criterion)

Front 83

________% of all outcomes will fall within three standard deviations of the means (49.85% on each side)

Back 83

99.7%

Front 84

______% of all outcomes will fall within two standard deviations of the mean (47.5% on each side)

Back 84

95%

Front 85

Because we know that the mean equals the median in a normal distribution, an individual who scores at the mean scored better than _____% of the sample

Back 85

50%

Front 86

Criterion-referenced interpretations

Back 86

1. the examinee's performance is not compared to a reference group but to a specified level of performance.

2. attempts to describe what they know or are capable of doing

3. are used most often when assessing client for neurogenic disorders, fluency disorders, and voice disorders.

4. may or may not be standardized

Front 87

Examples of criterion-reference interpretations

Back 87

Ex: Teachers evaluate students' performances in terms of "percentage correct" or letter grades to reflect mastery (i.e., A,B,C,D and F)

Mastery testing-involves determining whether the examinee has achieved a specific level of mastery of knowledge or skills

Cut scores (previously established) are used to determine if a student passes or fails (cut score 85%--85% pass and 84% fail)

Front 88

Authentic assessments are_______

Back 88

ongoing

Front 89

What are some important things to know about culture of the client?

Back 89

1. cultural groups have differing views of disability and intervention

2. cultural groups hold diverse views of a woman's role in society

3. cultural groups hold different views of familial authority

4. Names and titles used during communicative exchanges vary among cultures

5. Some cultural groups may be uncomfortable with case history and interview questions

6. Some cultures may be uncomfortable with testing practices

7. Individual achievement is viewed differently among cultural groups

8. Some cultures have different views about a child's behavior in the company of adults

9. Different view on the use of eye contact

10. Some cultures view time differently

11. Perceptions of personal space vary across cultures.

Front 90

Examples of cultural differences

Back 90

1. some consider it a person's fate to have a disability and intervention won't help

2. parent's may feel personally responsible for the disability

3. some feel that the disability is a spiritual curse or gift

4. some rely on holistic interventions

5. the father may be the spokesperson and addressing anyone else would be disrespectful

6. the spokesperson may be the godparents, grandparents, tribal elders, etc.

7. ask how an individual prefers to be addressed

8. questions may be perceived as rude or too personal

9. establish rapport first and collect the information over several visits if necessary

Front 91

Examples of cultural differences

Back 91

10. children learn through observation and may be unwilling to attempt unfamiliar tasks or may expect a demonstration of the task before they will attempt the task

11. Group achievement may be valued more than individual achievement

12. Some may value humility and modesty

13. children are to be seen not heard

14. children should not initiate conversations

15. others expect high levels of participation in conversation

16. can be a sign of disrespect for a child to make frequent or prolonged eye contact

17. adults will not maintain prolonged eye contact with other adults

18. Answering questions within an allotted amount of time

19. arriving on time for an appointment

20. "comfortable distance" between individuals varies with culture as well as with familiarity

Front 92

Names "Do's" and "Don'ts" that assist clinician in maintaining ethical standards, arriving at accurate appraisal of speech and lang problems and avoiding certain well known clinical pitfalls.

Back 92

1. Do not reveal clinical info to anyone except concerned clinical personnel

2. Do not discuss cases in the waiting room

3. Do not leave permanent files unattended

4. Treat the case as a client, not an old friend.

5. Dress the part (conservative dress is generally best)

6. have a set procedure

7. give parents an opportunity to relate their greatest concerns

8. do not ask for info that cannot be used

9. give appropriate tests

10. move to important areas quickly

11. follow tests procedures

12. Is there a speech and/or lang problem?

13. If so, what type? How severe? what are contributing factors?

14. What advice will you give the parent?

15. Present brief and accurate info

16. Do not include all info in report (i.e. unsupported facts: statements that cast doubt on other professionals)

17. include identifying info: a statement of the speech and/or lang problem; statement of recommendations.

Front 93

Validity

Back 93

Does the test measure what it claims to measure. There are several types of validity.

Front 94

Face validity refers to how test takers perceive the ______________ and ____________ of a test.

Back 94

attractiveness and appropriateness

Front 95

Why is face validity important?

Back 95

If tests takers consider the test to have face validity, they may offer a more conscientious effort to complete the test. If a test does not have face validity, they might hurry through a test and take it less seriously.

Front 96

_________ validity is not a valuable measure along because it is based on appearance not on content or outcomes.

Back 96

Face validity

Front 97

_______ validity tells us nothing about what a test actually measures.

Back 97

Face validity

Front 98

Constructs

Back 98

attributes that exist in the theoretical sense. thus, they do not exist in either the literal or physical sense. Despite this, we can observe and measure behaviors that provide evidence of these constructs.

Ex: Gravity, we cannot see gravity but we can see what we assume to be its results: a falling apple

Front 99

Criterion validity

Back 99

refers to validity that is established by use of an external criterion

Front 100

Example of criterion validity

Back 100

The Clinical Evaluation of Language Fundamentals-Fourth Edition is already accepted as a valid assessment of receptive and expressive language

Newer language tests are often compared to the CELF-4 which serves as the criterion measure.

Front 101

Factors influencing validity

Back 101

1. unclear directions

2. reading vocabulary and sentence structure is too difficult

3 Ambiguity

4. Inadequate time limits

5. Inappropriate level of difficulty of the test items

6. Poorly constructed test items

7. Test items are inappropriate for the outcomes being measured

8. Test is too short

9. Improper arrangement of the items

10. Identifiable pattern of answers

Front 102

Intra-rater reliability

Back 102

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

ra= one person

Front 103

Inter-rater reliability

Back 103

is established if results are consistent when more than one person rates the test

er=more than one person

Front 104

Test-retest reliability

Back 104

refers to a test's stability over time. It is determined by administering the same test multiple times to the same group and then comparing the scores.

Ex: If the scores from different administrations are the same or very similar, the test is considered stable and reliable

Front 105

Rater reliability

Back 105

refers to the level of agreement among individuals rating a test. It is determined by administering a single test audio or videotaping it so it can be stored multiple times

Front 106

You should always familiarize yourself with a test before:

Back 106

attempting to administer it to a client

Front 107

What is the goal of an SLP assessment?

Back 107

to draw a conclusion about the client's communication abilities

Front 108

It is best to practice giving the test to a person of the _______ age before administering it to the actual client

Back 108

same

Front 109

What is the simplest type of score

Back 109

Raw score

Front 110

A _____ score is simply the number of items scored (correct/incorrect, true/false)

Back 110

raw

Front 111

Test scores

Back 111

reflect the performance or ratings of the individuals completing test

Front 112

The terms ________________ and ____________ actually refer to the interpretation of test scores

Back 112

criterion-referenced

norm-referenced

Front 113

Example of criterion-referenced score interpretation

Back 113

If you report a student answered 85% of the items on a classroom language disorders exam, this is a criterion-referenced interpretation

Notice that you are not comparing the student's performance to that of the other students, you are comparing it to a standard. In this case perfect performance on the test.

Front 114

The normative reference group most often used to derive scores is called___________________

Back 114

standardization sample

Front 115

Another name for the normal curve

Back 115

bell-shaped curve

Front 116

Because the distribution in the normal curve is __________ relationship is the same in the inverse below the mean

Back 116

symmetrical

Ex: 1 SD below the individual exceed only about 16% of the population, etc. (cumulative %)

Front 117

An individual whose score falls 1 SD above the mean performs at a level exceeding approximately:

Back 117

84% of the sample

50% cumulative percentage + 34%

Front 118

Percentile ranks are _____________ near the middle of the distribution and ______________ near the tails of the distribution

Back 118

compressed

spread out

Front 119

The mean raw score is called the

Back 119

grade equivalent

Front 120

Percentile ranks are not

Back 120

percent correct

Front 121

________________ are not comparable across tests or even subtests

Back 121

grade equivalents

Front 122

There is not a predictable relationship between grade equivalents and ________________

Back 122

percentile ranks

Front 123

Celf-5

Back 123

x=100 SD=15

use standard score format

Ex: A score of 124 is 1.6 SD above the mean

Front 124

Norm referenced scores

Back 124

gives us the scores needed to qualify clients for services