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(Greek) To know apart from something else -Apart from normal -Apart from other communication disorders -Apart from other types of that disorder |
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-Reality: is there really a communication disorder? -Etiology: what's behind the communication disorder? -Clinical focus: improve client's communication functioning |
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Whether clients get services |
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The process of diagnosing |
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EBP (Evidence Based Practice) |
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Research, clinical expertise, client preferences and values |
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RTI (Response To Intervention) |
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In schools, increasing levels of services/interventions |
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Dynamic Assessment (aka trial therapy) |
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Exploring how client responds to different kinds of support--what kinds of scaffolding get them to the next level? |
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WHO ICF (World Health Organization for International Classification of Functioning)--how a person is functioning in their environment |
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"Abnormal interaction with selves, others, environment. Cultural component |
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1) Experience 2) Flexibility 3) Objectivity 4) Evaluative attitude 5) Persistent curiosity 6) Healthy skepticism 7) Interpersonal relationship attributes |
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Follow the client's lead and be in tune with their needs |
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-Don't just try to fix; look at underlying causes -Creativity (if I do this, what happens?) -Keep updated on what's out there--research, ASHA |
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Be careful with new articles & ideas (what is the theory/ evidence behind this technique?) |
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Interpersonal relationship attributes |
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-Sensitivity -Rapport -Focus on client |
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Goals of Diagnostic Interviewing |
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1) Obtaining information 2) Giving information 3) Providing support |
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-Define roles -Explain what's going to happen -State goals -Establish rapport |
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General topics to cover in interview |
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1) Client's perception 2) When did the problem arise, & under what conditions? 3) Has it changed in any way since it started? 4) How does it show up in that person's real life? 5) How are they coping? (emotionally, communicatively) 6) How is this communication issue affecting others in their life? 7) What do client/family hope to get out of the session? |
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Things to avoid in interview |
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1) Avoid talking too much 2) Don't stick to script at all costs-be flexible 3) Avoid too many yes/no questions 4) Avoid questions/responses that may indicate judgment or restrict what client will say 5) Avoid providing information too soon 6) Get to the point (avoid too many fillers/hedging) 7) Avoid staying at the superficial level |
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How to get out of the superficial level in an interview |
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-Ask open ended questions -Repeat back parts of what client said -Ask the same idea in different ways throughout the session |
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"Our goal is to improve your communication. As I get to know you, I'll have a better idea of what to expect." (Offer hope, but don't make predictions) |
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Stick to the word "typical" |
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-At the end of the first session -Always start with strengths -"These are the things I noticed that were harder" |
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6 basic principles for giving information |
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1) Don't expect them to remember everything/get it in one dose 2) Don't lecture or give advice 3) Simple language with analogies and examples 4) Give them something to take action towards 5) Be pleasant but frank and direct 6) Don't take things personally |
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-Have Kleenex ready -Let them be, don't say something right away -"Are you ready to move on?"/ give break, switch it up -"It's okay if the child doesn't do exactly what we want" -With brain injured adult, stay focused (ignore swearing etc.) but later, may focus on pragmatics |
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-Have been normed on a standardization sample, preferably many -Are always standardized (but not vice versa) -Compare client's performance with the performance of others -Is there a problem, and in what area? -Not a complete profile of strengths and weaknesses -Doesn't establish treatment goals |
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Criterion-referenced tests |
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-Client's performance compared to a standard/criterion, not a sample -Can they do it or not? -Gives specific information on a client's skills, levels -Good for establishing therapy goals |
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Does a test measure what it says it will measure? |
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-Construct -Content -Criterion-related -Concurrent -Predictive |
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Degree to which a test measures what it intends to measure |
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Do the items of the test truly represent the range of what we're looking at? |
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How well a score on the test can estimate performance on another measure |
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Can the score on a test predict a score at another time? |
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Interjudge/interrater reliability |
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How consistent the scores are across different raters |
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How consistent the scores of the same client are |
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Client-Specific Asessment |
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Develop own assessment materials with specific client in mind |
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Pros of Client-Specific Assessment |
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1) Avoids some pitfalls of standardized tests 2) Motivating for client |
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Cons of Client-Specific Asessment |
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1) No comparison to norms 2) Time consuming |
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Assessing communication in real life settings & everyday activities |
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Pros of Authentic Asessment |
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1) Representative of real life 2) Cheap 3) Culturally appropriate 4) Fewer false positives |
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Cons of Authentic Assessment |
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1) Time consuming 2) Subjective 3) Difficult to qualify someone based on authentic assessment measures |
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Seeing what the client can do with a little bit of help (scaffolding). Teach, test, retest |
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Different levels of scaffolding |
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Pros of Dynamic Assessment |
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1) Gives you helpful information for treatment planning 2) Reduces cultural bias 3) Assesses new learning |
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Cons of Dynamic Assessment |
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1) Time consuming 2) Doesn't give you a label (differential diagnosis) |
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Getting lots of information (classroom observation, writing sample, playground observation, etc.) and putting it all together |
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Pros of Portfolio Assessment |
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1) Very thorough 2) Interdisciplinary |
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Cons of Portfolio Assesment |
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1) Time consuming 2) Hard to coordinate |
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Alternative & Informal Assessment Approaches |
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1) Client-Specific Assessment 2) Authentic Assessment 3) Dynamic Assessment 4) Portfolio Assessment |
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