CDO 338 9.1 Assessment

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shanamd2011
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181614
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CDO 338 9.1 Assessment
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2012-11-04 16:54:14
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CDO 338 Assessment
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Assessment
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  1. Purpose of an initial evaluation
    • 1.Determine the reality of the problem
    • —-Describe Artic/Phono development/status.
    • -Determine if deviation from normal expectations warrant concern or intervention.
    • 2.Determine the etiology(ies)
    • —-Identify factors that relate to the presence or maintenance of the speech disorder.
    • 3.Provide a clinical focus as to potential treatment approaches
    • -Monitor changes in A/P abilities across time.
  2. Assessment process includes
    • Case history
    • Assessment
    • Planning for treatment
  3. Assessment Process Overview
    • 1. Referral
    • 2. Data Gathering
    • 3.  The Diagnostic/Evaluation
    • 4. Results
    • 5. Diagnosis or conclusions
    • 6. Recommendations
    • 7. Share clinical findings
  4. Data Gathering
    • Allows clinician to:
    • Anticipate areas needing assessment
    • Identify topics requiring further clarification
    • Pre-select appropriate evaluation materials and procedures
  5. Case History asks questions about:
    • General nature of communication &problem
    • —General development; motor, cognitive, social,
    • —Health history
    • —Educational background
    • —History of support services
  6. The Case History:  Limitations
    • Difficult Terminology
    • Insufficient Time
    • Respondent does not give enough information
    • —Significant time has elapsed between problem onset and time of assessment
    • —Other life events have hindered respondents ability to recall
    • —Cultural differences may have interfered.
  7. Pre-Assessment Interview
    • An opportunity to obtain information regarding the situation.
    • Introduce Self
    • Ask questions/Discuss
    • Summarize Major points from interview
  8. The Diagnostic/Evaluation Procedures
    • A. A comprehensive phonetic-phonemic evaluation is the core.
    • -Sample client’s speech. (Client Observation)
    • -Formal &  Informal Tests
    • -Conversational speech assessment in varying contexts
    • -Measures of intelligibility
    • B.Oral-facial mechanism examination:  structural & functional
    • C.Stimulability
    • D.Hearing Screening (obtain information about hearing abilities)
    • E.Screen related and collateral areas.
  9. Speech/Language Sample
    • Speech Intelligibility can also be evaluated from a speech/language sample.
    • It is required by law to have a speech sample of at least 20 utterances.
  10. Results
    • A.Score tests
    • B.Analyze & integrate data (Evaluate assessment info) to determine:
    •  Impressions:  Disorder?
    • Clients Strengths & Weaknesses
  11. Diagnosis or conclusions
    • A.Statement of Severity
    • B.Statement of Prognosis
  12. Share clinical findings...
    through an interview with client or caregiver, or other indicated professionals as requested via informal verbal summary and a formal written record  (Evaluation report).
  13. Assessment Protocol
    • Protocol (Structure/Tools) will Differ based on:
    • -Client
    • -Type of Disorder
    • -Setting
    • -Client’s history
    • -Involvement of Caregiver
  14. The Diagnostic
    (Evaluation by the Clinician)
    Initial Impression
    • -Collecting Data-through formal and informal observation.  Notice features of articulation
    • --Qualitative
    • --Quantitative
    • Assists in “tuning in your ear” for the pattern of artic/phono being used.
    • Allows clinician opportunity to solidify procedures being planned.
  15. Articulation/Phono Testing
    Formal and Informal Procedures
    • Formal
    • -Articulation Tests
    • Informal
    • -Listening/observing
    • -Collecting a Speech Sample
    • -Probe Lists
    • -Intelligibility Measures
    • -Diadochokinetic Measures
    • -—Stimulability
    • -Oral Mechanism/Peripheral Examination
  16. Formal Artic/PhonoTests
    Advantages:
    • 1.  Easy to give/score
    • 2.  Provide clinician with a quantifiable list of “incorrect” sound productions in different word positions.
    • 3.  Yields a standardized score. –important for insurance companies
  17. A formal test places into common language and measurement...
    what an excellent clinician already knows or suspects
  18. Formal Artic/Phono Tests
    Disadvantages:
    • 1. Sounds in words (initial medial final); may not represent child’s ability to produce a particular sound under natural speech conditions.
    • 2. Do not provide enough information about phonological system.
    • 3.  Not test all sounds: no vowels and few consonant clusters.
    • 4.  Probes a limited number of chances for each exemplar to occur.
  19. Considerations in selection of Artic/Phono tests
    • 1.  Appropriateness for age/developmental level of  client
    • 2.  Format for Error Analysis==Artic or Phono or Both
    • 3.  Normed Referenced yielding standard score or is it Criterion Referenced
    • a.  Reliability of Test
    • b.  Validity of Test
  20. Common types of tests
    • Norm-referenced
    • Criterion-referenced
  21. Criterion-referenced
    Do not attempt to compare an individual’s performance to anyone else’s, rather they identify what a client and cannot do compared to a predefined criterion.

    —Answers the ?—How does a client’s performance compare to an expected level of performance
  22. Norm-referenced
    Normed Reference test are always standardized.  They allow a comparison of an individuals performance to the performance of a larger group, called the normative group.
  23. Statistical Considerations of Tests
    • Reliability:  the dependability of a test or procedure to result in consistent results over repeated administrations and by different examiners
    • Validity:  the degree to which a procedure actually measures what it proposes to measure.

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