Methods Final

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Methods Final
2012-12-07 14:17:53

Jen's Methods Final
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  1. Laws, Regulations, Guidelines
    • Laws: bills; signed by executive officials; implemented
    • Regulations: executive agency generated to comply with laws (as they interpret them)
    • Guidelines: generated by agencies, schools, associations to implement the laws & regulations
  2. diff b/w old/new ways (positive behavior support)
    • old ways: general intervention for all behavior challenges; intervention is reactive; focus on behavior; quick fix
    • new ways: intervention matched to purpose of the behavior; intervention is proactive; focus on teaching new skills; long term interventions
  3. Communicative act (positive behavior support)
    • form: (the behavior used to comm.) words; sentences; point to picture; eye gaze; pulling adult; crying; tantrums.
    • Function: (the reason or purpose of the comm. behavior) request; escape activity; comment
    • Directed toward person
  4. functional analysis interview (positive behavior support)
    define behavior; describe freq & intensity; explore predictors (triggers); identify maintaining consequences; identify current comm. functions; describe efficiency of behavior; describe previous efforts; identify possible reinforcers
  5. stages of self discipline (group behavior management) 
    • power stage: disobedient in their behavior; imbalance of power b/w child & adult; don’t have rules of their own; adopts others as long as being overseen; typically outgrown at age 4-5; if not encouraged to grow, may stay here & imbalance isn’t there as much.
    • Reward/punishment stage: self serving stage; what’s in it for me; self-centered; individualistic morality; most move beyond at 8-9; behave when you are watching, out of control w/o supervision; little self discipline
    • Mutual interpersonal stage: how can I please you; interpersonal discipline; behave b/c they want you to like them; starting to have a sense of right & wrong; don’t need a heavy hand; need gentle reminders; behavior maybe inconsistent across contexts; encourage generalization beyond your relationship; show how behavior is important in other places
    • Social order stage: behave b/c it is the right thing to do; rarely get into trouble; have a sense of right & wrong; middle/high school but not consistently; can leave alone for 20-30 min; don’t appreciate assertive discipline; cooperative learning groups encourage this level
  6. Rules of group behavior management
    collaboratively make rules; don’t make too many; make them clear; post them as visual reminders; avoid confrontational lang (rather than “I cant believe you are talking again,” use “the other students are working quietly now, you need to turn around & work quietly too.”); be consistent
  7. proactiveness of group behavior management
    • make sure environment facilitates your goals- chairs are right size seat choices are appropriate; materials are available or procedures in place
    • be prepared- children know if you have a plan; mark transitions clearly; give expectations for next activity before ending activity; refer to rules rather than personal thought
    • make sure student knows the purpose of what they are doing; be aware when student starts to drift; use proximity or request when attention wanes; focus on positive; make sure to give lots of specific praise; display student’s work proudly 
  8. what doesn't work (group behavior management) 
    • reminder level- not a reprimand; a statement of fact
    • warning level- can be written or oral; steven is sitting sideways in his chair & keeps messing with things on Maria’s stuff. The teacher approaches steven & says, “steven, I expect you to turn around in your seat & participate in the game. This is your warning.”
    • Infraction level- consequence (agreed on beforehand) 
  9. reward systems (group behavior management) 
    • token economy: item such as a sticker can be exchanged for other preferred activities such as watching a movie, or playing on the computer; target behavior is identified. If the person exhibits behavior, a token is provided; state behavior in positive terms; give visual to show when enough is ready for trade.
    • Behavior contracts: similar to taken economy; identify target behavior; be specific; focus on product rather than behavior; go over it with children; provide feedback; provide rewards 
  10. direct & indirect service delivery 
    • direct: face to face services
    • indirect: no face to face; consult w/team or family 
  11. service delivery teams
    • multidisciplindary: each discipline conducts their own assessment; develops discipline specific goals; minimal integration of goals across disciplines; plans are individual; reflects expertise of field
    • interdisciplinary: each discipline conducts their own assessment; communicates with other disciplines; fosters complementary goal development; all disciplines incorporate elements of the goals & objectives of related fields in planning
    • transdisciplinary: team members have an ongoing dialogue (share info, knowledge & skills); develop single integrated service plan (single assessment; info reviewed together; single intervention plan) 
  12. principles of family centered practice
    family info is vital for good clinical practive in assessment & intervention process; common in work w/ very young children; important across the client’s lifespan; funding sources now are looking for functional outcomes; as baby boomers age, comm. disorders will increase. 
  13. family as a whole... it is greater than some of its parts (patterns, rules, behaviors, boundaries) [family centered practice]
    change in 1 part of the family affects the whole family system (interdependence); subsystems are embedded within a larger family system (diff family members have particular relationships); families exists w/in larger social & environmental context (extended families, neighborhoods, religious communities, political & economic communities); families are multigenerational (members & ideas of past generations & future anticipated generations) 
  14. challenges in family centered practice 
    diverse ethnic & cultural backgrounds; diff in family structure; impact of poverty on disability; increase in # of families that have parents or adults with disabilities; dynamic & complex system (roles of members, financial status, illness of others) 
  15. clarity, succinctness, redundancy respectfulness, genuiness (family centered practice) 
    • clarity- avoid professional jargon
    • succinctness- target info
    • redundancy- allow time to internalize & consider
  16. IFSP & IEP (family centered practice) 
    • IFSP (individual family service program)- goals are generated by parents; interim objectivies; materials & techniques are chosen together  [infants & toddlers]
    • IEP (individualized education plan)- developed by team including parents; true family contered intervention difficult b/c of- parent access to classrooms; availability of professionals to work with parents; parent ability to come to school (transportation/childcare), focus on school context. [school age children]
  17. dysarthria & apraxia (adult lang sampling) 
    • dysarthria: neuromuscular impairment (muscle weakness/paralysis); consistent errors; may have concomitant issues with smiling, swallowing, chewing
    • apraxia: neuromotor programming disturbance; no weakness or paralysis; inconsistent errors 
  18. how to evaluate intelligibility (adult lang sampling) 
    standard reading passages (contain all phonemes of English- rainbow passage); have naïve listener transcribe; get percentage of intelligibility
  19. prosody & fluency (adult lang sampling) 
    • prosody: evaluated by judgement; prosody voice screening protocol- phrasing, rate, stress
    • fluency: use passage & give more formal exam if warranted 
  20. voice terms (adult lang sampling) 
    • breathiness: air leakages; paralysis; nodules (callous), polyps (blister), cysts
    • hoarseness: breathiness & noise; lesions, inflammation, reinke’s edema (smoking, reflux, voice abuse)
    • harshness: perception of excessive tension, tightness, effort; hard glottal attacks, overadduction of folds
    • hypernasal
    • hyponasal
  21. pragmatic issues (adult lang sampling) 
    • examines several genres- pic description; procedure description; story retelling; conversation
    • paralinguistic (nonverbal comm.)- intonation; facial expression; eye contact; gestures; proxemics
  22. sensitivity & specificity (EBP) 
    • sensitivity: test identifies individuals that have a lang disorder; reduce false negatives (passing individuals w/a disorder)
    • specificity: test does not identify people that do not have problems; false positives (failing people that do not have a disorder)
    • want .80 or better in both 
  23. basic & applied research (EBP) 
    • basic: fundamental processes; underlying variables involved in comm.; not as applicable to clinical practice
    • applied: intervention approaches; able to be applied to clinical practice 
  24. general hierarchy of evidence (EBP) 
    • systematic review of randamozed control trials
    • single randomized controlled trial
    • systematic review of controlled trials w/o randomization
    • systematic review of single subject experiments
    • high quality controlled trial w/o randomization
    • longitudinal studies
    • case studies
    • anecdotal evidence
    • expert opinion 
  25. 6 steps to EBP
    develop a 4 part clinical question that focuses on PICO; develop family vision; investigate published research evidence; evaluate evidence; integrate internal & external evidence; apply & evaluate outcome of decision
  26. PICO
    Patient/patient group/problem; Intervention; Comparison; desired Outcome
  27. aided & unaided (AAC) 
    • aided symbols: external props needed; objects, pics, written word
    • unaided symbols: nothing external needed; gestures, signs, speech. Permits coding of an infinite number of messages; input simplified; works well for short term memory deficits; visual; reduction of physical demands; more transparent. 
  28. low & high tech (AAC) 
    • low: fixed or static display- pic exchange comm. system; comm. book, environmental choices.
    • mid: fixed or static; limited selection
    • high: dynamic; extended selection to unlimited selection 
  29. basics of diagnosis (autism) 
    should be made by a team; made primarily by observation; concentrate on triad of symptoms (social reciprocity, comm. deficits, repetitive or restricted interests) 
  30. names of EBP (autism) 
    • theory of mind: ability to take other’s perspective
    • executive functioning: planning, coordinating actions, controlling sequences of action & cognitive flexibility
    • central coherence: draw together diverse info to construct higher-level meaning in context