Goal of diagnostic process
to decide whether there is a significant communication problem and if so, to describe the deficit as much as possible relative to the normal sequence of language acquisition. DESCRIPTION IS THE KEY.
reasons to assess
(6) Screening, Differential Diagnosis (diagnosis), determine eligibility for service, establish baseline, develop intervention targets, track and document progress
Two Phases of the Diagnostic Process
involves collecting data via existing records ,case history, interviews and questionnaires,and direct examination of child
made through the STUDY and INTERPRETATION of data collected previously. and identify and label the problem (even though there is not always a cause)
Multidisciplinary, Interdisciplinary and Transdiscipliary. Involve the same folks, just differ in the level, time and type of communication
information gathered by clinicians and therapists separately and shared later
information is shared as it is happening
constant communication; all work together on shared goals
case history questions (5)
Interview caregivers/parents to determine:
what is the complaint/problem
when did it begin? onset sudden or gradual?
does problem vary in severity?
how does the child interact with the social environment?
case history data (11)
11 identification information, past treatment, personal characteristics, family history, physiological history, developmental history, medical history, communication history, educational history, social history, vocational history
Assessment planning questions (4)
What is the presenting problem? What do you already know? what do you want to know? how will you find out?
Steps to developing an assessment plan (5)
1. determine child's general developmental level
2. determine what to assess
3. determine method to assess
4. determine the order of assessment
5. write the plan down, include plan B
General developmental level
is child close to age level in terms of day-to-day functioning? if communication is above or below the baseline, appropriate adjustments can be made.
What to assess
should be comprehensive, cover aspects of hearing, oral motor function, comprehension and production of language
methods of assessment
best match between questions that need to be answered and methods to obtain data. Have back up plan and remember that spontaneous speech can be very different from standardized data
Order of assessment
begin with low structured activity, move to structured tasks. Alternate high/low structure. give breaks when needed. 15 minute intervals.
include goals and methods for each area. include plan B. Everything should be written in your plan.
yes/no. Answers whether or not there is a deficit
establish baseline function
id areas of normal functionality and those with difficulty to establish an interlinguistic profile
screening, establish baseline, establish goals, measure change
What to assess (3)
1 language function (comprehension and production), 2 domains of language (form, content, use) 3 Collateral areas (hearing, motor functioning, nonverbal cognition, social and emotional behavior, literacy, cognitive status
Comprehension and Production
Domains of Language
form, content use
hearing, motor functioning, nonverbal cognition, social and emotional behavior, literacy, and cognitive status.
How to assess (4)
1. standardized tests, 2 developmental scales, 3 criterion referenced procedures, and 4 behavioral observations.
norm referenced, high structure, child compared to peers on specific pre-determined test items. psychometrically sound, interpreted properly, used to demonstrate whether a child differs significantly from the norm. SHOULD NOT BE USED TO ESTABLISH BASELINE OR GOALS OR TO MEASURE PROGRESS
Criterion referenced, low structure, child compared against developmental criteria and information established by professional
are interview or observational instruments that sample behaviors from a particular developmental period. are not standardized and should not be used to determine a deficit, have clearly stated guidelines for administration, provide some type of equivalent score, helpful in establishing baseline.
criterion referenced procedures
determine if a child can attain a certain level of performance; establish baseline function, identify what a child knows and does not know to held identify targets for intervention; can be used in naturalistic and non-naturalistic setting
in contextualized and decontextualized sitatuations. Avoid over interpretation, but control linguistic stimuli and specify appropriate response (ie eye gaze, etc)
three major response approaches: elicited imitation, elicited production, structural analysis
eliciting a speech sample
listen, be patient, follow child's lead, don't ask dumb questions, consider child's perspective
designed by clinicians and involve checklists. Must know what you are looking for and document. Useful for charting progress
common in school. Test-teach-test format. observe clients learning process. answers three questions: how child approaches tasks, degree to which child's behavior is modifiable, which intervention styles and methods would be most useful.
goes beyond identifying deficits, evaluates effects on ability to communicate. especially important for nonverbal children.
hard to assess child
shy and quiet, non-compliant, hyperactive and impulsive, physically disabled, can use standardized interview procedures
integrating and interpreting assessment data
writing severity statement, making prognosis and recommendations
mild, moderate, severe or profound
excellent, good, fair, poor. Is an educated guess. should always be stated in positive terms
general statements about the need, directions, and approach to intervention that would be most appropriate for a particular child. Three parts: whether intervention is needed, goals of intervention based on assessment data, suggestions for methodology of intervention
statement of the problem, background information, test results, impressions/assessment, summary and prognosis and recommendations