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Clinical Methods in Communication Disorders

by: Tate McGlynn DVM

Clinical Methods in Communication Disorders CDIS 3300

Tate McGlynn DVM
GPA 3.73

Elizabeth Smith

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Elizabeth Smith
Class Notes
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This 8 page Class Notes was uploaded by Tate McGlynn DVM on Wednesday September 23, 2015. The Class Notes belongs to CDIS 3300 at Middle Tennessee State University taught by Elizabeth Smith in Fall. Since its upload, it has received 40 views. For similar materials see /class/213173/cdis-3300-middle-tennessee-state-university in Communication Disorders & Sciences at Middle Tennessee State University.

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Date Created: 09/23/15
CDIS 3300 Clinical Methods Exam 2 Elizabeth Smith Caitlyn Bishop Tuesday March 24th 1 Probe Procedure A probe is a procedure to nd ifa trained response is produced on the basis of generalization Target behaviors may include objectives from previous semesters or recommendations for the current semester 5 Clinician does not use modeling for this procedure a Results of probe procedure determine whether additional training is needed for that target behavior 2 Baseline Baseline is de ned as the rates of behavior in the absence of treatment 2 reasons to establish baseline Give a reliable and valid measure of client s behavior prior to treatment Without baseline it is not possible to evaluate client improvement andor treatment effectiveness Procedure Test only those behaviors that you plan to teach immediately For example only test initial position rst because it is likely the other will be fixed when initial is fixed Select stimuli prepare questions and instructions ahead oftime 5 Design a recording sheet on which all responses are entered and scored Administerthe baseline trials Correct responses should not be reinforced 3 Target Behaviors Factors considered Disorder ofthe client 5 Severity ofthe disorder Cognition age and education Clinician s expertise Duration of sessions Individual treatment or group treatment 4 Structure of Treatment Sessions Based on 2 factors the client and the stage of treatment Tightly structured sessions formal structure Early stages of treatment are often tightly structured A client who is minimally verbal nonverbal or has multiple misarticulations would respond better in a tight structure Loose structured sessions naturalistic structure 5 Latter stages oftreatment should always be loosely structured The target behavior should be used in conversational speech so the treatment resembles communication in natural settings 5 Maintenance of Target Behaviors 0 v lt Kgt lt Kgt lt Kgt lt Kgt Final treatment goal is maintenance Communicative behaviors must be produced in conversational speech in the natural environment and must be sustained over time Home visit homework roll play etc Shift reinforcement schedules after the target behavior is established reinforce an intermittent schedule Use social and conditioned generalized reinforcers so family members can carry over reinforcers at home Teach others to encourage target behaviors so treatment will be extended to natural environment Only if the signi cant others in the client s life know the exact target behaviors how to evoke them and how to enhance them Teach client self control from the beginning by asking client Was that a good insert target behavior Have client show off good behaviors or point out something heshe did well Reinforcement the process of arranging events to strengthen the future probability of certain behaviors Positive Reinforcers events that follow a response and therefore increase its frequency Primary Reinforcers events that increase frequency because of their biological survival value no past experience required Examples food and drink 5 Secondary Reinforcers events that select and strengthen behaviors using of past conditioning Social and cultural Examples Client must have past experience with smiles and phrases good job for reinforce to be effective Types of Secondary Reinforcers 0 Social Reinforcers verbal praise attention eye contact touch and facial expressions 0 Conditioned Generalized Reinforcers tokens marbles stickers money must be exchanged for preferred reinforcers o Informative Feedback giving information to the client about hisher performance following a response 0 HighProbability Behaviors the opportunity to engage in some type of activity Say words then play ball 7 Schedules of Reinforcement how many responses will be required before giving a reinforcer or when the reinforcerwill be given Continuous Reinforcement every response is reinforced Cannot continue throughout treatment because client may only produce behavior when a reinforcement is given Intermittent Schedules of Reinforcement Fixed Ratio Schedule predeterminedfixed number is required before reinforcer Variable Ratio Schedule number of responses varies around an average number Fixed Interval Schedule fixed duration of time using the behavior then reinforcer is given 9 Variable Interval Schedule time between reinforcement varies around an average time 9 Differential Reinforcement of Other Behavior clinician says a behavior that will not be reinforced Other behaviors are reinforced as long as the one targeted for extinction is not produced 8 Physical Stimuli is necessary to encourage target response Examples pictures objects toys demonstrated actions computer programs andor games 9 Demonstration action or skill is shown without the clinician expecting client immediately repeat it Gives client an overview of what will be done during treatment and what may be expected ofthem 10 Modeling the clinician shows client the target response the client is expected to learn Often used to teach new responses that the client has not been introduced to before The client s response that follows modeling is imitation 11 Withdrawing Modeling clinician stops modeling as soon as a measure of imitative responses has been met 12 Fading Modeling clinician progressively reduces the length of the modeled utterance 9 Correct responses are better maintained when modeling is faded than when it is suddenly withdrawn 9 Fading can also be called partial modeling or verbal prompts 9 Lesson plans may indicate with a model or with a verbal promptquot 13 Shaping teaching a new behavior in small sequenced steps 9 Often used because the final target response is too complex to be attempted in the initial treatment phase 9 Treatment almost always starts with a lower level at which the client can perform the required response with the help of modeling 9 Procedure 4 lt9 lt9 lt9 lt9 Describe nal target Describe initial response client should imitate it and it should have some relation to final target Describe intermediate response Model speci c response under training Use manual guidance if necessary Reinforce the correct response 14 Prompts verbal or nonverbal quothintsquot 15 Working with Other Professionals match de nition with name lt Kgt lt Kgt lt Kgt lt Kgt lt Kgt lt Kgt lt Kgt lt Kgt Dietitian professional with training in nutrition and diet Neurologist physician with specialized training in function and disorders of the nervous system Occupational Therapist provides evaluation and treatment of daily living skills for individuals with disabilities Otolaryngologist physician specializing in evaluation and treatment of disorders of the ear nose and throat Physiatrist physician with specialized training in rehabilitative medicine Physical Therapist provides assessment and treatment for disorders related to physical and musculoskeletal injuries Social Worker responsible for interviewing the family of potential clients and recommending appropriate services Multidisciplinary Assessment Team client is evaluated individually Transdisciplinary Assessment Team client is evaluated by the entire team OffCampus Practicum Site Site Public Schools Name lVIadison Clark Caitlvn Bishop amp Beza Ararsa Prerequisites An internship in a public school depends on the university and the state credential requirements Coursework relative to childhood speech and language disorders as well as experience working with children of different ages and disorders is necessary for practicum in a public school It may be required to enroll in your university credential program which has personnel to review your records required test results and grade point average before beginning your internship Some states require a student clinician to pass a competency exam Other requirements that may be enforced by public schools are fingerprint cards and the passing of a tuberculosis test Supervision An internship assignment or student teaching under a speechlanguage pathologist who is ASHA certi ed and meet s the state s credential requirements will be completed by a student clinician This will be done in accordance with ASHA s guidelines The supervisor may answer questions and guide the clinician but the clinician should be more independent at this level of practicum A midterm and nal evaluation aligned with the university grading policy are issued by the school speechlanguage pathologist A supervisor from the university s program may meet with and communicate with the student clinician and supervisor periodically Schedule School intemships are generally fullday assignments usually from 800 am to 3 pm three to ve days a week in some cases a weekly seminar is required as well A direct service takes place with a student or group of students is worked with directly Examples Pull out Method pulls the student out of class for treatement in a seperate setting 0 Pull in Services services in the classroom but in a separate area than the other students 0 Language Laboratory student attends treatment just like they would have math 0 Collaborative Instruction Model the SLP and teacher coordinate lesson plans and work together Indirect services are provided when the SLP does not directly treat the child but monitors and makes suggestions to teachers andor parents Types of Clients The caseload for student clinicians in this setting is extremely broad The students can vary by age number of disabilities and level of speech Some students may have multiple disabilites and some may have a single articulation error In addition to speech disorders school based SLPs may work with swallowing and feeding disorders and reading and writing disorders Report Writing amp Record Keeping It is issential to organize and maintain records for all of your students based on their IEP Individual Education Program Your speech and language objectives for each child should be tied to educational benchmarks In addition to learning how to write an IEP for a student you will also learn other new terms abbreviations and acronyms used in a school practicum Working with Families and Professionals As a student intem conducting meetings with parents and other professionals may be necessary so that you may learn to communicate effectively and work cooperatively so that your students learning is enhanced However ASHA has several guidelines on standards for SLPAs and their supervision As a student intem you may be asked by your supervisor to train an SLPA to perform certain activities Collaboration with other professions is an important component of school based treatment experience Learning to maximize your effectiveness through appropriate collaboration is a key skill to master since your time with each student is limited


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