Created by schaferrac
almost 9 years ago
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Question | Answer |
Why is it important to make E3B decisions | Helps to appropriately select dx & tx approaches. Best for the client. |
Consequences of not making E3B decision | May hinder client's progress & success in therapy. Also unethical because of client welfare. |
What does it take to become good at making E3B decisions | Training, clinical experience & review of literature |
Steps to making E3B decisions | 1. Develop PICO 2. Find/examine internal evidence 3. Find external evidence 4. Evaluate external evidence 5. Compare internal & external evidence 6. Document outcomes |
Difference between internal & external evidence | Internal- specific characteristics of client/client's family & clinician knowledge External- literature, research |
Internal evidence & how to obtain | Client characteristics (speech/language status, social, attentional, cognitive, educational), willingness to participate, preferences, clinician's wanted approach, documented success with approach, knowledge |
How to obtain external evidence | Conduct search for relevant literature, generate list of search terms. read titles & abstracts, use reference list in good articles |
Why is it important to consider both internal & external evidence? | Allows clinician to individualize treatment & find approach that best fits client's needs |
Difference between basic & applied research | Basic- examines processes Applied- examines intervention approaches |
Is basic or applied research more important? | Basic is god to know to help clinician understand how children develop speech & language. Applied is best for making clinical decisions because it speaks to the effectiveness of intervention approaches. |
What is a PICO question | P-patient I- intervention C-comparison treatment O- outcome |
Why are PICO questions important | Help find appropriate intervention approaches for client using internal & external evidence |
Given a topic, be able to generate a list of search terms | Consider: The disorder, intervention, skills targeted. |
How do you know if a research study is relevant to your client/PICO question | Does the study match the P, I and/or C, and O? |
How do you compare internal & external evidence findings to make a decision about which intervention approach to use? | Do they align? What evidence supports each approach? Does the evidence match client characteristics? Does one better match than the other? Does the evidence support effectiveness of tx? Which matches client & evidence to support its effectiveness? |
Why is it important to document outcomes? | Measure client's performance. Client's performance may or may not match evidence supporting your intervention (if lack of progress/limited progress, why? Should changes be made?) |
What is a SMART Goal? | S- strategic/specific M- measurable/meaningful A- attainable R- realistic T- time-bound |
Difference between overt & covert verbs | Overt- observable & measurable through actions or vision (ex: recite, repeat, state, point, name) Covert- refer to performance that cannot be directly observable "mental, invisible, cognitive or internal" (ex: determine, apply, learn, select, play) |
What are the three components of an object/STG? | Performance Condition Criterion |
Performance | Contains specific action client is expected to perform |
Condition | Linguistic context, type of activity, communication partner, type/level or prompts, type/level of support, amount of reinforcement |
Criterion | % accuracy, ratio, frequency/unit of time, rating scale, latency, appropriateness, measurement of duration |
How do SMART Goals relate to performance? | S= should be clearly defined M= should be measurable R= should result in meaningful change |
How do SMART Goals relate to condition | S= should be clearly defined |
How do SMART Goals relate to criterion? | M= should be appropriate method of measuring skill A= should be attainable in given period compared to baseline T= met by certain time/date |
Similarities & differences between STG & daily objectives | Performance- same Condition- same Criterion- SGT include duration & accuracy by semester. Daily objectives do not include duration & accuracy by session |
Components of a treatment report | Background Functional long-term goals Objectives (STGs) Procedures Frequency/duration of treatment Prognosis Comments |
6 stages of a single clinical transaction | 1. Present stimulus for desired behavior (S) 2. Client is processing the stimulus & deciding how to respond (O) 3. Client responds (R) 4. Client's response serves as stimulus for clinician (S) 5. Clinician processes client's response (O) 6. Clinician's response (R) |
What are the 3 possible stimuli that a clinician can provide for a client to improve the client's ability to produce a target behavior? | Modeling Guidance (verbal, gestural, physical & environmental) Information (behavioral or general) |
How do you know what type of stimuli to provide for your client when try to get a new behavior to occur? | Clinician should use stimulus for response, modeling, guidance & information |
What are the cognitions/thought processes that a clinician should be engaged in following each client response? | Correctness of client's responses, frequency of response correctness, client's attentiveness to therapy, how to respond. |
Why are cognitions important in making sure the clinical process works? | It allows the clinician to document progress & performance & make changes as necessary. |
What are the 2 possible responses that a clinician can provide to a client? | Reward & penalty |
Reward (R+) | ex: token economy (verbal or tangible) |
Penalty (P) | ex: limiting break time or taking away tokens |
How do you know what type of response to provide to your client when trying to get a new behavior to occur? | Continuous R+, P with increased success |
What are the different types of stimuli? | ? |
What are conditioned stimuli? | Stimuli (S+, S-, S0) that becomes conditioned when consistently associated with R+ or P |
Positive Stimulus (S+) | Ex: |
Negative Stimulus (S-) | Ex: |
Neutral Stimulus (S0) | Ex: |
How do you go about getting a new behavior to occur? | Using the CIM (Clinician Interaction Model) |
What types of stimuli will you use to get a new behavior to occur? | Stimulus for response, modeling, guidance, information |
What roles do clinicians & SOs serve during getting a new behavior to occur? | Clinicians- S+ for new S- for old SOs- S0 for new & old |
Responses for getting a new behavior to occur | Continuous R+, P with increased |
What is the goal of the habituation phase of therapy? | Getting new behavior to occur consistently in the clinic room. Make behavior independent of prompts, cues & rewards/ |
Role of clinician & SO during habituation | Clinician- S0 for new. Consultant SO- S+ for new S- for old |
Role of clinician & SO for generalization | Clinician- S0 for new. Consultant SO- S0 for new |
How do you adjust stimuli/antecedent event during habituation? | Clinician- stimulus for response becomes more abstract, modeling gone, fading guidance/information SOs- stimulus for response, modeling, guidance, information |
Responses for habituation phase | Decrease rewards & penalties should be almost gone |
Possible intermittent rewards schedules? | Fixed ratio, variable ratio, fixed interval, variable interval |
Why is verbal praise important during the habituation phase? | Move from tangible to verbal rewards, gradually increase trials/time between rewards, remove rewards. |
What should verbal praise look like/sound like? | Specific, private, process oriented, sincere, not set client up for failure, set up an appreciation of self, build on previous achievements, not compare clients, focus on effort and problem solving. |
How do you go about testing habituation? | If R+ is removed & behavior continues to occur, it is habituated. It R+ is removed & behavior no longer occurs, it is not habituated. |
What is the goal of the generalization phase of therapy? | Get new behavior to occur consistently outside of clinic room. Make behavior independent of prompts, cues & rewards outside of the clinic room. |
How do you adjust stimuli/antecedent events during generalization phase? | Clinician- none SOs- stimulus for response becomes more abstract. Modeling gone. Fading guidance/information. |
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