introduction to intervention an overview. is there “gold standard” intervention? kamhi (2006)...
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Introduction to Intervention
An Overview
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Is there “gold standard” intervention?
• Kamhi (2006) stated that it’s troubling to clinicians searching for a “gold standard” approach that works for all children– But a number of approaches have been
shown to “work”• Problem is they are theoretically
incompatible with each other• Some approaches provide transitional
methods to other approaches
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Goal of Intervention
Goal is to align clinical characteristics of SSD to approach that has a strong evidence base that best meets the client’s needs.
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Continuum of Intervention
Emerging – Developing - Elaborating
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Book Organization
• Template for each chapter (Table 1.2)1. Target populations
2. Assessment methods
3. Theoretical basis
4. Empirical basis
5. Practical requirements
6. Key components
7. Evaluation/Progress monitoring
8. CLD populations
9. Case study
10. Study questions
11. Future directions
12. Suggested readings
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Theoretical Basis: Level of Consequences Being Addressed
• World Health Organization (WHO): created a common language for comparisons of data across countries, health care disciplines, services, and time
• ICF-CY (International Classification of Functioning, Disability, and Health for Children and Youth)
– Provides a systematic coding scheme for health information systems
– Provides a scientific basis for consequences of health conditions
– Endorsed by number of professions, including ASHA in 2007
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ICF-CY Components (Table 1.3)
• Body Functions• Body Structures• Activities and Participation• Environmental Factors• Personal Factors
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Empirical Basis: Stages of Research
• 3 stages of programmatic research that fall along a continuum of research– Exploratory studies
• Consists of observation or feasibility studies
– Efficacy studies• Conditions of greater experimental control
– Effectiveness studies• Conditions that reflect more everyday practices
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EBP
• Clinical services improve when practitioners become “data seekers, data integrators, and critical evaluators” of the application of new knowledge to clinical cases
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Levels of Evidence
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Clinical Decision-Making
1. Examine client’s needs– Assessment and analysis results
• Severity, intelligibility, consistency, stimulability• Differential diagnosis (PI ~ AI ~ MSD)• Breadth of problem (language, literacy, etc)
– Case history– Other information (child’s previous tx
experiences, communication experiences, academic settings)
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Clinical Decision-Making (con’t)
2. EBP• Strongest available evidence given your
client’s needs, your clinical abilities, and the support available to you to implement the approach
3. PBE (Practice-Based Evidence)• What probe data, standardized testing, and
other methods will you use to document child’s progress?
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Overview of 23 Intervention Approaches (Table 1.5)
Developmental Level Targeted Stage of Production
Targeted Outcomes
Emerging Sound Systems
Planning Production
Developing Sound Systems
Programming Perception
Elaborating Sound Systems
Execution Phonological Awareness
Oral Language
Literacy
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Overview of Intervention Approaches (con’t)
• In addition to the 3 descriptors for each approach in previous table, each approach is summarized according to their:– Key Components– Technology/Materials required to implement
the approach– Populations for whom the approach is
designed
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Structural Framework for Intervention (Figure 1.1)