school of arts and sciences department of speech
TRANSCRIPT
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SchoolofArtsandSciencesDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicHandbookPolicyandProcedureManual
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TableofContentsIntropages3-11AppendixA-StudentConcernsandGrievancespage12AppendixB-ProfessionalCodeofConduct-ClinicPoliciespages13-34AppendixC-ElectronicMessageExchangepages35-39AppendixD-StudentClinicianRequirementspages40-58AppendixE-ProceduralSafeguardspages59-66AppendixF-ClinicAssignmentspages67-99AppendixG-ProfessionalWriting-HelpfulHintspages100-104AppendixH-GradingPolicypages105-124AppendixI-ClinicalSupervisionpages125-134AppendixJ-MediaSpecialistHandbook-StudentGuidelinespages135-142AppendixK-ClinicFormsSpring2018pages143-178AppendixL-DocumentationSamplespages179-209AppendixM-ClinicalPracticeRessourcespages210-211AppendixN-Resourcepage212
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TheIonaCollegeSpeech,LanguageandHearingClinichasassembledaClinicHandbooktosupporttheclinicalstudentsuccessinone’sclinicalpracticumexperienceattheIonaCollegeSpeech,LanguageandHearingClinic.TheClinicHandbookisnotintendedtoreplaceCollegePolicieslistedintheIonaCollegeUndergraduateandGraduateCatalog’sbuttosupplementthestudent’sprogramrequirements.GraduateCSDHandbookbuttosupplementthestudent’sprogramrequirements.
TheIonaCollegeCommunicationSciencesandDisordersprogramiscurrentlyanaccreditationcandidateforagraduateprograminspeechlanguagepathologyfromtheCouncilonAcademicAccreditation.TheClinicHandbookandtheGraduateCSDHandbookisnotintendedtoreplacetheIonaCollegeGraduateCatalog.TheGraduateCatalogdetailstheofficialrequirementsforcompletionoftheMaster’sDegree.TheGraduateCatalogisavailableonlineat:https://www.iona.edu/iona/media/Documents/Student%20Life/SFS/14-15GraduateCatalog.pdfTheClinicHandbookisalivingdocumentandmaybemodified,withnoticeatthediscretionoftheChairperson,ClinicDirectorand/orProgramDirectorPolicies,proceduresandinformationdocumentedmaybeupdatedand/orchangedaccordingly.Clinicalstudentswillbenotifiedviaupdatedwrittendocument
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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicThishandbookprovidesinformationpertainingtopolicy,procedureandrequirementsduringaone’spracticumexperienceincludingobservations,on-siteandoff-sitepracticum.ThishandbooksupportsboththeundergraduatestudentsandtheCSDstudents:SpeechLanguagePathologyandAudiologyMajorsClinicalPracticeinSpeech/LanguagePathologyI SCS418ClinicalPracticeinSpeech/LanguagePathologyII SCS419ClinicalPracticeinSpeech/LanguagePathologyIII SCS420MAinCommunicationsandDisordersThishandbookmaybeusedforthefollowingcoursesinconjunctionwiththegraduatehandbookPracticum1 CSD610Practicum2 CSD611Practicum3 CSD612
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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAccreditationTheMAprograminspeech-languagepathologyatIonaCollegeisaCandidateforAccreditationbytheCouncilonAcademicAccreditationinAudiologyandSpeech-LanguagePathology(CAA)oftheAmericanSpeech-Language-HearingAssociation,2200ResearchBoulevard#310,Rockville,Maryland20850,(800)498-2071or(301)296-5700.Candidacyisa"pre-accreditation"statuswiththeCAA,awardedtodevelopingoremergingprogramsforamaximumperiodoffiveyears.ComplaintProceduresRegardingAccreditationAnyquestionsregardingtheprogram'saccreditationstatusorcompliancewithaccreditationstandardsmaybedirectedtotheCouncilonAcademicAccreditation(CAA)atthefollowingaddress:CouncilonAcademicAccreditationAmericanSpeech-Language-HearingAssociation2200ResearchBoulevardRockville,MD20850-3289Phone:(800)498-2071(ASHAMembers),(800)638-8255(Non-members)Fax:(301)296-8580http://www.asha.org/academic/accreditation/
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DepartmentofSpeechCommunicationStudiesFacultyIonaCollege715NorthAve.NewRochelle,NY10801Attn:18PresidentStreetOffice:(914)633-2168Fax:(914)633-2393
JenniferGerometta,Phd,CCC-SLPChair,SpeechCommunicationStudiesDepartmentAssistantProfessorjgerometta@iona.eduDianeFerrero-Paluzzi,PhDAssociateProfessorInterimAssociateDeanoftheSchoolofArtsandSciencedferrero-paluzzi@iona.eduDorothyLeone,PhD,CCC-SLPCSDGraduateProgramCoordinatorAssistantProfessordleone@iona.eduMinJungKim,PhD,[email protected],PhD,CCC-SLP,[email protected],PhD,CCC-SLPAssistantProfessornvidalfinnerty@iona.eduLouisBankstonAdministrativeAssistant|[email protected]
DepartmentofSpeechCommunicationStudiesClinicalStaffIonaCollege715NorthAve.NewRochelle,NY10801Attn:IonaCollegeSpeech,Language&HearingClinicat83CloveRoadReception:(914)712-1990Fax:(712)-738-1056
MariaArmiento-DeMaria,MA,CCC-SLP,[email protected],MS,CCC-SLP,TSSLDAssistantClinicDirector;[email protected],MS,CCC-SLP,TSHHInterimOff-SiteCoordinatormcriscuola@iona.eduJenniferCronin-Komosinski,MA,[email protected],MS,CCC-SLP,TSSLDClinicalSupervisorhspatz@iona.eduMindyGarbarinoAdministrativeAssistantmgarbarino@[email protected]
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DepartmentofSpeechCommunicationStudies715NorthAvenueNewRochelle,NY10801Office:(914)633-2168FAX(914)633-2393SpeechLanguage&HearingClinic@83CloveRoadOffice:914-712-1990Fax(914)738-1056ClinicDirector(914)712-1990TheDepartmentofSpeechCommunicationsStudiesatIonaCollegeprovidesanon-siteclinicalpracticumexperienceforundergraduateSpeech-LanguagePathologyandAudiologystudentsandgraduatestudentsregisteredintheCommunicationSciencesandDisordersMasterofArtsprogram.Whileourclinicservesasatrainingopportunityforourstudents,everycaseiscloselysupervisedwithaclinicalteachingcomponent.SupervisionisconductedbycertifiedspeechlanguagepathologistsandaudiologistwhoaremembersoftheAmericanSpeech-Language-HearingAssociation,holdaCertificateofClinicalCompetenceandlicensedinNewYorkState.Theclinicprovidesprofessionalspeechandlanguageservicesincludingassessmentandtreatmentwithinateachingclinicenvironment.Servicesareprovidedtoindividualswithawiderangeofcommunicationdisordersanddelaystobothchildrenandadults.Servicesincludebutnotlimitedtoarticulationandphonologicaldisorders/delays,dysphagia,languagedelays,traumaticbraininjury,aphasia,voice,cognitive-communication,hearing,andfluencydisorders.Clientsaretypicallyreferredbyphysicians,schoolpersonnel,privatepracticeandbyclient’sthemselves.Audiologydiagnosticservicesareavailableforbothchildrenandadults.TheseservicessupportourlocalcommunityandneighboringresidentsaswellasprovideaclinicaleducationopportunityforourstudentsDianeFerrero-Paluzzi,PhDInterimAssociatesDeanoftheSchoolofArtsandScienceandthecoordinatoroftheSpeakers’Center,providesservicesintheareasofaccentreduction,communicationapprehension,regionaldialect,speechassignments,andvocalcoaching.TheSpeech,Language&HearingClinicandTheSpeakers’CenteratIonaCollegedoesnotdiscriminateinthedeliveryofclinicalservicesbasedonraceorethnicity,gender,age,religion,nationalorigin,sexualorientation,ordisability.
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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicVisionStatementThevisionoftheSpeech,Language&HearingClinicstrivestoprovideaprofessionalclinicalteachingexperienceforourstudentsandqualityservicestothecommunityweserve.MissionStatementTheSpeech,Language&HearingClinicprovidesapre-professionalexperienceattheonsiteclinicforourclinicalstudents.Thegoaloftheclinicistoprovidestudentclinicians'anopportunitytointegrateacademicsintoclinic,developclinicalknowledge,andskills,conductresearch-basedtherapyandpromotecriticalthinkingskills.Additionally,ourclinicalinstructorsarededicatedtoteachvaluesvitaltotheprofession.Clinicalinstructionincludesethicalbehavior,professionalcollaboration;enhanceknowledge,afocusonclinicalservicesandintegratingproblemsolvingskillsforthepurposesofdiagnosticandtherapeuticplanning.Studentswilldevelopeffectiveoralandwrittencommunicationaswellasproblemsolvingskillsintheirinitialpracticumexperiencenecessaryasafutureclinician.Duringthispre-professionalexperiencestudents,willbegintheprocessofpersonalself-evaluationandpre-practicumresponsibilitiestoadvocatefortheindividualwithacommunicativedisordersanddelays.Thesupervisee-supervisorcollaborationprocessisestablishedbythehighestqualityofservicetoindividualswithcommunicationdisordersacrosstheagespan.ValueStatementThecommunityattheSpeech,Language&HearingCliniciscommittedtothefollowingvalues:Service: Providethehighestqualityservicetoindividualsacrosstheagespanwith
communicationdisordersanddelays.Education: Provideourstudentswithpre-professionalclinicalexperiencetodeveloptheir
academicknowledgebase,integrateclinicalservices,andbeeffectiveclinicalinstructorsforourfutureprofessionals.
Communication: Provideasupportiveenvironmentthatallowsthedevelopmentofideasand
individualgrowth.Collaboration: Provideaprofessionalenvironmentthatincludestheessentialsofateam
approachtotreattheclient,supportingclientfamilies,andtoincludetheclientsintheirtherapyprogram.
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PositionStatementAllClinicalStudentsandCertifiedSpeechLanguagePathologistsattheIonaCollegeSpeech,Language&HearingClinicarerequiredtofollow:
§ ASHACodeofEthics§ Speech,Language&HearingClinicPoliciesandProcedures,§ ConfidentialityRequirements§ HealthInsurancePortabilityandAccountabilityAct(HIPAA)
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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAMessagefromtheClinicDirectorMariaArmiento-DeMaria,M.A.,CCC-SLP,TSHHWelcometoclinicalpracticum!Thisisanexcitingopportunitywhileyoutransitionandintegrateacademicsintoyourpracticumstudentexperience.Clinicalteachingandsupervisionisahands-onexperiencethatprovidesyou,theclinicalstudent,professionalguidancetodevelopeffectiveclinicalskillsforyourfutureprofession.Thepartnershiptheclinicalstaffwillextendincludesthedevelopmentofprofessionalproblemsolvingskills,independence,andempathy,enhancingprofessionaljudgmentwhileparallelingpersonaljudgment.Thisprocesswilldevelopyourpre-professionalclinicalskillsasacommitted,dependablestudentprofessionalthatcandocumentandcommunicatewithclients,families,professionals,andsupervisors.Eachstudentwilldevelopskillsattheirownindividualpace.Ilookforwardtowatchingyourgrowthasyourprogressduringyourclinicalexperience.
Prof.Armiento-DeMaria
QualitiesforaSuccessfulStudentClinician“BehaviorqualitiesthatareconsistentwithASHAincludeadesiretohelpotherswithintegrity,honesty,andrespect.Professionalqualitiesthatshouldbeobservedincludebutnotlimitedtomeetingallclinicalappointments,deadlines,workingcooperativelywithpeersandsupervisors,actingresponsibleforclinicmaterialsandequipment,preparedforallclinicsessions,maintainingaprofessionaldress.”(AccordingtoHedge,M.N.,&Davis,D.(2005).Clinicalmethodsandpracticuminspeech-languagepathology4thEd)
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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAppendixAStudentConcernsandGrievances-UpdatedSpring2018Ifstudentshaveaconcernorgrievanceduringtheirclinicalpracticumthefollowingstepsarerequiredintheorderdocumented:§ ContactyourimmediateClinicalSupervisortodiscussthesituation.
§ Ifthesituationisnotresolved,contacttheClinicDirectorandameetingwillbescheduledand
completedwithClinicDirector,MariaArmiento-DeMaria.
§ IfdeemedappropriateameetingbetweentheClinicalSupervisor,StudentandClinicDirectorwillbecompleted
§ Ifthesituationisnotresolved,ameetingwillberecommendedwithDr.DorothyLeone,PhDCCC-SLPCSDProgramDirectorand/orDr.JenniferGerometta,ChairPersonoftheSCSDepartment
Iftheissueisnotresolvedtothestudent’ssatisfactionbytheChairand/orCSDProgramDirectorthen,andONLYthen,canthestudentrequestameetingwiththeappropriateoffices:IonaCollegeDean’sOfficeSchoolofArts&Science715NorthAvenueNewRochelle,NY10801
JosephStabile,Ph.D.Dr.KatherineZaromatidisAssociateDeanDirectorofGraduateStudies,SchoolofArts&Science(914)-633-2253(914)[email protected]@iona.edu
Thefollowingcontactnumbersmaybehelpful:
IonaCollegeCounselingCenterSameulRudinAcademicResourceCenterSpellmanHallAmendHall914.633.2038 914.633.2217
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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAppendixBProfessionalCodeofConduct-ClinicPolicies
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalCodeofConduct PROFESSIONALCODEOFCONDUCTAllclinicalinstructorsandstudentclinicianswillfollowandadheretothehigheststandardsofprofessionalbehavior.AllindividualsactiveintheSpeech,Language&HearingClinicwillbeexpectedtofollowASHA’sCodeofEthics,standardsimplementedbytheCouncilonAcademicAccreditation,PoliciesandProceduressetforthattheSpeech,Language&HearingClinicandIonaCollege.StudentswillbeinstructedtoreviewASHA’sScopeofPracticeandASHA’sPreferredPracticePatterns.Studentswillbeexpectedtomaintainaccuratedocumentation,followConfidentialityGuidelinesandHIPAApractices.StudentsshouldpresentthemselvesasmembersoftheprofessionalcommunityIN,WHICHtheyaspire.ProfessionalPracticeGuidelines:Studentswilldemonstrateappropriateprofessionalskillswhilecommunicatingwithsupervisors,faculty,peers,staff,andclientfamilies.StudentswilldemonstrateappropriateprofessionalskillsbyfollowingHIPAArequirementsandadheringtoconfidentialinformationwiththeclientandtheclient’scaregivers.Sensitiveinformationwillnotbedivulgedthroughconversationand/orclientrecords.Studentswilldemonstrateappropriateprofessionalskillsbyfollowingtheirclinicalresponsibilities.Personalsituationsmayariseduringthepracticumexperience.Ifthisdoesoccur,everyeffortshouldbemadenottocompromisetheclient’scourseoftreatmentorthestudentclinician'spracticumexperience.Inasmuch,itistheresponsibilityofthestudenttoinformaClinicalSupervisororClinicDirectorawareofanyunforeseeninstance.Thus,theclient’sandtheclinicalstudentsexperiencecanbesupportedtomeettheneedsofthestudentandtheclient.Clinicalpracticumstudentswilllearntoprioritizetheirclinicalduties,academicrequirements,andpersonalsituations.Allclinicalstudentsareexpectedtoaskquestions,requesthelp,andclarifyanyconcernsthroughouttheirclinicalexperience.Furthermore,studentsareexpectedtobepreparedforallsessions,arriveontime,participateincleanupandorganizationoftheclinic.Studentswilldevelopprofessionalknowledgeandskillstogainindependenceandwillexpectedtotakeresponsibilityfortheiractions,respondtofeedbackpositively,shareinformation,andactasateammember.Pleasebeawareofyourowncommunicationstyle.Itisimportanttobuildrapportwithyourclientandtheirfamilies.Understandthatyoumustbeflexiblewithyourcommunicationbecausewhatmightworkforoneclientmaynotworkfortheother.Nonverbalandverbalcommunicationsarebothpowerfulandshouldbeusedwiththoughtfulness.Bemindfulofthemessageyouaresending!
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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicEthicsPolicy
ASHA IonaCollegePrincipleofEthics1:Individualsshallhonortheirresponsibilitytoholdparamountthewelfareofpersonstheyserveprofessionallyorwhoareparticipantsinresearchandscholarlyactivities,andtheyshalltreatanimalsinvolvedinresearchinahumanemanner.
TitleIXoftheEducationAmendmentsof1972ProhibitingSexDiscriminationinEducation:IonaCollegedoesnotdiscriminatebasedonsexinitseducationalprogramsoractivities.StudentParticipationinEstablishedReligiousObservances:ItisthepolicyofIonaCollegethatstudentsshouldnotexperienceadverseorprejudicialeffectsasaresultoftheirreligiousbeliefsorpractices.FamilyEducationalRightsandPrivacyActof1974:IonaCollegecomplieswiththisAct,protectstheprivacyofeducationalrecords,establishedtherightofstudentstoreviewtheirrecords,andprovideguidelinesforcorrectionofinaccurateormisleadingdatathroughformalorinformalhearings.
PrincipleofEthics2:Individualsshallhonortheirresponsibilitytoachieveandmaintainthehighestlevelofprofessionalcompetenceandperformance.
IonaCollegeMissionStatement:SchoolofArts&ScienceTheSchoolofArts&SciencesupportsthemissionofIonaCollegethroughitscommitmenttofosteringacademicexcellenceandintellectualinquiryintheliberalartstradition.Throughitsdiverseprogramsandwiththecareandcommitmentofacommunityofteachers-scholars,theSchoolofferscoursesofstudythatareacademicallychallenging,androotedinliberalartseducation.Infurtheranceofthesecommitments,theSchoolstrivesto:provideaneducationthatiscurrent,student-centered,outcome-based,andinvolvesanappropriatemixofclassroom-basedinstruction,independentresearch,andinternshiporpracticalexperience;equipstudentswiththeskillsnecessaryforsuccessinarapidlychangingenvironment:criticalthinking,effectiveoralandwrittencommunication,problemsolving,collaborativelearning,ethicaldecisionmaking,scientific,technologicalandaestheticliteracy;
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instillinstudentsthehabitsofmindenablingthemtopossessourmostprecioushumanheritage:thoseideas,beliefs,writings,andcreativeexpressionsthatarethebasisofintellectual,cultural,andmoraldevelopment;deepenstudents'self-awareness,reflectiveness,andcommitmenttoacoreofvaluesthatwillilluminateboththeirpersonalrelationshipsandtheirrelationshiptoapluralisticsocietywiththequalitiesofintelligence,tolerance,decency,compassion,andappreciationofculturesothersthantheirown;recruit,retain,andsupportthedevelopmentofafacultyofexceptionalteacher-scholarswhosepedagogyisinformedbyresearch,experience,andscholarship.(Revised,December2012)AttendancePolicy:Studentsareexpectedtoacceptpersonalresponsibilityforabsences,andareresponsibleforfulfillingallrequirementsandcompletingallassignmentsmadeineachcourse.
PrincipleofEthics3:IndividualsshallhonortheirresponsibilitytothepublicwhenadvocatingfortheunmetcommunicationandswallowingneedsofthepublicandshallprovideaccurateInformationinvolvinganyaspectoftheprofessions.
IonaCollegeMissionStatement
PrincipleofEthics4:Individualsshallupholdthedignityandautonomyoftheprofessions,maintaincollaborativeandharmoniousinterprofessionalrelationships,andaccepttheprofessions’self-imposedstandards.
IonaCollegeMissionStatement
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalCodeofConductAnyfamiliesorclientswishingtoshowgratitudeforservicesshouldbeforwardedtoyourimmediateClinicalSupervisor.Itissuggestedthattheclinicalstudentsintrainingnotacceptgifts.Clientfamiliesarewelcometomakedonationstotheclinic.OffsiteActivitiesPersons’mayrequestoutsideactivitiesfromourstudentclinicians.Examplesofactivitiesmayincludebabysitting,actingasatutorinrelationtospeechandlanguageservices,orevenprovidingservicesathome.ThesetypesofactivitieswillputastudentatriskbyviolatingtheASHACodeofEthicsandPoliciesandProceduressetforthattheSpeech,Language&HearingClinic.Ifastudenthasaquestionaboutaspecificactivity,pleasefollowupwiththeClinicDirectortodiscusstheactivityanddetermineiftheactivitywouldbeaviolation.CONFIDENTIALITYClinicstudentswillberequiredtocompleteclinicpaperworkontheEMRsystem:Medicat.ThefollowingformsmustbedocumentedusingMedicat:ClientContactForm,LessonPlans,SOAPnotes,progressreports,andevaluations.AdditionalGuidelinestoFollow:
§ Donotdiscussyourclient/patient’snameinpublicareas§ Donotdiscussyourclientinpublicareas§ DiscussionsofclientsforthepurposesofinterventionsandideasmusttakeplaceinONLYprivate
areasofthedepartment§ Donotleaveclientreports,lessonplansorotherwrittendocumentationunattended§ AllfilesandwrittendocumentationmustbeplacedinthelockedcabinetintheCopy/PrintRoom
intheSpeech,LanguageandHearingClinic§ Draftsofanywrittendocumentationmustbeshredded§ Refertoyourclientbytheirinitialsandor“theclient”inclassdiscussions§ Followofficerulesaboutcheckingoutclientfolders§ Ifastudentneedstostepawayfromtheircomputerscreen,computersmustbelockedpriorto
thestudentleaving§ Obtainwrittenconsentfromtheclientorlegalguardianoftheclienttoaudiotape,videotapeor
takeaphotograph
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalCodeofConductClientChartAllclientsreceivingservicesattheIonaCollegeSpeech,Language&HearingClinichaveaSessionClientChartlockedinthecopy/printroom.Allchartsand/orfilespertainingtoclientsaffiliatedwiththeIonaCollegeSpeech,Language&HearingClinicMUSTfollowHIPAARegulations,ConfidentialityGuidelinesandsignin/outproceduresCharts/filesareNOTpermittedoutsideoftheIonaCollegeSpeech,LanguageandHearingClinicAuthorizationisrequiredfordocumentationtobecopiedortransferredtoanothersiteorperson.Seeyourimmediatesupervisorforprocedureguidelines.Sign-OutProcedureSessionClientChartsarelockedintheCopy/PrintRoomdesignatedfilingcabinet.Whenyouneedtoreviewand/orretrieveachartONLYauthorizedclinicstaffpersonnelareauthorizedtoreleasetheserecords.Also,notestudentsarerequiredtosignin/outthecharts,timeandreason.AllSessionClientChartsmaybereviewedONLYintheclinic.Allchartsmustbereturnedthesamedayofsignout.ChartsnotreturnedasperclinicalpoliciesandprocedureswillbefurtherquestionedtodetermineiftherewasabreachinHIPAAregulationsand/orConfidentialitypolices.
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ProcedureforSessionClientChartsDesignatedclinicalstaffassociatesONLYhavetheauthoritytoreleaseaclient’schart:AdministrativeAssistantandClinicalSupervisors.StudentcliniciansDONOThavetheauthoritytoremovecharts.AnIonaCollegeSpeech,Language&HearingClinicrepresentativeSCSrepresentativemustbepresentinorderforastudentcliniciantocheckouttheCharts.ChartingGuidelines
DesignatedChartCheckOut/InHours
ChartCheckOutHoursaredesignated.StudentCliniciansmustprioritizetheirtimeforpaperworkandmeetings.ChartsareNOTALLOWEDoutsidetheclinicspace
ClinicalStudents ClinicalStudentsMUSTSIGNOUT
CHARTandSIGNINCHARTOfficeSpace ClinicalStudentsDONOThave
permissiontoremovechartsfromtheSpeech,Language&HearingClinic
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalCodeofConductWHATISHIPAA?HIPAAstandsfortheHealthInsurancePortabilityandAccountabilityAct,whichwasimplementedin1996.Thisactcreatednationalrulesregardingtheprivacyofhealthcareinformation.Patientaccesstorecords,patienteducationregardingprivacy,andreceivingpatientconsentbeforethereleaseofinformationisincludedunderthisact.HIPAAalsoestablishedformatsfortheelectronictransmissionofclinicaldata.WhatisthePrivacyRule?TheprivacyruleofHIPAAenablestheprotectionofindividuallyidentifiablehealthinformationcontainedinapatient’smedicalrecord,includingbothhardandsoftfiles.Thisinformationincludesapatient’sname,address,SocialSecuritynumber,financialdata,etc.ThecompliancedateforthisRulewasineffectonApril14,2003.Howdoesthisaffectme?Asastudentclinician,youmustabidebythesefederallawstosecureclientconfidentiality.PleaserefertotheConfidentialityAgreement.HowwillIknowwhatIcanandcannotdo?YouwillreceiveacopyofyourConfidentialityAgreement,specifyingtheregulations.HowwillIinformtheclientsofourclinicpractices?ClientswillbegivenaNoticeofPrivacyPracticestoread.Theywillthensignthisnotice,documentingthattheyhavebeeninformed.FormoreinformationaboutHIPAA,visit:https://www.hhs.gov/hipaa/index.html/https://www.cms.gov/index.htmlhttps://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalCodeofConductConfidentialityAgreementI_____________________________________________________understandthataspartofmyclinicalpracticumattheIonaCollegeSpeech,Language&HearingClinic,orasanemployeeintheDepartmentofSpeechCommunicationStudies,Imustprotecttheprivacy,securityandintegrityofclientsandtheirrecordsatalltimes.Iagreetoabidebyallstateandfederallawsandregulationsgoverningtheconfidentialityofindividualhealthrecordsandinformation.IagreethatIwillnotbehaveinsuchawayastocauseabreachofconfidentialitythatincludesbutisnotlimitedto:OpenDiscussion:Discussinginformationcontainedinfilesordistributingfilestoothers;Discussingaclient’sconfidentialinformationwithanotherstudentorfacultymemberwhereitcanbeoverheardbyotherclientsandindividualsnotinvolvedinthecareofthatclient(e.g.,discussingaclientinahallwayorwaitingarea);Discussingaclientwithfriends,otherclients,otherprofessionals,oranyone,insideoroutsidetheClinicnotdirectlyinvolvedinthecareofthatclientorinaconsultativeroleregardingtheclient’scare.ReleaseofInformation:Releasingclientrecordswithouttheclient’sconsentunlessrequiredbylaw.(Consentmustbegivenbywrittenrelease,orbyfaxedandsignedmemo,andmustspecifywhichpartsoftherecordmaybereleased.)
§ RecordsManagementandStorage:§ Leavingrecordsunsecuredinanopenareawhereindividualsnotinvolvedinthecareofthat
clientcanviewthem;§ RemovingclientfoldersfromtheClinicorDepartmentareaswhereindividualsnotinvolvedin
thecareofthatclientcanviewthem;§ Leavingcomputerworkstationscreenswithidentifiableclientinformationunattendedor
unlockedsothatanyonemayvieworaccessotherclient’sconfidentialinformation; § Leavingreports,treatmentplansorsessionplansinprintersorgarbagewithoutbeing
shredded;§ Savingidentifiableclientinformationoncomputerdiskorharddrive;§ Transmittingreportswithidentifiableconfidentialinformationviaemail;§ Makingcopiesofclientinformationorreports;
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§ Removinganyreportsorrawdatafromtheclientfolder;§ Maintainingvideotapesofclientsessionsaftertheendoftheclinicalassignmentoutsideofthe
clinic/department.DisciplineforanemployeeshallbeimposedinaccordancewithCollegepolicies.Thismayincludeterminationforviolatingstateorfederallaws.DisciplineforastudentshallbeimposedinaccordancewithCollegepolicies.Coursegrademaybedroppedoneletterforeachoffense,clinicalclockhourswillnotbeawardedforthatassignmentand/orareportplacedinthestudent’spermanentrecord.IunderstandthatImaybesubjecttolegalactionifIviolatestateorfederalstatutesregardingprotectedhealthinformation.Iagreetoabidebyallthestatementscontainedinthisdocument.Signature________________________________________________Date____________________________
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalCodeofConductPolicyCLINICALPROFESSIONALCODEOFCONDUCTPOLICYupdatedforSpring2018AnystudentinviolationoftheProfessionalCodeofConductand/orProfessionalGuidelinesincludethefollowing:FirstOffense
§ AmeetingwiththeClinicalSupervisorandClinicDirectorwillbeconducted.
§ Awrittenwarningwillbecompletedandplacedinthestudent’sfolder.
§ Aclinicalfocusplanwillbeimplemented.
§ Clinicgrademaybeloweredafullgrade.
§ CaseloadmaybereassignedSecondOffense:
§ AmeetingwiththeClinicalSupervisorandClinicDirectorwillbeconducted.
§ Apermanentletterwillbeplacedinthestudent’sfolder.
§ Studentwillbeautomaticallyremovedfromtheirtherapyassignmentandfailclinic.
§ Aclinicalexperiencethatisnotsuccessfullycompleted,theclinicalhourswillnotbeaccrued
§ ACommitteeMeetingmaytakeplaceasdeterminedbytheSCSDepartmentChairorCSDProgramDirector.
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalCodeofConductClinicExitProcedureClinicExitProcedure:UpdatedforSpring2018Attheendofeachsemester,CLINICEXITMeetingsarearequirement.TheSLPthatsupervisesyouandyourclientwillemailyoutoscheduleaFIRMCLINICEXITMEETINGDATEThefollowingprocedureswillbeconductedduringtheCLINICEXITMEETING:
§ SessionClientChartreview
§ SessionClientChartreview(alldocumentsnotedinthesessionclientchartoutlinemustbefiledatthetimeoftheClinicExitMeeting)
§ AllpaperworkandchartsmustbereadyforreviewfortheClinicalSupervisor.
§ AlldocumentsneedtobefiledaccordinglyfortheClinicalSupervisortosubmitagradeandsignoffonClinicClockHours.ThereisNOEXCEPTIONforANYpaperworktobemissing.Anypaperworknotcompletedwillbeconsideredlateand/orwillnotcounttowardshours.SeeClinicExitPolicyforfurtherdetails.
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalCodeofConductClinicExitPolicyCLINICALPROFESSIONALCODEOFCONDUCTPOLICYatthetimeoftheCLINICEXIT-updatedforSpring2018Thefollowingviolationsincludebutnotlimitedto:ViolationsIncludebutnotlimitedto:
§ NotParticipatingintheClinicExit§ Chartsnotreadyforreview§ MissingDocumentation§ ProgressReportnotcomplete
SpecialNote:AnymissingdocumentationmayberecoveredONLYatthetimeoftheClinicExitMeetingifdeemedappropriatebyclinicexitmeetingsupervisorFirstOffense
§ Clinicgradewillbeloweredbyafullgradeasdemonstratedbytheviolationlevel§ ClinicFailurewillbewarrantediftheProgressReportisnotcompleted.§ ClinicFailurewillbewarrantedifdocumentationisinaccurate§ AmeetingwiththeClinicalSupervisorandClinicDirectorwillbeconducted.§ Aclinicalexperiencethatisnotsuccessfullycompleted,theclinicalhourswillnotbeaccrued§ WrittenDocumentationofthespecificoffensewillbeplacedinthestudent’sfile§ ACommitteeMeetingmaytakeplaceasdeterminedbytheSCSDepartmentChairorCSDProgram
Director.
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalCodeofConductSummary
ProfessionalCodeofConductViolationSummary
______________________________________________________ClinicalStaff Date
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicThefollowingexamplesareconsideredprofessionalcodeofconductprocedureviolationsthatmayincludetheEMRsystem,SessionClientChartandClinicFlashDrive
§ ScreenShotofdocumentation§ Removingsessionclientchartsfromtheclinic§ LeavingcomputerunattendedwithclientchartopenontheEMRsystemand/orsessionclientcharts
unattended.§ Notfollowingsignout/signinprocedures§ Notshreddingdraftsoflessonplans,reports§ AllidentifyinginformationMUSTBEremovedwithelectronicmessaging§ Filesmustbereviewedintheclinic§ Noportionofthefilemaybecopiedorphotographedorscannedorscreenshot
FirstOffense
§ AmeetingwiththeClinicalSupervisorandClinicDirectorwillbeconducted.§ Awrittenwarningwillbecompletedandplacedinthestudent’sfolder.§ Aclinicalfocusplanwillbeimplemented.§ Clinicgrademaybeloweredafullgrade.§ Caseloadmaybereassigned
SecondOffense:
§ AmeetingwiththeClinicalSupervisorandClinicDirectorwillbeconducted.§ Apermanentletterwillbeplacedinthestudent’sfolder.§ Studentwillautomaticallyfailclinic.§ Aclinicalexperiencethatisnotsuccessfullycompleted,theclinicalhourswillnotbeaccrued§ ACommitteeMeetingmaytakeplaceasdeterminedbytheSCSDepartmentChairorCSDProgram
Director.
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicWrittenDocumentationPolicyWrittenDocumentationPolicy(documentsincludingclientcharting)-updatedforSpring2018Thefollowingviolationsincludebutnotlimitedto:
§ Latesubmission§ Followingwrittendocumentationprocedures§ Providinginaccuratedocumentation§ Falsifyingrecords§ Plagiarism§ RemovingrecordsfromtheClinic§ Breachofconfidentialityguidelines§ BreachofHIPAAregulations
OnlyOffense
§ AmeetingwiththeClinicalSupervisorandClinicDirectorwillbeconducted.§ Clinicgradewillbeloweredbyafullgrade§ Accrualofclinicalclockhourswillbeforfeited§ WrittenDocumentationofthespecificoffensewillbeplacedinthestudent’sfile§ Caseloadmaybereassigned
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicWrittenDocumentationExtensionRequestWrittenDocumentationExtensionRequest-UpdatedSpring2018AWrittenDocumentationExtensionmayberequestedinadvance.StudentsmayrequestpermissioninwritingtotheirprimarySLPonthecasetorequestforanextension.Anextensionmayincludebutnotlimitedtoclassconflict,studentabsence.ItisatthediscretionoftheSLPtograntawrittendocumentationextension.Ifgrantedaduedatemustbedocumented.WrittenExtensionwillNOTbegrantedpastthelastdayofclinicclients.WrittenExtensionwillNOTbegrantedforprogressreportsorclinicexitmeetings
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClockHourPolicyClockHourPolicy-UpdatedSpring2018
Studentsparticipatingasastudentclinicianareeligiblefortheaccrualofclockhoursachievingthefollowingcriteria:ClinicalClockhoursareawardedbasedonthefollowingtwocriteria:
1. ClinicalStudentsmustaachieveaminimalFinalGradeofBinclinicAND
2. ThediscretionoftheprofessionalSLPtoprovidesignatureandASHAcredentialstoapproveclockhours.Awarding/grantingofclockhoursisatthediscretionanddelegationoftheclinicalsupervisor,basedonprofessionalclinicaljudgment/rationalandinaccordancewithASHAguidelines.
ImportantProtocol:
§ ClockHourswillNOTbeawardedtoclinicalpracticumstudentsreceivingagradebelowa“B”foraclinicalcourse.
§ Studentcliniciansareresponsibleforcomputingclockhoursandcompletingtheclockhourform
§ Studentsareresponsibleforkeepingtheoriginalcopyoftheirclinicaldocumentationforpersonalrecords.Theclinicisnotresponsibleforstudentclinicaldocumentation
ClockHourGuidelinesEligibilitytoaccrueclockhoursisbasedupontheguidelinesdocumentedinthefollowingdocument:
Council for Clinical Certification in Audiology and Speech-Language Pathology of the American Speech-Language-Hearing Association. (2013). 2014 Standards for the Certificate of Clinical Competence in Speech-Language Pathology. Retrieved [date] from http://www.asha.org/Certification/2014-Speech-Language-Pathology-Certification-Standards/.
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicCSDStudentsHourRequirementsAspertheCouncilforClinicalCertificationinAudiologyandSpeech-LanguagePathologyoftheAmericanSpeech-Language-HearingAssociation.(2013).2014StandardsfortheCertificateofClinicalCompetenceinSpeech-LanguagePathology.Retrieved[date]fromhttp://www.asha.org/Certification/2014-Speech-Language-Pathology-Certification-Standards/.Applicantsmustcompleteaminimumof325ofthe400clockhoursatthegraduatelevel(StandardVD)duringsupervisedclinicalexperienceswithvarioustypesofpopulations,communicationdisorders,differencesanddisabilitiesRecommendedHourRequirement:ChildSpeechDiagnostic (10hoursRecommended)ChildLanguageDiagnostic (10hoursrecommended)AdultSpeechDiagnostic (10hoursRecommended)AdultLanguageDiagnostic (10hoursrecommended)ChildLanguageTherapy (10hoursrecommended)ChildSpeechTherapy (10hoursrecommended)AdultLanguageTherapy (10hoursrecommended)AdultSpeechTherapy (10hoursrecommended)
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicStudentClinicAttendancePolicy
StudentClinicAttendancePolicy-updatedSpring2018
Procedures:Clinicalstudentsareresponsibletocontactandinformtheclientand/orcaregiverofacancellationthatrelatestothestudentclinicianpersonalconflictand/orillness.Ifpossible,providetheclientand/orcaregiver24-hournotice.ClinicalstudentsareresponsibletoemailtheirPrimarySLPandCCtheClinicDirectorofacancelledsessionBYtheStudentClinician.Itisbestpracticetoprovidea24-houradvancednotice.StudentClinicAttendancePolicy-UnexpectedCancellation-updatedFall2018Ifstudentsarecancellingduetounexpectedsicknessorunforeseencircumstance.Itisthestudent’sresponsibilitytoemailthefamilyandcopytheimmediateSLPandMrs.Garbarinoofthecancellation.Ifthereisnotaresponsebackfromthefamilyconfirmingthatthestudentcliniciancancelledthesession–thestudentmustcontactMrs.GarbarinoandrequestMrs.Garbarinotocallthefamily.Allstudentcancellationsrequiredocumentationandthestudentisrequiredtomake-upthesessionAllstudentcliniciansarerequiredtoprovidedocumentationforanabsencethatwillbefiledaccordingly.ClinicalStudentsarerequiredtoconductamakeupsessionViolationsoftheStudentClinicAttendancePolicyIncludebutnotlimitedto:
§ NoShowNoCalltoclinicalsession
§ Cancellationswithoutdocumentation
§ TwoormorecancellationswithorwithoutdocumentationsClinicalStudentsinviolationoftheClinicalAttendancePolicythefollowingwilloccur:OnlyOffense
§ AmeetingwiththeClinicalSupervisorandClinicDirectorwillbeconducted.
§ Awrittenwarningwillbecompletedandplacedinthestudent’sfolder.
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§ Aclinicalfocusplanwillbeimplemented.
§ Clinicgrademaybeloweredafullgrade.
§ Caseloadmaybereassigned
DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicStudentClinicAttendancePolicy-AdvancedNoticeStudentClinicAttendancePolicyAdvancedNotice-updatedSpring2018Studentswhohaveanadvancedconflictwithascheduledsessionmustfollowthestepsbelow:
1. CompleteawrittenrequesttotheClinicDirectoratleast10businessdaysinadvance2. Documentationmustaccompanythewrittenrequesttocancelasessionduetoastudentcancelingthe
session3. Studentsmusthaveamakeupsessionalreadyscheduledforthecancelledsession
ViolationsoftheStudentClinicAttendancePolicyAdvancedNoticeIncludebutnotlimitedto:§ NoShowNoCalltoclinicalsession
§ Cancellationswithoutdocumentation
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClientAttendancePolicyClientAttendancePolicy-UpdatedSpring2018 Procedures:StudentCliniciansareexpectedtocalltheclientand/orcaregivertofollowupiftheclientisnotpresentwithin15minutesoftheirtreatmenttime.StudentCliniciansareexpectedtoreporttoyourimmediateClinicalSupervisorifthefollowingsituationsarepresented:
§ IfachildclientisbeingpickedupfromsomeonethatisnotfiledontheIonaCollegeSpeech,Language&HearingFormorapersonthathasNOTbeenintroducedtothestudentclinicianpriortotherapysessions,thestudentclinicianmustbringtheclienttotheprimarySLPonstaff.TheprimarySLPwillberesponsiblefortheimmediatefollowuptothefamily.
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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAppendixCElectronicMessageExchange
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ELECTRONICMESSAGETRANSMISSIONThefollowingstatementMUSTBEINCLUDEDinanyemailexchangerelatingtoclinic(i.e.Ifcontactingfamiliesand/orotherprofessionalsthatrelatestoyourcase):Thiselectronicmessagetransmissioncontainsinformationthatmaybeproprietary,confidentialand/orprivileged.Theinformationisintendedonlyfortheuseoftheindividual(s)orentitynamedabove.Ifyouarenottheintendedrecipient,beawarethatanydisclosure,copyingordistributionoruseofthecontentsofthisinformationisprohibited.Ifyouhavereceivedthiselectronictransmissioninerror,pleasedeleteitandanycopies,andnotifythesenderimmediatelybyreplyingtotheaddresslistedinthe“From:”field.Protocol:StudentCliniciansmustcopytheprimarySLPwithallclinicbusinessemailsthatdirectlyrelatetotheclientundertheSLP’ssupervision/licensureProf.A-DmustbecopiedonallclinicbusinessemailsEmailAccountNames:AllclinicalstudentsarerequiredtousetheirIONAemailaddressduringcontactwithaclinicalsupervisor.Emailswillnotberespondedtoifusingapersonalemailaddress.E-mailConfidentiality:Studentsusingemailstoexchangeandrequestclinicalinformation(includingstudentpeer,supervisor,orfaculty)mustcontinuetofollowconfidentiality,privacyandHIPAAguidelines.ReportdraftssuchasSOAPnotes,progressreportsareNOTpermittedtobetransmittedelectronically.Ifrequestingspecificinformationaboutaclient,removeallidentifyinginformationE-mailEtiquette:TheIonaCollegeSpeech,Language&HearingClinicsupportstheuseofe-mailwithasetofrulesrelatedtoprofessionalresponsibility.Thefollowingguidelinesarerecommendedwhenstudentsusee-mailtocommunicatewithClinicalStaffforon-siteandoff-sitesupervisors:
§ Studentsareexpectedtorespondtoe-mailsentbyClinicalStaff.
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§ AClinicalStaffpersonnelisresponsibleforprovidinginformationouttoastudentandstudentshavetheresponsibilitytoreadtheemail
§ ClinicalStaffpersonnelisnotresponsibleforundeliverablee-mailsduetofullmailboxesorincorrectforwardingaddresses.
§ Studentsshouldcheckinyourclutterand/orspaminboxesaswell
§ Expectaresponseinnolessthan3businessdays.
§ Clinicalstaffreservestherighttorespondonlytoe-mailsthathavesubjectheadingsaswellasthosethathaveasignature/identification.
§ Clinicalstaffarenotrequiredtorespondtoe-mailsduringweekends,holidaysorvacations.
§ Beconciseandproofread,spell-checkandgrammar-checkyoure-mail.
E-mailBody
§ Writemessageswithadescendingorderofimportance,i.e.,themostimportantpointyouwanttomakewouldbefirst,nextcomesthesecondmostimportant,thethirdimportantpointafter,andsoon.
§ Beconciseandbullet-pointyourthoughtswhenpossible.§ Createanelectronicsignaturetobeinsertedattheendofyoure-mailsotherecipientknowswhoyou
are.§ Ifyouwouldlikearesponsetoyourmessage,saysointhebodyofthee-mail.Readerstendtoanswer
e-mailifasked.§ Proofread,spellcheckandgrammarcheckyoure-mail.
E-mailLength
§ E-mailisnotasubstituteforofficehours.Studentsareexpectedtobeconciseintheire-mails,bulletingquestions,answers,andideas.
§ Keepe-mailmessagesasshortaspossiblewithamaximumof300wordsorupto5pointsorquestions.Remember,shortermessagestendtobeansweredquickerthanlongerones.
§ Studentsmustcheckwiththeiracademicinstructorsandclinicalstaffregardingindividualpreferencesfore-maillength.
E-mailAttachments
§ Attachmentsmustbeappropriatetothesubjectdiscussed.Donotattachanythingthatisnotexplainedinthee-mailbody.E-mailResponseTimeAlthoughe-mailisquickandconvenient,studentsmustbereasonableintheirexpectationsregardingtheresponsetimefromsomeonetowhome-mailwassent.
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§ Donotexpectresponsesduringweekends,holidaysorvacationperiodsfromfacultymembersandstaff.§ Donotexpectorrequirearesponsefromanyoneinlessthanatleast3businessdays.
E-mailTips
§ Ifyouareexpectingaresponse,saysointhebodyofthetext.Shouldyounotreceivearesponseto
yourmessage,itisnotwisetoassumethepersonreceivedthemailandisignoringyou.Givetheappropriateamountoftime(72hours)andthene-mailtherecipientagainaskingifs/hereceivedthefirstmessage.
§ Donotexpectaresponsefromifthereisnosignatureenteredinyourmessage.§ Makesureifyousayyouareattachingadocumentorfiletoyoure-mail,youhavedoneso.It’savery
commonmistaketoforgetaboutaddingattachments.§ Donotwriteinallcapsasthisconsidered“electronicyelling”andverypoorform.§ Donotassumeallabbreviationsareunderstood.Somethinglike“BTW”isoftenusedtoabbreviate“by
theway”howeveritcannotbeassumedthattheabbreviationisuniversallyunderstood.Unlesspreviouslyusedbythee-mailrecipient,definetheabbreviation.
§ Confidentialinformationshouldneverbediscussedinemail.Ifyouarereferringtoaclientneverusetheperson’sname;onlyinitialsareappropriatetouse.Consider
§ ItisnotwisetogossipaboutanyoneinE-MAIL,asyouneverknowtowhomitmaybeforwarded.§ Confidentialinformationshouldneverbediscussedine-mail.Ifyouarereferringtoaclient,donotuse
theperson’sname.Initialsareappropriatetouse.§ Proofreadyoure-mailformistakes§ E-mailisawrittendocument:itisforeverinprint.
Warnings
§ Youmustinformyourdirectsupervisoranye-mailinterruptionofcommunication.§ Limitemailstonomorethanoneperday.§ Donotexpectclinicalstafftorespondtoyoure-mailifitisnotsigned,orhasanunidentifiableaccount
name.§ Donotexpectfacultytorespondtoe-mailwithoutsubjectheadings.§ Utilizeonlysimpleandcommonlyavailablefontsinyoure-mail–notallcomputershavethesame
exactfontsets.§ Itisinappropriatetouse“fun”fontsforacademicallyandprofessionallyrelatedcommunications.§ Donotsendoutunsolicitedjokes.
ElectronicDevices:
§ ThereisZEROTOLERANCEforpersonalcellphone,IPAD,ANDLAPTOPuseinaprofessionalenvironment.Useofthesedeviceswillbeinterpretedasabreachinconfidentialityand/orHIPAARegulations.Ifoneisfoundguilty,thisisconsideredaFederalOffense.
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§ AwrittenrequesttouseelectronicsforpurposefultherapytargetsmaybegrantedONLYIFthestudentrequeststhepermissioninwriting.TheClinicalStaffwillreviewtherequestandapproveordisapprovetherequest.
§ ComputeruseattheSpeech,Language&HearingClinicislimitedtoclinicrelateduseandclinicdocumentationviatheassignedclinicflashdriveONLY.§ Texting,personalphonecallsand/orpersonalemailsareNOTpermittedduringclinicorclasstime.§ SocialNetworkingisprohibitedonanysiteduetorisksofprivacy,unauthorizedpicturesandstatementsrelatedtotheclinic,clients,clinicalstafforstudentpeers.
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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAppendixDStudentClinicianRequirements
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SchoolofArts&ScienceSpeech,Language&HearingClinic
Student:_________________________Semester:_________________________
ON-SITECLINICREQUIREMENTS
(updated 8/16/18)
DocumentationRequiredTypeofWritten
DocumentationSubmittedDate
ReceivedSupervisorInitials
VerificationofClinicalObservationHours(25hours) ¨ Logs¨ VerificationLetter
ChildAbuseSeminar ¨ CertificateDated:
ProofOfLiabilityInsurance ¨ Policydates:
ProofofVaccinationorImmunitytoMeasles,Mumps,&Rubella
¨ MMRVaccinationCertificate¨ MedicalExemption¨ ReligiousExemption
ProofofTuberculinSkinTest(RequiredAnnually)DateofResults:
¨ PPDCertificate¨ MedicalExemption
EssentialFunctions ¨ SignedForm
CPRCertification ¨ CertificateDated:
ConfidentialityAgreement(RequiredAnnually) ¨ SignedForm
HandbookAgreement ¨ SignedForm
SocialMediaAgreement ¨ SignedForm
IDBadgeAgreement ¨ SignedForm
On-LineHIPAAtraining/certificate ¨ SignedForm
UNDERGRADUATESTUDENTFEESONLY:$55.00CLINICFEEAND
$30.00HANDBOOKFEE(SEEPROF.A-DFORANYSTUDENTFEECONCERNS)
PrimarySupervisorSignature(fileiscomplete): ______________________
Supervisor’sASHA#: ______________________RecordofCommunications:_______________________________________________________________________________________
_______________________________________________________________________________________
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_______________________________________________________________________________________
_______________________________________________________________
ResourcesWorkshopResourceswww.iona.edu/Academics/School-of-Arts-Science/Departments/Education/Certification-and-Workshop-Information/Workshops.aspxhttp://www.nysmandatedreporter.org/ StudentLiabilityInsurancewww.proliability.com/professional-liability-insurance/speech-language-pathologists/american-speech-language-hearing-associationwww.hpso.com/individuals/professional-liability/healthcare-professions-coveredHerearethelinksthatsomestudentshavepassedalongCPR/AEDcoursehttps://cpraedcourse.com/?version=v1ChildAbuseSeminarhttp://www.nysmandatedreporter.org/TBSkinTestIonaWellnessCenterlocatedat760NorthAvenuePPDprovided
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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicFingerprintingTheIonaCollegeCampusSafetyandSecuritydoesnothavethecapabilitytoperformdigitalfingerprintinginhouse.ThefingerprintingsystemapprovedbytheStateofNewYorkhasmovedtoadigitalformat(Livescan)andIwouldreferallstudentstoMorphoTrustthatneedtobefingerprinted.ThefollowinglinkdetailsalltheirlocationswithinNewYorkState.http://www.l1enrollment.com/locations/?st=nyThislistwillprovidestudentsanopportunitytohavethefingerprintingcompletedclosetotheirhomesoratseverallocationswithinWestchesterCounty.Thedirectionsforfingerprintingcanbefoundatthislink:http://www.highered.nysed.gov/tsei/ospra/
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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicConfirmationofClinicalPracticumHandbookI_______________________________(printname)confirmthatIhavereceivedtheIonaCollegeSpeech,Language&HearingClinicHandbookon___________________(date).IcertifythatIhavereadthedocumentedpoliciesandprocedureslistedinthehandbookandunderstandtheinformation.ThisdocumentmaybemodifiedatthediscretionoftheDepartmentofSpeechCommunicationStudiesIacknowledgethatIamresponsibleforthismaterialandwillcontinuetoreviewthehandbook_______________________________(signname)___________________(date).IunderstandthatitismyresponsibilitytocontacttheClinicDirectororaClinicalSupervisors’foranyadditionalinformation._______________________________(signname)___________________(date)________________________________________________________________StudentSignature,date
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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicSocialNetworkingPolicyI_______________________________(printname)usesocialnetworking(texting,Facebook,twitter,LinkedInetc).BysigningbelowcertifiesthatIwillNOTnametheIonaCollegeSpeech,Language&HearingClinicoroff-siteaffiliationsinmypersonalnetworkingcitesthatdeemstheclinic,clients,students,staffand/ordepartmentinanynegativecontext.IfIdopublishanyinformationthatrelatestoapracticumexperienceIamsubjecttofederalregulationsinviolationofHIPAAandConfidentialityPolicyandProcedures.Furthermore,IamatriskforviolatingtheASHACodeofEthicsandriskbeingexpelledfromtheSpeechCommunicationDepartment________________________________________________________________StudentSignature,date
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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicESSENTIALFUNCTIONSFORCLINICALPRACTICUMSTUDENTSINTHEIONACOLLEGESPEECH,LANGUAGEANDHEARINGCLINIC1.TheSpeech,LanguageandHearingClinicatIonaCollegeiscommittedtotheeducationofallqualifiedIonastudents,includingstudentswithdisabilitieswho,withorwithoutreasonableaccommodation,arecapableofperformingtheessentialfunctionsrequiredoftheprogram.ItisthepolicyofIonaCollegetocomplywiththeAmericanswithDisabilitiesAct,Section504oftheCivilRightsRestorationActof1973,and all state and local requirements regarding individuals with disabilities. Under these laws, nootherwisequalifiedandcompetentstudentwithadisabilityshallbedeniedaccesstoorparticipationinservices, programs, and activities solely on the basis of the disability. In accordance with federalregulations established by the Americans with Disabilities Act (ADA), the following standards aredescribedtoassisteachstudentinevaluatinghisorherprospectforacademicandclinicalsuccess.Whenastudent’sabilitytoperformiscompromised,thestudentmustdemonstratealternativemeansand/orabilitiestoperformtheessentialfunctionsdescribed.Sensory/ObservationalAbilitiesStudentsmustbe capableof acquiringadefined levelof required informationaspresented througheducationalexperiences inbothbasicartsandsciencesandclinicalsciences.Toachievetherequiredcompetencies intheclassroomsetting,studentsmustperceive,assimilate,and integrate informationfromavarietyofsources.Thesesourcesincludeoralpresentation,printedmaterial,visualmedia,andlive demonstrations. Consequently, students must have the potential to demonstrate adequatefunctionaluseofvisual, tactile,auditoryandothersensoryandperceptualmodalities toenablesuchobservations and information acquisition necessary for academic and clinical performance. Studentsmust have adequate sensory and observational abilities to recognize disorders of speech fluency;abnormal articulation; abnormal voice, resonance, and respiration characteristics; oral and writtenlanguagedisordersintheareasofsemantics,pragmatics,syntax,morphology,andphonology;signsofhearing disorders; signs of cognitive disorders; and signs of abnormal social interaction related tocommunicationdisorders. Inaddition, studentsneed tobeable tovisualizeanatomic structuresanddiscriminatefindingsonvarious imagingstudies,aswellastodiscriminatetext,numbers,tables,andgraphs associated with diagnostic instruments and tests. Furthermore, students should have thepotentialtodevelopsufficientsensory(visualandauditory)functionandmotorcoordinationtosafelyandaccuratelyassessandremediatepatientsusingtheequipmentandmaterialsoftheprofession.
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CommunicationAbilitiesEffective communication is critical for students to build relationships with faculty, advisors, fellowstudents, coworkers, clients, and their significant others in the student’s various roles of learner,colleague,consultant,andleader.Studentsmustbeabletogather,comprehend,utilizeanddisseminateinformation effectively, efficiently and according to professional standards. Students are required tocommunicateproficiently inbothoralandwrittenEnglish,ata levelsufficienttomeetcurricularandclinicaldemands.Studentsmustbeabletoelicitinformation,gatherinformation,anddescribefindingsverballyandinwritingandthiscommunicationshouldbecomprehensiblebypatients,professionals,andlaypersons. In accordance with a technical report developed by ASHA’s Joint Subcommittee of theExecutiveBoardonEnglishLanguageProficiency(seeStudentsandProfessionalsWhoSpeakEnglishwithAccents and Nonstandard Dialects: Issues and Recommendations available athttp://www.asha.org/policy/TR1998-00154.htm),studentsandprofessionals“whospeakanonstandarddialectorwhospeakwithanaccent”must,whenmodelingisnecessary,be“abletomodelthetargetphoneme,grammaticalfeature,orotheraspectofspeechandlanguagethatcharacterizestheclient'sparticularproblem.”Studentsmustbeabletocommunicateeffectivelyandsensitivelywithpatientsandcolleagues,includingindividualsfromdifferentculturalandsocialbackgrounds;thisincludes,butisnotlimitedto,theabilitytoestablishrapportwithpatients.Furthermore,studentsmusthavethepotentialto effectively communicate judgments and treatment information and to observe, recognize andunderstandnon-verbalbehavior.InaccordancewithaprofessionalissuesstatementdevelopedbyASHA(see Cultural Competence in Professional Service Delivery available athttp://www.asha.org/policy/PI2011-00326.htm),studentsandprofessionalsmustdemonstrate“culturalcompetence” to be able to deliver clinically competent services to individuals with communicationdisorders.MotorAbilitiesStudentsmust possess themotor functions needed tomanipulate testing and treatmentmaterials,manipulateequipment(suchasprostheses,devices,orbedcontrols),orprovidegeneralandemergencytreatmenttoclients.Themotorcapacitiesusuallyincludethephysicalstrengthandcoordinationtosafelyhandleandmoveclients;performgeneralandemergencyprocedures;ordirectclientsinvariouspracticesettings,accordingtotheneedsofprofessionalpracticeinspeech-languagepathology.Intellectual/CognitiveAbilitiesStudentsmust demonstrate critical thinking skills so that they can problem-solve creatively,masterabstract ideas, and synthesize informationpresented in academic, laboratory and fieldwork settings.Studentsmustbeabletocomprehend,retain,integrate,synthesize,andapplyinformationsufficienttomeetcurricularandclinicaldemands; identifyrelevantfindingsfromhistory,evaluation,anddatatoformulateadiagnosis,prognosis,andmanagementplan;andsolveproblems,reason,andmakesoundclinicaljudgmentsinpatientassessment,diagnosticplanning,andtherapeuticplanningconsistentwiththeprinciplesofevidence-basedpracticeinspeech-languagepathology. Insomeareas,thisrequirescomprehensionof three-dimensional relationshipsandunderstandingof the spatial relationshipsofstructures.Studentsmustdevelopandexhibitasenseofmedicalethics,andalsorecognizeandapplypertinentlegalandethicalstandards.BehavioralandSocialAbilitiesStudents must demonstrate emotional stability and di display mature, empathic, and effectiveinterpersonalrelationshipswithstudents,patients,andhealthcareworkers.Studentsmustbeableto
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toleratephysicallyandemotionallytaxingworkloadsandtofunctioneffectivelyunderstress.Theymustbeabletoadapttochangingenvironments,displayflexibility,andfunctioninthefaceoftheuncertaintiesinherentintheclinicalsetting.Studentsmustexhibittheabilityandcommitmenttoworkwithindividualsinanintensesettingtomeettheneedsofpeopleofdiversecultures,agegroups,socioeconomicgroupsandchallengeswithoutbias.Theseindividualsmaybeseverelyinjured;theymaybelimitedbycognitive,emotionalandfunctionaldeficits;andtheirbehaviormaycreateattimesanaversivereaction.Theabilitytointeractwiththeseindividualswithoutbeingjudgmentalorprejudicediscriticalinestablishingone’sprofessionalism and therapeutic relationship. Students must be able to manage the use of timeeffectively and systematize actions to completeprofessional and technical taskswithin realistic timeconstraints.Studentsmustalsobeabletoacceptappropriatesuggestionsandconstructivecriticismand,if necessary, respond by modification of behavior. Compassion, integrity, concern for others,interpersonalskills, interestandmotivationareallpersonalqualitiesthatarecritical tocompletetheprofessionalprograminspeech-languagepathology.ProfessionalResponsibilityStudentsmusthavethecapacitytomeetthechallengesofanymedicalsituationthatrequiresareadinessforimmediateandappropriateresponsewithoutinterferenceofpersonalormedicalproblems.Thismayrequireancillarytraining(e.g.,CPR,firstaid,infectioncontrol,evacuationprocedures).Itiseachstudent’sresponsibilitytoattendandbeabletotraveltoandfromclassesandclinicalassignmentsontime,andpossess the organizational skills and stamina for performing required tasks and assignments withinallottedtimeframes.Thisinvolvesfrequentoral,written,andpracticalexaminationsordemonstrations.Thestudentmusthavetheabilitytoperformproblem-solvingtasksinatimelymanner.Studentsmustexhibit adherence to policies of the College, their program, and clinical sites. This includesmattersrangingfromprofessionaldressandbehavior,toattendingtotheirprogram’sacademicschedule,whichmaydiffer from theCollege’s academic calendar andbe subject to changeat any time.During theiracademictenure,studentsmustlearnanddemonstrateknowledgeofandcommitmenttothecodeofethicsoftheirprofessionandbehaviorthatreflectsasenseofrightandwronginthecontextofcare.Students are expected to take initiative to direct their own learning. They are required to workcooperativelyandcollaborativelywithotherstudentsonassignedprojects,andparticipatewillinglyinasupervisoryprocessinvolvingevaluationofabilitiesandreasoningskills.AsstudentsintheM.A.programwith a concentration in Speech-LanguagePathology, they accept and complywith theDepartment’smission in that they strive to become clinicianswho “utilize evidence-based practice; adhere to thehighestpersonalandprofessionalethicalstandards;employcriticalthinkingandselfanalysis;recognizethevalueofadvancedandcontinuingeducation;demonstrateempathy,altruism,andaccountabilityintheirclinicalpractice;andaspiretoprovideexceptionalqualityofserviceforadiversityofpersonsofallageswithcommunication,swallowing,andbalancedisordersinanequitableandinclusivemanner.”NOTES:
• IonaCollegeisanEqualOpportunity/AffirmativeActionInstitutionandiscommittedtosocialjustice.TheCommunication Sciences and Disorders Program fully supports that commitment and expects tomaintainapositiveclinicalandlearningenvironmentbaseduponopencommunication,mutualrespect,andnondiscrimination.Ourfacilitydoesnotdiscriminateonthebasisofrace,sex,age,disability,veteranstatus,religion,sexualorientation,color,ornationalorigin.TheIonaCollegecommunityiscommittedtocreating and fostering a positive learning andworking environment based on open communication,mutualrespect,andinclusion.
• Studentswithadisabilitywhoanticipatetheneedforanytypeofaccommodationinordertoparticipate
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in class or clinic are encouraged tomake appropriate arrangements with the Director of AcademicSupport(914-633-2226).
• StudentswhoarereturningtotheCSDprogramafteramedicalissue/leave,mustcontacttheAssistantDean for Student Academic Services (914-633-2207) and provide medical documentation andnotificationofanydisabilitiesand/oraccommodationsrequired.
• FormoreinformationonIonaCollege’sPolicyonAccommodationsforStudentswithDisabilities,pleaseseetheOfficeoftheOmbudspersonpageontheIonaCollegewebsiteathttp://www.iona.edu/About/Administrative-Offices-Departments/Office-of-the-Ombudsperson.aspx1.ThematerialinthissectiononEssentialFunctionshasbeenadaptedfrom:AmericanSpeech-Language-HearingAssociation.(1998).StudentsandprofessionalswhospeakEnglishwithaccentsandnonstandarddialects:Issuesandrecommendations[TechnicalReport].Availablefromwww.asha.org/policy.AmericanSpeech-Language-HearingAssociation.(2011).Culturalcompetenceinprofessionalservicedelivery[ProfessionalIssuesStatement].Availablefromwww.asha.org/policy.Hayes,L.,etal.(2005).Essentialfunctionschecklist.CommunicationSciencesandDisorders,CollegeofHealthProfessions,MedicalUniversityofSouthCarolina,Charleston,SC.Katz,J.R.,Woods,S.L.,Cameron,C.A.,&Milam,S.(2004).Essentialqualificationsfornursingstudents.NursingOutlook,52,277-288.SetonHallUniversity(2011).Standardsforessentialfunctions.Speech-LanguagePathology,SchoolofHealthandMedicalSciences,SouthOrange,NJ.Availableathttp://www.shu.edu/academics/gradmeded/ms-speech-language-pathology/upload/SLP_Essential_Functions.pdfWestVirginiaUniversity(2011).EssentialFunctionsforStudentsintheM.S.PrograminSpeech-LanguagePathology.Morganotwn,WV.Availableathttp://csd.wvu.edu/r/download/148819.
EssentialFunctionsI_______________________________(printname)havereceivedandreviewedtheEssentialFunctionsfortheIonaCollegeSpeech,LanguageandHearingClinic.MysignaturebelowindicatesthatIunderstandtheinformationandthatIamabletoperformallabilitiesdescribed.________________________________________________________________StudentSignature,date
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ClinicalObservationVerificationThisistoverifythat(studentname)____________________________hascompleted___________hoursofclinicalobservationwithintheASHAScopeofPracticeofSpeechLanguagePathologywithintheASHA2014Standards.IhavepersonallyverifiedthateachobservationsupervisorisstatelicensedandholdscurrentlytheCertificateofClinicalCompetencefromtheAmericanSpeech-LanguageandHearingAssociationatthetimeofthestudent’sobservation.ClinicalInstructor:________________________ Faculty: _______________________Signature:________________________ Signature:______________________Date:________________________ Date:______________________ASHA#:________________________ ASHA#:______________________STATE,LICENSE#________________________ STATE,LICENSE#_____________________
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAll student clinicians are strongly encouraged to be members of the National Student Speech LanguageHearing Association. http://www.asha.org/Members/NSSLHA/Pre-Professional-Guidelines/. Please reviewthefollowingguidelinessetforth.ProfessionalGuidelinesoftheNationalStudentSpeech-Language-HearingAssociationPreambleAcademic institutions exist for the transmission of knowledge, the pursuit of truth, the personal andprofessionaldevelopmentofstudents,andthegeneralwellbeingofsociety.Freeinquiryandfreeexpressionareindispensabletotheattainmentofthesegoals.Asmembersoftheacademiccommunity,studentsshouldbeencouragedtodevelopthecapacityforcriticaljudgmentandtoengageinasustainedandindependentsearchfortruth,whileconductingthemselvesinaprofessionalmanner. Freedomtoteachandfreedomtolearnareinseparablefacetsofacademicfreedom.Thefreedomtolearndependsuponappropriateopportunitiesandconditionsintheclassroom,onthecampus,inclinicalfacilities,andinthelargercommunity.Studentsshouldexercisetheirfreedomwithresponsibility.Theresponsibilitytosecureandtorespectgeneralconditionsconducivetothefreedomtolearnissharedbyallmembersof theacademic community. Each collegeanduniversityhas aduty todeveloppolicies andprocedures,whichprovideandsafeguardthisfreedom.Suchpoliciesandproceduresshouldbedevelopedateachinstitutionwithintheframeworkofgeneralguidelinesandwiththebroadestpossibleparticipationofthemembersoftheacademiccommunity.ThepurposeofthisstatementistoenumeratetheprofessionalguidelinesbywhichstudentsbeingeducatedinSpeechLanguagePathologyandAudiologyshouldabide.GuidelineIStudentsshallholdparamountthewelfareofpersonsservedduringclinicalpracticum.A. Students shall adhere to the clinical guidelines establishedby the clinical supervisor and/or educationprogram,consistentwiththestandardsoftheAmericanSpeechLanguageHearingAssociation.B. Students shall seek approval from their clinical supervisor before implementing any aspect of clientmanagement/service.C.Studentsshallidentifythemselvesasstudentcliniciansorinternsthroughouttheirclinicalpracticumexperience.D.Studentsshalluseeveryresourceavailabletoprovidethebestpossiblelearningexperience/service.
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E.Studentsshallfullyinformsubjectsparticipatinginresearchorteachingactivitiesofthenatureandpossibleeffectsoftheseactivities.F.Studentsshalltakeallreasonableprecautionstoavoidinjurytopersonsinthedeliveryofprofessionalservices.G.Studentsshallevaluateservicesrenderedtodetermineeffectiveness.H.Studentsshallabidebylocal/stateregulationstoacceptorrefuseremunerationforspeechlanguageandhearingclinicalservicesconsistentwithpoliciesoftheASHACouncilonProfessionalStandards.Proscriptions
1. Studentsmustnotexploitpersonsinthedeliveryofclinicalservicesandmustnothesitatetorecommendthedismissalofpersonsfromtreatmentwherebenefitcannotreasonablybeexpectedorwherecontinuingtreatmentwouldbeunnecessary.
2. Studentsmustnotguaranteetheresultsofanytherapeuticprocedures,directlyorbyimplication.Areasonablestatementofprognosismaybemadebutonlyifsuchinformationisapprovedbythesupervisor.Cautionmustbeexercisednottomisleadpersonsservedtoexpectresultsthatcannotbepredictedfromsoundevidence.
3. Studentsmustnotusepersonsforlearningexperiencesinamannerthatconstitutesinvasionofprivacyorfailstoaffordinformedfreechoicetoparticipate.
4. Studentsmustnotevaluateortreatcommunicativedisordersoradministerdiagnosticclinicalservicesexceptunder"direct"supervisionofaqualifiedpersonasexplainedinthedocumentsentitled"RequirementsfortheCertificatesofClinicalCompetence"publishedbytheAmericanSpeechLanguageHearingAssociation.
5. Studentsmustnotrevealtounauthorizedpersonsanyclinicalorpersonalinformationobtainedfromindividualsservedbystudentclinicians.
6. Studentsmustnotdiscriminateinthedeliveryofclinicalservicesonthebasisofrace,sex,age,orreligionnationalorigin,disability,orsexualorientation.GuidelineIIStudentsshallmaintainhighstandardsofprofessionalcompetence.A.Studentsparticipatinginaclinicalpracticumexperienceshallpossessrequisiteacademicand/orclinicalqualificationsspecifiedbytheeducationprogram.B.Studentsshallcontinuetheirprofessionaldevelopmentthroughouttheircareersbymaintainingastateoftheartknowledgeofprofessionalpublishedmaterialandattendanceatprofessionalcontinuingeducationcourses.C.Studentsshallmaintainadequaterecordsofclinicalservicesrendered.
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D.Studentsshallmakedecisionsconcerningpersonsreceivingclinicalservicesonthebasisofobjectivedata.E.Studentsshallpresentproductstheyhavedevelopedtotheirprofessionalcolleaguesinamannerconsistentwithhighestprofessionalstandards.Proscriptions1.Studentsmustnotreferanypersonsinneedofclinicalservicestopersonsorprofessionalswhoarenotqualified.2.Studentsmustnotparticipateinactivities,whichmightinitiatedisparagingcommentsaboutspeechlanguagehearingservices,personnel,and/orcolleagues.GuidelinesIIIStudents'statementstopersonsservedandtothepublicshallprovideaccurateinformationaboutthenatureandmanagementofspeechlanguageandhearingdisorders,andabouttheprofessionsandservicesrenderedbyitspractitioners.Proscriptions1.Studentsmustnotmisrepresenttheireducationorcompetence.2. Students' public statements providing information about professional services and productsmust notcontainrepresentationsorclaimsthatarefalse,deceptive,ormisleading.3. Studentsmust not use professional or commercial affiliations in anyway thatwouldmislead or limitservicestopersonsserved.GuidelineIVStudents shallhonor their responsibilities to theirprofessionsand their relationshipswithcolleaguesandmembersofalliedprofessions.A. Students shall strive to assist in maintaining and expanding high professional standards for theireducationalprogram.B.Studentsshallstrivetoincreaseknowledgewithintheprofessionbyconductingresearch.C.Studentsshallseekcreditforprofessionalpublicationswhentheircontributionswarrantit.D.Studentsshallestablishprofessionalrelationswithstudentcolleaguesandmembersofrelatedprofessions.GuidelineVStudentsshallupholdthedignityoftheprofessionsandaccepttheprofessions'selfimposedstandards.A.Studentsshallinformeducationprogramdirectorsofviolationsoftheseprofessionalguidelines.
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B.Studentsshallcooperatewithaprogramdirector'sorothereducationalcommittees'inquiriesintomattersofprofessional conduct related to these professional guidelines and shall follow established university/collegegrievanceproceduresincludingdueprocessprocessesifnecessarytoalleviatethegrievance.
DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicApplicationsCSDGraduateCandidatesStudentName: Date: Schoole-mail: Alt.e-mail: Homephone: Mobilephone: Applicationfor(pleasecheck):□CSD610(Year:_____)□CSD6111(Year:_____)□CSD612(Year:_____) Briefdescriptionofclinicalexperiencetodate:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________PracticumCoursesClass Semester TXHours DXHours Diagnosis/
BackgroundAge
CSD610 CSD611 CSD612
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StudentName: Date: Studentaddress(attimeofoff-siteplacement): ________________________AreyouabletocommunicateinalanguageotherthanEnglish(includingASL)?Ifso,indicatelanguage(s)andlevelofproficiency: ____________ Doyouholdadegree,certificate,orhavetraining/workexperienceinanotherfield?Ifso,pleasedescribe: Whatareyourgoalsforthesemester?(Goalsmayreflectclinicalskillsyou’dliketoimprove,trainingorexperienceyou’dliketohave,orotherareas): Documentneedsforanyrequiredareasand/orexperiences Otherfactorstobeconsidered: ExpectedDateofGraduation: _____________________________Totalnumberofclinicalhourstodate: _____________________________
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StudentSignature Date
SpeechCommunicationStudiesDepartmentIonaCollegeSpeechLanguageHearingClinicUndergraduateApplicationforOn-SiteClinicalRotation StudentName
ExpectedDateofGraduation
CurrentGPA Advisor
Fall2012UndergraduateMajors:PrerequisitesrequiredtoregisterforSCS419SCS420
Class Grade
SCS361 SCS362 SCS418
Provideastatementofinterestwhyyouwouldliketoparticipateinclinic: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________
______________________________________________
StudentSignature,Date
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ClinicalDescription
Prospectivestudentsinterestedinapplyingforanon-siteundergraduateclinicalpracticumwillmeetthefollowingrequirements: ApprovalRequirements
GPARequirement 3.2 RecommendationLetter Favorable
Letter
ClinicalFacultyInterview FavorableInterview
ClinicalPoliciesandProcedures
Studentsapplyingforclinicalpracticummustsubmitthefollowing:applicationandletterofrecommendation.Policyonrecommendationletter:maybecompletedbyfacultyfromanydepartmentoremployer.Letterstodocumentcontactinformationandrelationshiptotheprospectivestudent.Familymembersarenotpermittedtowriteletters.CompleteddocumentstobesubmittedbyMay1foraFallClinicExperienceorbyNovember30thforaSpringClinicExperiencetoMariaArmiento-DeMaria,MA,CCC-SLPClinicalFacultyInterviewswilltakeplaceduringFinalsWeek.Decisionswillbesentviaemail.ProspectivestudentsapprovedMUSTcomplete2semestersofclinicalpracticumunlessnotedbytheChairPersonorClinicDirector.Allstudentsparticipatingon-siteattheIonaCollegeSpeech,Language&HearingClinicwillhaveaminimalmandatorycaseload:2individualclientsOR1individualclientand1Group.CaseloadaccommodationrequestsmustbemadeinwritingandapprovedbyClinicDirectororAsst.ClinicalDirector.Thefollowingrequirementsaremandatedto2weekspriortoaclinicstartdate:
DateCompleted
25hoursofClinicalObservation ChildAbuseSeminar FingerprintingReceipt(ifapplicable) ProofofLiabilityInsurance(MustbeamembertoNSSLHA) ProofofVaccinations:rubella,mumps,hepatitisB Tuberculinskintest(PPD) CPRCertification $55.00ClinicFee $30.00HandbookFee HandbookReviewAgreement SocialNetworkingPolicy
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProceduralSafeguardsStandardPrecautionsThepurposeofthispolicyistoreducetheriskofoccupationalexposuretothoseinvolvedintheSpeech,Language&HearingClinic.Thisprocedureisdesignedtominimizeanyriskfortransmissionofanycommunicablediseases;cytomegalovirus(CMV),hepatitisB(HBV),herpessimples,tuberculosis,influenza,andacquiredimmunedeficiencysyndrome(AIDS).Themainpotentialhazardisthroughsaliva;however,therearefewreportsoftheseoccurrences.Thefollowingprecautionsaretobeobserved:1.Bloodorotherbodyfluidsfromallclientsshouldbeconsideredinfected.2.Humanbitesarecharacterizedasanincreasedriskforinfection.3.Disposableglovesshouldbewornwhentheclinicianismeetingtheclient’sfaceormouth.4.Removeglovesbypeelingthemofffromthewristandturntheglovesinsideout.5.Handsshouldbewashedimmediatelyafterglovesareremoved.6.Disinfectalltabletopsafterseeingtheclient.7.Tonguedepressors,gloves,orotheritemsplacedinthemouthshouldbeplacedinthegarbage.Resourceshttp://www.asha.org/slp/infectioncontrol/
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProceduralSafeguardsHandHygiene
ThistechniqueistobeutilizedbyEVERYclinicianbeforeandafterEVERYclientcontact.
§ Turnonthefaucet§ Usecontinuousrunningwater§ Wethands.§ Useliquidsoaptolatherhands,wristsandforearms.§ Rubhandsvigorouslyfor60secondswithsoapywater.§ Rinsethoroughly,allowingwatertodrainfromfingertipstoforearms.§ Usepapertowelstodryhands.§ Turnofffaucetswithdrypapertowelsafterdryinghands.
Protocol:
§ Beforebeginningwork§ Beforeandaftereating§ Afterusingthebathroom§ Afterblowingtheirnoseorcoughing§ Aftereachpatientcontact§ Beforeandafterremovinggloves
HandSanitizersarealsoavailable.FollowthesameprotocolastheHandWashingTechniqueResourceshttp://www.asha.org/slp/infectioncontrol/https://www.cdc.gov/handwashing/when-how-handwashing.html
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProceduralSafeguardsInfectionControlTherapyRooms
§ Alltherapyroomsshouldbeequippedwithcleaningproducts,garbagecan,andtissues.IfthisisnotthecasepleasereportthistotheAdministrativeAssistantorSupervisor.
§ Therapyroomsshouldbedisinfectedbyawipe.Thisincludesanyhardsurfacesuchasthetable,chairarmsandbacks,anddoorknobsaftereachsession.
§ Ifanyclientneedsassistancetouseatissueuseglovestoassist.§ Bathroom/Diaperchangingistheresponsibilityofthefamily/caregiver.Bringtheclientwithyouto
notifythefamilymemberiftheclientisreporting/indicatingNEEDStousetherestroomClinicMaterials
§ Alltoysand/orobjectsshouldbecleanedwithadisinfectantwipeimmediatelyaftereachsession.
SANITIZINGCLINICMATERIALGUIDELINES
§ AllclinicmaterialsusedintreatmentaretobesanitizedBEFOREandAFTERsessions.
§ Sanitizingwipesareavailableineachtreatmentroom.
§ Priortosessions,pleaseadheretothefollowing:
1. Wipematerialswithwipes(thisincludestoysandfoammatsifusing)2. Washhandswithsoapandwater.Haveantibacterialhandsanitizeravailableonahigh
shelfintreatmentroomforusethroughoutsessionwhensoapandwaterisnotavailable.
3. Ifyouneedtoleavetreatmentroomforanyreasonwithyourclient(orhaveanactivityplannedforoutsidethetreatmentroom),usehandsanitizeruponyourreturntotreatmentroom.
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4. Ifforanyreasonyourclientbecomesphysicallyillintreatmentroom,orincommonareas(hallway,etc)–pleasealertclinicstaffsothatfacilitiesmaybecontactedtoaddresstheissue.Donglovesandsanitizeallitemsmaterialsclientcameincontactwith–toys/materials;table,chairs.
§ Washhandswithsoapandwaterattheconclusionofyoursession.
***********Aseparatebleachingschedulewillbeprovidedforteamsofstudentsatmidtermandfinaltosignupformaintainingmaterials(Fall,Spring,andSummersemesters).
ProtocolforBleachingMaterials
§ Materialsaretobeplacedinbucketwitha10:1ratioofbleachtowater(thatistosay¼to¾cupbleachpergallonofwater)
§ Itemsshouldbeplacedinawellventilatedspaceonamatorcoveredtabletoairdry
§ Studentcliniciansshouldusegloveswhenengaginginbleachingofmaterials.
OralMotorExaminations/Treatment
§ Handsshouldbepreandpostexam§ NON-LATEXGlovestobeused§ Placetoolsonacleanpapertowel:Penlights,disposablegloves,tonguedepressors,stopwatch,
whistles,ANDSTRAWSetc.§ Disposeofanyitemsnon-permanentitemsinaredplasticbagtobethrownaway.§ Wipeallpermanentitemswithdisinfectantwipes.
Resourceshttp://www.asha.org/slp/infectioncontrol/
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProceduralSafeguardsSafetyProceduresEmergencyExitsFrontEntranceoftheClinicEmergencyDoorLocatedtotherightofthesmallobservationroomEmergencyDoorLocatedinthekitchenetteareaIncasesofemergencies,theclinicalpracticumstudentsshouldfollowtheprocedureslisted:EvacuationActivationofafirealarm/carbonmonoxidealarmand/orlossofelectricalpower,studentcliniciansshouldremovethemselvesandtheirclientsquietlyandquicklyoutofthebuildingusingthenearestexit.Therapyroomdoorsshouldbeclosed.Walkcalmlyandinanorderlyfashion.ThestudentclinicianisrequiredtoleadtheirclienttothefrontentranceoftheSpeech,Language&HearingClinic.Allstudentsarerequiredtostaywiththeirclients.TheClinicalSupervisorwillmeetthestudentsandclientsatthedesignatedarea.AccidentsIntheeventofamajorinjuryoraccident,call911immediately.Intheeventofaminorinjury,afirstaidkitisavailableintheSpeech,Language&HearingClinic.Ifastudentclinicianand/oraclientbecomesillorhasanaccident,notifytheClinicalSupervisorandtheSecurity,immediately.Forallsituations,anincidentreportwillbecompletedbyIonaCollegeSecurityonsiteatthetimeoftheincident.
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ImportantPhoneNumbersNewRochellePoliceDepartmentEmergencies:911Fornon-emergencies:(914)654-2300DepartmentofCampusSafetyandSecurityRobertV.LaPentaStudentUnionPhone:(914)633-2245CampusSafetyAnnex(SpellmanHall)Staffed24-hoursPhone:(914)633-2560Itisimportanttonoteforanystudent,staffand/orclientthatwishestoreceivetransportationbacktothemaincampuscancontactsecurity
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Faculty
GroupTherapy3 Observation Audiology
Room118 116 Group
Therapy GroupTherapy2
GroupTherapy
Suite3 Suite 114
117 2
Emergency
Exit Closet 113
134 121
Restroom
Kitchen/Prep 119
Group GroupTherapy1
Restroom Therapy 112
120 Suite
1
111
EmergencyExit133 Faculty
Therapy
110
ObeservationLab StudentStudy
122 Therapy9 106
109
Closet
123
Therapy6
Therapy
7 Therapy8
125 124 108
Office1
126
Therapy
1
132
Tele/Data Copy/Print Conference
Therapy
2 107 104 Room
131 103 105
Office2
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments
ClinicalAssignmentswillbeINDIVIDUALIZEDforeachpracticumstudent.Studentcliniciansmayparticipateinoneofthefollowingclinicalactivities.Possibleassignmentsincludebutnotlimitedto:
§ ClinicalObservationsProtocol§ IndividualServiceCaseloadAssignment§ GroupServiceCaseload
ClinicalObservationsClinicalObservations:StudentcliniciansassignedtoONLYclinicalobservationswilldeveloptheirclinicalknowledgeandskillsbyobservingprofessionalmembersofASHA.StudentswillfollowpolicyandprocedureoutlinedintheObservationHandbook.Aclinicalsupervisorwillbeassignedtothosestudentstransitioningtotheon-siteclinic.Thisassignmentwillhelpthestudentacclimateintoaclinicenvironmentasastudentclinician.IndividualServicesIndividualServices:Studentclinicianswillberequiredtoparticipateinweeklyclassinstruction(Undergraduatestudents52minutesweekly,CSDstudents2hoursweekly)forclinicalservicedevelopmentincludingplanning,documentation,andevaluatingclinicalskills.AdditionalstudentswillalsoscheduleofficehourmeetingwiththeirprimarySLP’s.UndergraduateandCSDstudentswhodonothaveclinicalpracticumexperiencewillparticipateinagrouporindividualmeetingswiththeirprimarySLPtoprepareforastudentpracticumrotationstart.GroupServicesGroupServices:Studentcliniciansparticipatewithapeer(s)androtateastheleadclinician.TeammeetingswillbescheduledasdirectedbytheprimarySLP.
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:Preparation
Preparationpriortothestartofclinic:
§ ReviewClinicHandbook§ StudentswillreceiveconfirmationofclientscheduleviaemailfromtheAdministrativeAssistant§ Theclinicalstudentisresponsibleforcontactingtheclientand/orclientfamilytoconfirmschedule
andstartdate.PhoneCallPolicy:StudentsarerequiredtoconductphonecallsintheclinicONLY.Studentsarenotabletosharetheirpersonalphone/contactnumberwiththefamily.Studentsshouldemailthefamilytoscheduleaphonemeeting.ThisphonemeetingmustbeconductedintheclinicONLY
§ Atthetimeoftheinitialphonecallcompletethefollowing:§ Studentsshouldintroducethemselves§ Confirmthesessiondateandtherapyschedulefortheupcomingsemester§ Conductaninformalinterviewonly(duetoHIPAAregulations)andaskthefamilycontactwhatthe
goaloftherapyis.
Providetheclientwiththefollowingofficenumber(s):(914)712-1990or(914)712-1991Thefamiliesshouldbecontactingtheoffice(notthestudentclinician)oremail.Studentsshouldreviewinformationanddevelopknowledgeandskillsofthecommunicationdisorder/delaythatyouareassignedto.Todeveloptherapyservicesanddeterminebaseline,onemusthaveagoodunderstandingofthedisorderordelay.Studentsshouldhaveallpaperwork(i.e.lessonplans,observationforms)necessaryforclinicorganizedandpreparedforsessionclientchart
Ifyouareworkingwithareturningclient.CompleteaChartReview:
§ Client’sname,address,telephone,dateofbirth,chronologicalage,dateoflastspeech-languageevaluation,previoustherapydate
§ Diagnosis§ PertinentBackgroundinformation,medicalhistory,familyhistory,developmentalmilestones,
educationalinformation,social/employmenthistory,education/cognitivelevel,medication§ SummaryofPreviousTherapyandothertreatmentprograms§ Reviewpastvideosessions
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§ Developquestionsforclinicalsupervisor
Ifyouareworkingwithanewclientstudentneedstodevelopknowledgeperthebackgroundprovidedbyclient.Forexample,reviewdevelopmentalnorms,signsandsymptomsofadisorderordelay,expectedageranges,playskills.PhoneCallScenarioCallyourclient:Introduceyourselfandconfirmthesessionschedulefortheupcomingsemester.Thisisalsothetime,toconductan“informalinterview”.Inquiretothecaregiverortheclientwhattheirspecificspeech&languageconcernsare,ifanyprogressorregressionhasbeennoticed,andwhatwouldliketobeworkedonforthesemester.ChildclientscenarioMynameisMariaandIamgoingtobethestudentclinicianfor“Jane”.WearescheduledonTuesdaysandThursdaysfrom3:30to4:00.IfyouhaveafewminutesIwouldliketoaskyousomequestionsabout“Jane”.WhatareyourconcernsforJane’sspeech?HowhasJanedoneoverthesummer?Whatareaswouldyouliketoworkonthissemester?CanyousharewithmeanyspecificlikesthatJanemayhave?AdultclientscenarioMynameisMariaandIamgoingtobethestudentclinicianfor“John”.WearescheduledonTuesdaysandThursdaysfrom3:30to4:00.IfyouhaveafewminutesIwouldliketoaskyou(iftheclientcanadvocateforhimorherself)orthecaregiver(whowillbetheprimarycontactperson)afewquestions.Whatareyourgoalsfortheupcomingsemester?Whatareaswouldyouliketoworkonthissemester?HelpfulQuestionsduringphonecontact:
§ Howwouldyoudescribethespeechorlanguageproblem?§ Hastheclientmadeimprovementsintheirskills?§ Whatactivitieshaveworkedforcarryoverinthehome?§ Hastherebeenanychangesinthehomeorschoolinthepast3months?§ Howistheclient’shealth?Anychanges?§ Whatismotivatingfortheclient?§ Whatareyourgoalsfortheupcomingsemester?§ AllcallsarerequiredtobeloggedontheClientContactSheet
Requirement:EachtimeyouattempttocalltocontactaclientfamilythismustbeloggedontheClientContactSheetwithabriefdescription.SeeExampleBelow
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SchoolofArtsandSciencesDepartmentofSpeechCommunicationStudiesIonaCollegeSpeech,Language&HearingClinicClientContactForm
ClientName DOB MorF Guardian/ContactPerson
Address City,State,ZipCode PhoneNumber CellPhone EmailAddress
DateCorrespondence/InformationDisclosed/CommentsInitials
1/12/17 SpoketoMrs.Snowat9:00amtoconfirmtheclinicschedule
MA-D
3/15/17 Voicemailwasprovidedat11:15tocancelthesessionduetosnowclosure
MA-D
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:BaselineData
PlanningpriortoyourfirstsessionBASELINEDATAmustbedevelopedtoidentifyareaofneedsandjustifyspecifictherapytargets.
§ Baselinedataiscollectedduringthefirsttwoinitialsessions:confirmwithinstructorand/orimmediatesupervisor
§ CompileadatacollectionstrategyRESEARCH
§ Preliminaryspeechandlanguagediagnosisforasolidknowledgebaseofthepreliminarycommunicationdisorderand/ordelay
§ TypesoftherapyplanningCREATE
§ Behaviormanagementstrategy§ “ToDoList”foreachtherapysession
DocumentationPreparationTheLessonPlanforthescheduledsessionmustbeupdatedinMedicatpriortoyourscheduledsession(LessonPlanduedateswillbeannounced).YourimmediateSLPSupervisormayrequireaspecifictimedateforreviewandchangesrequiredaccordingly.SessionClientChartsMustbepreparedpriortoeachsession.SeeClinicFormAppendixtoreviewthemostuptodatecriteria
LessonPlans:PriortoeachsessionthelessonplanmustbeuploadedintoMedicatwithallheadingdocumentedpriortothescheduledsession.
Itisimportanttonote:
§ EachsessionMUSTbeaccountedfor-cancelledsessionsbyclientorstudent,schoolclosingsandholidays
§ LessonplansarerequiredforALLsessions.Therearenoexceptions
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AlldocumentationMUSTbecompletedattheIonaCollegeSpeech,Language&HearingClinicviaMedicat
IfthereisanunforeseencircumstancewiththeEMRsystemthatdoesnotallowtheusertologon,thestudentclinicianMUST
§ InformprimarySLPofthecase§ Pertinentdocumentsmustbecompletedinahardformat(handwrite)§ BlueInkmustbeused§ FiledocumentsintheClientSessionChart§ UploadpertinentdocumentsintoEMRsystemafterEMRsystemisrestored.
DURINGTHESESSIONTheSessionClientChartisexpectedtobecompletedwithalldocumentationforSLP’stoprovideappropriatefeedbackofthesession.DATATRACKINGDURINGSESSIONTotrackprogress,datamustbecompletedforeachsession.Datatrackingisarequirement.Studentcliniciansmayusedatachartsfromtheirtextbookand/ornarrativenotebookstyletocollectdata.Datatrackingisnotpermittedonanypersonaldevicesorlaptopsinthetherapyrooms.AlldatacollectionformsMUSTbefiledundertheSupervisorFeedbackFormafterthesessioniscomplete.ScanningDocumentsIfdeemedappropriateandapprovedsuchas
§ DocumentsthattheclientfamiliesdonotsubmitviaMedicatClientPortal§ Documentsrelatedtoclinicsession(ifEMRsystemisdown)
Studentswillberequiredtodothefollowing:
§ ReceivewrittenpermissionfromSLPtoscananduploaddocuments-MediaSpecialistmustbecopiedonthisinorderforameetingtobescheduled.
§ SetupameetingwiththeMediaSpecialisttocompletethescanninganduploadingprocess§ RouteinMedicatthedocumentsthatwerescannedtoyourSLP§ EmailyourSLPthatthishasbeencompletedsotheSLPcansign/lockthedocument
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:TreatmentSessionsStudentCliniciansuseguidelinesbelowtosupportsessionpreparationandself-evaluationasaclinicalstudent.
FrameworkforTreatmentSessionsSelfEvaluationforStudentSessions
OrganizationMaterialsOrganizedUnderstandhowtousethematerialsCreateActivityMapCreateaTo-DoListBehaviorManagementPlanDevelopedRoomSetup
Wasthereenoughmaterials?WasIconfidentwiththematerials?Didtheclientunderstandtheproceduresofthesession
TimeAppropriatestart&endtimeConsistentpaceforclient’sneedsMaintainingtopicandtask
Wasanytimewastedduringthesession?Wasthepaceappropriatefortheclient?DoIneedtochangethepaceofpresentation?DidIstayontaskDidtheclientstayontaskWhatwasdonefortransitionDidIprovideampleopportunitiesformyclienttorespond?
PresentationClient/GuardianispartofthetherapyplanningProvidecleardirectionsModelingofexpectedresponsesAgeappropriatematerialsTypeofreinforcementSessionClosure
Isthebehaviormanagementplansuccessful?Wasthereinforcementspecific?WerethematerialsIused&languageageappropriatefortheclient?DidIprovidespecificinformationfortheimportanceofactivities?HowdidImodelthepreferredresponses?HowdidIclosethesession
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ClientSpecific
ActivitiesrelatedtotheclientsdailyinterestActivitieschallengingfortheclient
DidIrelatetotheclientasapersonalaswell?DidIresearchtheclientsculturalbackgroundDidIgivehomeworktoincludethefamilysupport
Environment&ManagementRapportestablishedSupportclientRe-DirectedClient
DoIhaveapositiverapportwiththeclient&family?DidIgivetheclientenoughtimetorespond?DidItalktoomuch?Wasmyclientinterestedintheactivities?WhatdidIdotoredirectclientwhenofftask?
HOMEWORKAllclientsshouldhaveaHomeworkFolder.ThepurposeofaHomeworkFolderistoprovidethefamilyand/orcaregiverthenecessarytoolstocarryovertechniquesusedfromthesessions.Thisalsosupportsdocumentationofprogress,servicequality,andcarryoveroutsideoftheclinicsetting.Attheendofeachsemester,studentcliniciansshouldbeprovidingacarryoverhomepackettosupportskillsthathavebeenlearned.SUBMISSIONOFDOCUMENTATIONAFTERTHESESSIONTheDailyProgressNote(SOAPNote)mustbecompletedtodocumentthesessionconducted.TheProgressNote(SOAPNOTE)mustbecompletedthesamedaybythecloseofclinic.Theorderofsubmissionforeachsessionincludeslessonplan,SOAPnoteanddatasheet.ToorganizesubmissionofSOAPnotes,reviewsandrewrites.ClinicalStudentsarerequiredtocompletetheSOAPNOTEROUTINGREPORT.Thisformshouldbeplacedonlefthandsidetosupportnotereviews.
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Processofsessionnote/SOAPnotereviewsLessonplanswillbeviewedbytheprimarySLPonthedayofthesession.PleaseseeyourprimarySLPforalternativesubmissionrequirementsifneeded.TheSLPwillreviewthelessonplanatthetimeofthesession.SOAPnoteswillbereviewedbasedontheprimarySLP’sscheduleAllrewritesrequireameetingwiththeprimarySLPClinicalMeetingswiththeprimarySLPwillincludebenotlimitedto:
§ Re-writealessonplan,discusstherapyplanning,supportwrittendocumentationforknowledgeandskilldevelopment.
§ Areasofneedisspecifictoeachstudent§ Ameetingisrequiredtoreviewtheneedsoftherewrite.StudentsareREQUIREDto
setupameetingwiththeprimarySLPassoonaspossible.Thelongerastudentwaitstoscheduleameetingafuturerewritescanaccumulateandaclientchartisnotcurrent.
§ ItisexpectedstudentscontacttheirSLPwithinaweektoscheduleameeting§ Ifunabletoscheduleameeting,emailyourimmediatesupervisorforanalternative
meetingtime§ AtthetimeofthemeetingtheSLPwillprovideaduedatewhentherewriteisdue§ Theupdatedlessonplanand/orSOAPnotemustbesubmittedwiththeoriginal
documentsfromthatsession.§ Theupdatedlessonplanand/orSOAPnoteshouldhaveaREWRITEHEADING§ Therewritemustalsoincludesignature,dateandtimeofcompletingtherewrite
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:GroupRotationClinicalstudentsparticipatinginaGroupRotationattheIonaCollegeSpeech,Language&HearingClinicwilljoin2to3studentclinicianswithamaximumof5clientspergroup.ThegoalofGroupTherapyistoprovideanopportunityforclientstocarryoverstrategiesand/or,developnewskillsinapeerenvironment.Eachstudentclinicianwillleadatherapysession.Theleadclinicianisresponsibleforthecompletedlessonplan;SOAPnoteandmaterials.Allstudentswillberequiredtomeetasateamtodesignatespecificspeech-languagetargetsthattheleadclinicianwilladdress.Thiscommunicationisimportantforthetransitionanddevelopmentforthestudentcliniciansandclients.Thesupportingclinicianswillcollectdata,provideindividualizedsupportifdeemedappropriate,andwritesubsequentSOAPnotes.Hoursaccruedfortreatmentserviceswillbedirectclienttimefortheleadstudentclinician.SeeyourprimarySLPforadditionalproceduresrequiredasitpertainstoyourgroup.
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:ProgressStatementsAsdeterminedbytheprimarySLPaprogressstatementmayberequired.Aprogressstatementmaysupportclinicalneeds,progresstodates,performanceoutcomesandrecommendationsforcurrentservices.
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:ProgressReportsProgressReportwillberequiredforeachclient’sreceivingtherapyservicesattheIonaCollegeSpeech,Language&HearingClinic.Thesereportsaredueattheendofeachsemestertosupportservicesbeingprovided,justifyingrecommendationsandprovidingtheclinicalstudentwrittendocumentationopportunitiesconsistentwiththeprofession.AProgressReportDraftdateisscheduledforeachsemester.PleaseseetheClinicCalendarforduedate.ProgressReportAgenda:AProgressReportDraftwillbesubmittedontheduedatedocumentedontheClinicCalendar;theprimarySLPonthecaseawillreviewthedraftandthereportwillbereturnedforrevision.ThestudentclinicianwillbeabletoupdatethereporttoimplementthechangespertheprimarySLP’sfeedback.Additionally,thestudentclinicianhastheopportunitytore-submittheProgressReportDraftonmorethanonesubmission.Thepurposeoftheadditionalsubmissionistodevelopthestudentclinicianswrittendocumentationskillsandtoprovidetheclientwithafullreport.AFinalProgressReportwillhavetheProfessionalssignatureonthereport.TheduedatefortheProgressReportisyourFinalClinicExitmeeting.ThisreportmusthavetheSLP’ssignatureatthetimeoftheClinicExitIftheProgressReportisnotcompletedatthetimeoftheClinicExitthestudentwillbeinviolation(PleaseseeClinicalPolicyforClinicExit)
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:DiagnosticRotationCSDGraduateStudentsandundergraduateSLP-AstudentswhohavecompletedadiagnosticcourseMUSTmeetwiththeprimarySLPtoreceiveclearancetoconductapartialand/orfulldiagnostic.Thisclearanceincludesbutnotlimitedto–asdirectedbytheDiagnosticCourseInstructor,asdirectedbytheprimarySLP,studentdemonstratingknowledgeandskillstocomplete,andjustificationforthediagnostic.Studentswhohavenotcompletedadiagnosticcoursewithintheundergraduateand/orgraduatecurriculummayonlybetrained/clearedbytheSLPandcanshadowthediagnosticwiththeprimarySLPconductingtheassessment. Procedurestofollowpriortotheevaluation:
§ AllconsentformsmustbesignedbytheclientorclientcaregiverincludingthePermissiontoevaluateandAudio/Videotapereleaseformpriortotheevaluation.
§ CompleteandthoroughreviewoftheClient’sChart(ifapplicable)
§ Contacttheclienttodiscussspecificsoftheevaluation,theanticipatedstartandend
dateoftheevaluation.
§ Conductanintakehistorytosupporttypesofassessmentandjustificationtocompletetheassessment
§ Reviewandcompleteathoroughreviewoftheassessmentsandscoringpatterns.
Preparation
§ Studentsneedtobepreparedpriortoevaluation:
§ MeetwithprimarySLPforpreparationfortheevaluationprocess
§ Bepreparedwithanyrequiredmaterialsfortheassessment
§ Theassignedstudentwillcompletetheassessmentwillintroducethemselvestotheclientandcaregiverspresent.
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Specificdirectionsforconductinganevaluation:
§ Anassignedstudentwillconductaninterviewtoobtaininformationforacompletehistoryandanyspecificconcernsrelatingtospeechandlanguageissues.
§ Completetheformalassessmentsandclinicalobservationsasindicated
§ Completeanoralmotorexam.
§ Conductapure-tonehearingscreening.
§ Finalexitinterviewwiththeclientandcaregiversthestatusoftheprogressofthe
evaluationandinformalresultscanbediscussedwiththesupervisorpresent.Thefollowingprocedurestocompleteaftertheevaluation:
§ Allassessments,materials,andequipmentshouldbereturnedtotheclinicandsignedbackin.
§ ReviewtheresultsandcompileadraftreportusingtheEvaluationReportOutline.
§ Acompleteddraftoftheevaluationmustbesubmitted5daysaftertheevaluationis
completed.
§ TheprimarySLPwillreviewandreturntothediagnosticgroup.Apresentationofthewrittenreportandreviewoftherecordedevaluationwillbediscussedattheteammeeting.
§ Afinalreportwithcorrectionsmustbesubmittedwithin1weekwithcorrections.
§ Theformalreportandtestingformsmustbefiledintheclient’sfolder.
§ Completeclinicalpracticumhourforms.
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:AdditionalConsiderationsFamilyMeetingsStudentcliniciansshouldbeupdatingclientfamiliesonaconsistentbasis.Withthatbeing,discusstheseupdateswithinthe60-minutescheduledtherapysession.TheseupdatesmustbedocumentedonSOAPnotes.Foranyrecommendationsviaprogressreportsand/ordiagnosticreportafamilymeetingMUSTtakeplacewiththeprimarySLPpresent.Professionallyprogresstodatemustbesummarizedtogivethefamiliesanopportunitytounderstandstatustodateandanyrelevantinformationpertainingtotherapy.
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:AdditionalConsiderationsEvidence-BasedPracticeEBPPreparedbyDorothyLeoneforIonaCollegeSpeech,Language&HearingClinicHandbookSummer2012
Evidence-BasedPractice(EBP)inSpeechLanguagePathology(SLP)WhatisEBP?“The conscientious, explicit, and judicious integration of 1) best available external evidence from systematicresearch,2)bestavailableevidenceinternaltoclinicalpractice,and3)bestavailableevidenceconcerningthepreferencesofafullyinformedpatient”(Dollaghan,2008).“ThegoalofEBPistheintegrationof:(a)clinicalexpertise/expertopinion,(b)externalscientificevidence,and(c)client/patient/caregiver perspectives to provide high-quality services reflecting the interests, values, needs, andchoicesoftheindividualsweserve”(ASHA,2012).
*Figurefromhttp://www.asha.org/Members/ebp/intro/
How/WhydidEBPstart?NoChildLeftBehind(NCLB)2002:mandatedthatchildrenhadtobeexposedto“scientifically-basedinstructionalstrategies”
ASHA: sessions began to appear at annual convention in 1999; technical report written in 2004 and positionstatementin2005
WhoneedstoknowaboutEBP?
Everyclinicianneedstothinkaboutall3categoriesofEBP,includingresearch,clinicalpractice,andthepatient,foreverysession.
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Speech,Language&HearingClinicEvidence-BasedPracticeEBPPreparedbyDorothyLeoneforIonaCollegeSpeech,Language&HearingClinicHandbookSummer2012
HowcanaclinicianuseEBPtoshapehisorhersession?Foreverysessionplanned,aclinicianmustthinkaboutallthree“corners”ofthetriangle:research,clinicalpractice,andtheclient.At IonaCollege’sSpeech,Language&HearingClinic,cliniciansareprovidedaspacetowritehisorher“rationale.”Therationalemustsupportwhytheclinicianmadecertainchoicesforthetherapyplanandshouldbenotedintheappropriatesection(seefollowingpage).
LongTermGoals__________________________________________________________________________________
Activity/Procedures/Materials__________________________________________________________________________________
ShortTermGoals__________________________________________________________________________________
Rationale/EBP__________________________________________________________________________________________________
WhatisanexampleofaRationale/EBPbox?Building lexicalassociations isanotedstrategy fordevelopingword retrieval skills inadultswhohaveexperienced a neural injury (Brookshire, 2003). Moreover, the client has previously stated that thisstrategyhelpsherrememberadesiredwordorterm.Therefore,continuingtodeveloptheseassociationswilllikelyimprovefluidityoftheclient’sgeneralconversationalskills.Brookshire,R.H. (2003). IntroductiontoNeurogenicCommunicationDisorders,6thedition. St.Louis,MO:Mosby.WhatshouldbewrittenintheRationale/EBPboxonaclinician’ssessionplan?Aclinician’srationaleshouldincludeajustificationforwhyaparticulartherapeuticstrategywaschosen.Therationaleshouldconsiderall3componentsofEBP.
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Let’stakealookateachsentenceintheaboveexample:Sentence#1:Thecurrentbestevidence,theresearch:“Buildinglexicalassociationsisanotedstrategyfordevelopingwordretrievalskillsinadultswhohaveexperiencedaneuralinjury(Brookshire,2003).”Sentence#2:Theclient/patientvalues:Moreover,theclienthaspreviouslystatedthatthisstrategyhelpsherrememberadesiredwordorterm.Sentence#3:Clinicalexpertise:Therefore,continuingtodeveloptheseassociationswill likely improvefluidityoftheclient’sgeneralconversationalskills.Sentence#4:Thecitation(note:mustbecitedwithinthetextandthenfullreferenceinAPAstyleattheendoftherationale):intext:(Brookshire,2003)andthenfollowingfullcitation:Brookshire,R.H.(2003).IntroductiontoNeurogenicCommunicationDisorders,6thedition.St.Louis,MO:Mosby.ReferencesAmericanSpeechLanguageHearingAssociation(ASHA).(2012).Retrievedfromhttp://www.asha.org/Members/ebp/intro/Dollaghan,C.A.(2008).TheHandbookforEvidence-basedPracticeinCommunicationDisorders.Baltimore,MD:PaulH.BrooksPublishingCo.
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:AdditionalConsiderationsInterventionforyourBilingualClientOriginalPreparationbyJenniferGeromettaforIonaCollegeSpeech,Language&HearingClinicHandbookSpring2012UpdatedPreparationbyDr.NancyVidal-FinnertyforIonaCollegeSpeech,Language&HearingClinicHandbookSpring2018
InterventionforYourBilingualClient
TipsforSuccessfulTreatmentwithaBilingualClientv Successful therapy forabilingual ispromotedbyapositive, confident,and relaxedattitudeandbynaturalisticlanguage-facilitatingcontexts.
v The focus for a bilingual child should be to learn language, not necessarily mainstream. Evidencesuggeststhatastrongbaseinthefirstlanguagepromoteslearningasecondlanguage.
v Monitoring phonological change across the two languages is important because it is possible thatintervention provided in one language will generalize to the other language given the interdependencebetweenthetwolanguages.
v Interventionmethodsforbilingualchildrenshouldmirrorthenaturalwaysinwhichbilingualspeakersuselanguage.
v Theclinicianshouldhaveapositiveattitudetowardthechild’snativelanguage.Theclinicianshouldnotdiscourageorbanthechildfromusingtheirnativelanguage.
v Speechtherapyisveryeffectivewhenincludingthechild’sprimarylanguageasmuchaspossible.Ifamonolingualclinicianfeelscomfortable,theymayintegratesomewordsduringtheirsession.
v Amonolingualtherapistshouldnotattempttotreatachildinalanguagethetherapistisnotfluentin.Ifthetherapistwantstolearnafewwordsinthelanguagetogaintrust,demonstratecodeswitching,thatisfine,buttheycannotattempttotreatinthatlanguage.
v Somewaysamonolingualcliniciancanintegratesomeofthewordsintheirsessionthatachildmayuseathomeisbyaskingthechild,parent,orrelativetotranslateafewwords.
v It is important to remember thatone language couldhavemanydifferentdialects. FOREXAMPLEConsonantdeletionmayoccurinacertaindialectandthatdoesnotmeanthatitisaspeecherrorthatneedstobetreated.
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v Itisveryimportanttoinvolvetheparentsinthetherapyinorderforittobesuccessful.
v Parents should encourage their child by reading to them at home, and use language-facilitatingactivities.
TreatingaBilingualClientasaMonolingualClinician:v Mostcertifiedprofessionalsdonotbelievethattheypossesstheknowledgeandskillbasetoworkwithculturallyandlinguisticallydiverseclients,buttheyneedtobeconfidentthatitispossible.v When speaking with an individual who is not a near-fluent English speaker, one might need tocollaboratewithotherprofessionalswhospeaktheindividual'sfirstlanguage.v Interpretersmaybetrainedtoadministertheactivitiesandtranscribethestudent'sresponses.v Therapyshouldonlybeconductedinthelanguagetheclinicianisfluentin.Theclinicianiscapableisimplementingsomewordsintheclient’sL1,butthatistogaintrustortodemonstratecodeswitching.
WHEN WORKING WITH ALL CHILDREN (BILINGUAL AND MONOLINGUAL) WITHPHONOLOGICAL DISORDERS, SLPS NEED TO DETERMINE HOW THEIR GOALSWILL BEIMPLEMENTED.THEREARE3DIFFERENTAPPROACHESIFCLINCIANISBILINGUAL1. VerticalApproach:whenonegoalistaughtatatimeuntilcriterionismet.Maybeusedtofocusonagoalthatisspecifictoonelanguage.
2. HorizontalApproach:IftheClinicianisBilingualinthebothoftheclient’slanguages,morethanonegoalisfocusedonineachsession.MaybeusedtotargetonegoalinLanguage1andonegoalinLanguage2.Iftheclinicianismonolingual,therapyshouldonlybeconductedinthelanguagetheyarefluentin.
3. CyclicalApproach:Anumberofgoalsarebeingaddressed inacyclical fashionbutonlyonegoal isincorporated at a time within a session. This approach would be used to not only rotate targets but alsolanguagesifpossible.
FunFacts:
v Children who are bilingual form a better depth of knowledge understanding word relationships than
monolingualchildren.
v Forexample:theideathatthewordcarandbusarebothconsideredvehicles.
v Bilinguals may encounter an easier time separating both relevant and irrelevant verbal and nonverbalinformationthenmonolinguals.
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v Theaverageageofdementiaonsetmayoccurlaterinbilingualindividuals.
v Bilingualchildrendisplaybetterperformanceindivergentthinkingaswellasinothermeta-cognitiveskillssuchastheprocessingofnewinformation.
v Bilingualshaveincreasedgraymatterdensityneurologicallyinlefthemisphereareasthanmonolinguals.
v Accordingtothe1990census,oneofeverysevenchildrenofschoolageintheU.S.spokealanguageotherthanEnglishathome.Thereisanestimated5.2millionbilingualchildrenthatareenrolledinschoolsintheUS,whichhasbeena61%increasesince1994.Thisincreasingnumberofbilingualchildrenhasresultedinchallengestoprovideassessmentandinterventiontobilingualchildren,especiallywithphonologicaldisorders.
v
Table1-Therapist-IdentifiedSuccessfulPractices
FocusArea Example(s)Given
Client Useofculturallyappropriatetoysormaterials.
Goalsadjustedaccordingtoclientneedssuchaslevelsofdesiredindependenceorimprovedfunctionalcommunicationacross
settings.Targetnon-specificgoalsnotrelatedtolanguagetoassistbuilding
arapport.Forexample,maketheclientfeelcomfortabledemonstratingplayskills.
Exploreclientgoalsregardingacculturationandbilingualism.
Client’sCommunicationCommunity
BecomefamiliarwiththeClient’sbackground,byinvitingtheparentstoobservethesessioninordertocarryoversomeofthe
goalsathomeinL1.Networkingwitheducationalprofessionals.
Culture Useofculturallyappropriatetoysandmaterials.
Individualizetherapytoensurethatculturalandlinguisticdifferencesareacknowledgedandhonored.
Reviewtreatmentplanwithculturalinformantwhoistheparentandensuringapprovaloftheplanbeforeimplementation.
Increasingcommunication,explanations,andbuildrapportwithclients.
Clinician Fortreatmentplanning,usingobservationacrossasmanycontextsaspossible,interviewswithmonoandbilingualteachersandstaff.
Fortreatmentplanning,familyandcommunityreport.Performdynamicandplay-basedassessments,gatherandanalyze
languagesamples.Source:TreatmentofCulturallyandLinguisticallyDiverseClients:WhatAreWeDoingThatWorks?BySusanForinger-Burk and Georgia Hambrecht
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ContactFirstStepsisanOrganizationcreatedfortreatingBilingualChildren.YoumaycontacttheFounderoftheorganizationforanyquestionsinregardstotreatingabilingualclient.
AsktoSpeakwithEvelynSeda:OfficeNumber:(914)663-7070
Resources“Locutour Multimedia Cognitive Rehabilitation.” Fonología En Español: Tratamiento SpanishPhonology:Intervention.LOCUTOUR™COGNITIVEREHABILITATIONMULTIMEDIA.Kohnert,Kathryn,MarnaScarry-Larkin,andElizabethPrice."TheASHALeader."AssessmentandInterventionforBilingualChildrenwithPhonologicalDisorders.Web.27Apr.2012.<http://www.asha.org/Publications/leader/2007/070213/f070213a/>.“TheASHALeader”Bilingualism:Consequences forLanguage,Cognition,Development,and theBrain: “What Clinicians Should Know” By: Viorica Marian, Yasmeen Faroqi-Shah, MargaritaKaushanskaya,HenrikeK.Blumenfeld,&LiSheng.“TheASHALeader”TreatmentofCulturallyandLinguisticallyDiverseClients:WhatAreWeDoingThatWorks?Foringer-Burk,S.,Hambrecht,G.,Thordardottir,E.(2006,August15).LanguageInterventionfromaBilingualMindset.TheASHALeader
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PolishTranslationbyAnnaWyludaforIonaCollegeSpeech,Language&HearingClinicHandbookSpring2018
InterwencjadlaTwojegoklientadwujęzycznego
Wskazówkidotycząceskutecznegoleczeniazapomocąklientadwujęzycznego•Udanaterapiadladwujęzycznegojestpromowanaprzezpozytywne,pewnesiebieispokojnepodejścieorazprzeznaturalistycznekontekstyułatwiającejęzyk.•Celemdwujęzycznegodzieckapowinnobyćuczeniesięjęzyka,niekonieczniegłównegonurtu.Dowodysugerują,żesilnabazawpierwszymjęzykusprzyjanaucedrugiegojęzyka.•Monitorowaniezmianfonologicznychwobujęzykachjestważne,ponieważmożliwejest,żeinterwencjawjednymjęzykuzostanieuogólnionanainnyjęzyk,biorącpoduwagęwspółzależnośćmiędzydwomajęzykami.•Metodyinterwencjidladziecidwujęzycznychpowinnyodzwierciedlaćnaturalnesposobyposługiwaniasięjęzykiemprzezosobyposługującesięjęzykiemdwujęzycznym.•Lekarzpowinienmiećpozytywnenastawieniedoojczystegojęzykadziecka.Lekarzniepowinienzniechęcaćdzieckadokorzystaniazojczystegojęzyka.•Terapiamowyjestbardzoskuteczna,gdywmożliwienajwiększymstopniuwłączasięjęzykpodstawowydziecka.Jeślijednojęzycznyklinicystaczujesiękomfortowo,możewłączyćpewnesłowapodczassesji.•Terapeutajednojęzycznyniepowinienpróbowaćleczyćdzieckawjęzyku,wktórymterapeutaniejestbiegły.Jeśliterapeutachcenauczyćsiękilkusłówwjęzyku,abyzdobyćzaufanie,wykazaćzmianękodu,tojestwporządku,aleniemożepróbowaćtraktowaćwtymjęzyku.•Niektóresposoby,wjakiejednojęzycznyklinicystamożezintegrowaćniektóresłowazichsesji,któredzieckomożeużywaćwdomu,topoprosićdziecko,rodzicalubkrewnegooprzetłumaczeniekilkusłów.•Ważnejest,abypamiętać,żejedenjęzykmożemiećwieleróżnychdialektów.NAPRZYKŁADUsuwaniesklejekmożewystępowaćwpewnymdialekcieinieoznaczato,żejesttobłądmowy,którynależyleczyć.•Bardzoważnejestzaangażowanierodzicówwterapię,abyodnieśćsukces.•Rodzicepowinnizachęcaćswojedziecko,czytającjewdomuiwykorzystującćwiczeniajęzykowe.
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Traktowanieklientadwujęzycznegojakolekarzajednojęzycznego:•Większośćcertyfikowanychspecjalistówniewierzy,żeposiadająwiedzęiumiejętnościpotrzebnedopracyzklientamizróżnicowanymikulturowoijęzykowo,alemusząmiećpewność,żejesttomożliwe.•Podczasrozmowyzosobą,któraniejestpłynniemówcąpoangielsku,koniecznemożebyćnawiązaniewspółpracyzinnymispecjalistamiposługującymisiępierwszymjęzykiemosoby.•Tłumaczeustnimogąbyćprzeszkoleniwzakresiezarządzaniadziałaniamiiprzepisywaniaodpowiedziuczniów.•Terapiapowinnabyćprowadzonawyłączniewjęzyku,wktórymlekarzjestbiegły.KlinicystajestwstaniewprowadzićpewnesłowawL1klienta,alejesttozdobyciezaufanialubzademonstrowaniezmianykodu.PODCZASPRACYZEWSZYSTKIMIDZIECIMI(DWUSTRONNYMIIMONOLINGUALNYMI)ZZABURZENIAMIFONOLOGICZNYMI,SLPSPOTRZEBUJEOKREŚLIĆ,JAKICHCELEZOSTANĄWDROŻONE.TAMSĄ3RÓŻNEPODEJŚCIA,JEŚLICLINCIANJESTDWUDNIOWY1.Podejściepionowe:kiedyjedenceljestnauczanynaraz,dopókiniezostaniespełnionekryterium.Możebyćużywanydoskupieniasięnacelu,któryjestspecyficznydlajednegojęzyka.2.Podejściehoryzontalne:Jeślilekarzjestdwujęzycznywobujęzykachklienta,wkażdejsesjikoncentrujesięwięcejniżjedencel.Możebyćstosowanydoosiągnięciajednegoceluwjęzyku1ijednegoceluwjęzyku2.Jeśliklinicystajestjednojęzyczny,terapiapowinnabyćprowadzonawyłączniewjęzyku,wktórymbieglewłada.3.Podejściecykliczne:Wielecelówjestrozwiązywanychcyklicznie,aletylkojedenceljestwłączonywczasiesesji.Takiepodejściebyłobyużywanedonietylkorotacjicelów,aletakżejęzyków,jeślitomożliwe.Fakty:
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•Dziecidwujęzycznetworząlepszągłębięwiedzy,rozumiejącrelacjesłowoniżjednojęzycznedzieci.•Naprzykład:pomysł,żesłowosamochódiautobussąuważanezapojazdy.•Dwujęzycznemogąnapotkaćłatwiejszyczasoddzielającyzarównoistotne,jakinieistotneinformacjewerbalneiniewerbalne,anastępniejednojęzyczne.•Średniwiekwystąpieniademencjimożewystąpićpóźniejuosóbdwujęzycznych.•Dziecidwujęzycznewykazująlepszewynikiwrozbieżnymmyśleniu,jakrównieżwinnychumiejętnościachmeta-kognitywnych,takichjakprzetwarzanienowychinformacji.•Osobydwujęzycznemająneurologiczniezwiększonągęstośćistotyszarejwobszarachlewejpółkulimózguniżosobyjednojęzyczne.•Wedługspisuz1990r.JednonasiedemdzieciwwiekuszkolnymwUSAmówiłowjęzykuinnymniżangielski.Szacujesię,że5,2milionadwujęzycznychdziecijestzapisanychdoszkółwUSA,costanowiwzrosto61%od1994roku.Tarosnącaliczbadziecidwujęzycznychdoprowadziładowyzwańzwiązanychzocenąiinterwencjądziecidwujęzycznych,zwłaszczazzaburzeniamifonologicznymi..
Tabela1-Zidentyfikowaneprzezterapeutyudanepraktyki
Obsz Podane
Klient
Używanieodpowiednichkulturowozabaweklubmateriałów.
Celedostosowanedopotrzebklienta,takiejakpoziompożądanejniezależnościlubpoprawionafunkcjonalnakomunikacjamiędzy
ustawieniami.Kierujsięniespecyficznymicelaminiezwiązanymizjęzykiem,abypomócwbudowaniurelacji.Naprzykładspraw,abyklientczułsię
komfortowo,demonstrującumiejętnościgry.Poznajceleklientówdotycząceakulturacjiidwujęzyczności.
Społecznośćkomunikacyjnaklienta
Zapoznajsięześrodowiskiemklienta,zapraszającrodzicówdoobserwowaniasesji,abyprzenieśćniektórecelewdomuwL1.Nawiązywaniekontaktówzprofesjonalistamiedukacyjnymi.
Kultura Używaniekulturowoodpowiednichzabawekimateriałów.
Zindywidualizujterapię,abyupewnićsię,żeróżnicekulturoweijęzykowesąuznawaneihonorowane.
Zapoznajsięzplanemleczeniazinformatoremkulturalnym,któryjestrodzicemizapewnijzatwierdzenieplanuprzedjego
wdrożeniem.Zwiększeniekomunikacji,wyjaśnieńibudowaniarelacjizklientami.
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Klinicysta Planowanieleczenia,wykorzystanieobserwacjiwmożliwiejaknajwiększejliczbiekontekstów,wywiadyzmonoidwujęzycznymi
nauczycielamiipersonelem.Doplanowanialeczenia,raportrodzinnyispołeczności.
Wykonujocenydynamiczneiopartenazabawie,zbierajianalizujpróbkijęzykowe.
Źródło:TreatmentofCulturallyandLinguisticallyDiverseClients:WhatAreWeDoingThatWorks?BySusanForinger-Burk and Georgia Hambrecht
Kontakt
Organizacjastworzonadoleczeniadziecidwujęzycznych.MożeszskontaktowaćsięzZałożycielemorganizacjiwprzypadkujakichkolwiekpytańdotyczącychtraktowaniaklientadwujęzycznego.
PoprośorozmowęzEvelynSeda:Numerbiura:(914)663-7070Zasoby
“Locutour Multimedia Cognitive Rehabilitation.” Fonología En Español: Tratamiento SpanishPhonology:Intervention.LOCUTOUR™COGNITIVEREHABILITATIONMULTIMEDIA.Kohnert,Kathryn,MarnaScarry-Larkin,andElizabethPrice."TheASHALeader."AssessmentandInterventionforBilingualChildrenwithPhonologicalDisorders.Web.27Apr.2012.<http://www.asha.org/Publications/leader/2007/070213/f070213a/>.“TheASHALeader”Bilingualism:Consequences forLanguage,Cognition,Development,and theBrain: “What Clinicians Should Know” By: Viorica Marian, Yasmeen Faroqi-Shah, MargaritaKaushanskaya,HenrikeK.Blumenfeld,&LiSheng.“TheASHALeader”TreatmentofCulturallyandLinguisticallyDiverseClients:WhatAreWeDoingThatWorks?Foringer-Burk,S.,Hambrecht,G.,Thordardottir,E.(2006,August15).LanguageInterventionfromaBilingualMindset.TheASHALeader
95
SpanishTranslationbyJhovanaFigueraforIonaCollegeSpeech,Language&HearingClinicHandbookSpring2018
Intervención para su cliente bilingüe
Consejos para un tratamiento exitoso con un cliente bilingüe v Terapia acertada para un niño bilingüe es promovida con una actitud positiva, confiada y relajada. Diferentes contextos pueden facilitar un lenguaje más natural.
v Lo más importante para un niño bilingüe debe ser aprender el idioma, no necesariamente el idioma convencional. La evidencia sugiere que una base fuerte en la primera lengua promueve el aprendizaje de una segunda lengua.
v Las dos lenguas deben ser monitoreadas porque cambio fonológico a través de los dos idiomas se pueden presentar, es posible que la intervención provista en una lengua sea generalizada a la otra lengua dada la interdependencia entre los dos idiomas.
v Métodos de intervención para niños bilingües deben reflejar las formas naturales en que hablantes bilingües utilizan el idioma.
v El logopeda debe tener una actitud positiva hacia la lengua materna del niño. El logopeda no debe desalentar o prohibir al niño usar su lengua materna.
v La terapia del lenguaje es muy eficaz cuando se incluye la lengua primaria del niño tanto como sea posible. Si un logopeda monolingüe se siente cómodo, él o ella podría integrar algunas palabras durante la sesión.
v El logopeda monolingüe no debe intentar tratar a un niño en un lenguaje que no es fluido para él. Si el logopeda quiere aprender algunas palabras en la lengua del cliente para ganar confianza y cambiar de una lengua a otra está muy bien, pero él no debe intentar tratar al niño en ese idioma.
v El logopeda monolingüe puede preguntar a los padres del niño que traduzcan algunas palabras. Estas palabras pueden ser integradas durante la sesión.
v Es importante recordar que una lengua puede tener muchos diversos dialectos. Por ejemplo, supresión de consonante puede ocurrir en un cierto dialecto y eso no significa que es un error de expresión que debe ser tratado.
vPara que la terapia sea un éxito, es muy importante incluir a los padres.
v En la casa los padres podrían leer libros a sus niños para estimular el habito por la lectura, facilitando diferentes actividades.
Tratar a un cliente bilingüe con un logopeda monolingüe: v Muchos profesionales certificados, no creen que ellos posean los conocimientos y habilidades necesarias para trabajar con clientes que poseen diferente cultura y lengua, pero ellos necesitan estar confiados que trabajar con estos niños es posible.
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v Cuando se hable con un cliente que no habla inglés, un profesional que hable la lengua de la persona, podría colaborar v Intérpretes pueden ser entrenados para administrar las actividades y transcribir las respuestas de los estudiantes.
v la Terapia debe realizarse sólo en el lenguaje que el logopeda maneja con fluidez. Podría ser que el logopeda sea capaz de implementar algunas palabras en L1 del cliente, pero eso lo podría utilizar para ganarse la confianza o demostrar código cambio con el cliente.
CUANDO SE TRABAJA CON TODOS LOS NIÑOS CON TRASTORNOS FONOLÓGICOS (BILINGÜES Y MONOLINGÜES), LOGOPEDAS NECESITAN DETERMINAR CÓMO SE APLICARÁN SUS METAS.
EXISTEN 3 ENFOQUES DIFERENTES SI EL LOGOPEDA ES BILINGÜE
1. Enfoque vertical: cuando se enseña una meta en un tiempo hasta que se cumple el criterio. Se puede utilizar para centrarse en un objetivo que es específico a una lengua.
2. Enfoque horizontal: Si el logopeda habla en los dos idiomas del cliente, más de un objetivo está
enfocado en cada sesión. Puede utilizarse para alcanzar una meta en lengua 1 y otra en la lengua 2. Si el logopeda es monolingüe, la terapia debe realizarse sólo en la lengua que es fluida para el logopeda.
3. Enfoque cíclico: varias metas se abordan de manera cíclica, pero sólo uno de los objetivos se incorpora a la vez dentro de una sesión. Este enfoque se utiliza para girar no sólo objetivos sino también idiomas si es posible.
Datos divertidos: v Los niños que son bilingües interiorizan más el conocimiento entendiendo la relaciones de las palabras más que los niños que hablan una sola lengua.
v Por ejemplo: la idea de que la palabra coche y autobús son considerados vehículos.
v niños Bilingües pueden encontrar que es más fácil separar la información relevante e irrelevante, verbal y no verbal más que niños monolingües.
v La edad promedio de inicio de la demencia puede ocurrir más tarde en individuos bilingües.
v Niños bilingües muestran mejor desempeño en el pensamiento divergente, así como otras habilidades metacognitivas tales como el procesamiento de nueva información.
v Personas Bilingües han aumentado la densidad de materia gris neurológicamente en áreas del hemisferio izquierdo más que los monolingües.
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v Según el censo de 1990, uno de cada siete niños en edad escolar en los Estados Unidos habla un idioma diferente al inglés en casa. Hay un estimado 5,2 millones de niños bilingües que están inscritos en las escuelas en los Estados Unidos, esta cifra ha aumentado un 61% desde 1994. Este creciente número de niños bilingües ha dado lugar a desafíos al proporcionar evaluación e intervención a niños bilingües, especialmente con trastornos fonológicos.
Tabla 1 - logopeda-identificar prácticas exitosas Enfoque Zona Ejemplos dados Cliente Uso de materiales o juguetes culturalmente apropiados.
Objetivos adaptados según las necesidades del cliente tales como los niveles de independencia deseada o la mejora de la
comunicación funcional a través de los ajustes.
Apunte metas no específicas no relacionadas con el lenguaje para ayudar a construir una relación. Por ejemplo, haga que
el cliente se sienta cómodo demostrando habilidades de juego..
Explorar objetivos del cliente con respecto a su cultura y a su bilingüismo.
Comunidad de la comunicación del cliente
Familiarizarse con los antecedentes del cliente, invitando a los padres para observar la sesión para llevar algunos de los
objetivos en el país en L1.
Trabajo en la red con profesionales de la educación. Cultura Uso de materiales y juguetes apropiados culturalmente.
Individualizar el tratamiento para asegurar que las diferencias culturales y lingüísticas sean reconocidas y
honradas.
Revise el plan de tratamiento con el informante cultural que es el padre y asegurese de opener la aprobación del plan
antes de la implementación.
Incrementar la comunicación, explicaciones y construir una buena relación con los clientes.
Fonoaudiólogo Para la planificación del tratamiento, es bueno utilizar la observación en diferentes contextos, tantos como sea posible, entrevistas con profesores mono y bilingües y
personal.
Para la planificación del tratamiento informe a la familia y a la comunidad.
Realizar evaluaciones dinámicas y basadas en análisis del lenguaje
Fuente: tratamiento de clientes cultural y lingüísticamente diversos: ¿Qué hacemos que funcione? Por Susan Foringer-Burk y Georgia Hambrecht
Contacto
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Primeros pasos es una organización creada para el tratamiento de niños bilingües. Para cualquier duda en lo que respecta al tratamiento de un cliente bilingüe puede comunicarse con el fundador de la organización.
Pedir hablar con Seda de Evelyn: número de oficina: (914) 663-7070
Recursos "Rehabilitación cognitiva Multimedia de Locutour." Fonologia En Español: fonología española Tratamiento: intervención. LO C UTO U R™ Rehabilitación cognitiva M U L T I M E D I a. Kohnert, Kathryn, Marna Scarry Larkin y el precio de Elizabeth. "El líder ASHA". Evaluación e intervención para niños bilingües con trastornos fonológicos. Web. 27 de abril de 2012. <http://www.asha.org/Publications/leader/2007/070213/f070213a/ >. " El líder de ASHA "Bilingualism: consecuencias para el lenguaje, cognición, desarrollo y el cerebro:"Lo que los médicos deben saber" por: Viorica Marian, Yasmeen Faroqi-Shah, Margarita Kaushanskaya, Henrike K. Blumenfeld y Sheng Li. "El líder ASHA" tratamiento de clientes cultural y lingüísticamente diversos: ¿Qué hacemos que funcione? Foringer-Burk, S., Hambrecht, G., Thordardottir, E. (2006, 15 de agosto). Lenguaje la intervención de una mentalidad bilingüe. El líder ASHA
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:AdditionalConsiderationsClinicPolicyGuidelines
§ Iftheclientislate,thestudentclinicianisrequiredtoinformthePrimarySLP.Callclientiftheyhavenotarrivedbythefirst15minutesofthesession.
§ ThePrimarySLPshouldbenotifiedifaclienthas3unexcusedabsences.§ Ifthestudentclinicianmustcancelasession,itistheresponsibilityofthestudentto
notifytheclientassoonaspossibleviatelephoneand/oremailthePrimarySLPandtheClinicDirectoratleast24hoursinadvance.
§ Itisexpectedthatthestudentclinicianispresentatleast15minutespriortothesessionstarttimetogreettheclient.Pleasebeginandendsessionsontimeduetospaceandschedulingconstraints.
§ StudentsdonothavepermissiontoleavetheSpeech,Language&HearingClinicwithaclientunlesswrittenparent/guardianandtheIonaCollegeSpeechLanguage&HearingClinicprovidespermissionwithaSLPpresent
§ Providetheclient/clientfamiliestheappropriateConsentPackageandtheCaseHistoryForm.
§ ThestudentclinicianmustreviewandsigntheConfidentialityAgreementForm.Otherwisestudentswillnotbetreatingclients.
§ AllchartingwillberandomlycheckedforHIPAApurposesandConfidentialityGuidelines.§ Undergraduatestudentsarerequiredtoobserveclinicsessionsiftheirclientcancels.Itis
recommendedtheCSDgraduatestudentcliniciansobserveaclinicsessioniftheirclientcancels.
§ ClientsareNOTtobeleftinthetherapyroombythemselves.Ifthestudentneedstoleaveforanyreason,theclientmustcomewiththeclinicalstudent.
§ StudentCliniciansarenotpermittedtoassistaclientwiththerestroom.Iftheclientisaminorinformthefamily.Iftheclientisanadultinformthecaregiver.
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Tosupportclinicalknowledgeandskilldevelopmentstudentclinicianshavetheopportunitytohave
§ MeetingswithyourprimarySLP§ CompleteMidtermReviewwithyouprimarySLP§ CompleteVideoReviewsandanalyzeclinicalskills§ InformtheprimarySLPiffamiliesarerequestinganyreportstobemailedout/copied.
Authorizedpersonnel(primarySLP,ClinicDirectorandAdminAsst)mustauthorizetoconsiderreleaseofreports.
OfficeHourMeetingsStudentswillbeexpectedtoparticipateinmeetingswiththeirprimarySLPThegoalofthesemeetingsforthestudentclinicianistodemonstratetheirclinicalideas,askquestionsandshowcasetheirknowledgeandskillstodate.AsharedcommunicationbetweentheSLPandstudentclinicianwillsupportthestudentprogressforclinicaldevelopment.Studentswillbeexpectedtoaskquestions,shareexperiences,anddevelopclinicalskills.Thisdevelopsones'clinicalknowledgeandthisfurtherdemonstratesone'sknowledgethroughoralcommunication.TheOfficeHourMeetingswillfurtherprovideanopportunityfortheclinicalstudentstodemonstratetheirabilitytointegrateacademicsintoclinic,shareanddeveloptheirclinicalknowledgeandskills,followingclinicalprocedures,ConfidentialityGuidelines;andSafetyProcedures.Thus,furtherdemonstratingone’slearningskills,anddevelopingproblemsolvingandclinicalskills.OfficeHourMeetingsincludebutarenotlimitedtolectures,reviewofwrittendocumentation,ANDDEVELOPMENToflessonplans,videoreviews,andtherapyideas.OfficeHourmeetingsareatimeforopendiscussions.Pleaseaskquestions.ProfessionalConductduringOfficeHourMeetingsStudentsareexpectednottotextduringOfficeHourMeetings.YouwillbeASKEDTOleave.Useoflaptopswillneedadvancedpermission.
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalWriting
AmericanSpeech-Language-HearingAssociation.(2016).Codeofethics[Ethics].Availablefromwww.asha.org/policy/.
PrincipleofEthicsIIndividualsshallhonortheirresponsibilitytoholdparamountthewelfareofthepersonstheyserveprofessionallyorparticipantsinresearchandscholarlyactivitiesandshalltreatanimalsinvolvedinresearchinahumanemanner.RulesofEthicsOIndividualsshallprotecttheconfidentialityandsecurityofrecordsofprofessionalservicesprovided,researchandscholarlyactivitiesconducted,andproductsdispensed.Accesstotheserecordsshallbeallowedonlywhendoingsoisnecessarytoprotectthewelfareofthepersonorofthecommunity,islegallyauthorized,orisotherwiserequiredbylaw.Professionalwritingskillsfortheclinicalstudentisadevelopmentalprocess.Inordertodevelopwritingskills,theclinicalstudentmustparticipateintheprocess.Studentscanbuildtheirwritingrepertoirebyusingtheirtextasareference,reviewclientfiles,andrefertotheirtextbooks.ExpectationsforProfessionalWritingSkillsincludeOrganizedThoughts;GrammaticallyCorrectSentences;NoSpellingErrors;NeatandClean;DevelopingprofessionalterminologySLP’sassignedtotheclientcasewillberesponsibleforreviewingwrittendocumentationandprovidingsupportforwrittendevelopmentexpectations.StudentsarerequiredtomeetwithaSLPifare-writeisrequired.
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalWriting:GoalWritingHelpfulHintsLongTermGoals:
§ TheLongTermGoalrepresentswhatyouwanttoachievefortheclientandtheskillstobeaccomplishedforthedurationoftreatment.
§ TheLongTermGoalrepresents
o Whatyouwanttoimproveo ThepurposeofwhyyouwanttoimprovethespecificS/LDelay;Impairment;
Deficit(SpecificS/LDelay;Impairment;Deficito Wheretheseskillswillbeshowcased
Whatisthespeechandlanguageissue+whyyouwanttoachieveit+wherewillclientusetheirskillsExample:
§ Toimproveexpressivelanguageskillsforfunctionalcommunicationinandoutsideofclinic
§ Toimprovearticulationskillsforfunctionalintelligibilityinandoutsideofclinic§ Toincreasesafetyandefficiencyofswallowingtomaintainadequatehydrationand
nutritionalneedsShortTermGoals/ObjectivesThesegoalsarethestepstohelpachievetheLongTermGoal.Inordertomeasureprogress,shorttermgoalsshouldbemeasurable.
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TheGoal-OutlineQuestion(AccordingtoLannyButler,MS,OTR)Who+willdo+what+underwhatcircumstances+towhatcriteria+howoften?Who? TheclientWillDo? Will(produce,identify,complete)What? Theactionexpectedbyclient(atphraselevel,/k/in
initialpositionofwords)UnderWhatCircumstances? TasktobeperformedToWhatCriteria? Howwellthetaskwillbeperformed(80%ofthe
time,4outof5trials)HowOften? Within/consecutive4sessionsTheclient(who)willread(willdo)sentencelevelmaterial(what)atanindependentlevel(circumstance)80%ofthetime(criteria)within4sessions(howoften)
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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalWriting:DailyProgressNote SOAPNOTESS:SubjectiveInitialobservationpertainingtotheclientwhichincludesbutnotlimitedtoclientbehavior,motivation,anycomplaints,mentalstatus,impressionoftheclients’behaviorO:ObjectiveDataobtainedduringeachsessionperthetaskpresentedwithinthesession.Theresponsesofthetreatmentgoals.A:AssessmentProfessionaljudgmentofthesession;includetheclient’sresponse,effectivenessand/orchallengesofthetreatmentprovided.Whatwasdoneclinically?Mayalsoincludepreviousprogresstocomparesessionstoaddressclients’needs,training,teammeetings,andconferences.Includethecommunicationdiagnosis.P:PlanPlanoftreatmentfornextsession.Recommendationsforfurtherconsultationsand/orchangesingoalplanning.Examples:S:Theclienteasilytransitionedintothesession.Hewasalertandparticipatedinallactivitiespresented.Theclientreportsfollowthroughwiththehomeprogram.O:Theclientrespondedtosimpleyes/noquestionswith60%accuracy;followed1stepand2steprelateddirectionswith75%accuracy;andrespondedtosentencecompletiontasks80%accuracywithmoderatephonemiccueing.A:Theclienthasmaderelativeprogresstodateintheareasofauditorycomprehensionandverbalexpression.Hecontinuestopresentwithnon-fluentaphasiacharacterizedbyapraxiaandwordretrievaldifficulties.ImprovementnotedviaadaptingMITtreatment.P:Toimproveauditoryandverbalexpressionskillsforimprovedfunctionalcommunicationskills.
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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAppendixHGradingPolicy
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Speech,Language&HearingClinicGradingPolicy ClinicalPracticumisasupervisedprogramthatsupportsspeech-languagepathologystudentstoworkwithindividualsthatarediagnosedwithacommunicationand/orswallowingdisorderordelays.Thepurposeofateachingclinicistosupportthestudent’sintegrationofacademics,clinic,andresearchinatherapytobeginthepracticalapproachforclinicalservices.Studentswilldevelopandintegrateknowledgeandskills,demonstrateASHACodeofEthicsanddeveloptheirclinicalapproachaspartoftheirfutureprofession.GradinginClinicalPracticumisbasedoncompetencylevelofindependenceofknowledgeandskillsofcommunicationdisordersanddelays.Thegoalis“Independentandeffectiveclinicalknowledge,skills,andperformance”.Thislevelofindependenceissupportedbyaseriesofclinicalpracticumexperiences.Theinitialphaseinclinicalpracticumforsomestudentcliniciansmayincludefeelingsofbeingoverwhelmed,anxious,nervous,andthoughtsof“notknowingwhattodo”,“Idon’tknowwhattodo”,“Tellmewhattodo”.Thesefeelingsarevalid,normalandexpected.Theclinicalsupervisor’sresponsibilityistoprepare,guideanddevelopclinicalskillswiththestudentclinicianwhohascompletedspecificcoursework.Duringastudent’sclinicalprogression,itisexpectedthatthestudentstakeresponsibilityoftheirclinicalexperience.Responsibilityincludesinitiatingquestionsfordevelopmentandknowledge,aconsistenteffortintheplanningprocess,carryingoversuggestionsbysupervisors,preparingmaterials,completingalldocumentation,andadheringtoprofessionalstandards.Constructivecriticismispartoftheprocessofclinicalpracticum.Thepurposeoffeedbackisconstructiveandnotpersonal.Thisisanopportunityforstudentclinicianstodeveloptheirskillsandlearntoself-evaluatetheirownclinicalskills.Studentcliniciansthatarenotopentofeedbackorimplementthefeedback,maylimittheirclinicalgrowthandindependence.Studentcliniciansaregiventheopportunitytodeveloptheirskillsandprovidetheclinicalsupervisortheevidenceoftheirparticipation,knowledge,growth,andskillsinpracticum.Studentcliniciansalsoneedtotakeresponsibilityfortheclinicaldevelopmentandparticipatewithandinclinicalinstruction.Independencedoesnotmeancompletinganddevelopingplanofcareonyourown.Independenceintheteachingclinicsettinginvolvesdiscussionswithyour
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SLP,sharingmaterials,EBP,probingquestionsfordevelopmentknowledgeandskills,andconsistentlyevaluatingyourselfasaclinicianThetherapyprocesswithaclientiscontinuous,developing,andproblemsolving.Inasmuch,thestudentclinicalprocessinpracticumiscontinuous,developing,andproblemsolving.Clinicalgradingisevaluatedonratingstoincludeskillsofstrength,areasofneededimprovement,progress,emergingskillsandskillsnotevident. PracticumGradingisevaluatedusingaratingscaletoassessmultipleclinicalareas.MidtermReviews:Studentswillbeexpectedtoevaluatetheirclinicalskillsindependentlyandproviderationalesfortheirskilllevelforeachskillbeingevaluated.TheevaluationcompletedbytheStudentisNOTtheMidtermGrade.Theevaluationistheinitialprocessofevaluationone’sclinicalskills.Theprimaryclinicalsupervisorwillreviewtheevaluationandre-evaluateeachclinicalskill.Studentswillparticipateinamidtermreviewtodiscussclinicalskills,areasofstrength,areasofneededimprovement,progress,emergingskills,andskillsnotevident.Final:Theprimaryclinicalsupervisorwillcompletethepracticumassessmentforthefinalclinicalpracticumgrade.(Seeinstructor/syllabitodetermineweightofgradingforspecificcourse)InaccordancewiththeCouncilforClinicalCertificationinAudiologyandSpeech-LanguagePathology’s(CFCC)2014standardsandtheCAA’s2017standardsprofessionalcompetenciesforclinicaldevelopmentissupportedbyformativeandsummativepracticesalongwiththeAnderson’sContinuumSupervisionModelisintegratedinordertoevaluatetheknowledgeandskilldevelopmentduringone’spracticumexperience.2017CAAofASHAstandards:
§ Standard3.1.1BProfessionalpracticecompetencies:accountability,integrity,effectivecommunicationskills,clinicalreasoning,evidence-basedpractice,concernforindividualserved,culturalcompetence,professionalduty,collaborativepractice
§ Standard3.1.3BIdentificationandpreventionofSpeech,LanguageandSwallowingDisordersandDifferences:Principlesandmethodsofidentificationofcommunicationandswallowingdisordersanddifferences
§ Standards3.1.4BEvaluationofspeech,language,andswallowingdisordersanddifferences:Articulation,Fluency,Voiceandresonance,Receptiveandexpressivelanguage(phonology,morphology,syntax,semantics,pragmatics,prelinguisticcommunication,andparalinguisticcommunication)inspeaking,listening,reading,writing,andmanualmodalities,Hearing,Swallowing,Cognitiveaspectsofcommunication,Socialaspectsofcommunication,Augmentativeandalternativecommunicationneeds
§ Standards3.1.5BInterventiontominimizetheeffectsofchangesinthespeech,language,andswallowingmechanisms:Articulation,Fluency,Voiceandresonance,Receptiveandexpressivelanguage(phonology,morphology,syntax,semantics,pragmatics,prelinguisticcommunication,andparalinguisticcommunication)inspeaking,listening,reading,writing,andmanualmodalities,Hearing,Swallowing,
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Cognitiveaspectsofcommunication,Socialaspectsofcommunication,Augmentativeandalternativecommunicationneeds
§ Standards3.1.6B:GeneralKnowledgeandskillsapplicabletoprofessionalpractice:Ethicalconduct,integrationandapplicationofknowledgeoftheinterdependenceofspeech,language,andhearing;Engagementincontemporaryprofessionalissuesandadvocacy;Processesofclinicaleducationandsupervision;Professionalismandprofessionalbehaviorinkeepingwiththeexpectationsforaspeech-languagepathologist;Interactionskillsandpersonalqualities,includingcounselingandcollaboration;Self-evaluationofeffectivenessofpractice
(Seemoreat:https://caa.asha.org/wp-content/uploads/Accreditation-Standards-for-Graduate-Programs.pdf)
2014CFCCStandards:
§ StandardIV-C:Theapplicantmustdemonstrateknowledgeofcommunicationandswallowingdisordersanddifferences,includingtheappropriateetiologies,characteristics,anatomical/physiological,acoustic,psychological,developmental,andlinguisticandculturalcorrelatesinthefollowingareas:articulation,fluency,voiceandresonance,includingrespirationandphonation,receptiveandexpressivelanguage(phonology,morphology,syntax,semantics,pragmatics,prelinguisticcommunicationandparalinguisticcommunication)inspeaking,listening,reading,writing,hearing,includingtheimpactonspeechandlanguage,swallowing(oral,pharyngeal,esophageal,andrelatedfunctions,includingoralfunctionforfeeding,orofacialmyology),cognitiveaspectsofcommunication(attention,memory,sequencing,problem-solving,executivefunctioning),socialaspectsofcommunication(includingchallengingbehavior,ineffectivesocialskills,andlackofcommunicationopportunities),andaugmentativeandalternativecommunicationmodalities
§ StandardIV-D:ForeachoftheareasspecifiedinStandardIV-C,theapplicantmusthavedemonstratedcurrentknowledgeoftheprinciplesandmethodsofprevention,assessment,andinterventionforpeoplewithcommunicationandswallowingdisorders,includingconsiderationofanatomical/physiological,psychological,developmental,andlinguisticandculturalcorrelates.
§ StandardIV-E:Theapplicantmusthavedemonstratedknowledgeofstandardsofethicalconduct.§ StandardIV-F:Theapplicantmusthavedemonstratedknowledgeofprocessesusedinresearchandofthe
integrationofresearchprinciplesintoevidence-basedclinicalpractice.§ StandardIV-G:Theapplicantmusthavedemonstratedknowledgeofcontemporaryprofessionalissues.§ StandardIV-H:Theapplicantmusthavedemonstratedknowledgeofentrylevelandadvanced
certifications,licensure,andotherrelevantprofessionalcredentials,aswellaslocal,state,andnationalregulationsandpoliciesrelevanttoprofessionalpractice.-
§ StandardV-A:Theapplicantmusthavedemonstratedskillsinoralandwrittenorotherformsofcommunicationsufficientforentryintoprofessionalpractice.
§ StandardV-B:heapplicantforcertificationmusthavecompletedaprogramofstudythatincludedexperiencessufficientinbreadthanddepthtoachievethefollowingskillsoutcomes:(1.Evaluation2.Intervention3.InteractionandPersonalQualities)
§ StandardV-C:Theapplicantforcertificationinspeech-languagepathologymustcompleteaminimumof400clockhoursofsupervisedclinicalexperienceinthepracticeofspeech-languagepathology.Twenty-fivehoursmustbespentinclinicalobservation,and375hoursmustbespentindirectclient/patientcontact.
§ StandardV-D:Atleast325ofthe400clockhoursmustbecompletedwhiletheapplicantisengagedingraduatestudyinaprogramaccreditedinspeech-languagepathologybytheCouncilonAcademicAccreditationinAudiologyandSpeech-LanguagePathology.
§ StandardV-E:SupervisionmustbeprovidedbyindividualswhoholdtheCertificateofClinicalCompetenceintheappropriateprofession.Theamountofdirectsupervisionmustbecommensuratewiththestudent'sknowledge,skills,andexperience,mustnotbelessthan25%ofthestudent'stotalcontactwitheach
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client/patient,andmusttakeplaceperiodicallythroughoutthepracticum.Supervisionmustbesufficienttoensurethewelfareoftheclient/patient.
§ StandardV-F:Supervisedpracticummustincludeexperiencewithclient/patientpopulationsacrossthelifespanandfromculturally/linguisticallydiversebackgrounds.Practicummustincludeexperiencewithclient/patientpopulationswithvarioustypesandseveritiesofcommunicationand/orrelateddisorders,differences,anddisabilities.
Seemoreat:http://www.asha.org/Certification/2014-Speech-Language-Pathology-Certification-Standards/
CouncilforClinicalCertificationinAudiologyandSpeech-LanguagePathologyoftheAmericanSpeech-Language-HearingAssociation.(2013).2014StandardsfortheCertificateofClinicalCompetenceinSpeech-LanguagePathology
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Speech,Language&HearingClinicClinicalFocusPlanPolicyCFPDocumentUpdatedFall2018byJackieMcDonaghSpring2018byJessicaScaringella
CLINICALFOCUSPLANPOLICYANDPROCEDURE–INSTRUCTIONALAPPROACH
Purpose ToprovideadditionalsupporttoClinicalPracticumStudentCliniciansonan
individual or small group basis. There are two types of plans: (1) anInstructionalApproach isused to target improvementofKnowledgeandSkillsjudgedtobebelowexpectationsbythereferringClinicalSupervisor(s);and (2)aMentoringApproach isused tosupportStudentClinicianswithhigherlevelskillswhoseektodevelopmoreadvancedKnowledgeandSkills.ThisdocumentaddressestheInstructionalApproach.
Responsible ClinicDirectorParties: AssistantClinicDirector|OnSiteCoordinator ClinicalSupervisors Procedure: ThefollowingstepssummarizeproceduresfortheClinicalFocusPlan
(CFP)–InstructionalApproach:
(1) The Clinical Supervisor(s) identifies specific areas to betargeted for improvement and specifies a time frame (i.e.,improvement within four weeks), based on the followingcriteria:TheStudentClinicianisfunctioningataLevelOneorLevel Two on Knowledge and Skills identified in the gradingrubric,theStudentClinicianrequestsadditionalsupportwithself-expressed areas of difficulty, or substantial difficultyintegrating into/managing clinical expectations. the StudentCliniciandemonstratesadditionalsupportinadditiontoIftheStudent Clinician has more than one Clinical Supervisor, allsupervisorsconfertodiscussidentifiedneeds,eitherinpersonorviae-mail.
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(2) TheClinicalSupervisor(s)informstheStudentClinicianoftheareas needing improvement during a face-to-face meeting,andmaintainswrittendocumentationofthemeetingcontentand Student Clinician response (See Appendix E: Record ofMeetingsand Instruction).TheClinicalSupervisormakes therecommendationforaClinicalFocusPlan.
(3) TheClinicalSupervisornotifiestheAssistantClinicDirectorbye-mail that a referral is being made, and attaches thecompletedClinicalFocusPlanReferralformtothee-mail(SeeAppendix A). If there is more than one direct ClinicalSupervisor,theprimarysupervisorconferswithallotherdirectClinicalSupervisorsviae-mailpriortocompletingthereferralformtoseekinputregardingareasofKnowledgeandSkillthatfall below expectations. The names of all direct ClinicalSupervisorswillbelistedonthereferralform.
(4) TheAssistantClinicDirector|OnSiteCoordinatormeetswith
the student to develop specific goals for the Plan based onneeds determined by the direct Clinical Supervisors, to beachievedatthe80%levelofmastery(seeAppendixB:SampleGoals).
(5) ThewrittenCFPispreparedbytheAssistantClinicDirector|On Site Coordinator according to the format provided (seeAppendixC:CFP)andissignedbybothparties.
(6) The original written CFP is retained by the Assistant ClinicDirector|OnSiteCoordinator,andcopiesareprovidedtothestudent,ClinicalSupervisor(s),andClinicDirector.
(7) The Student Clinician is instructed to make copies of thewrittenCFPandtoplaceacopyofthesignedCFPinthechartofeachclient.
(8) TheAssistantClinicDirector|OnSiteCoordinatorschedulesand holds weekly meetings with the Student Clinician toprovide direct instruction in targeted areas to facilitateprogress towards Plan goals, and maintains writtendocumentation of the meetings, to be filed in the StudentClinician’s individualadvising file (SeeAppendixD:RecordofMeetingsandInstruction).
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(9) TheAssistantClinicDirector |On SiteCoordinator developswritten Action Step assignments to be completed by theStudentClinicianeachweek (seeAppendixE: SampleActionSteps),whichare recorded in the top sectionof the InterimActionReportform(seeAppendixF).
(10) After completing each assignment, the Student Cliniciancompletes awritten InterimActionReport (seeAppendix F),whichisdiscussedwiththeAssistantClinicDirector|OnSiteCoordinator during the weekly follow-up meeting. Afterreviewoftheassignment,thereportissignedbybothparties.
(11) TheStudentClinicianplacesacopyofthesignedInterimActionReportinhis/herstudentchart.
(12) TheClinicalSupervisor(s)informtheAssistantClinicDirector|On SiteCoordinator inwritingof any concerns that ariseorotherareasforstudentdevelopmentthatareidentifiedafterinitiationoftheCFP.
(13) The Assistant Clinic Director | On Site Coordinator provides
specificperiodicwrittenupdatestotheClinicalSupervisor(s)(e.g.,after4instructionalmeetingswiththeStudentClinician)and to the Clinic Director regarding the Student Clinician’sresponse to intervention and progress towards goals, andrequestsfeedbackfromtheClinicalSupervisor(s)onprogressdemonstratedtowardsgoals.
(14) Methodsofevaluationwillincludethefollowing:
(a) Direct Supervisor assessment of student performance in
targetedgoalareas,bydirectobservationduringmeetingsandtreatmentsessions;and(b) DirectSupervisorandAssistantClinicDirector|OnSiteCoordinatorassessmentofwrittenwork(e.g.,clinicaldocumentation,writtenassignments,lessonplans,etc.).
Assessmentofprogressmayinclude,butisnotlimitedto,thefollowing:studentperformanceonActionStepassignments;student preparation for meetings with the Supervisors, asevidenced by active, collaborative participation; studentdevelopment and implementation of long- and short-termgoalsandlessonplansthataresupportedbyappropriateEBP
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sources;andstudentintegrationofacademicknowledgeandEBPintotreatmentplanningandimplementation.
The Assistant Clinic Director | On Site Coordinator and thedirectClinicalSupervisor(s)willcollaboratetodeterminethefollowing:(a) MeasurablestudentprogresstowardsCFPgoalsandlevel
ofmasteryachievedforeachgoal;
(b) Whethergoalshavebeenmet;
(c) Whethertherearegoalsthatrequiremoretimetoachievemastery;
(d) Whether there are additional concerns or areas for
identifiedasneedingdevelopment;and
(e) DispositionofthePlan:
1- ExtensionofthePlanisrecommendedtoallowmoretime for mastery of goals or to address recently-identifiedareasneedingdevelopment,or
2- DischargeofthePlanisrecommended,withgoalsmet.
(15) TheAssistantClinicDirector|OnSiteCoordinatorpreparesasummaryreport(seeAppendixG)upondischargeoftheCFP(i.e.,whengoalsaremet,orattheconclusionofthesemester).Copies of the summary are provided to the direct ClinicalSupervisor(s)andtotheClinic.Goalsaredeemedmetwhen80%masteryisachieved.
ListofAppendices:AppendixA–CFPReferralAppendixB–CFPGoalsAppendixC–ClinicalFocusPlanAppendixD–MeetingLogAppendixE–ActionSteps(Assignments)AppendixF–ActionReportAppendixG–SemesterCFPSummar
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AppendixA–ClinicalFocusPlanReferral–InstructionalApproach
Student: ClinicalSupervisor(s): ReferralCompletedBy: ReferralDate:
ReasonsforReferralUsingthecategoriesbelow(takenfromthegradingspreadsheet),pleaseindicatebycheckmark
allareasinneedofadditionalsupporttofacilitatedevelopmentofknowledgeandskills.A“BelowExpectations”designationisequivalenttoaLevelOneorLevelTwoonthegradingrubric.Intervention/ClinicalSkills BelowExpectationsCompletesathoroughreviewofclient’sfile(formalrecords,casehistory,progressreports)–ReturningClient
MeetswithSLPtopreparefornewclientprogram–NewClient Contactsfamiliestointroducethemselvesasthestudentclinician,confirmsschedule,&gathersfurtherinformationtosupportinitialplanofcare
Developmentofbaselinescreeningappropriateforage,genderandcognitiveskills
Resultsofbaselinedatademonstratespresentknowledgeofcommunicationdelay,disorderorimpairment
Therapydevelopmentisappropriateforcommunicationdisorderand/ordelay
Planofcare(LessonPlan)includesEBP Planofcare(LessonPlan)includesgoalsfromfamily,clientand/orguardian
Priortosessionstart–ispreparedwithmaterialsandgreetsclient Materialsareappropriatefortargets,clientlevelandinterests Adaptsand/ordevelopsnovelinstructionalmaterialsasneeded Sessionstarts&endsontime Providesvisualand/orverbalsupportforsessionorganizationandexpectations
Providesclientwithpurposeofeachactivity(aswellastransitionofactivities)toincludeclientinthedevelopmentofplanofcare
Providesverbalandnon-verbalreinforcementsforfeedbacktoimproveclientsuccessforcommunicationneeds
Providesmanagementandgeneralizationstrategiestoimproveclientsuccessforcommunicationneeds
Recognizesandmanagesclient’sbehaviorforoptimalsessionsuccess Includesmaximumopportunitiesforclienttomeetalltargetspresented
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Studentclinicianaddresseseachgoalthatwasdocumentedforthesession
Thecommunicationdisorder,delayorimpairmentisthefocusoftheplanofcare
Appropriatedatacollectioniscompletedformeasuringperformanceandprogress
Formatpresentedisengagingfortheclient Physicalenvironmentisappropriateforclientneeds Studentclinicianself-evaluatesprofessionalismduringsessionwithanuprightposture,providesdirectionsandisalert
Effectivecommunicationwiththeclient/familytodiscussspeechlanguageprogresstodate,goals,needs
Followsthroughwiththespeechlanguagepathologisttoimproveknowledgeofskills,problemsolveclientneeds,anddevelopclinicalskills
InterpersonalQualities BelowExpectationsMeetingswithspeechlanguagepathologist:studentdemonstratescommitmentforseekingsupportandclarification
Meetingswithspeechlanguagepathologist:studentcomespreparedwithquestionsand/oragenda
Meetingswithspeechlanguagepathologist:studentcommitstomeetingswithsupervisors
Meetingswithspeechlanguagepathologist:communicateseffectivelywithSLPfordevelopmentofprofessionalknowledge
Relatescomfortablywithclientandmaintainsconfidentimage Appropriatebehaviorisestablishedandmaintained Respondsappropriatelytopsychologicalandphysicalneeds Modifiesinteractionalstyletoenhancestudentclinicianeffectiveness Demonstratesanunderstandingandincorporatesclient’sculturalbackgroundandsocio-economicstatus
Oralcommunicationskillsareeffectivewiththeclient/clientfamilyincludinginterpretationofclinicalterminologyandprovidingupdatedinformationabouttheclient’stherapyprogram
Takesinitiativetodevelopclinicalknowledgeandskillsfortherapeuticpractices
Managesclinicaldemandswitheaseandflexibility Collaborateswithotherprofessionalsincasemanagement Demonstratesemotionalmaturityandahealthyindependenceintheclinicsetting
Professionalism BelowExpectations
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Maintainsaprofessionalappearanceandfollowsthedresscode(refertohandbookforguidelines)
DiscussionofclientsfollowHIPAAregulations Languageusedintheclinicisprofessionalandtopicsareappropriateforabusinessenvironment
Establishedrapportwithclientsandfamiliestoexpressconcernsanddiscusstherapyprogram
Ontimeforsessionsincludinggreetingtheclientandinitiatesapromptstarttimeofthesession
Attendsandparticipatesinmeetingsthatrelatetoclinicaldevelopment Dependableandcommitted:sessionsarepreparedandorganized Demonstratesthebestinterestsfortheclient:anadvocatefortheclientneedsincludingwithinthesession’sbestpractices
Consistentinitiative:resourceful,asksquestions,andimplementsSLP’srecommendations
Professionalresponsibilityisconsistentwithinitiatingcontactwithasupervisor,self-evaluatesownskillsandtakesresponsibilitywithoutblamingothersand/orexternalfactors
Demonstratesrespectfortheprofessionandclinicwhilemaintainingaprofessionaldemeanorandbehavioratalltimes
Communicateseffectivelyusingappropriaterate,pitchandvolumewithclients,families,professionals,andpeers–communicationisorganized,articulatewithappropriateuseofgrammar
DemonstratesknowledgeofASHAstandardsandappliesASHA’sCodeofEthics
Followsonsiteclinicalproceduresincludingconfidentialityguidelines,HIPAAregulations,safetyproceduresandtimeframeofprojects
AcademicandClinicalBase BelowExpectationsUsesacademics&EBPtodevelopbaselinedataprotocolandsubsequenttreatmentprogram
Understandingthenatureofthecommunicativedisordersanddifferencesanddemonstratesviasession,discussion,andwrittenformat
Courseworkapplied,integratesdevelopmentalcharts,and/orresearchmethods
Observedintheclinicpreparingforpracticum:practicesassessmentsandtreatmenttechniques
Demonstratesanunderstandingofacademics&EBPtogeneralizetheinformationintotheclinicalsetting
LearningSkills BelowExpectationsSeeksclarification,problemsolvesandproposessolutions
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Receivessuggestionswithoutresistance Promptlyandeffectivelyincorporatessupervisor’sdirectives Demonstratesanunderstandingoftheclient’scommunicationskillsandtakesinitiativetosuggestnewtherapyapproaches
Self-evaluationtomeetpre-professionalgoals.Identifiesareasofstrength&areasthatrequireimprovement
WrittenDocumentation BelowExpectationsInitialdraftsofwrittendocumentationrepresentbestefforts Submitsdocumentationontime Consistentlyfollowsclinicguidelines,formatfordocumentationpurposes
WrittendocumentationprogressionisevidencedbyapplicationoftheSLP’srecommendations
Reportingisorganized,neat,andcomplete Documentationisproofreadwithappropriategrammar,clearsentencestructure,andnospellingerrors
Includesahighlevelofprofessionalterminology Writesclearbehaviorallong-termandshort-termobjectivesforclients Informationisorganizedandconcisewithconsistentinterpretationofinformation
AdditionalInformation:
Pleaseincludeadditionalinformationregardingaboveindicatedareaswhichcurrentlyfallbelowexpectations.Discussareasofimprovementandpossiblegoalstobetargeted.Pleaseindicate
whatattemptshavebeenmadesofarwhichwereunsuccessfulinordertosupportimplementationofClinicalFocusPlan.
Speech-Language
PathologistSignature,Credentials,Date
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AppendixB–SampleGoalsforClinicalFocusPlan,InstructionalApproach
Theplanmustspecifyexpecteddateofachievement,andthecriterionlevelformastery(e.g.,80%accuracy). Goals should be tailored specifically to the individual student clinician in order toimproveknowledgeandskillsinareasofimprovement.Goalsshouldbemeasurableandclearlywritten.SampleGoalsAddressingPreparation/SessionImplementation:
o Thestudentclinicianwillpreparematerialsforallsessionsatleast24hourspriortothescheduledsession;materialsmustbeappropriateforclientage,skills,andgoaltargets.Thestudentclinicianshouldappearcomfortableusingthematerialsduringthesession,andtheformatofsessionsmustbeengagingtotheclient.
o Thestudentclinicianwilldevelopandexecuteorganized,engaging,client-specificsessionswhichsupportandtargettheclient’sneedsinafunctionalway.Thestudentclinicianwillconductorganizedsessionsevidencedbyincludingandinformingtheclientoftransitions,utilizingage-appropriatetransitionsbetweenactivities,providingvisualand/orverbalsupportforsessionorganizationandexpectations,andincludingtheclient/client’sfamilyintheplanofcare.
o Thestudentclinicianwillimproveinherutilizationaswellasvariationofengagingandmotivatingage-appropriatematerialstokeeptheclient’sinterestthroughoutthesessionandtoeffectivelytargetspeechandlanguagegoals.
SampleGoalsAddressingWrittenDocumentation:
o Thestudentclinicianwilldemonstrateimprovementintheareaofwrittendocumentation,specificallyintheareasofmechanics(e.g.,grammar,syntax,spelling),clinicallanguageandterminology,andcontentwhichreflectsappropriateclinicalreasoningandanalysis.Thestudentclinicianwillproofreadallwrittendocumentationentirelypriortosubmission.
o Thestudentclinicianwilldevelopanddocumentappropriate,measureablelong-termandshort-termgoalsforallclients,adjustingandmodifyingbasedonclients’performance,throughoutthesemesterutilizingsupportingdata.
o Thestudentclinicianwilldemonstrateimprovedandaccuratedatacollectionskills.Thestudentclinicianwillanalyze/interpretdataaccuratelytodetermineclient’sleveloffunctionandprogresstowardgoals.
o Thestudentclinicianwilldevelopappropriate,measureablelong-termandshort-termgoalsfortheclient,adjustingandmodifyingbasedonclientperformance,throughoutthesemesterutilizingsupportingdata.
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SampleGoalsAddressingEBP:
o Thestudentclinicianwillincludeandappropriatelydocumentevidence-basedpractice(EBP)resourceswithinallwrittendocumentation(e.g.,lessonplans,SOAPnotes,progressreports/statements)inordertoaccuratelyjustifygoals,therapystrategies,and/ortechniquestosupportapplicationofacademicsandEBPintotheclinicsetting.
o ThestudentclinicianwilleffectivelyimplementthedocumentedEBPintosessionsinordertodemonstrateunderstandingofapplicationofacademicsandEBPintoclinicsessions.
o Thestudentclinicianwillconductappropriateresearchrelatedtoclientcommunicationdisorder(s)suggestedbyclinicalsupervisor(s)priortoweeklyCFPmeetings,and(1)mustcometoCFPmeetingspreparedtodiscusstheseresearchfindings,and(2)mustprovidetheCFPsupervisorwithappropriatewrittendocumentationoftheresearchconducted.
SampleGoalsAddressingTherapyApproaches/Implementation:
o Thestudentclinicianwillimproveknowledgeandskillsinallninescopesofpractice,withanincreasedfocusonassignedclients’diagnoses,inordertoincreaseapplicationofacademiccontentintotherapeuticpractice.
o Thestudentclinicianwilldemonstrateknowledgeandapplicationofvarioustreatmentapproachesandmethodsinordertovarytreatmentactivitiesandtargetmultiplegoalswithinsessions.
SampleGoalsAddressingInterpersonalSkills/SupervisorFeedback:
o Thestudentclinicianwillimplementallsupervisorfeedbackandsuggestionsprovidedviawrittenandverbalmodalitiesintowrittendocumentationand/ortherapysessionswithnomorethanonerevisionoftheoriginal.Thestudentclinicianwillactivelyandindependentlyseekclarificationduringin-personmeetingsasneededinordertoimplementfeedbackandsuggestionsaccurately,efficiently,andimmediately.
o Thestudentclinicianwilldevelopprofessionalcommunicationskillsandacceptanceofsitepoliciesandproceduresinordertoprepareforoff-siteplacement.Thestudentclinicianwillseeksupervisorsupportduringin-personmeetings,asopposedtoinappropriatetimes(e.g.,whenasupervisorisactivelysupervising,withoutaskingthesupervisorifshehastimetomeet,etc.).Meetingsshouldbescheduledasperclinicpolicy/procedure.
o Thestudentclinicianwilltakeinitiativeinschedulingmeetingswithsupervisorsforsupportonaregularbasis(atleast1-2meetingsweekly)andwillutilizemeetingsastheprimarymeansofcommunicationwithSLP.
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o Thestudentclinicianwillobservesessionstargetingrelatedspeechandlanguagegoalswithintheclinicatleastonetimeperweekandkeepalogoftheseobservations.
SampleGoalsAddressingClinicPolicies/Procedures:
o Thestudentclinicianwilladheretoallonsiteclinicalprocedures,including,butnotlimitedto,maintaininganorganizedandcompletechart,completingdocumentation(e.g.,attendancelog,SOAPnoteroutingsheet)onaregularbasis,andadheringtoallduedates.
o ThestudentclinicianwillsubmitlessonplansforMondaysessions,intheirentirety,byWednesdays5:00pm,inordertobereviewedatanearlierdatebySLP.ThestudentclinicianwillobtainapprovalfromthesupervisingSLPpriortoimplementationofthelessonplan.ThestudentclinicianshouldattendweeklymeetingsonWednesdayswiththeprimarysupervisorinordertodiscusstheplanandhavethelessonplanapproved.
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AppendixC:ClinicalFocusPlan
Student: Student’sName
ClinicalSupervisor(s): NameofClinicalSupervisor(s)DesignatedClinicalFocusPlanSupervisor: NameofDesignatedCFPSupervisorImplementationDate: DateofImplementation–Whendidtheplanbegin
ThewrittenClinicalFocusPlanestablishedwiththeStudentClinicianmustincludespecificgoals.ThePlanmustspecifyexpecteddateofachievement,andthecriterionlevelformastery(80%).
STUDENTCLINICIANKNOWLEDGEANDSKILLS
Studentclinician’sspecificgoalsshouldbelistedhere.
GENERALGOALSFORDEVELOPMENTOFKNOWLEDGEANDSKILLS
AcquisitionofKnowledgeandSkillsrelatedto:
1- Evidence-BasedPracticeresearch2- Datacollection,analysisandinterpretation3- Identificationofappropriatetreatmentapproaches,activitiesandmaterials4- Writtenclinicaldocumentation
AdherencetoallClinicPoliciesandProcedures,andtospecificpoliciesandproceduresoftheClinicalFocusPlan:
1- StudentClinicianwilladheretoallclinicpoliciesandprocedures2- StudentClinicianwillmaintainacopyofthesignedCFPintheSessionClientChartforeach
client.3- StudentClinicianwillcompleteweeklyActionStepsassignedbytheclinicalfocusplan
supervisor,anddocumentcompletioninaweeklyCFPInterimActionReport.4- StudentClinicianwillattendaCFPweeklymeetingwiththeclinicalfocusplansupervisor,and
proactivelyscheduleregularmeetingswithallsupervisorstodiscusstreatmentplanningandimplementation,andclientprogress.
StudentClinicianwillmaintainanorganizedandcompleteSessionClientChartforeachclientandmaintainalldocumentationutilizingtheMedicat(EMR)systemappropriately.
STUDENT-FOCUSEDGOALSFORDEVELOPMENTOFKNOWLEDGEANDSKILLS
Thestudentclinicianshouldselectgoalsforhim/herself.Whatdoesthestudentclinicianaimto
improveonthroughoutthesemester?
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METHODOFEVALUATION
Howwillthestudentclinicianbeevaluated?
Collaborative:TheDesignatedClinicalSupervisorandalldirectClinicalSupervisorsparticipateinstudentassessmentthroughcollaborativein-person,emailand/ortelephonecommunication.Allsupervisorswillcollaborativelydetermineprogresstowardgoals.Methods:
1- Directobservationduringtreatmentsessions(remoteorpush-in)andmeetings2- Assessmentofwrittenwork/assignments
EXPECTEDDATETOACHIEVEGOALS
BywhendoestheCFPSupervisorexpectthestudentclinicianwillachievethegoalsoutlinedintheCFP?
EXAMPLE:BytheendoftheSpring2018semester
CONSEQUENCEIFPLANISNOTACHIEVEDIfCFPgoalsandplanofactionbenchmarksarenotmet(includingALLsupervisorsuggestions),StudentClinicianisatriskforfailureofthiscourse.FailureofthiscoursemayresultintheStudentCliniciannotobtainingclinicalclockhoursandpossibleneedtorepeatthecourseandon-siteplacementduringthefollowingsemester;needtorepeatthiscoursemayresultinadelayingraduation.FailuretomeetthegoalsandPlanofActionforthisCFPmayalsoresultinareductioninclientcaseloadforthecurrentandfuturesemesters.
STUDENTCLINICIAN DATE
CLINICALFOCUSPLANSUPERVISOR DATE
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AppendixD–RecordofMeetingsandInstruction
STUDENT: IMPLEMENTATIONDATE: CLINICALSUPERVISOR(S): DESIGNATEDCFPSUPERVISOR:
MeetingRecord
DATE GRP 1:1 INSTRUCTIONPROVIDED INITIALS
DESIGNATEDCLINICALSUPERVISOR DATE
AppendixE–SampleActionSteps
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Writtenweeklyassignments(ActionSteps)areassignedbytheClinicalFocusPlanSupervisor.
ListedbelowaresampleActionSteps;itisanticipatedthatotherActionStepswillbedevelopedthatarespecifictothegoalsoftheCFP.
AftercompletingEBPresearch,consultwiththeclinicalsupervisorstoselecttwotreatmentapproacheswhichmaybeimplementedintotherapysessionswiththeassignedclients.Writeasummaryforeachtreatmentapproachthat(1)includesabriefrationaleforuseofthetreatmentapproach,and(2)describeshowtheapproachisimplementedinclinicalpractice.Bepreparedtoverballydiscusseachtreatmentapproachanditsrelevancetoimplementationwithintheclinicsetting.Usinginformationprovidedinperson/viawrittenhandouts,andimplementingclinicalsupervisor(s)feedback,revisetwoshorttermgoals:consultwiththeclinicalsupervisorstoclarifyanyfeedbackasneeded;reviewterminology(e.g.,“within”or“by”and“across”or“over),accuracylevelaveragedforallsessionsversuscriterionachievedateachofmultipleconsecutivesessions.ModifyeachgoaltofittheSMARTgoaloutlineasdiscussedintheCFPmeeting.ReadASHAdocumentsrelatedtotheASHACodeofEthicsandASHAStandards,includingScopeofPracticeforSpeech-LanguagePathologistsandEvidence-BasedPractice(linksprovidedtoASHAwebsiteinCFPmeeting).Provideawrittensummaryofeachdocument(i.e.,whatdidyoulearn)andbepreparedtodiscussintheCFPmeetingscheduled01/22/18.CommunicateeffectivelyandinatimelymannerwithallClinicalSupervisors,followingClinicPoliciesandProcedures,adheringtoallappropriatetimeframes.ObserveatleastonesessionconductedintheclinicwithpermissionfromtheCFPsupervisor,clinicdirector,andprimarysupervisor.Maintainrecordoftheday/timeofthesessionandnoteatleast3observationswhichcanbeimplementedintofuturesessions(i.e.,whatdidyoulearn,whatideasdidyougather).Thesessionmustbeviewedinitsentirety,fromstarttofinish.Bringthesenotes(writteninanyformatpreferred)totheCFPmeetingscheduled01/22/18.ReviewthelessonplanforclientALon01/17/18.Implementallsupervisorfeedbackintoarevisedlessonplan.Seekclarificationviain-personmeetingswiththedirectsupervisorasneededifanyfeedbackisunclear.BringboththecorrectedandtherevisedcopiesofthelessonplansfortheCFPmeetingscheduled01/22/18.
AppendixF–InterimActionReport-Sample
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STUDENT:
STUDENT’SNAME
IMPLEMENTATIONDATE:
CLINICALSUPERVISOR(S):
DESIGNATEDCFPSUPERVISOR:
ASSIGNEDACTIONSTEPS
1- StudentClinicianwillresearchtreatmentapproaches(TraditionalApproach,CyclesApproach)andprovideawrittensummaryofeachandhowthetreatmentapproachesmaybeimplementedwiththeclient.Anyformatpreferredbythestudentclinicianmaybeutilized(e.g.,bulletpoints,chart,paragraphs).
2- StudentClinicianwillciteEBPinalllessonplansandSOAPnotestosupportgoalsandtreatmentapproaches/strategies.TheEBPshouldspecificallystateandexplain:
a. whythetreatmentapproachisappropriatefortheclient/diagnosisb. howtheresearchsupportstheanalysisandinterpretationofdatacollected
3- Studentclinicianwillreviewsupervisor’sfeedbackonlessonplanstodateandimplementallfeedbackprovided,followingupwithdirectclinicalsupervisorviain-personmeetingsasneededinordertoseekclarification.
DateDue:10/23/17
STUDENT DOCUMENTATION OF ACTION STEP COMPLETION
1- ReviewofwrittenlessonplansandSOAPnotes2- Writtensummariesoftheselectedtreatmentapproaches(separateattachment)
STUDENTDOCUMENTATIONOFRESEARCHEFFORTS–INCLUDEURLS/CITATIONS
Includeaseparateattachmentlistingcitationsforallresourcesconsulted,usingpropercitationformat.Incompletecitationswillnotbeaccepted(e.g.,providingonlyURLs).
STUDENTCLINICIAN DATE
DESIGNATEDCLINICALSUPERVISOR DATE
AppendixG–ClinicalFocusPlanSummaryReport
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STUDENT:STUDENT’SNAMEIMPLEMENTATION:07/17-08/04/17CLINICALSUPERVISOR(S):LISTEACHSUPERVISORDESIGNATEDCLINICALSUPERVISOR:M.A.,CCC-SLP,TSSLD
MeetingDates 07/14/17,07/17/17,07/21/17,07/28/17,08/04/17
SupervisorFocusedGoalsToDate
Listallsupervisor-initiatedgoalswhichweretargetedthroughouttheClinicalFocusPlan.
AssignedActionSteps
ListeachActionStepwhichwasaddressedthroughouttheClinicalFocusPlan.Theseshouldbecopiedfromeachassignmentprovidedtothestudentclinicianandincludedates.
ProgresstoGoals
Restateeachgoal,theneachsupervisorshoulddocumentimpressions,approximatelevelofmastery,andsupportingdetails.Forexample:
Goal:Thestudentclinicianwilldemonstrateimprovementintheareaofwrittendocumentationintheareasofmechanics(e.g.,grammar,syntax,spelling),clinicallanguageandterminology,andcontentwhichreflectsappropriateclinicalreasoningandanalysis.Thestudentclinicianwillproofreadallwrittendocumentationinitsentiretypriortosubmission.
SLPSomeimprovementisnoted,althougherrorsingrammar,syntaxandsemanticspersist.Basedondiscussionsduringmeetingswiththestudent,itappearsthatshedoesnotrecognizetheseerrors.Attimes,syntaxandsemanticsobscureherintendedmeaning,especiallyinwrittenanalysesofprogresstowardsgoalsanddiscussionofremainingdeficits.Iestimatethatthecurrentlevelofmasteryisapproximately75%.
SLPThestudentclinicianimprovedintheareaofwrittendocumentationintheareaofmechanics,asevidencedbyreviewofclientactivecharts.However,writtendocumentationcontinuestopresentwithsomeerrorsingrammar,suchasincompletesentences.TheCFPsupervisorhasdiscussedstrategies,suchasreadingaloud,inordertoproofreadmoreeffectively.Veryminimalspellingerrorswerenotedasthesemesterprogressed.Thestudentclinicianimprovedintermsofuseofclinicallanguageandterminologyoncediscussedandterminologywasintroduced.Contentdoesnotconsistentlyreflectappropriateclinicalreasoningandanalysis.Estimatedlevelofmasteryisjudgedtobe75-80%.
ImpressionsandThoughts
IncludeabriefsummaryofprogresstowardtheCFPandprogresstowarddevelopmentofknowledgeandskills.
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RecommendationWhataretherecommendationsregardingtheCFP?ItisrecommendedthattheCFPcontinue…Dischargeisrecommended…
Submittedby Name,Credentials,&Date
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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAppendixIClinicalSupervisionSkillsforaClinicalSupervisorarebasedonthefollowing:AmericanSpeech-Language-HearingAssociation.(2008).KnowledgeandSkillsNeededbySpeech-LanguagePathologistsProvidingClinicalSupervision[KnowledgeandSkills].Availablefromwww.asha.org/policy.
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ASHA'spositionstatementaffirmsthatclinicalsupervision(alsocalledclinicalteachingorclinicaleducation)isadistinctareaofexpertiseandpractice,andthatitiscriticallyimportantthatindividualswhoengageinsupervisionobtaineducationinthesupervisoryprocess.DevelopingKnowledgeandSkillsAllcertifiedSLPshavereceivedsupervisionduringtheirstudentpracticaandclinicalfellowship;however,thisbyitselfdoesnotensurecompetenceasasupervisor.Furthermore,achievingclinicalcompetencedoesnotimplythatonehasthespecialskillsrequiredtobeaneffectivesupervisor.ASHAdoesnothavespecificrequirementsforcourseworkorcredentialstoserveasasupervisor;however,somestatesorsettingsmayrequirecourseworkand/oryearsofexperiencetoserveasasupervisor.Knowledgeandskillsmaybedevelopedinavarietyofways:participatingincoursesorworkshopsonsupervision,engaginginself-study,participatinginDivision12(AdministrationandSupervision),andgainingmentoredexperiencesundertheguidanceofanexperiencedclinicaleducator.Thefollowing12itemsrepresentcoreareasofknowledgeandskills.Thesuperviseeisanessentialpartnerinthesupervisoryprocess;however,theseareasarepresentedfromtheperspectiveofknowledgeandskillsthatshouldbeacquiredbythesupervisor.
I.PreparationfortheSupervisoryExperience
A.KnowledgeRequired
1. Befamiliarwiththeliteratureonsupervisionandtheimpactofsupervisorbehaviorsonthegrowthanddevelopmentofthesupervisee.2. Recognizethatplanningandgoalsettingarecriticalcomponentsofthesupervisoryprocessbothfortheclinicalcareprovidedtotheclientbythesuperviseeandfortheprofessionalgrowthofthesupervisee.3. Understandthevalueofdifferentobservationformatstobenefitsuperviseegrowthanddevelopment.4. Understandtheimportanceofimplementingasupervisorystylethatcorrespondstotheknowledgeandskilllevelofthesupervisee.5. Understandthebasicprinciplesanddynamicsofeffectivecollaboration.6. Befamiliarwithdatacollectionmethodsandtoolsforanalysisofclinicalbehaviors.7. Understandtypesandusesoftechnologyandtheirapplicationinsupervisi
B.SkillsRequired
1. Facilitateanunderstandingofthesupervisoryprocessthatincludestheobjectivesofsupervision,therolesoftheparticipants,thecomponentsofthesupervisoryprocess,andacleardescriptionoftheassignedtasksandresponsibilities.2. Assistthesuperviseeinformulatinggoalsfortheclinicalandsupervisoryprocesses,asneeded.3. Assessthesupervisee'sknowledge,skills,andpriorexperiencesinrelationshiptotheclientsserved.4. Adaptordevelopobservationalformatsthatfacilitateobjectivedatacollection.5. Beabletoselectandapplyasupervisorystylebasedontheneedsoftheclientsserved,andtheknowledgeandskillofthesupervisee.6. Modeleffectivecollaborationandcommunicationskillsininterdisciplinaryteams.7. Beabletoanalyzethedatacollectedtofacilitatethesupervisee'sclinicalskilldevelopmentandprofessionalgrowth.8. Usetechnologyasappropriatetoenhancecommunicationeffectivenessandefficiencyinthesupervisoryprocess.
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II.InterpersonalCommunicationandtheSupervisor-SuperviseeRelationship
A.KnowledgeRequired
1. Understandthebasicprinciplesanddynamicsofeffectiveinterpersonalcommunication.2. Understanddifferentlearningstylesandhowtoworkmosteffectivelywitheachstyleinthesupervisoryrelationship.3. Understandhowdifferencesinage,gender,culture,socialroles,andself-conceptcanpresentchallengestoeffectiveinterpersonalcommunication.4. Understandtheimportanceofeffectivelisteningskills.5. Understanddifferencesincommunicationstyles,includingcultural/linguistic,generational,andgenderdifferences,andhowthismayhaveanimpactontheworkingrelationshipwiththesupervisee.6. Befamiliarwithresearchonsupervisionintermsofdevelopingsupervisoryrelationshipsandinanalyzingsupervisorandsuperviseebehaviors.7. Understandkeyprinciplesofconflictresolution.
B.SkillsRequired
1. Demonstratetheuseofeffectiveinterpersonalskills.2. Facilitatethesupervisee'suseofinterpersonalcommunicationskillsthatwillmaximizecommunicationeffectiveness.3. Recognizeandaccommodatedifferencesinlearningstylesaspartofthesupervisoryprocess.4. Recognize and be able to address the challenges to successful communication interactions (e.g., generational and/or gender differences andcultural/linguisticfactors).5. Recognizeandaccommodatedifferencesincommunicationstyles.6. Demonstratebehaviorsthatfacilitateeffectivelistening(e.g.,silentlistening,questioning,paraphrasing,empathizing,andsupporting).7. Maintainaprofessionalandsupportiverelationshipthatallowsforbothsuperviseeandsupervisorgrowth.8. Applyresearchonsupervisionindevelopingsupervisoryrelationshipsandinanalyzingsupervisorandsuperviseebehaviors.9. Conductasupervisorself-assessmenttoidentifystrengthsaswellasareasthatneedimprovement(e.g.,interpersonalcommunication).10. Useappropriateconflictresolutionstrategies.
III.DevelopmentoftheSupervisee'sCriticalThinkingandProblem-SolvingSkills
A.KnowledgeRequired
1. Understandmethodsofcollectingdatatoanalyzetheclinicalandsupervisoryprocesses.2. Understandhowdatacanbeusedtofacilitatechangeinclient,clinician,and/orsupervisorybehaviors.3. Understandhowcommunicationstyleinfluencesthesupervisee'sdevelopmentofcriticalthinkingandproblem-solvingskills.4. Understandtheuseofself-evaluationtopromotesuperviseegrowth.
B.SkillsRequired
1. Assistthesuperviseeinusingavarietyofdatacollectionprocedures.2. Assistthesuperviseeinobjectivelyanalyzingandinterpretingthedataobtainedandinunderstandinghowtouseitformodificationof
interventionplans.3. Assistthesuperviseeinidentifyingsalientpatternsineitherclinicianorclientbehaviorthatfacilitateorhinderlearning.4. Uselanguagethatfostersindependentthinkingandassiststhesuperviseeinrecognizinganddefiningproblems,andindevelopingsolutions.5. Assistthesuperviseeindeterminingwhethertheobjectivesfortheclientand/orthesupervisoryexperiencehavebeenmet.
IV.DevelopmentoftheSupervisee'sClinicalCompetenceinAssessment
A.KnowledgeRequired
1. Understandanddemonstratebestpractices,includingtheapplicationofcurrentresearchinspeech-languagepathology,forassessingclientswithspecificcommunicationandswallowingdisorders.2. Understandprinciplesandtechniquesforestablishinganeffectiveclient–clinicianrelationship.3. Understandassessmenttoolsandtechniquesspecifictotheclientsserved.4. Understandtheprinciplesofcounselingwhenprovidingassessmentresults.5. Understandanddemonstratealternativeassessmentproceduresforlinguisticallydiverseclients,includingtheuseofinterpretersandculture
brokers.
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B.SkillsRequired
1. Facilitatethesupervisee'suseofbestpracticesinassessment,includingtheapplicationofcurrentresearchtotheassessmentprocess.2. Facilitatethesupervisee'suseofverbalandnonverbalbehaviorstoestablishaneffectiveclient–clinicianrelationship.3. Assistthesuperviseeinselectingandusingassessmenttoolsandtechniquesspecifictotheclientsserved.4. Assistthesuperviseeinprovidingrationalesfortheselectedprocedures.5. Demonstratehowtointegrateassessmentfindingsandobservationstodiagnoseanddevelopappropriaterecommendationsforintervention
and/ormanagement.6. Provideinstruction,modeling,and/orfeedbackincounselingclientsand/orcaregiversaboutassessmentresultsandrecommendationsina
respectfulandsensitivemanner.7. Facilitatethesupervisee'sabilitytousealternativeassessmentproceduresforlinguisticallydiverseclients.
V.DevelopmentoftheSupervisee'sClinicalCompetenceinIntervention
A.KnowledgeRequired
1. Understandbestpractices,includingtheapplicationofcurrentresearchinspeech-languagepathology,fordevelopingatreatmentplanforandprovidinginterventiontoclientswithspecificcommunicationandswallowingdisorders.2. Befamiliarwithinterventionmaterials,procedures,andtechniquesthatareevidencebased.3. Befamiliarwithmethodsofdatacollectiontoanalyzeclientbehaviorsandperformance.4. Understandtheroleofcounselinginthetherapeuticprocess.5. Knowwhenandhowtoidentifyanduseresourcesforinterventionwithlinguisticallydiverseclients.
B.SkillsRequired
1. Assistthesuperviseeindevelopingandprioritizingappropriatetreatmentgoals.2. Facilitatethesupervisee'sconsiderationofevidenceinselectingmaterials,procedures,andtechniques,andinprovidingarationalefortheiruse.3. Assistthesuperviseeinselectingandusingavarietyofclinicalmaterialsandtechniquesappropriatetotheclientsserved,andinprovidinga
rationalefortheiruse.4. Demonstratetheuseofavarietyofdatacollectionproceduresappropriatetothespecificclinicalsituation.5. Assistthesuperviseeinanalyzingthedatacollectedinordertoreformulategoals,treatmentplans,procedures,andtechniques.6. Facilitatesupervisee'seffectiveuseofcounselingtopromoteandfacilitatechangeinclientand/orcaregiverbehavior.7. Facilitatethesupervisee'suseofalternativeinterventionmaterialsortechniquesforlinguisticallydiverseclients.
VI.SupervisoryConferencesorMeetingsofClinicalTeachingTeams
A.KnowledgeRequired
1. Understandtheimportanceofschedulingregularsupervisoryconferencesand/orteammeetings.2. Understandtheuseofsupervisoryconferencestoaddresssalientissuesrelevanttotheprofessionalgrowthofboththesupervisorandthe
supervisee.3. Understandtheneedtoinvolvethesuperviseeinjointlyestablishingtheconferenceagenda(e.g.,purpose,content,timing,andrationale).4. Understandhowtofacilitateajointdiscussionofclinicalorsupervisoryissues.5. Understandthecharacteristicsofconstructivefeedbackandthestrategiesforprovidingsuchfeedback.6. Understandtheimportanceofdatacollectionandanalysisforevaluatingtheeffectivenessofconferencesand/orteammeetings.7. Demonstratecollaborativebehaviorswhenfunctioningaspartofaservicedeliveryteam.
B.SkillsRequired
1. Regularlyschedulesupervisoryconferencesand/orteammeetings.2. Facilitateplanningofsupervisoryconferenceagendasincollaborationwiththesupervisee.3. Selectitemsfortheconferencebasedonsaliency,accessibilityofpatternsfortreatment,andtheuseofdatathatareappropriateformeasuring
theaccomplishmentofclinicalandsupervisoryobjectives.4. Useactivelisteningaswellasverbalandnonverbalresponsebehaviorsthatfacilitatethesupervisee'sactiveparticipationintheconference.5. Abilitytousethetypeofquestionsthatstimulatethinkingandpromoteproblemsolvingbythesupervisee.6. Providefeedbackthatisdescriptiveandobjectiveratherthanevaluative.
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7. Usedatacollectiontoanalyzetheextenttowhichthecontentanddynamicsoftheconferencearefacilitatinggoalachievement,desiredoutcomes,andplannedchanges.8. Assistthesuperviseeincollaboratingandfunctioningeffectivelyasamemberofaservicedeliveryteam.
VII.EvaluatingtheGrowthoftheSuperviseeBothasaClinicianandasaProfessional
A.KnowledgeRequired
1. Recognizethesignificanceofthesupervisoryroleinclinicalaccountabilitytotheclientsservedandtothegrowthofthesupervisee.2. Understandtheevaluationprocessasacollaborativeactivityandfacilitatetheinvolvementofthesuperviseeinthisprocess.3. Understandthepurposesanduseofevaluationtoolstomeasuretheclinicalandprofessionalgrowthofthesupervisee.4. Understandthedifferencesbetweensubjectiveandobjectiveaspectsofevaluation.5. Understandstrategiesthatfosterself-evaluation
B.SkillsRequired
1. Usedatacollectionmethodsthatwillassistinanalyzingtherelationshipbetweenclient/superviseebehaviorsandspecificclinicaloutcomes.2. Identifyand/ordevelopandappropriatelyuseevaluationtoolsthatmeasuretheclinicalandprofessionalgrowthofthesupervisee.3. Analyzedatacollectedpriortoformulatingconclusionsandevaluatingthesupervisee'sclinicalskills.4. Provideverbalandwrittenfeedbackthatisdescriptiveandobjectiveinatimelymanner.5. Assistthesuperviseeindescribingandmeasuringhisorherownprogressandachievement.
VIII.Diversity(Ability,Race,Ethnicity,Gender,Age,Culture,Language,Class,Experience,andEducation)
A.KnowledgeRequired
1. Understandhowdifferences(e.g.,race,culture,gender,age)mayinfluencelearningandbehavioralstylesandhowtoadjustsupervisorystyletomeetthesupervisee'sneeds.2. Understandtherolecultureplaysinthewayindividualsinteractwiththoseinpositionsofauthority.3. Considercross-culturaldifferencesindeterminingappropriatefeedbackmechanismsandmodes.4. Understandimpactofassimilationand/oracculturationprocessesonaperson'sbehavioralresponsestyle.5. Understandimpactofcultureandlanguagedifferencesonclinicianinteractionswithclientsand/orfamilymembers.
B.SkillsRequired
1. Createalearningandworkenvironmentthatusesthestrengthsandexpertiseofallparticipants.2. Demonstrateempathyandconcernforothersasevidencedbybehaviorssuchasactivelistening,askingquestions,andfacilitatingopenand
honestcommunication.3. Applyculturallyappropriatemethodsforprovidingfeedbacktosupervisees.4. Knowwhentoconsultsomeonewhocanserveasaculturalmediatororadvisorconcerningeffectivestrategiesforculturallyappropriate
interactionswithindividuals(clientsandsupervisees)fromspecificbackgrounds.5. Demonstratetheeffectiveuseofinterpreters,translators,and/orculturebrokersasappropriateforclientsfromdiversebackground
IX.TheDevelopmentandMaintenanceofClinicalandSupervisoryDocumentation
A.KnowledgeRequired
1. Understandthevalueofaccurateandtimelydocumentation.2. Understandeffectiverecord-keepingsystemsandpracticesforclinicallyrelatedinteractions.3. Understandcurrentregulatoryrequirementsforclinicaldocumentationindifferentsettings(e.g.,healthcare,schools).4. Befamiliarwithdocumentationformatsusedindifferentsettings.
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B.SkillsRequired
1. Facilitatethesupervisee'sabilitytocompleteclinicaldocumentationaccuratelyandeffectively,andincompliancewithaccreditingandregulatoryagenciesandthirdpartyfundingsources.2. Assistthesuperviseeinsharinginformationcollaborativelywhileadheringtorequirementsforconfidentiality(e.g.,HIPAA,FERPA).3. Assistthesuperviseeinmaintainingdocumentationregardingsupervisoryinteractions(e.g.,ClinicalFellowshiprequirements).
X.Ethical,Regulatory,andLegalRequirements
A.KnowledgeRequired
1. Understandcurrentstandardsforstudentsupervision(CouncilonAcademicAccreditationinAudiologyandSpeech-LanguagePathology,2004)2. Understandcurrentstandardsformentoringclinicalfellows(CouncilforClinicalCertificationinAudiologyandSpeech-LanguagePathology,
2005).3. UnderstandcurrentASHACodeofEthicsrules,particularlyregardingsupervision,competence,delegation,representationofcredentials,and
interprofessionalandintraprofessionalrelationships.4. Understandcurrentstatelicensureboardrequirementsforsupervision.5. Understandstate,national,andsetting-specificrequirementsforconfidentialityandprivacy,billing,anddocumentationpolicies.
B.SkillsRequired
1. AdheretoallASHA,state,andfacilitystandards,regulations,andrequirementsforsupervision.2. Assistthesuperviseeinadheringtostandards,regulations,andsetting-specificrequirementsfordocumentation,billing,andprotectionofprivacy
andconfidentiality.3. Demonstrateethicalbehaviorsinbothinterprofessionalandintraprofessionalrelationships.4. Assistthesuperviseeinconformingwithstandardsandregulationsforprofessionalconduct.5. Assistthesuperviseeindevelopingstrategiestoremaincurrentwithstandardsandregulationsthroughouttheirprofessionalcareers.
XI.PrinciplesofMentoring
A.KnowledgeRequired
1. Understandthesimilaritiesanddifferencesbetweensupervisionandmentoring.2. Understandhowtheskilllevelofthesuperviseeinfluencesthementoringprocess(e.g.,mentoringismoreappropriatewithindividualswhoare
approachingtheself-supervisionstage).3. Understandhowtofacilitatetheprofessionalandpersonalgrowthofsupervisees.4. Understandthekeyaspectsofmentoring,includingeducating,modeling,consulting,coaching,encouraging,supporting,andcounseling.
B.SkillsRequired
1. Modelprofessionalandpersonalbehaviorsnecessaryformaintenanceandlife-longdevelopmentofprofessionalcompetency.2. Fosteramutuallytrustingrelationshipwiththesupervisee.3. Communicateinamannerthatprovidessupportandencouragement.4. Provideprofessionalgrowthopportunitiestothesupervisee.
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CLINICALSUPERVISIONInaccordancewithASHAandtheCouncilforClinicalCertificationinAudiologyandSpeech-LanguagePathology(CFCC)standards(StandardV-E),supervisionforthestudentswillbeprovidedbyindividualswhoholdtheCertificateofClinicalCompetenceandlicensedinNewYorkState.Supervisionwillbeaminimumof25%ofdirecttreatmenttimethroughoutthetrainingperiod.Supervisionwillbeaminimumof50%ofdirectevaluationtimethroughoutthetrainingperiod.Inadditiontothesupervision,studentswillbeevaluatedthroughmeetings,recordings,writtenreports,discussionswithfamilies,andinteractionsandprofessionalismattheonsiteclinic.Supervisionincludesbutnotlimitedtoobservationoflivetreatmentand/orevaluationsessions,observationsofrecordedsessions,verbalfeedbackandwrittenfeedbackinreferencetothestructureofthesessionaswellaswrittendocumentation,andinformaland/orformalmeetingswiththestudentclinician.ThesupervisorandstudentclinicianswillscheduleaMIDTERMREVIEWtodiscussprogresstodateandareastoimproveandafinalCLINICEXITmeetingtoclosethePermanentClientChart.Supervisionisbasedonthefollowing13tasksaccordingtoAmericanSpeech-Language-HearingAssociation.(1985).ClinicalSupervisioninSpeech-LanguagePathologyandAudiology[PositionStatement].Availablefromwww.asha.org/policy.TasksofSupervisionAcentralpremiseofsupervisionisthateffectiveclinicalteachinginvolves,inafundamentalway,thedevelopmentofself-analysis,self-evaluation,andproblem-solvingskillsonthepartoftheindividualbeingsupervised.Thesuccessofclinicalteachingrestslargelyontheachievementofthisgoal.Further,thedemonstrationofqualityclinicalskillsinsupervisorsisgenerallyacceptedasaprerequisitetosupervisionofstudents,aswellasofthoseintheClinicalFellowshipYearoremployedascertifiedspeech-languagepathologistsoraudiologists.Outlinedinthispaperare13tasksbasictoeffectiveclinicalteachingandconstitutingthedistinctareaofpractice,whichcomprisesclinicalsupervisionincommunicationdisorders.Thecommitteestressesthatthelevelofpreparationandexperienceofthesupervisee,theparticularworksettingofthesupervisorandsupervisee,andclientvariableswillinfluencetherelativeemphasisofeachtaskinactualpractice.Thetasksandtheirsupportingcompetencieswhichfollowarejudgedtohavefacevalidityasestablishedbyexpertsintheareaofsupervision,andbybothselectandwidespreadpeerreview.Thecommitteerecognizestheneedforfurthervalidationandstronglyencouragesongoinginvestigation.Untilsuchtimeasmorerigorousmeasuresofvalidityareestablished,itwillbeparticularlyimportantforthetasksandcompetenciestobereviewedperiodicallythroughqualityassuranceprocedures.MechanismssuchasPatientCareAuditandChildServicesReviewSystemappeartoofferusefulmeansforquality
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assuranceinthesupervisorytasksandcompetencies.Otherproceduresappropriatetospecificworksettingsmayalsobeselected.Thetasksofsupervisiondiscussedabovefollow:
1. Establishingandmaintaininganeffectiveworkingrelationshipwiththesupervise
2. Assistingthesuperviseeindevelopingclinicalgoalsandobjectives
3. Assistingthesuperviseeindevelopingandrefiningassessmentskills
4. Assistingthesuperviseeindevelopingandrefiningclinicalmanagementskills
5. Demonstratingforandparticipatingwiththesuperviseeintheclinicalprocess
6. Assistingthesuperviseeinobservingandanalyzingassessmentandtreatmentsessions
7. Assistingthesuperviseeinthedevelopmentandmaintenanceofclinicalandsupervisoryrecords
8. Interactingwiththesuperviseeinplanning,executing,andanalyzingsupervisoryconferences
9. Assistingthesuperviseeinevaluationofclinicalperformance
10. Assistingthesuperviseeindevelopingskillsofverbalreporting,writing,andediting
11. Sharinginformationregardingethical,legal,regulatory,andreimbursementaspectsofprofessionalpractice;
12. Modelingandfacilitatingprofessionalconduct;and
13. Demonstratingresearchskillsintheclinicalorsupervisoryprocesses.
Resource American Speech-Language-Hearing Association. (1985). Clinical supervision in speech-language pathology and audiology [Position Statement]. Available from www.asha.org/policy. http://www.asha.org/policy/PS1985-00220/
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Speech,Language&HearingClinicCourseCAAStandardsClinicrotationisdesignedtoaddressthefollowing2017CAAofASHAstandards:
§ Standard3.1.1BProfessionalpracticecompetencies:accountability,integrity,effectivecommunicationskills,clinicalreasoning,evidence-basedpractice,concernforindividualserved,culturalcompetence,professionalduty,collaborativepractice
§ Standard3.1.3BIdentificationandpreventionofSpeech,LanguageandSwallowingDisordersandDifferences:Principlesandmethodsofidentificationofcommunicationandswallowingdisordersanddifferences
§ Standards3.1.4BEvaluationofspeech,language,andswallowingdisordersanddifferences:Articulation,Fluency,Voiceandresonance,Receptiveandexpressivelanguage(phonology,morphology,syntax,semantics,pragmatics,prelinguisticcommunication,andparalinguisticcommunication)inspeaking,listening,reading,writing,andmanualmodalities,Hearing,Swallowing,Cognitiveaspectsofcommunication,Socialaspectsofcommunication,Augmentativeandalternativecommunicationneeds
§ Standards3.1.5BInterventiontominimizetheeffectsofchangesinthespeech,language,andswallowingmechanisms:Articulation,Fluency,Voiceandresonance,Receptiveandexpressivelanguage(phonology,morphology,syntax,semantics,pragmatics,prelinguisticcommunication,andparalinguisticcommunication)inspeaking,listening,reading,writing,andmanualmodalities,Hearing,Swallowing,Cognitiveaspectsofcommunication,Socialaspectsofcommunication,Augmentativeandalternativecommunicationneeds
§ Standards3.1.6B:GeneralKnowledgeandskillsapplicabletoprofessionalpractice:Ethicalconduct,integrationandapplicationofknowledgeoftheinterdependenceofspeech,language,andhearing;Engagementincontemporaryprofessionalissuesandadvocacy;Processesofclinicaleducationandsupervision;Professionalismandprofessionalbehaviorinkeepingwiththeexpectationsforaspeech-languagepathologist;Interactionskillsandpersonalqualities,includingcounselingandcollaboration;Self-evaluationofeffectivenessofpractice
(Seemoreat:https://caa.asha.org/wp-content/uploads/Accreditation-Standards-for-Graduate-Programs.pdf)
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Speech,Language&HearingClinicOn-SiteProtocolforSLPsupervisorsSLP'swhoareassignedastheprimarySLPforastudentwillberequiredtoreviewthatstudent’sclinicadvisingfolder,confirmandsignthatthestudentclinicrequirementsareuptodateandthatstudentisreadytobegintheclinicsemester.PrimarySLP’swillberequiredtosendanemailtothestudentsinformingthestudentsthattheyareclearedtostartclinic.PleaseCCallsupervisingSLP’s.SLP'spleasereviewthefollowingguidelinesfromASHA:IssuesinEthics:SupervisionofStudentClinicianASHA-certifiedindividualswhosupervisestudentscannotdelegatetheresponsibilityforclinicaldecisionmakingandmanagementtothestudent.Thelegalandethicalresponsibilityforpersonsservedremainswiththecertifiedindividual.However,thestudentcan,aspartoftheeducationalprocess,makeclientmanagementrecommendationsanddecisionspendingreviewandapprovalbythesupervisor.Further,thesupervisormustinformtheclientorclient’sfamilyofthequalificationsandcredentialsofthestudentsuperviseeinvolvedintheprovisionofclinicalservices. IonaCollegeSpeech,LanguageandHearingClinicSLP'sarerequiredtoreviewandapprovealldocumentationincludingbutnotlimitedto:consentpackages(pleaseseetheAdministrativeAssistantforguidelines),SOAPnotes,progressreports,evaluations,outsidesitereports.IonaCollegeSpeech,LanguageandHearingClinicSLP'sarerequiredtoupholdASHAStandardsforclinicalknowledgeandskillsandASHACodeofEthicsthatrelatetotheclientundertheirlicensureandthestudenttheSLPissupervising
Allsupervisedclinicalactivitiesprovidedbythestudentmustfallwithinthescopeofpracticeforthespecificprofessiontocounttowardthestudent'scertification.Thesupervisororpreceptormustachieveandmaintaincompetencyinsupervisorypracticeaswellasinthedisabilityareasforwhichsupervisionisprovided.TheamountofsupervisionprovidedbytheASHA-certifiedsupervisormustbecommensuratewiththestudent’sknowledge,experience,andcompetencetoensurethatthewelfareoftheclientisprotected.Thesupervisormustalsoensurethatthestudentsuperviseemaintainsconfidentialityofclientinformationanddocumentsallclientrecordsandbillinginformation,ifapplicable,inanaccurateandtimelymanner.
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IonaCollegeSpeech,LanguageandHearingClinicSLP'smustreporttotheClinicDirector,Asst.ClinicDirector,On-SiteCoordinatorand/orAdministrativeAssistantifaclientisassignedthatdoesnotfallundertheSLP'spractice.Differencesmayexistinthetypeandamountofsupervisionofstudentsuperviseesthatisrequiredforteachercertificationinaudiologyandspeech-languagepathology,statelicensureintheprofessionsofaudiologyandspeech-languagepathology,andASHAcertificationinaudiologyandspeech-languagepathology.InstateswherecredentialrequirementsorstatelicensurerequirementsdifferfromASHAcertificationstandards,supervisedclinicalexperiences(includingstudentpracticaforteacherlicensing)willcounttowardormaybeappliedtowardASHAcertificationrequirementsonlyifthoseclinicalexperiencehourshavebeensupervisedbyASHA-certifiedpersonnel.IonaCollegeSpeech,LanguageandHearingClinicSLP'sarescheduledtosupporttherequirementslistedAccordingto2017CAAofASHAStandardV-E:“SupervisionmustbeprovidedbyindividualswhoholdtheCertificateofClinicalCompetenceintheappropriateprofession.Theamountofdirectsupervisionmustbecommensuratewiththestudent'sknowledge,skills,andexperience,mustnotbelessthan25%ofthestudent'stotalcontactwitheachclient/patient,andmusttakeplaceperiodicallythroughoutthepracticum.Supervisionmustbesufficienttoensurethewelfareoftheclient/patient.
Implementation:Directsupervisionmustbeinrealtime.Asupervisormustbeavailabletoconsultwithastudentprovidingclinicalservicestothesupervisor'sclient.Supervisionofclinicalpracticumisintendedtoprovideguidanceandfeedbackandtofacilitatethestudent'sacquisitionofessentialclinicalskills.Theamountofdirectsupervisionmustbecommensuratewiththestudent'sknowledge,skills,andexperience,mustnotbelessthan25%ofthestudent'stotalcontactwitheachclient/patient,andmusttakeplaceperiodicallythroughoutthepracticum.Supervisionmustbesufficienttoensurethewelfareoftheclient/patient.”
IonaCollegeSpeech,LanguageandHearingClinicSLP'sareboundtoreportanychangesinsupervisionrequirementsorneedswithin4sessionsforastudentand/orclient.These4sessionsmayincludeclinicpreparationmeetings,sessionobservation,and/orsubmissionofstudentwork.IonaCollegeSpeech,LanguageandHearingClinicSLP’ssupportsupervisionrequirementincludingminimumrequirementsof25%fortreatmentand50%fordiagnosticswiththeamountandtypeofsupervisionadjustedtomeettheneedsofthestudent.Beginningstudentsreceivemoresupervision;secondyearstudentsaresupervisedlessandexpectedtobemoreindependent.IonaCollegeSpeech,LanguageandHearingClinicSLP'swilladjustneedsofsupervisionbasedonstudent’sclinicalexperience,academiccourseworkandclientneeds.
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SchoolofArtsandSciencesDepartmentofSpeechCommunicationStudiesAppendixJMediaSpecialistHandbookPreparedbyPeterConsadoriforIonaCollegeSpeech,LanguageandHearingHandbookSpring2018
IonaCollegeInformationTechnologyComputerUsePolicy
ThefollowingactionsareprohibitedundertheComputerUsePolicyofIonaCollege.
• Anyattempttomodifyordamagecomputerequipment
• Anyattempttomodifyordamagecomputerornetworksoftware
• Improperuseofthecomputerequipment
• UsinganIDbelongingtoanotheruser
• Unauthorizedreading,useof,ordeletionofprivatefilesoremailbelongingtoanotheruser
• SharinguserIDsandpasswordswithotherusersoranyotherperson
• Anyattempttocircumventsystemprotectionandsecurityfeatures
• Engaginginunauthorizedduplication,alterationordestructionofdata,programsorsoftware
• Transmitting or disclosing data, programs or software belonging to others or duplicating copyrightedmaterials
• Use of computer resources for private purposes, including, but not limited to, the use of computerresourcesforprofitmakingorillegalpurposes
• Maintainingcreditcarddatainanyelectronicformatoroncomputers
• Transmittingcreditcarddatabyemail.For the full Iona College Computer Use Policy visit http://www.iona.edu/Student-Life/Student-Resources/Information-Technology/Information-Policies/Computer-Use-Policy.aspx
ClinicComputers/PrivacyScreens
Theclinichasatotalof29computersthatthestudentsmayuse.Thecomputersaretobeusedonlyforclinicalpurposes.Computersmaynotbereservedatanytime.Thecomputersareonafirstcomefirstservebasis.Studentsmayneveruseacomputerthatanotherstudentisloggedinto.Thestudentmusteitheruse the “shut down” function or “restart” to log into their own account before using the computer.Studentsmayneverchange,installoruninstallanyprogramsonthecliniccomputers.Thecliniccomputersareequippedwithprivacyscreens.Theprivacyscreensallowtheuserofthemachinetoseebutothersnexttothestudentwillnotbeabletoseethescreen.ThesescreenprotectorsmaynotberemovedforanyreasonunlessauthorizedbytheMediaSpecialistoraSupervisor.Ifanyofthepreviouslystatedinstructionsarenotfollowed,itwillbeabreachoftheHealthInsurancePortabilityandAccountabilityAct.AbreachofHIPAAwillbereportedtotheon-siteSupervisorandwillresultinafollowupmeetingwiththeClinicDirector.
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Printing
Therearetwoprintersthatthestudentscanuseintheclinic.Thereisacolorprinterandablackandwhiteprinterthatmaybeusedforclinicalpurposesonly.Toprintcolor,thestudentmustsendtheirprintingjobtotheLanierprinterlocatedintheCopy/Printroom(Room103).Atotaloffivecomputersthatareabletoprinttothatspecificprinter.Thosecomputersaremarkedwithawhitelabelthatreads“PrintAbled”.Theblackandwhiteprintercanbeaccessedbyanyofthe18computersthatareavailabletothestudents.Toprinttothisprinter,thestudentmustsendtheirprintingjobtotheIP191printerlocatedintheConferenceroom(Room105).PleasenotethattheblackandwhiteprintermayonlybeusedforprintingSOAPnotes,LessonPlansandProgressReports.Becausethedocumentsthatarebeingprintedareconfidential,everystudentmust report to theMedia Specialist any problems theymay have printing. The issuemust bereportedatthetimeoftheprintingattemptsothattheMediaSpecialistcanresolveitandthedocumentcanbecollectedbythestudent.Allstudentsareresponsibleforthedocumentsthatareprinted.Atnotimecanadocumentbeleft intheprinter. Ifadocument is left inaprinter, itwillbeabreachoftheHealthInsurancePortabilityandAccountabilityAct.AbreachofHIPAAwillbereportedtotheon-siteSupervisorand will result in a follow up meeting with the Clinic Director.
iPads:Clinic/Personal
StudentsareallowedtousecliniciPadsforclinicalpurposesonlywithintheclinic.TouseaniPadforasession,thestudentmustsignouttheiPadusingadedicatedsignoutsheet.WhensigningouttheiPad,thestudentacknowledgestheprocedureofusingthe iPad in the IonaCollegeSpeech,LanguageandHearingClinic.ForthelistofiPaduseprocedurespleaseseeFormA: iPad/FMsignoutsheetonpage138.
PersonaliPadsarenotallowedtobeusedinIonaCollegeSpeech,LanguageandHearingClinic.
Clientinformationincludingbutnotlimitedtoclinicaldocumentation,identifyinginformation,photos,
videosoraudiorecordingsarenotallowedtobestoredorsavedontoclinicorpersonaldevicesaswell
as apps installed on said devices. It is expected studentswill sign a release understanding clinical
informationwillnotbestoredonanyportabledevices.
If client informationofanykindwas storedonto thedeviceorappsof thedevice, theclient/client’sguardianwillbenotifiedof the incidentbya representativeof the IonaCollegeSpeech, Language&HearingClinic.
PersonalLaptops
Theuseofpersonallaptopsforclinicalpurposesisstrictlyprohibitedintheclinic.
FMReceivers
Thisdeviceusesinfraredtechnologytoallowsupervisorstousetheircomputerstospeaktothestudentswhiletheyareinaclinicalsession.TheReceiversincludeabatterypackreceiverandasingleheadphone.Thebatterypackcanbewornaroundtheneckorplacedinapocket. Eachreceiver is labeledwithanumber.Thisnumbercorrespondswith the therapyroomnumber thestudentwillbeusing for their
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session. The units are stored in a locked cabinet in room 103. If the student is required to use thistechnology,theMediaSpecialistwillprovidethemwithaunit.Thestudentmustsignthereceiveroutonthedesignatedsignoutsheet(seeFormA,pg.138).Thereceivermustbereturnedimmediatelyafterthesessioniscompleted.
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FormA:iPad/FMSignOut
• TheiPadsintheIonaCollegeSpeech,Language&HearingClinicaretobeusedinclinicalsessionsfortherapeuticpurposesonly.• ThestudentmayonlysignoutoneiPadand/orFMdeviceatatime.• ThestudentmaynotleavetheinsideoftheclinicwithacliniciPadorFMdevice.• ThestudentmaynotgivetheiPadorFMdevicetoanotherstudentclinician.• iPadsorFMdevicescannotbeleftunattended.• ThestudentmustreturntheiPadorFMdeviceimmediatelyaftertheirclinicalsessioniscompleted.• iPadcasesmaynotberemovedfromthedeviceatanytime.• NoclientinformationmaybeenteredintotheiPadatanytime.Ifaspecificapprequiresaclientidentifier(ie.Name,DOB,etc.)thestudentistousea
clientspecificnumberthatthestudentcanacquirefromtheAdministrativeAssistant.StudentName iPad
PFMP
iPad/FM#
StudentSignature(Confirmingthatyouunderstandallstepsoftheprocedureabove)
Date TimeOut
StaffInt.
TimeIn
StaffInt.
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Visi-Pitch
TheVisiPitchisopenforallstudentstouseatanytimetheclinicisopen.Studentsmayalsousethesystemduringtheirclinicalsessions.Studentsmustdocumentandadviseasupervisorthattheywillbeusingthesystemduringtheirsession.Thestudentmustbefamiliarwiththesystembeforeusingit.TheVisi-PitchissetupintheFacultyTherapyroom(Room110).ThecomputerthattheVisi-Pitchisinstalledonmustbeturnedoffafteruse.NoclinicaldataisallowedtobestoredorsavedontothisVisi-Pitchcomputer.
Inventory
Studentsareallowedtousetheresourcesthatwehaveintheclinic.Theseresourcesincludebooks,toys,puzzles,cards,boardgames,treatmentmaterials(ex.LARKKit)andworkbooks.Theseitemscanbecheckedouttobeusedfor a student’s session. The studentwill only be allowed to checkmaterials in and out during the designatedinventoryhoursthatarepostedabovethefrontdesk.TocheckoutanitemthestudentwillgetaccesstotheclosetwherethematerialsarestoredandbringthematerialsheorshewouldliketocheckouttotheMediaSpecialist.TheMediaSpecialistwillscantheitemsintotheinventorysystemandgivethestudentatimeand/ordaythattheitemmustbecheckedinby.Thestudentwillbeallowedtocheckoutamaterialasearlyasonedaybeforeuseandthestudentisallowedtocheckinamaterialaslateasonedayafteruse.WeekendsarenotincludedinthecountsoifastudentchecksoutamaterialtobeusedonaFriday,thematerialcanbecheckedinnolaterthanMonday.Whenamaterialischeckedbackintothesystem,thestudentisresponsibleforreturningtheitemtoitsdesignatedroom/cabinet. Ifanitemisnotcheckedbackinbythedatethatwasgiventothemtheitemwillbeconsideredoverdueandemailwillbesentouttothestudent.
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Medicat
MedicatisanelectronicdocumentationprogramthatisusedintheIonaCollegeSpeech,LanguageandHearingClinic.AllcomputershaveaccesstoMedicatandeachuserwillhavetheirownuniquecredentialstologintothesystem.Belowarenotesfortheusersonhowtousethesystem.Ifanyofthestatedinstructionsbelowarenotfollowed,itwillbeabreachoftheHealthInsurancePortabilityandAccountabilityAct.AbreachofHIPAA
willbereportedtotheon-siteSupervisorandwillresultinafollowupmeetingwiththeClinicDirector.
MedicatUserGuideNotes(StudentUsers)
LoggingIn:
1) DoubleClickontheMedicatIconlocatedonthecomputer’sdesktop2) EnteryourusernameandpasswordthatisspecifictoMedicat3) OnceloggedintotheremotedesktopclickonMedicatEHRtolaunchtheelectronicdocumentationprogram.4) Re-enteryourMedicatspecificCredentials.
ChangingYourPassword:
1) Whenyouconnecttotheremotedesktopforthefirsttimeyouwillneedtochangeyourpassword.Clickstartintheprogram.
2) Clickthewords“WindowsSecurity”locatedinthetoprightcornerofthebox3) Select“ChangePassword”4) Changeyourpasswordtomeettherequirementsofthesystem.
CreatingaNoteforaClient:
1) DoubleClickontheMedicatIconlocatedonthecomputer’sdesktop2) EnteryourusernameandpasswordthatisspecifictoMedicat3) OnceloggedintotheremotedesktopclickonMedicatEHRtolaunchtheelectronicdocumentationprogram.4) Re-enteryourMedicatspecificCredentials5) Selectthe“Patient”buttononthetopofthescreen.6) Searchforyourclientusinglastnameorclientnumberusingthesearchbarinthetoplefthadcornerofthe
screen.7) Select“ProgressNote”intheNewsectionofthescreenonthelefthandside.8) Onceselected,anewscreenwillappeartotherightoftheoptionyoujustselected.Selectthe“+”symbolnext
tonoteyouwanttowriteunderthe“Progress”section9) Whenthenotetemplateisselectedanewscreenwillappear.Fillintheinformationasneededtocompletethe
form.10) Whenallinformationhasbeenaddedtothenote,signthenoteusingthe“sign”buttonabovethenoteyou
justcreated.IMPORTANT:DONOTSELECTTHESIGNBUTTONONTHEBOTTOMOFTHESCREEN.Ifthebottombutton is selected, it will lock the note and youwill not be able tomake changes using your Supervisor’sfeedback.
11) Aftersigningthenote,selectthe“summary”sectionofthenoteandaddyourNameandwhatthenoteis.(ex.JaneSmith–SOAPnote)
12) OncethenoteissignedusingtheTOPbutton.SelecttheSLPthatsupervisesyoursessionusingthe“Route”dropdownmenu.IMPORTANT:OTHERUSERSAREINTHISDROPDOWNMENU.PLEASEBESURETOSELECTTHECORRECTUSER.ROUTINGTHENOTETOANYONEOTHERTHANYOURSLPWILLBEABREACHOFHIPAA.
13) OncethecorrectSLPhasbeenselected,click“save”onthebottomofthescreenandthen“close”.14) Complete steps 8-14 when revising any notes using Supervisor’s feedback. Step 11 will not need to be
completedeverytimeyouarerevisinganote.
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AddingaClientContactFormtoClientChart:
1) DoubleClickontheMedicatIconlocatedonthecomputer’sdesktop2) EnteryourusernameandpasswordthatisspecifictoMedicat3) OnceloggedintotheremotedesktopclickonMedicatEHRtolaunchtheelectronicdocumentationprogram.
4) Re-enteryourMedicatspecificCredentials5) Selectthe“Patient”buttononthetopofthescreen.6) Searchforyourclientusinglastnameorclientnumberusingthesearchbarinthetoplefthadcornerofthescreen.7) Select“Form”intheNewsectionofthescreenonthelefthandside8) Doubleclickontheclientcontactformintheboxontheupperlefthandcornerofyourscreen.9) Fillouttheform10) Oncetheformiscompleted,select“Lock”onthebottomtoolbartoaddittothechartViewingAllNotesintheChart:
1) DoubleClickontheMedicatIconlocatedonthecomputer’sdesktop2) EnteryourusernameandpasswordthatisspecifictoMedicat3) OnceloggedintotheremotedesktopclickonMedicatEHRtolaunchtheelectronicdocumentationprogram.4) Re-enteryourMedicatspecificCredentials5) Selectthe“Patient”buttononthetopofthescreen.6) Searchforyourclientusinglastnameorclientnumberusingthesearchbarinthetoplefthadcornerofthescreen.7) Select“AllNotes”intheChartsectionofthescreenonthelefthandside8) Allnotesintheclientschartwillappear9) Clickingoncewillopenthenoteonthebottomofthescreenforyourreview.
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Speech,Language&HearingClinicFileOrganization:SessionClientCharts TheSessionClientChartwillbeusedduringthetherapysessiontosupporttheorganizationoftodocumenttosupportoperationsoftheclinic,clientandsessions.TheseSessionClientChartswillbekeptconfidentialandnottoberemovedfromtheclinic.ThesechartsareREQUIREDtobesubmittedforfilingatthecloseoftheclinic.
LeftSideofChart RightSideofChart
ToptoBottomOrder ToptoBottomOrder
SOAPNoteRoutingReport
1. ClientSummaryAttendanceSheet2. MonthlyAttendanceLogwithCorrespondingSessionDates
a. CompletedSupervisor’sEvaluationFeedbackFormb. DataCollectionSheetattached
SupervisorEvaluationFeedbackFormwiththeheadingcompleteanddateofthesessionthatwillbereviewed.IonaCollegeCaseHistoryForm
3. ConfidentialityAgreement4. StudentClinicianDocumentationof
(Absence,Permissions)
IonaCollege,ConsentPackageFormalReports(outsideofIona)Correspondence
__________________________________________StudentClinician,date__________________________________________Speech-LanguagePathologist,dateTheabovesignaturecertifiesalldocumentationwaspresentandcompletedatthetimeofthestudent’sclinicexi
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SpeechLanguage&HearingClinicSOAPNoteRoutingofReport
StudentName: Client:SemesterSessionDate SC:SOAP
CompletionSLPIRDate Re-WriteorTherapy
PlanningSLP&SCMeetingDate
Re-WriteDue SLPFinalSOAPNoteApproved
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Speech,Language&HearingClinicSupervisorsEvaluationFeedbackForm
StudentClinician: SLP ClientInitials: Date
SupervisionWrittenFeedbackEvaluation SuggestedSLPAssessmentoftheSession SLPCommentsClinicianClientRelationship�Warm�Respectful�Engaging�ProfessionalEmpathy�Interestintreatmentsession�ProfessionalDemeanor�AppropriateDressCode�Appropriaterapportandfollowupwithfamily�Respectingculturalbackground&client’sage�ClientengagedandrespectingclinicianEffectivenessofMaterialsandProcedures�Ageappropriatematerials�Languageisunderstoodandmeetstheneedsoftheclient�Datarecorded�Clearandconcisedirections/informationprovided:Clientunderstandswhatisexpected�Timeisusedeffectivelyandefficiently�Homeassignmentsprovided/feedbacktofamiliesSetup�ActiveChartavailableandfollowingprocedures�Sessionsetuppriortosession/sessionsetuporganized�Documentationisclearlywritten�ASHACodeofEthicspresentedDiagnostic�Appropriateprocedurespresented�Administrationisinaccordanceofprocedures�AgeappropriateInformalassessmentImplementationofGoals�TargetsreflectedasindicatedbyLTG&STG’s�Gooduseofmaterials&sessionstructuretomeetmultipletargets&responses�Objectivesareappropriateforclientsleveloffunction�Provideselicitation,modelsbehaviors/targets,discriminatestargets�Strategiesincluding(i.e.Auditory/Visualstimulation)�Feedbacknotedviapositive/corrective:Consistent&appropriatereinforcement�Feedbacknotedviapositive/corrective:Consistent&appropriatereinforcement�Flexibilitymeetingclient’sneeds�Transitionsappropriate&informativefortarget/goaltransitions�Clinicianvs.clienttalk:Efficienttimegivenforclienttorespond�Clinicianunderstandsclientsbehavior�Appropriatebehaviormanagementused�ImplementingEBPasindicated�HealthPrecautionsused
Howdoesthestudentcliniciandemonstrateanunderstandingofthecommunicationissueoftheirclient?Aretheclient’sneedsbeingmetthroughthetherapysessionimplemented?Howdoesthestudentcliniciantransitiontherapyactivities?Arevisualschedules/TODOlistsbeingimplemented?Describethedirectionsthestudentclinicianuses?Isthelanguageusedbythestudentclinicianunderstoodbytheclient?Describetheuseofdatacollection?WhatcompensatorystrategiesarebeingimplemenWhatchangeswouldyoumake?ted?Aremultisensoryapproachesbeingused?
Anyinteractionwiththefamily?
Studentpresentationofprofessionaldemeanor/rapport;nonverbalpresentationofactiveengagementduringthesessionWhatchangeswouldyoumake?
__________________________________________________________________
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StudentSignature/DateIhavereviewedtheobservingSpeechLanguagePathologistsrecommendationsandunderstandthatitismyresponsibilitytomeetwithasupervisorifanysuggestion(s)isunclear
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Speech,Language&HearingClinicAttendanceLogMonth:
DateServicesInitialsSessionMin
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Total#ofTherapySessions:_________Total#ofHours:__________
SLPNotes
STXDXArticulation C:A: C:A: C:A:
Fluency C:A: C:A: C:A:Voice/Resonance C:A: C:A: C:A:Receptive/ExpressiveLanguage
C:A: C:A: C:A:
Hearing C:A: C:A: C:A:Swallowing C:A: C:A: C:A:Cognitive C:A: C:A: C:A:SocialAspectsofCommunication
C:A: C:A: C:A:
Augmentative&ACM C:A: C:A: C:A:Other:Directcontactwithclientandfamilyincounseling
C:A: C:A: C:A:
ASHAMember:__________________________________________ASHANumber:___________________________________________
Signature:
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SchoolofArtsandSciencesDepartmentofSpeechCommunicationStudiesIonaCollegeSpeech,Language&HearingClinicClientContactForm
ClientNameDOB MorF Guardian/ContactPerson
Address City,State,ZipCodePhoneNumberCellPhoneEmailAddress
DateCorrespondence/InformationDisclosed/CommentsInitials
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Speech,Language&HearingClinic Date:Clickheretoentertext. StudentClinician:Clickheretoentertext.Client:Clickheretoentertext. Frequency:Clickheretoentertext. Session# Clickheretoentertext. DOB:Clickheretoentertext. CA:Clickheretoentertext. SLP/Time:___________________
LongTermGoals:
ShortTermGoals SupportingEvidence:ClinicalResearch,Client/FamilyInput,Clinicalexpertise(procedure,techniques,materials
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Speech,Language&HearingClinic Date:___________________ DailyProgressNote Time:___________________S/LDX: ___________________ ICD-10Code: ___________________
StudentClinician: Date: Time:
SLPInitialReview Date: MeetWithSupervisorto:£Re-write£TherapyPlanning
SLPComments:
SLP&SCMeetingDate: SLPFinalSOAPNoteApprovalDate:
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Speech,Language&HearingClinicProgressReport(SampleOutlineforProgressReport)
I.BackgroundInformation:IncludethefollowinginformationinNARRATIVEFORM:
• Client’sname• chronologicalage• speech-languagediagnosis• currentlyreceivess/ltherapyatIonaCollegeSL&HClinic,frequency/duration/Sizeofsession;• Pastmedicalhistory,anysignificantissues• Familyhistory:Whodoestheclientlivewith?Familyhistoryofs/ldisorderordelays?primarylanguage
spokenathome• EducationalHistory(ifapplicable);Doestheclientreceiveanyservicesinschool?Ifso,what?• DevelopmentalMilestones&Speech/LanguageMilestones• CorrespondencewithotherprofessionalsoutsideoftheIonaCollegeSL&HClinic;Doestheclientreceive
anyadditionalservicesoutsideoftheclinic(notpreviouslymentionedineducationalhistory)?Anypreviousservicesthatwerediscontinued?Etc.II.StatusatStartofTherapy:Statementindicatingclientscurrentspeech-languageskillsatthestartoftherapy.Reportoninformationcollectedfrombaselinedata.III.TherapyObjectives&ProgresstoDate:Speech–LanguageDiagnosis(i.e.artic,fluency)LTG’s:ListLTGandunderneathgoallistSTGthatcorrespondswiththelong-termgoalUnderEACHSTGINDICATEiftheobjectivewasmetornot:Criterionmet(date)/Criterionnotmet
ClientName: DateofBirth:
Parent(s)/Guardian(s):[Caregiverifapplicable] ChronologicalAge:Address: DateofReport:
PhoneNumber: S/LDx:TherapyPeriod:(StartDate-EndDate) SessionsAttended:(#outof#)Frequency/Duration/Size: StudentClinician:ClinicalSupervisor:(PrimarySupervisor) ClinicalSupervisor:(SecondarySupervisor)
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Iftheobjectivewasnotmet-provideabriefstatementastowhattheclientisabletodoIV.AdditionalInformation:Discusstherapytargets,reinforcements,strategies,materials,ANDEBP.Discusstheoveralltherapyexperience;successesandchallenges.Ifanyadditionaltestingwasconducted(includingoralmotorexam-listresults.V.StatusattheEndTherapy:Statementindicatingclient’scurrentspeech-languageskillsattheendoftherapy(thisstatementshouldjustifytherecommendations)VI.PrognosisStatement:PredictiveStatement:Whatwillthelikelyoutcomebeduring/aftertherapy?Duetowhatconditions?(Ex:Prognosisisjudgedtobegoodastheclientcompleteshomeworkaftereverysession,carryoverispracticedathomewithparents,clientattendsallsessions,clientismotivatedtoachievegoals)VII.Recommendations:Planforfutureservices;includegoalsthatshouldbetargetedifyouarerecommendingcontinuedtherapy.____________________________________ ______________________________StudentClinician,DateSpeechLanguagePathologist,Date
_______________________________________
ASHA#
_______________________________________ StateLicense
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Speech,Language&HearingClinicProgressReport(AlternativeOutlineforProgressReport/ChartFormat)
I.BackgroundInformation:IncludethefollowinginformationinNARRATIVEFORM:
• Client’sname• chronologicalage• speech-languagediagnosis• currentlyreceivess/ltherapyatIonaCollegeSL&HClinic,frequency/duration/Sizeofsession;• Pastmedicalhistory,anysignificantissues• Familyhistory:Whodoestheclientlivewith?Familyhistoryofs/ldisorderordelays?primarylanguage
spokenathome• EducationalHistory(ifapplicable);Doestheclientreceiveanyservicesinschool?Ifso,what?• DevelopmentalMilestones&Speech/LanguageMilestones• CorrespondencewithotherprofessionalsoutsideoftheIonaCollegeSL&HClinic;Doestheclient
receiveanyadditionalservicesoutsideoftheclinic(notpreviouslymentionedineducationalhistory)?Anypreviousservicesthatwerediscontinued?Etc.
II.StatusatStartofTherapy:Statementindicatingclientscurrentspeech-languageskillsatthestartoftherapy.Reportoninformationcollectedfrombaselinedata.III.TherapyObjectives&ProgresstoDate:Speech–LanguageDiagnosis(i.e.artic,fluency)ListGoalsinachartformatShortTermGoals InitialStatus/Baseline ChangeinStatusIncludeallmeasurablegoals(i.e.Theclientwill___80%ofthetime)
Includeinitialstartofdata(i.e.73%)
Providemeasurableperformanceofcurrentstatus.(i.e.96%accuracy.CriterionMet)
ClientName: DateofBirth:
Parent(s)/Guardian(s):[Caregiverifapplicable] ChronologicalAge:Address: DateofReport:
PhoneNumber: S/LDx:TherapyPeriod:(StartDate-EndDate) SessionsAttended:(#outof#)Frequency/Duration/Size: StudentClinician:ClinicalSupervisor:(PrimarySupervisor) ClinicalSupervisor:(SecondarySupervisor)
164
IV.AdditionalInformation:Discusstherapytargets,reinforcements,strategies,materials,ANDEBP.Discusstheoveralltherapyexperience;successesandchallenges.Ifanyadditionaltestingwasconducted(includingoralmotorexam-listresults.V.StatusattheEndTherapy:Statementindicatingclient’scurrentspeech-languageskillsattheendoftherapy(thisstatementshouldjustifytherecommendations)VI.PrognosisStatement:PredictiveStatement:Whatwillthelikelyoutcomebeduring/aftertherapy?Duetowhatconditions?(Ex:Prognosisisjudgedtobegoodastheclientcompleteshomeworkaftereverysession,carryoverispracticedathomewithparents,clientattendsallsessions,clientismotivatedtoachievegoals)VII.Recommendations:Planforfutureservices;includegoalsthatshouldbetargetedifyouarerecommendingcontinuedtherapy._________________________________ __________________________________StudentClinician,DateSpeechLanguagePathologist,Date
_______________________________________ ASHA#
_______________________________________
StateLicense
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Speech,Language&HearingClinicProgressStatement
Client Diagnosis DOB Freq/Dur CA #Ofsessionsattended DOR ClinicalSupervisor StudentClinician DateApproved
InitialAssessmentandFunctionalLevel(atstartofservice):PertinentBackgroundInformationNarrativeSummarytodateincludingbutnotlimitedtohistoryandjustificationofservicestodate PresentLevelofPerformance
WNLMildModSevereN/AArticulation Fluency(rate,typical/nontypicaldisfluencies) Voice(pitch,intensity,quality)andresonance Language(Auditory,Verbal,Reading,Writing) Hearing(informal,formal) Swallowing Cognitive(orientation,memory,problem-solving) SocialAspectsofCommunication(sociallanguage) Augmentative&AlternativeCommunicationModalities OralMotor(Structure,Function)
AdditionalObservationonlevelofperformance
NarrativeSummaryindicatingpertinentinformationcontributingtoperformance/progresstodate
ProgressAchievedtoDate:
Currentskillstodate
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Recommendations:Statementindicatingrecommendationsalongwithjustification
STUDENTCLINICIAN DATE
SUPERVISOR DATE
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SPEECH,LANGUAGE&HEARINGCLINICDIAGNOSTICREPORT(CHILD)(SampleOutlineforDiagnosticReport/CHILD)*DiagnosticReportshouldincludebutisnotlimitedtothefollowing:
BackgroundInformation:NAMEOFCLIENTisaCHRONOLOGICALAGEwasseenforaspeechandlanguageevaluation(duetoconcernsof/Todetermineprogresstodate).ThisclientwasreferredfortheevaluationbyNAMEonDATEforREASON.PertinenthistorywasobtainedviainterviewbyNAMEandactedasareliableinformantandthecasehistoryformofDATE.Prenatalbirthhistorywasreportedas________.NAMEOFCLIENTwastheproductof____weekgestationperiodvia(vaginal/C-sectiondelivery)atBIRTHWEIGHT.Medicalhistorywasreportedas_______(IncludeanyinformationsuchasNICUstay;earinfections,foodallergies,asthma)FamilyhistoryTheclientcurrentlyliveswith(Reportfamilymembers,siblings,grandparents,andbabysitter).Theprimarylanguagespokenathomeis___________andNAMEOFCLIENTisexposedto(secondarylanguage;ifapplicable,discusstheirabilitytoread,write,speakandlisteninsecondarylanguage)Developmentalmilestoneswerereportedas_________(includegross,fine,andspeechmilestones)NAMEOFCLIENTcurrentlyattends(EDUCATIONALINFORMATION).NAMEOFINFORMANTreported(discussanyissueswithschool/receivinganysupport/informationfromschool).Pastservicesinclude(indicatecourseofevaluationsthroughEarlyIntervention,CPSE,private,schoolandhistoryoftreatmentandfrequency).
ClientName: DateofBirth:
Parent(s)/Guardian(s)/Informant(s): ChronologicalAge:
Address: DateofReport:
PhoneNumber: StudentClinician:
ClinicalSupervisor:(PrimarySupervisor) ClinicalSupervisor:(SecondarySupervisor)
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Parent/ClientConcern:Mr./Mrs.Reportedconcernswith(i.e.speech/languagedevelopment,articulation,sounds,followingdirections…anyexamplethattheparentreports).Discussanyissuesofbehaviorwhenmakingwantsandneedsknown(i.e.biting,hitting,useofgestures,yes/noresponses)ClinicalObservation:NAMEOFCLIENTeasilyestablishedarapportwiththeunknownexaminerandparticipatedinallactivitiespresented.Spontaneoususeoflanguagewascharacterizedby_______.He/Herwasabletomakeherwantandneedsknownvia________Intelligibilitywasjudgedtobe_________.Theclientwasabletoattendto_______.Processingskillswerejudgedtobe___________forunderstandingoflanguageandfollowingdirectionswithincontext.FormalTestingListEachAssessmentUsed/ConductedNameofformalassessment(abbreviations)i.e.GoldmanFristoeTestofArticulation-3(GFTA-3)InformalTesting8(ifnotusingorinadditiontoaformalmeasure).ListEACHinformalmeasureused/conductedHearing/AuditoryFunctionInformalhearingacuitywasjudgedtobewithinnormallimitsattheconversationalspeechlevelindicatinghearingtobewithinnormallimitsviaoneandthreefeetdistances.(Theclientturnedwhenhis/hernamewascalled;clientlookedtowardsthewindowwhenanenvironmentalnoisewasoutside;clientrespondedtobells/whistles).HearingwasjudgedtobewithinnormallimitsinaquietenvironmentbasedoninformalobservationArticulationTheFORMALASSESSMENTwasusedtoevaluatearticulationskillsattheonewordlevel.Soundswereassessedintheinitial,medial,andfinalpositionsofwords.Resultsoftheevaluationindicatedthefollowing:
RawScore StandardScore PercentilePerPercentileRank
AgeEquivalent
Meanstandardscore= 100StandardDeviation= +/-15Thefollowingtablesummarizesarticulationerrors
IncludeerrorsinallpositionsIndicateandreferencewhensoundsareexpectedtobepresentatcurrentage
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ThefollowingtableindicatesphonologicalprocessesIncludedevelopmentaland/ornondevelopmentalphonologicalprocesses
IndicateagewhenprocessesareexpectedtoageoutIntelligibilityduringconnectedspeechwasjudgedtobe______________characterizedby__________________.Mr./Mrs._________reportthattheyareabletounderstandNAMEOFCLIENT%ofthetimewithcontextknownorunknown.INFORMANTfurtherindicatedthatanunknownlistenerisabletounderstandCLIENT%ofthetimewithcontextknownorunknown.Thisexaminerwasabletounderstandconnectedspeech%ofthetimewithcontextknown/unknown.AccordingtoEBP/SOURCE(ex:BowenorGard,Gillman,Gorman)achildofAGEintelligibilityshouldbeunderstood%ofthetimebytheircaregivers.Voice:Clinicalobservationindicatedpitch,quality,intensity,&resonancewerejudgedtobe_____________________.(SeparateEvaluationforaformalvoiceassessmentifapplicable)Fluency:Clinicalobservationrevealedrateofspeechanddisfluentpatternstobe____________________________.(SeparateEvaluationforaformalvoiceassessmentifapplicable)OralMotorExamAnoralperipheralexamination(informalorformal)wascompletedandrevealedthattheoralmechanismisintactforcommunicationandfeedingpurposes.Theresultsoftheevaluationindicatedthatfacialsymmetrywasjudgetobe_____;tonewasalsonotedtobe__________;labialstructureandfunctionwasjudgedtobe_______characterizedby_______;lingualstructureandfunctionwasjudgedtobe________characterizedby___________.Intraoralexaminationrevealedhard/softpalatestructureandfunctiontobe_________;frenulumtobe________;dentitionwasjudgedtobe________;andsecretionswere__________.Observationofbreathingrevealed_________/appropriateforthecoordinationofrespirationandphonation.LANGUAGETheNAMEOFFORMALASSESSMENTwasadministeredtoevaluate_____________________.Theassessmentiscomposedof__________________.The_______isusedtoevaluate___________.Theresultsoftheevaluationareasfollows(examplesofsometablesandassessments)PreschoolLanguageScale–5
Subscale RawScore StandardScore %ileRank AgeEquivalentAuditoryComprehension ExpressiveCommunication TotalLanguage
Mean= 100
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StandardDeviation= +/-15ClinicalEvaluationofLanguageFundamentals-4thEditionCELF-5Subtest RawScore StandardScore %ileFormulatedSentences WordStructure Concepts&FOLLOWINGDirections
CELF-5CoreLanguage:Mean=100;StandardDeviation=+/-15CELF-5Subtest: Mean=100;StandardDeviation=+/-3PeabodyPictureVocabularyTest-4thEditionRawScore StandardScore Percentile
Mean=100StandardDeviation= +/-15ResultsofLanguageSample=MLU(UseanddiscussEBP)ForyoungerchildrenalsodiscussPlaySkills(UseandiscussEBP)Discussoverallresults/performanceoftheassessment?Weretheskillsjudgedtobewithinnormallimits?Whatwastheclientabletodo?Whatspeechandlanguageareaswerecompromised?ProvideexamplesoferrorsResultsofauditorycomprehensionindicatesLEVELofDelay/ImpairmentcharacterizedbyResultsofexpressionlanguageindicatesLEVELofDelay/ImpairmentcharacterizedbyResultsofvocabularyskillsindicatesLEVELofDelayResultsofplayskillsindicatesLEVELofDelayPRAGMATICLANGUAGEPragmaticskillsindicatehowoneintegrateslanguageusewithinsocialcontexts.NAMEOFCLIENTwasableto(useappropriateeyecontact,initiate,participate&turn-takewithinaverbalexchange;judgenon-verbalcuesaccordingly;codeswitchwithdifferentcommunicationpartners)Results:NAMEOFCLIENTisaCHRONOLOGICALAGEwasseenforaformalspeechandlanguageassessmentduetoconcernsof____________________.Theresultsoftheevaluationindicatedsummarizefindingsofformal,informal,andobservationresults.Accordingtotheresultsoftheevaluationtheclientpresentswith___________characterizedby___________________.
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RecommendationsProvidespecificrecommendationsfortherapyservicesItisrecommendedthatNAMEOFCLIENTreceivespeechandlanguageservicestwotimesperweektoimprove(Recommendanystrategiesand/orotherprofessionals)Theresultsoftheevaluationwerediscussedwith_______________.The____________________agreewiththeresultsoftheevaluationandrecommendationsfortreatment._______________________________________________________StudentClinician,DateClinicalSupervisor,Date
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SPEECH,LANGUAGE&HEARINGCLINICDIAGNOSTICREPORT(ADULT)(SampleOutlineforDiagnosticReport/ADULT)*DiagnosticReportshouldincludebutisnotlimitedtothefollowing:
BackgroundInformation:NAMEOFCLIENTisCHRONOLOGICALAGEwasseenforaspeechandlanguageevaluation(duetoconcernsof__________)(todetermineprogresstodate).ThisclientwasreferredfortheevaluationbyNAMEonDATEforREASON.Theclientidentifiersincluded(client’sname,dateofbirth,address).Theclientwasaccompaniedby(NAMEOFSUPPORT)whowaspresentduringtheevaluation.PertinenthistorywasobtainedviainterviewbyNAMEandactedasareliableinformantandthecasehistoryformofDATE.Theclientdescribedhis/hersspeechandlanguagefunctioningas________________.Pertinentmedicalhistoryisremarkablefor______________onDATE.Thecasehistoryreporton/theclientreported__________________(courseofimpairment,hospitalstays,homecare,pasttherapy)PertinentSocial/EmploymentHistorywasreportedthattheclientliveswith(orlivesalone/homehealthaide).Theclientisaretired___________________.Theclientreportspreviousspeechtherapyat__________________.Currentmedicationsatthetimeoftheevaluationinclude_____________________.Caregiver/ClientConcern:NAMEOFCLIENTdescribesspeechandlanguagefunctioningas______________.Theclientsgoalfortreatmentinclude___________________________.
ClientName: DateofBirth:
Parent(s)/Guardian(s)/Informant(s): ChronologicalAge:
Address: DateofReport:
PhoneNumber: StudentClinician:
ClinicalSupervisor:(PrimarySupervisor) ClinicalSupervisor:(SecondarySupervisor)
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ClinicalObservation:NAMEOFCLIENTwasabletomakehis/herswantsandneedsknownvia______________.Theclientwasorientedto(person,place,andtime).AuditoryattentionskillswerejudgedtoLEVELofimpairment(orjudgedtobewithinnormallimits).Problemsolving/reasoningskillswerejudgedtobeLEVELofimpairment(orjudgedtobewithinnormallimits).Patient’sawarenessforsafetyanddeficitarejudgedtobeLEVELofimpairment(orjudgedtobewithinnormallimits).Intelligibilitywasjudgedtobe________________________.FormalTestingListEachAssessmentUsed/ConductedNameofformalassessment(abbreviations)i.e.BostonDiagnosticAphasiaExamination-ThirdEdition(BDAE-3)InformalTesting(ifnotusingorinadditiontoaformalmeasure).ListEACHinformalmeasureused/conductedHearing/AuditoryFunctionInformalhearingacuitywasjudgedtobewithinnormallimitsattheconversationalspeechlevelindicatinghearingtobewithinnormallimitsviaoneandthreefeetdistances.(Theclientturnedwhenhis/hernamewascalled;clientlookedtowardsthewindowwhenanenvironmentalnoisewasoutside;clientrespondedtobells/whistles).HearingwasjudgedtobewithinnormallimitsinaquietenvironmentbasedoninformalobservationArticulationTheclientsspeechintelligibilityisLEVELreducesattheWORD/PHRASE/SENTENCE/CONVERSATIONALLeveldueto_____________________characterizedby(decreasedarticulatoryprecision/decreasedcoordinationofrespirationandphonation/increasedrateofspeech/,decreasedrateofspeech/reducedvocalintensity).Dueto___________________highlyvariablespeecherrors/delayedinitiationofspeechsounds/syllablerepetitions.Voice:Clinicalobservationindicatedpitch,quality,intensity,&resonancewerejudgedtobe___________________.(SeparateEvaluationforaformalvoiceassessmentifapplicable)Fluency:Clinicalobservationrevealedrateofspeechanddisfluentpatternstobe________________________.(SeparateEvaluationforaformalvoiceassessmentifapplicable)
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OralMotorExamAnoralperipheralexamination(informalorformal)wascompletedandrevealedthattheoralmechanismisintactforcommunicationandfeedingpurposes.Theresultsoftheevaluationindicatedthatfacialsymmetrywasjudgetobe_____;tonewasalsonotedtobe__________;labialstructureandfunctionwasjudgedtobe_______characterizedby_______;lingualstructureandfunctionwasjudgedtobe________characterizedby___________.Intraoralexaminationrevealedhard/softpalatestructureandfunctiontobe_________;frenulumtobe________;dentitionwasjudgedtobe________;andsecretionswere__________.Observationofbreathingrevealed_________/appropriateforthecoordinationofrespirationandphonation.LANGUAGETheNAMEOFFORMALASSESSMENTwasadministeredtoevaluate_______________________.Theassessmentiscomposedof___________________.The____________isusedtoevaluate_____________.Theresultsoftheevaluationareasfollows(examplesofsometablesandassessments)BostonDiagnosticAphasiaExamination-ThirdEdition
BDAE-3Subtest RawScore StandardScore %ile
Mean=100;StandardDeviation=+/-15DiscussabilitytoreadandwriteReadingComprehensionWrittenExpressionPRAGMATICLANGUAGEPragmaticskillsindicatehowoneintegrateslanguageusewithinsocialcontexts.NAMEOFCLIENTpragmaticskillswerejudgedtobeLEVELofimpairmentcharacterizedby(turn-taking,poorresponseelaboration,agitation)Results:NAMEOFCLIENTisaCHRONOLOGICALAGEwasseenforaformalspeechandlanguageassessmentduetoconcernsof_________________.Theresultsoftheevaluationindicatedsummarizefindingsofformal,informal,andobservationresults.Accordingtotheresultsoftheevaluationtheclientpresentswith______________characterizedby_________________________.RecommendationsProvidespecificrecommendationsfortherapyservicesItisrecommendedthatNAMEOFCLIENTreceivespeechandlanguageservicestwotimesperweektoimprove(Recommendanystrategiesand/orotherprofessionals)Theresultsoftheevaluationwerediscussedwith_______________.The_________________agreewiththeresultsoftheevaluationandrecommendationsfortreatment.
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_____________________________________________________StudentClinician,DateSpeech-LanguagePathologist,Date
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Speech,Language&HearingClinicRoutingReportFormalClockHourSummaryFormStudentEvaluationFeedbackFormBaselineDataForm
177
SpeechLanguage&HearingClinicRoutingofReportCoverSheet
StudentName: TypeofReport:
� MonthlyProgressStatement � ProgressReport � EvaluationReport
Instructions: ClinicalStudent:pleasedocumentthedate,timeandyourinitialswheneachdraftissubmitted.Eachtimeyousubmitareport,providethepreviousreportthatwasreviewedandattachtheroutingreportcoversheet. Speech-LanguagePathologist:pleasedocumentthedate,timeandyourinitialswhenreturningthedocument.
ClinicalStudentSubmission Speech-LanguagePathologist:Returned/Edited
Draft Date Time Initials Notes Draft Date Time Initials
1st 1st 2nd 2nd 3rd 3rd 4th 4th 5th 5th
FinalReport: FinalSignature:
Copygiventoclient: Approvedby:
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Speech,Language&HearingClinicClinicClockHourFormSTUDENTCLINICIAN
StudentID# SEMESTER ScreensTreatmentDiagnosticsArticulation C:A: C:A: C:A:
Fluency C:A: C:A: C:A:Voice/Resonance C:A: C:A: C:A:Receptive/ExpressiveLanguage C:A: C:A: C:A:Hearing C:A: C:A: C:A:Swallowing C:A: C:A: C:A:
Cognitive C:A: C:A: C:A:SocialAspectsofCommunication C:A: C:A: C:A:Augmentative&ACM C:A: C:A: C:A: Other:Directcontactwithclientandfamilyincounseling C:A: C:A: C:A:C=EIEarlyIntervention(0-3)(PS)Preschool(3-5);(SA)SchoolAge(5-17);A=Adult(18andolder)TreatmentTotalTime DiagnosticTotalTime
ASHAMemberName
ASHAMemberSignature ASHAMemberNumber StateLicensureNumber Date
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Speech,Language&HearingClinicStudentEvaluationFeedbackForm
Speech,Language&HearingClinicStudentEvaluationFeedbackForm
ClinicalStudentswillberequiredtocompletethefollowingStudentEvaluationFeedbackFormduedatedeterminedbyyourimmediateSLP).Thepurposeofthisformisfortheclinicalstudenttoviewyourselfasa“clinician”,toevaluateyourclient’sneedsandthestepsneededtoachieveyourgoals.Thisshouldbeusedtohelpyouview“whatyouaredoingclinically”withinyoursessions,toimprovethetherapyanddevelopyourknowledgeandskillsforclinicalapplication.
StudentClinician:Clickheretoentertext.ClientInitials:Clickheretoentertext.DateofSession:Clickheretoentertext.
TheStudentEvaluationFeedbackMUSTincludethefollowing:VideoReview(asassignedbytheSLPandaWrittenSummary(usethefollowingpromptquestionstosupportyourwrittendocumentationalongwithanyadditionalquestionsand/orrequirementsbyyourSLP
§ Arethereinforcersmotivatingtheclient?IFSo-How?
§ AmIdeliveringreinforcersappropriately?IFSo-How?
§ Isthescheduleofreinforcementcontinuousorintermittent?Describe
§ AmIteachingthetargetbehaviorinsmallenoughsteps?Whatarethesteps?
§ HowdidIincludepromptsandscaffoldingduringthissession?
§ AmIpresentingthestimuliwhentheclientisnotpayingattention?Howdoesthissupportfunctionaltherapy?
§ AmIprogrammingasufficientvarietyoftargetbehaviorsduringeachsession?
§ AmIallowingtheclienttomaketoomanyerrorsinarowwithoutmodifyingthetask?
§ AmIprovidingfeedbackregarding/reinforcementswhatisdonewell?Doestheclientunderstandwhytheyareparticipatinginspeechtherapyservices?
§ Isthepatientboredwiththerapymaterials?IfSo-whatdoyouneedtodo?
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§ Isthestudentclinicianboredwiththetherapymaterials?
§ DoIprovideinstructionsclearly?Ifso-How?DidIallowtheenoughtimefortheclienttorespond?
§ DidIprepareenoughmaterialstoaddressandsupporttheclientandgoalsforfunctionaltherapy?
§ WhatisoneimprovementIcouldhavemadetoimprovetoday’ssession?WhatwouldIdodifferently?
§ HowdidIimplementpriorsupervisorfeedbackand/orself-assessment?
§ WhatisoneareainwhichIfeelIimprovedon/induringthesession?
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Speech,Language&HearingClinicFormativeAssessmentStudentEvaluationFeedbackFormFall2018-Spring2019
StudentswillparticipateinaformalStudentEvaluationFeedbackevaluationinordertomonitorcriticalthinking,decision-makingandproblemsolvingskillstosupportknowledgeandskilldevelopmentduringtheirlearningprocess.
InaccordancewithprofessionalstandardsandbaseduponSyllabusprovided,videoreviewsarerequiredforbothUndergraduateandGraduatelevelClinicalPracticumStudents.ThepurposeofthesereviewsistoaddtoFORMATIVEEXPERIENCESofstudentclinicians(developmentasfutureprofessionalsinthefieldofSLP).Assuch,thisexperienceaimstoincreaseStudentClinicians’:
- Developmentofself-analysisskillsandhowstudentclinicianperformanceimpactsclientoutcomes
- Abilitytopresentlongrangegoalsandtreatmentplanningforaclientcaseload.
- ThefollowingarerequiredPERSEMESTER:Two(2)reviewsforUndergraduatestudents
andThree(3)reviewsforGraduatestudents.****Intheeventthatthereisnotconsentforvideorecordingbyclient/clientfamily,alternatearrangementstobedetermined.****Inconjunctionwiththeabovevideorequirement,additionalvideoreviewsmayberequestedatthediscretionofthesupervisingorvideoSLPs.
PROCEDURESFORREVIEWS:
- AvideoisrecordedbySLP.Thestudentclinicianprovidesawrittenanalysisofrecordedsession(tobemaintainedinclientsessionchartuntilthedateofvideoreview).Detailstobeincludedinwrittenportionareincludedinatemplateinstudenthandbook.
- OnceStudentclinicianisinformedviaemailbySLPthatsessionhasbeenrecorded,Studentclinicianthensignsupforvideoreviewdate(providedinafolderinSLPoffice)–studentclinicianmustsignforareviewnomorethan(7)daysfollowingbeinginformedregardingrecording.
- Atvideoreview,Studentcliniciansarerequiredtoprovidewrittenanalysisofsessionandareexpectedtoperformasactiveparticipantsinreviewsession(egconversationalexchangeregardingvariouscomponentsoftreatmentsession–suchasclientbehaviors;clinicianawarenessofgoalsandtreatmentplanning;factorsimpactingachievementofclientgoals.Whatthe“nextstep”intreatmentplanningmaybeconsideredclinically.
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Speech,Language&HearingClinicBaselineCollectionDataFormClient StudentClinician DOB Date CA S/LSkillAddressing
Target 10TrialsofTraining ResultsSpeech-LanguageTarget12345678910Results
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NoteResponses(+)CorrectResponse (-)Incorrectresponse (x)NoResponse (m)Modeled (I)IndependentResponseAdaptedfrom:DiscreteTrialTreatmentRecordingSheet,AppendixL,ClinicalMethodsandPracticuminSpeech-LanguagePathology,p.38
Speech,Language&HearingClinicDocumentationSamplesAppendixLUpdatedSpring2018
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Sample Data Collection
DataCollectionSession#(Date)
ClientArrival:Alert/DistractedOntime/LateClientParticipation:Willing/UnwillinglyAttentive/DistractedSTG#1-Signingfor“me”
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Opportunities Attempts PercentageCorrect
STG#2-Signingfor“alldone”
Opportunities Attempts PercentageCorrect
STG#3-AttentiontoActivityActivity Timeofattention#1 #2 #3 #4 #5 #6 #7 STG#4-Turn-Taking
Opportunities Attempts PercentageCorrect
STG#5-ResponsetoSound
Opportunities Attempts PercentageCorrect
AdditionalObservations:
ActivityNumber1Picture
Sticker
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ActivityNumber2Picture
Sticker
ActivityNumber3Picture
Sticker
ActivityNumber4Picture
Sticker
PictureofReward
BehaviorManagementPlan#1:Thischartisavisualbehaviormanagementplantomaketheclientawareofthescheduleofactivitiesaswellastoassistaclientwithtransitions.Attheendofeachactivityastickerisprovidedtomarkatransitionfromthecurrentactivitytothenext.Therewardpictureservesasmotivationfortheclienttocompleteallactivitiestoreceivethedesiredreward.Itisimportanttocontinuetothestickerawardingthroughoutthesessiontocontinuallyremindtheclientwhatiscomingnextandwhatisexpectedinordertoreceivethereward.BehaviorManagementPlan#2:
1) Printoutpicturesorwordcardsforeachactivity.2) Postthepicturesinorderofoccurrenceonthewallofthesessionroomwithaclothes-
pinattachedtothefirstplannedactivity.
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3) Allowtheclienttomovetheclothes-pinduringtransitionsfromoneactivitytothenext.Thismethodallowstheclienttobepartoftheprogressionofthesessionwhilestillmaintainingaschedule.Theclientisawareofthescheduleandcanreferbacktothepicturesonthewall.Thestudentcliniciancanusethepicturesasreferenceandcanvisuallyobservehowfarthesessionasprogressedbasedonlocationoftheclothespin.BehaviorManagementPlan#3:Usingaposterboard,createacolumnofactivitieslistedinorderofoccurrenceandattachwithVelcro.Atthebottomoftheposterboardattachtwoenvelopes,onelabeled“finished”or“alldone”andtheotherlabeledrewards.Attheendofeachactivityallowtheclienttoremovetheactivitycardandplaceitintothe“finished”envelopetoprovidevisualsupportthattheactivityhasended.Whenallactivitieshavebeenremovedfromtheboard,allowtheclienttopickarewardfromthecorrespondingenvelope.BehaviorManagementPlan#4:FollowingfromtheTEACCHmodel,createacollectionofactivitiesthatyouwouldliketoaccomplishinasessioninpictureorwordformat.Presenttheseactivitycardstotheclienttwoorthreeatatimeandallowtheclienttochoosewhichactivitytoparticipatein.Whentheactivityiscompleteallowtheclienttoplacetheactivitycardintoacanorenvelopelabeled“finished”tovisuallysupporttheendoftheactivity.Continuetocycleofchoosingactivitiesuntilallarecomplete.Thismethodisidealforclientsrequiringvariabilityintransitiontimingand/orisworkingonattentionskills.SampleProgressReport Name:DOB:Parents:CA:Address:DateofReport:S/LDiagnosis:Phone:TherapyPeriod:SessionsAttended:21/25(includingtwomake-upsessions)
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Frequency/Duration:StudentClinician:ClinicalSupervisor:BackgroundInformation:
TheclientcurrentlyreceivesspeechservicestwiceperweekforthirtyminutesessionsattheIonaCollegeSpeechandLanguageHearingClinicandthreetimesperweekforthirtyminutessessionsatschoolinadditiontooccupationalandphysicaltherapies.Theclientisastudentinaself-containedpreschoolclassroomforchildrenwithdevelopmentaldisabilities.
AccordingtothecasehistoryformcompletedbythemotherinFall2012,developmentalmilestonesconsistofthefollowing:sittingat7months,crawlingat9months,standingat20months,walkingat22months,andfeedingselfat22months.Theclientisstillworkingtowardsindependentdressingandindependenttoileting.Themothernotedthatsinglewordusestartedat15months,combiningwordsat20months,andnamingsimpleobjectsat24months.Theclient’smotherstatedthatgesturesaretheprimarymodeofcommunication,butwilluseone-twowordutterancesifencouragebyanadult.Useofsimplequestionsorengaginginconversationshasnotyetbegun.
Theclient’sbirthandmedicalhistoriesareunremarkable,withtheexceptionofhead,foot,andmouthdiseaseat26months.Currentlytheclientfollowsaglutenanddairysensitivediet.
Theclientisanonlychildlivingathomewithbothparents.Alotoftimeisalsospentthegrandmother.EnglishistheprimarylanguagespokenathomethoughKoreanisoccasionallyused.Theclient’sfatherpresentedwithspeechdelaysasachildandbeganspeakingattwoandahalfyearsold.StatusatStartofTherapy: Atthestartoftherapyon9/13/12,theclientdemonstratedtheabilitytoimitateverbalmodels(providedbythestudentclinician)andvisualmodels(manualsignusedbythestudentclinician).Theclientwasabletofollowasimpleonestepdirection,suchas“putin/on”whenprovidedwithmaximalsupportfromthestudentclinician.Atthattime,eyecontactwiththestudentclinicianwasnotobservedandtheclientoftenchosetoparticipateinpresentedactivitiesalone,inaseparatespace,asopposedtoparallelplayorjointattention.Theclientdemonstratedbehavioralstimmingincludingspinning,jumping,andscreamingobservedonthefirstsessionwhenthespacebecameoverwhelmingandduringthesecondsessionwhentherewasnointerestinplannedactivities.TherapyObjectives/ProgresstoDate:
SpeechandLanguageDiagnosis:delaysinexpressive,receptive,andpragmaticlanguage.LongTermGoal#1:Toimproveexpressionofwantsandneedsforfunctionalexpressivelanguageskillsinandoutsideoftheclinic.ShortTermGoal
Theclientwillperformthesignfor“more”withmaximalpromptingbythestudentclinician80%ofthetimewithin2sessions.
(Criterionmet9/25/12)
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ShortTermGoal
Theclientwillperformthesignfor“more”withminimalpromptingbythestudentclinician80%ofthetimewithin4sessions.
(Criterionmet10/16/12)
ShortTermGoal
Theclientwilllabel7outof10givenobjectsorpictureswithmaximalverbalpromptingbythestudentclinician80%ofthetimewithin1session.
(Criterionmet10/18/12)
ShortTermGoal
Theclientwilllabelfacialfeatures(eyes,lips,etc.)whenpresentedwiththevisualcuewithminimalpromptingbythestudentclinician80%ofthetimewithin4sessions.
(Criterionmet11/15/12)ShortTermGoal
Theclientwilllabelprovidedpicturesinabookwithmoderateverbalpromptingbythestudentclinician80%ofthetimewithin4sessions.Notmet;Theclientshowsrecognitionofpicturesthroughpointinggesturesorverbalattempts(ex.Productionofthefirstsoundoftheword).Todatetheclientwillimitatethestudentclinician’sverbalmodelofthetargetpicture60%-70%ofopportunities.
ShortTermGoal
Theclientwillpairthesignfor“more”withtheverbalproductionofadesiredobjectwithmaximalverbalpromptingbythestudentclinician80%ofthetimewithin4sessions.Notmet;Theclientproducesthesignfor“more”withminimalpromptingfromthestudentclinician.Maximalpromptingisneededtoelicitaverbalattachmenttomaketherequestneed-specific.Todatetheclientwillusethesignfor“more”withtheadditionofthespecificverbalizedrequest50%ofopportunities.
ShortTermGoal
Theclientwilllabelbodyparts(head,feet,hands,bellyetc.)whenprovidedwithavisualcuewithmoderateverbalpromptingbythestudentclinician80%ofthetimewithin4sessions.Notmet;implementedonlessonplanfor11/20/12.Goaladdedaftertheachievementoflabelingfacialfeaturestocontinueimprovementonage-appropriatelanguage.
LongTermGoal#2:Toimprovereceptivelanguageskillsforfunctionalcommunicationinandoutsideoftheclinic.ShortTermGoal
Theclientwillfollowaonestepcommandwithmaximalverbalandvisualpromptingbythestudentclinician80%ofthetimewithin4sessions.
(Criterionmet10/04/12)ShortTermGoal
Theclientwillidentifyoneobjectinachoiceoftwowithmaximalverbalandvisualpromptingbythestudentclinician80%ofthetimewithin4sessions.
(Criterionmet10/04/12)
ShortTermGoal
Theclientwillfollowaonestepcommandwithminimalverbalandvisualpromptingbythestudentclinician80%ofthetimewithin4sessions.
(DEEMEDINAPPROPRIATELEVELOFSUPPORTon10/09/12;Changeisbelow)ShortTermGoal
Theclientwillfollowaonestepcommandwithmoderateverbalandvisualpromptingbythestudentclinician80%ofthetimewithin4sessions.
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Notmet;Theclientfollowsaonestepcommandapproximately55%-65%ofopportunities;typicallyrequiresthepairingatheverbalrequestwiththecorrespondingactionbeforesheperformstherequestedcommand.
ShortTermGoal
Theclientwillidentifyoneobjectinachoiceoftwowithminimalverbalandvisualpromptingbythestudentclinician80%ofthetimewithin4sessions.
(DEEMEDINAPPROPRIATELEVELOFSUPPORTon10/09/12;Changeisbelow)ShortTermGoal
Theclientwillidentifyoneobjectinachoiceoftwowithmoderateverbalandvisualpromptingbythestudentclinician80%ofthetimewithin4sessions.Notmet;Theclientwillidentifythetargetobjectinachoiceoftwoapproximately60%oftheopportunities;typicallygrabsbothobjects,requiringpromptingfromthestudentclinician,andthenwillidentifywithonechoice.
LongTermGoal#3:Toimprovepragmaticskillsforageappropriatesocialinteractionsinandoutsideoftheclinic.ShortTermGoal Theclientwillmakeeyecontactwiththestudentcliniciantosignifyarequestwithmaximal
visualpromptingbythestudentclinician80%ofthetimewithin4sessions.(Criterionmet10/04/12)
ShortTermGoal Theclientwillmakeeyecontactwiththestudentcliniciantosignifyarequestwithminimalvisualpromptingbythestudentclinician80%ofthetimewithin4sessions.
(DEEMEDINAPPROPRIATELEVELOFSUPPORTon10/09/12;Changeisbelow)ShortTermGoal Theclientwillmakeeyecontactwiththestudentcliniciantosignifyarequestwith
moderatevisualpromptingbythestudentclinician80%ofthetimewithin4sessions.Notmet;Theclientpairseyecontactwitharequestapproximately40%ofopportunities.Typicallyreliesonavisualreminder,suchasholdingadesiredobjecttothestudentclinician’seyes,asanaidforperformanceofthisgoal.
ShortTermGoal Theclientwillgreet(hiandbye)thestudentclinicianatthebeginningandendofeachsessionwithmaximalverbalpromptingbythestudentclinician80%ofthetimewithin4sessions.Notmet;Theclientinconsistentlygreetsthestudentclinicianatthebeginningofthesessionbutsteadilysays“bye-bye”attheendofthesession.
AdditionalInformation: Theclientiscurrentlyworkingtowardsthedevelopmentofexpressive,receptive,andpragmaticlanguageskills.Eachsessioniscreatedbasedonaroutinethathasbeenset.Thesessionbeginswiththecliententeringtheroom,jumpingonthetrampolineorsittingatthetable(dependentuponbehavioratarrivaltotheclinic)andreadingapre-selectedbook.Aftercompletionofreadingthebookwithacorrespondinginteractiveactivity,afollow-upactivitythatfocusesonasegmentofthebookoccurs.Manytimestheseactivitieswillincludeafocusonanimals,colors,bodyparts,orcounting.Theendofthesessionincludesanart/sensoryactivity,followedby“good-byebubbles”.Thisroutineissupportedwithavisualscheduletoassistwithtransitioningfromoneactivitytothenext. AccordingtotheAmericanSpeech-LanguageHearingAssociation,typicallyanindividualattheclient’sagelevelhasvocabularyofapproximately1,000words,usescomplexsentencescomposedof3-4words,canengageinconversationaboutrelatabletopics(school,activities,interests),andusesthenameofadesiredobjectinatwowordrequest.Receptively,achildofthisagewillfollowatwostepdirection,answer“who”,“what”,and“where”questions,andwill
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understandthedifferenceinmeaningofopposites(big/little,on/off,up/down).Theclientusesgesturesastheprimarymethodformakingarequest.Recentlytheclienthasbegunusingthesignsfor“more”and“eat”independently,withthedevelopmentofaverbalattachmentforaspecificobjectwhenprovidedwithmaximallevelprompting.Typically,onlyonewordutterancesareused,unlessimitatingverbalpromptsprovidedbythestudentclinician.Withtheuseofanestablishedroutine,theclienthasbegunproducingcommonlyusedphrasessuchas“turnpage”,“morestickers”,“bye-byebubbles”,and“popbubbles”withoutprompting.Currentlytheclientisbeginningtolabelpicturesinstoriesandobjectsinactivities(colors,animals,etc.).Engagementinconversationhasnotyetbegun.Theclientwillfollowaonestepdirectionwithminimalvisualpromptingfromthestudentclinician.Whenaskedtochoosebetweenobjects,suchasacolorpaintorsticker,theclientwillrespondwithgesture(pointing,glancing),butdoesnotprovideaverbalanswer.ResearchfromStevenP.ShevlovoftheAmericanAcademyofPediatricsdescribedthepragmatic(social)languageofanindividualoftheclient’sagetoincludeactiveengagementwithpeers,desirefornewexperiences,andpretendplay.Theclientiscurrentlyworkingtowardsdevelopingconsistenteyecontactwhenmakingrequests.Currentlyeyecontactisusedwhensigning“more”butnotwhengreetingthestudentclinician(duringhello/goodbyeroutine).Visualcuessuchasholdingasticker,toy,orfoodtothestudentclinician’seyehaveencouragedanincreaseineyecontact.Manuelsignshavebeenimplementedintothesessiontoincreasetheclient’sattentiontotheactionsofthestudentclinicianfordevelopmentofjointattention.Themasteryofthesesignsisnotanexpectation,butinsteadtheiruseistoincreaseattentivenesstothelanguageusedbythestudentclinician.
Eachsessionincorporatesactivitiesaimedtowardselicitingimprovementofoutlinedgoals.Thedevelopmentaltoylistchart,adaptedfromthebook,TheNewLanguageofToys:TeachingCommunicationSkillstoSpecial-NeedsChildren(1996)bySueSchwartz,listsboardgames,picturematchinggames,sandboxplay,pretendplaykits,andshapesortersasage-appropriatetoysfortheclient’sage.ResearchfromLorraineNicholich(1977)andJaneKatz(2001)describestheplayskillsofachildintheagerangeoftheclienttoincorporate“pretendplaysequenceswithtwoormorechildrenwithatheme,assignedroles,andlanguageappropriatetothescenario”.Currentlytheclientdemonstratesskillsofself-relatedsymbolicplay(playbehaviorthatusesobjectsfortheirtruepurposeandinvolvingonlythechild).Theclientpreferstoplayaloneratherthantogetherwiththestudentcliniciananddoesnotdeviatefromtheoriginalpurposeofatoy.Theclientthoroughlyenjoyssensoryplay(moon-sand,waterplay,andriceboxes)andshapesorterswithcorrespondingcolorthemes.Inaddition,theclientreactswelltoactivitiessuchasfarmanddollhouses,babydolls,puzzles,andbooks.Theclientgreatlyenjoysmusicthereforesing-alongsongshaverecentlybeenaddedwhenrelatedtoactivities.Forexample,theABC’s,OldMacDonald,andHead,Shoulders,Knees,andToes,haveallbeenusedtoelicitlanguagegrowth.Incorporatingpretendplaymodels,workingtowardsfollowingdirectionstocorrespondtoboardgames,andincreasingjointattentionwillallowdevelopmenttowardsage-appropriateplaylevel.
Readingisanactivityusedinallsessions.Thereismuchresearchsupportingtheideaofinteractivereadingasanappropriatemethodforincreasingvocabulary,jointattention,andteachingemergentliteracyskills.ThearticleentitledUsingInteractiveStoryBookReadingtoIncreaseLanguageandLiteracySkillsofChildrenwithAutismSpectrumDisorder(KellyWhalon,MaryFrancesHanline,andJuliannWoods,2007)supportstheuseofinteractivereadingtoelicitspontaneouslanguagewiththenaturalenvironmentdevelopedthroughreadingabook.Eachsessionbeginswithreadingabookwhileacorrespondingactivityparallelstheprogressionofthe
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story.Forexample,whenreadingTheVeryHungryCaterpillar,theclient“fed”thecaterpillarthefoodsinsequencewiththeprogressionofthestory.Storymaps,charactersbeingplacedinorderofthereoccurrence,havealsobeenusedtoparallelthestory’sprogression.Thiscategoryofactivityhasallowedtheclienttodevelopfollowingdirections,increasingattentiontoanactivity,andincreasingvocabularyrepertoire. Sensoryinputthroughartandenhancedactivitymaterialsoccursineverysession.Forexample,storymapcharactersoftenhavesensorymaterialssuchasbuttons,feathers,texturedpaper,orpom-pomsattached.Attheconclusionofeachsession,anartactivityoccurstoallowtheclienttoexploreandelicitspontaneouslanguageinreactiontotheexperience.Theclientthoroughlyenjoyswaterplayandmoonsand.Intheseactivitiesshovelsandminipailsareusedtoallowthewaterormoonsandtobedisplaced,tobepouredovertheclient’shands,ortocreateshapes.Verbalmodelsareincorporatedtodescribewhatthestudentclinicianisdoingorasareactiontowhattheclientdoes.Everysessionalsoendswiththeuseofbubbleswhichencouragesjointattentionwiththestudentclinicianastheclientpopsthebubbles,useshandoverhandtoholdthebubblewand,andsaysgoodbye. Onherfirstsession,theclientdisplayedahighinterestinsparklystickers.Thisinteresttransferredintoabehaviormanagementplantoencourageattentivenessinactivities.Eachsessionisplannedoutthroughpicturesonachart.Aftereachactivityiscompleted,theclientchoosesonestickertoplaceonthechart.Behaviorspecificreinforcementsuchas“goodworkfinishingthepuzzle”or“greatjobsayinghellotoday”correspondswiththestickerbeingplacedonthechart.Thisbehaviormanagementplanallowsthestickerstobeusedinaneffectivewayaswellasprovidingavisualsupportofthesession.Inadditiontothestickers,thetrampolineisalsousedwhennecessary.Whentheclientstrugglestoattendtoanactivityoristired,stimmingbehaviorssuchasbeginningtojump,scream,orspinmayoccur.Thetrampolineisapositivewayfortheclienttoregainattentionandcalmfromoverstimulation. Parentinvolvementisveryimportant.Theclient’sparentscomeintotheroomforallsessions.Atthebeginningofthesemesterengagementinactivitieswouldnotoccurunlesstheparents’weresittingwiththeclient.Nowtheclientisabletositseparately,whiletheclient’sparentssitatthetable,andattendstoallactivities.Thissituationallowsfortheparentstoobserveprogressaswellastoseewhichstrategiesproducesuccess.Carryoverissuccessfulbecausetheclient’sparentsarelearningthroughobservationofthesession.Typicallyattheclient’sageitwouldbeexpectedoftheclienttowelcomenewexperiencesandenvironments,butexpressionofanxietyinnewsituationsrequiresthecorrespondencebetweentheparentsandthestudentcliniciantoassureasuccessfulpatternoftherapysessions. Currentlytheclientpresentswiththeabilitytoindependentlysign“more”whenrequesting(typicallystickers,food,orsensorymaterials)whileusingeyecontactwhenprovidedwithminimalvisualprompting.Theclienthasdemonstratedimprovementinlabeling,usuallyduringreading,aswellaswhenprovidedwithverbalpromptsfromthestudentclinician.Theclientimitatesmosttwoutterancelanguagemodelsprovidedbythestudentclinicianandfollowsmostonestepcommandswhenprovidedwithavisualmodel.Therefore,nextsemesterwillfocusontheclient’sdevelopmentofindependentuseofexpressiveandreceptivelanguageuseinadditiontodevelopmentofage-appropriateplayandsocialskillsforfunctionalcommunication.Recommendations: TheclientshouldcontinuereceivingservicesattheIonaCollegeSpeechandLanguageHearingClinictwiceperweekforthirtyminutesessions.Continuationofserviceswillallowfor
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continualimprovementindevelopingageappropriatelanguageintheareasofexpressive,receptive,andpragmaticlanguage.
SampleLessonPlan
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ProgressNote
S:Theclientarrivedtothesessionontime,alert,andwillingtoentertheroom.Theclientactivelyengagedinallactivitiespresented.O:Theclientproducedthesignfor“alldone”attheendofactivities57%ofopportunitieswhenprovidedwithhandoverhandmodelingfromthestudentclinician.Whenrequestingtousethetrampolineandduringturn-takingactivitiestheclientproducedthesignfor“me”40%ofopportunitieswhenprovidedwithhandoverhandmodelingfromthestudentclinician.Theclient’sattentiontoactivitiesrangedfrom1-15minutes,withthelongestattentiontimetothewaterplaysensoryactivityandtheshortesttothelegos.Theclientrespondedtonamecallandthestartofthemusicwithagesturalresponseofaheadturn20%ofopportunities.Turn-takingwasnotobservedinthissession.A:Theclientpresentswithdelaysinexpressiveandpragmaticlanguage.Theclientcanmakeachoicebetweentwoobjectswithassistanceofsigningtosignalthebeginningandendinganactivityofchoice.Theclientparticipatesinjointattentionwithanobjectofchoiceandusesmaterialsinself-relatedsymbolicplay.Withtheuseofmaximalverbalandvisualpromptingtheclientwillengageinjointattentionwiththestudentclinician.Forexample,duringwaterplaytheclientusednonverbalgesturestoengagewiththestudentcliniciansuchashandingtheshoveltothestudentclinicianandreachingforthestudentclinician’shandtoaskforhelp.Theclient-centeredstructureofthesessionmeetstheclient’sneedforflexibletransitionsaswellasprovidinganenvironmentrichinmeaningfullanguagemodels.Redirectionoccurscontinuallyinthesessiontomaintaintheclient’sfocusonactivities.Examplesofredirectionincluderepositioningmaterialsinnewwaysandusingbubblestoregaintheclient’sattention.The15minutesensorytimeattheendofthesessionisdeemedanappropriateactivitythroughtheuseofsensoryenhancedmaterialspairedwithmusictomaintaintheattentionoftheclientthroughtheendofthesession.Languagemodelingoccursthroughoutthesessiontodescribeboththeactionsoftheclientandstudentcliniciantoencouragevocalizations.Imitationsofsimplesoundssuchas/b/and/m/havebeenobserved,especiallyintimesofexcitementfortheclient.P:Thecontinueduseofaclient-centeredsessionstructurewithage-appropriatetoysandmaterialswilloccurtoelicitthedevelopmentofageappropriateexpressiveandpragmaticlanguage.Inaddition,thestudentclinicianwillrequestpermissiontospeakwiththeclient’sathomespeechtherapisttodiscussprogressandmethodsusedtocreatesessionplansthatbestmeettheclient’sneeds.
SampleProgressNote
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Speech,Language&HearingClinicDiagnosticReport
Name:********Bobcombe DateofBirth:05/01/1983Address:131BrooksideAvenue DateofEvaluation:City.State:MountVernon,NY Telephone:914-860-6767 DateofReport: ChronologicalAge:Parents:JuneBobcombeCaregiver:BarbaraGraduateClinician:ClinicalSupervisor:AssessmentMaterials:
- AdultCaseHistoryForms–2/18/15- Oral-PeripheralExamination(OPE)–7/15/15- HearingScreening–7/15/15- ScalesofCognitiveAbilityforTraumaticBrainInjury(SCATBI)–3/04/15,3/09/15,&
3/23/15- ArizonaBatteryforCommunicationDisordersofDementia(ABCD)–07/01/15&07/06/15- ScalesofCognitiveandCommunicationAbilityforNeurorehabilitation(SCCAN)–
07/08/15&07/13/15- FrenchayDysarthriaAssessment:SecondEdition(FDA-2)–7/13/15- AssessmentofPragmaticSkills–07/13/15
BACKGROUNDINFORMATION********wasbornonMay1st,1983andisa32yearand2montholdmale.HewasseenforaspeechandlanguageevaluationatIonaCollege’sSpeech,LanguageandHearingClinictodetermineprogresstodate.HewasreferredtoIonaCollege’sSpeechandLanguageClinicfortreatmentbythespeechsupervisorfromtheBurkeRehabilitationCenter.Mrs.Bobcombeactedasareliableinformantbyprovidingpertinentbackgroundinformationthatwasobtainedviaaninpersonparentinterview.AdditionalinformationwascompiledbythecasehistoryformscompletedbyMrs.Bobcombeon2/18/15.Duringaninpersoninterview,Mrs.Bobcombestatedthat********wasinvolvedinavehicularaccidentinwhichhiscarcollidedwithatree,resultinginaTraumaticBrainInjury(TBI)onJanuary11,2011.DuetotheTBI,theclienthasbeendiagnosedwithaseverecognitivecommunicationimpairmentandmixeddysarthria.MedicalHistoryAfterthevehicularaccident,********washospitalizedtotreataTraumaticBrainInjury.Hesufferedfromaheadinjuryandvisualproblemsduetotheaccident.CurrentmedicationsatthetimeoftheevaluationincludeBaclofentoreducemusclespasms.
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Family,Educational,andSocialHistory********hasreceivedhisBachelorsofArtsDegreeinengineeringandcomputerscienceatHowardUniversityinWashington,DC.HecurrentlylivesathomeinMountVernon,NYwithhismotherandfather.Thereisanunremarkablehistoryofanyspeech,languageandhearingproblemswithinthefamily.Asperthemother’sreport,********’saide,Barabra,spendsmostofthedaywithhim,for12hoursaday,5daysaweek.Mrs.Bobcombeand********’saidearetheprimarycaregiversof********.Hecurrentlyreceivesphysicaltherapyonceaweekwithinhishome.LanguageBackgroundandUseSincethediagnosisofaTraumaticBrainInjuryinJanuaryof2011]hasreceivedspeechandlanguageservicesfromHelenHayesandBurkeRehabilitationCenter.Additionally,hewasattendingSt.Andrewsforgrouptherapy.Mrs.Bobcombereportedthat,“********hasmadetremendousimprovementssincehisaccident.”Shestated,“********haschallengeswithspeech,cognition,thinking,andreasoning,buthehasnodifficultywithswallowing.”Parent/CaregiverConcernMrs.Bobcombereportedconcernswith********’sspeechandlanguagedifficulties.Shesaid********hasdifficultymakinghiswantsandneedsknown.Shebelievesthatstimulatinghisbrainwillresultinapositiveoutcome.Hergoalsareforhimtocommunicatemorecoherently.CLINICALOBSERVATIONS********accompaniedthestudentclinicianintothetherapyroomduringtheevaluation.Theclientwasaccompaniedbyhisaide,Barbarawhowasnotpresentduringtheevaluation.Heestablishedarapportwiththestudentclinicianfromthestartoftheevaluation(07/01/15)totheendoftheevaluation(07/15/15).********wasnotorientatedtoperson,place,ortime.Hesmiledanddemonstratedinconsistentattentionandcompliancethroughouttheactivitiesthatwerepresentedtohim.Auditoryattentionskillswerejudgedtobeseverelyimpaired.Problemsolving/reasoningskillswerejudgedtobeseverelyimpaired.Intelligibilitywasjudgedtobeapproximately50-60%intelligibletoanunknownlistener.Theresultsoftheevaluationaredeterminedtobeanaccuratemeasureofhercurrentspeechandlanguageabilities.HEARING/AUDTIORYFUNCTIONAhearingscreeningisapartofthecompletediagnosticevaluationtoidentifyapotentialperipheralhearinglossthatmayaffectaclient’scommunicativedevelopmentorabilities(Shipley&McAfee,2009).Aninformalhearingscreeningwasobtainedon06/15/15toassessthestructuralandfunctionaladequacyof********’sear.Thehearingscreeningconsistedofapure-toneaudiometricscreening,tympanometry,andanotoscopeexamination.Thepure-toneaudiometricscreeningassessedtheclient’sabilitytohearsingletones,presentedatvaryinglevelsofpitch(500Hz,1000Hz,2000Hz,4000Hz)andintensity(50dB,45dB,40dB,35dB,30dB,25dB,and20dB).********wasinstructedtoraisehishandwhenhehearda“beep”sound.Maximumverbalredirectionwasneededfromthestudentcliniciantomaintain********’sattentionthroughoutthepure-toneaudiometricscreening.********respondedtopuretonespresentedat40dBat1000Hzunilaterallyintherightear,howeverhedidnotrespondto20dB,25dB,30dB,and35dB,40dB,45dB,and50dBat500-4000Hzintheleftear.Atympanometrywasconductedtomeasure
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Antony’smobilityandpressurewithinthemiddleearspace.ThetympanometryresultedinatypeBtympanogrambilaterally,suggestingabnormalmiddleearfunctionandshape.Theotoscopeexaminationwasacquiredtoview********’stympanicmembrane.Thebilateralearcanalsandtympanicmembraneswerenotvisibletothestudentclinician.Resultsofthehearingscreeningindictedthat********’shearingmaynotbewithinfunctionallimitsforconversationalspeechtasks.Afullaudiologicalexaminationisrecommendedatthistimeduetotheresultsofthehearingscreening.VOICE,PHONATION,ANDRESONANCEAnaudio-perceptualanalysisofthevoicewascompletedthroughclinicalobservation.Thefeaturesofvoiceareidentifiedaspitch,quality,loudness,nasalresonance,andoralresonance(Shipley&McAfee,2009).Basedonclinicaljudgment,********’svocalpitch,loudness,resonance,andqualityareinconsistentforhisageandgender.Abnormalpitchandqualityisobservedduringhisspeech.Hepresentswithdifficultieswithvolumeandcontrolofhisvoice.Hisresonanceischaracterizedbyhyper/hyponasaltyspeech.Basedon********’svoicecharacteristics,acompleteevaluationbyanotolaryngologist(ENT)isrecommendedatthistime.FLUENCYAccordingtoShipleyandMcAfee(2009),fluentspeechflowsinarhythmic,smooth,andeffortlessmanner.Allspeakersexperiencemomentsofdisfluency,butdisfluenciesthataffectaspeakerforadequatecommunicationisabnormal(Shipley&McAfee,2009).Duringconversationalspeech,clinicalobservationsrevealed********’sdisfluentpatternstobewithinnormallimits.********demonstratedadecreasedrateofspeechwhenheappearedtobefatigued.Ashisspeechratedecreased,hisspeechintelligibilitydecreased.No“stuttering-like”disfluenciesorsecondarybehaviorswereobservedduringtheevaluation.ORALMOTOREXAMAnoral-peripheralexamination(OPE)wasperformedon6/15/15toassessthestructuralandfunctionaladequacyofspeechandswallowingmechanisms.AnOPEisacriticalcomponentofaspeechandlanguageevaluationtoidentifyanystructuralorfunctionalfactorsthatmayrelatetoacommunicationdisorderordysphagia(Shipley&McAfee,2009).StructureTheresultsoftheevaluationindicatedthat********’sfacialfeatureswerejudgedtobeasymmetricalatrestandinconversationwithabnormaltonicity.Inspectionofthejawandlipsrevealedtohangloweranddeviatetotheleftsideofhisface.********’spalateandoropharyngealstructureswereexaminedtobeunremarkableandsufficientforspeechproduction.Atrest,thetongueDentitionwasobservedtobehealthywithnormalcoloringandpresentedwithaClassIocclusion(normal).Hisfirstmolarontherightsideofhismouthwasmissing.********presentedwithnounexpectedgrowthsorfistula.Intraoralexaminationrevealedhardpalatetobehealthywithnormalcolor,heightandwidth.Thesoftpalateappearedstructurallyhealthywithnormalcoloraswell.ThetonsilswerenotobservedduringtheOPE.
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Function********demonstratedadecreasedlabialfunctioncharacterizedbyalimitedrangeofmotionandcoordinationincludingtheelevationoftheupperlip,retractionofthelowerlip,andprotrusion.Lingualfunctionwasreducedashedemonstratedlimitedandspasticretraction,elevation,depression,andlateralizationmovements.Uponlingualmovementsofprotrusionandretraction,********’stonguedeviatestotheleftside.Lipandtonguestrengthappearedreducedtoopposingpressureandwithinnormallimits.Frenulumwasobservedtobewithinnormallimits.Basedonclinicaljudgment,Hyper/hyponasalitywaspresent.Motorfunctionandstrengthofthejawappearedweak,reduced,andjerky.Notemporarymandibularjoint(TMJ)noiseswerepresent.Adiadochokinesistestrevealed********’sinabilitytoproduce/pə/,/tə/,/kə/anaverageof15-20timeswithin3-5secondsintervals.ThissuggestspossibledamagetotheTrigeminalNerveorCentralNervousSystemaffectingCranialNerveV.DuringthesensorycomponentassessmentofCranialNerveV,********reportedthathecouldnotfeelsensationontheinnerliningofhisrightcheek.ResultsTheoverallresultsoftheOPErevealedinadequatestructuralandfunctionalintegrityof********’sspeechandswallowingmechanisms.DYSARTHRIAASSESSMENTTheFrenchayDysarthriaAssessment,SecondEdition(FDA-2;Enderby&Palmer,1983)wasadministeredtoassess********’sperformanceforthemeasurement,differentialdescription,anddiagnosisofdysarthria.TheFDA-2wasadministeredatIonaCollege’sSpeech,Language,andHearingClinicon7/13/15.Maximumverbalredirectionwasneededfromthestudentcliniciantomaintainhisattentionandcomplianceduringtheadministrationoftheassessment.Thetestisdividedintosevensections:Reflexes,Respiration,Lips,Palate,Laryngeal,Tongue,andIntelligibility(Enderby&Palmer,1983).ReflexesTheReflexessectionoftheFDA-2providescontextualinformationthatinformstheclinicianofgeneraloromotorneuromuscularstatusaffectingbothvoluntaryandinvoluntarycontrol(Enderby&Palmer,1983).IntheareaofReflexes:Cough/Swallow,********’saide,Barbarareportedthathehasnodifficultywithhiscoughanddoesnotchokewhenheiseating.Basedonclinicalobservations,********demonstratesaweakcoughreflexandfoodreminisceremainsinhismouthaftereating.HereceivedaBasedonclinicaljudgment,intheareaofReflexes:Dribble/Drool,********dribbles/droolswhenleaningforwardornotconcentratingandhehassomedegreeofcontrol.RespirationTheRespirationsectionoftheFDA-2providesratingsofrespirationatrestandinspeech(Enderby&Palmer,1983).IntheareaofRespiration:AtRest,********demonstratednodifficultytakingadeepbreathinginthroughhismouthandlettingitoutthroughhismouth.IntheareaofRespiration:InSpeech,********demonstrateddifficultycountingto20asquicklyaspossibleinonebreath.Basedonclinicalobservations,hespokequicklyandhisvoicefaded.Additionally,herequiredfourbreathstocompletethistask.LipsTheLipssectionoftheFDA-2providesratingscalestoassessaclient’slipsatrest,spread,seal,alternate,andinspeech(Enderby&Palmer,1983).IntheareaofLips:Atrest,********’slips
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wereobservedwhenhewasmakingnoattempttospeak.Observationsrevealedthathislipsareslightlydroopingapartandasymmetricalbydeviatingtotheleftsideofhisface,butonlynoticeabletoaskilledobserver.IntheLips:Sealsection,********wasinstructedtoblowairintohischeckandmaintainfor15seconds.Additionally,hewasinstructedtosay“/p//p/”clearly10times.Basedonclinicalobservations,********demonstratedverypoorlipsealduetopressurelostfromonesegmentofhislips.Heisabletoattemptclosure,butunabletomaintain.IntheareaofLips:Alternate,********wasinstructedtorepeat“ooee”10times.Basedonclinicaljudgment,hisshapeofhislipswererecognizableasbeingdifferent.IntheLips:InSpeechsection,********’slipmovementwasobservedduringconversation.********’slipswereobservedtohaveconsistentlypoormovementsacousticallyrepresentedasweakorexplosive.Thereweremanyomissionsoflabialshaping.PalateThePalatesectionoftheFDA-2providesratingscalestoassessaclient’spalateforfluids,maintenance,andinspeech(Enderby&Palmer,1983).IntheareaofPalate:Fluids,********’saideBarbara,reportedthathehasnodifficultydrinkingoreating.InthePalate:Maintenancesection,********wasinstructedtosay“ah-ah-ah”fivetimes.Basedonclinicaljudgment,********palatewasslightlyasymmetricalbutmaintainsmovement.IntheareaofPalate:InSpeech,********wasinstructedtosay“/maypay/”and“nay-bay.”Basedonclinicalobservations,********demonstratedmoderatetogrosshypernasalityandimbalancednasalresonance.LaryngealTheLaryngealsectionoftheFDA-2providesratingscalestoassessaclient’palatefortime,pitch,volume,andinspeech(Enderby&Palmer,1983).DuringtheLaryngeal:Timesection,********wasinstructedtosay“ah”foraslongaspossible.Basedonclinicaljudgment,hecansay“ah”for3to4secondsclearly.IntheareaofLaryngeal:Pitch,********wasinstructedtosingascaleofatleastsixnotes.Basedonclinicalobservations,hedemonstratedminimalchangeinpitch,buthedidshowadifferencebetweenhighandlow.IntheLaryngeal:Volumesection,********wasinstructedtocounttofive,increasingvolumeoneachnumber.Basedonclinicalfindings,hisvoiceproductionwasmostlyeffective,buttherewasnotedoccasionalinappropriateuseofvolumeandpitch.IntheareaofLaryngeal:InSpeech,********’sphonation,volume,andpitchwereassessedinconversationalspeech.Basedonclinicalinterpretations,hisvoiceproductionrequiredeffortandattention,deteriorates,andcanbeunpredictable.TongueTheTonguesectionoftheFDA-2providesratingscalestoassessaclient’stongueatrest,protrusion,elevation,lateral,alternate,andinspeech(Enderby&Palmer,1983).IntheareaofTongue:Atrest,********wasinstructedtoopenhismouthwhilethestudentclinicianobservedhistongueatrest.Basedonclinicaljudgment,histonguewasnoticeabledeviatedtotheleftsideandinvoluntarymovementwereapparent.IntheTongue:Protrusionsection,********wasinstructedtostickhistonguecompletelyoutandretractfivetimes.Basedonclinicalobservations,hevariesinabilityduetohistonguemovementbeingirregularandaccompaniedbynoticeabletremor.DuringtheTongue:Elevationsection,********wasinstructedtopointhistonguetowardthenoseandthentowardthechin,insequence,fivetimes.Basedonclinicalinterpretations,histonguemoveswellinbothways,butmovementislaboredandincomplete.IntheareaofTongue:Lateral,********wasinstructedtomovehistongueoutsideofhismouthfromonesidetoanotherfivetimes.Clinicalobservationsrevealedthat********movedhistonguewellbutslowlyduetothetasktakingatotalof5-6seconds.IntheTongue:Alternate
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section,********said“kala”10timesasquicklyaspossible.The“la”soundwasjudgedtobewellarticulated,butthe“ka”soundispoorlypresented.Additionally,thetaskstookabout10secondstocomplete.DuringtheTongue:InSpeechsection,********’stonguemovementswereobservedduringconversationalspeech.Heproducedcorrectarticulationinconversationalspeech,butslowalternatingmovementsmadespeechlabored.Therewereseveralomissionsofconsonants.IntelligibilityTheIntelligibilitysectionoftheFDA-2provideswordsandshortsentencesforaclienttoreadasanindicationofintelligibility.IntheareaofIntelligibility:Words,********wasinstructedtoread12wordsfromaselectionofrandomcards.Basedonclinicalobservations,8ofthe12wordsthatwerereadwereinterpretedcorrectly.IntheIntelligibility:Sentencessection,********read12sentencecardsthatwereselectedatrandom.7outofthe12wordthathereadwerejudgedtobecorrect.DuringtheIntelligibility:Conversationsection,********andstudentclinicianengagedinaconversationforabout5minutes.Basedonclinicaljudgment,********’sspeechisseverelydistortedanditcanbeunderstoodabouthalfthetime.ResultsBasedonclinicalobservations,theresultsoftheFDA-2assessmentrevealedthat********demonstratescharacteristicsofamixedupperandlowermotorneuronlesion.Thelowestratingscoreswereforallofthelaryngeal,tongue,andliptasks.Thehighestratescoreswereforthepalatalmovementinswallowingandsensorytesting.COGNTIVECOMMUNICATIONClinicalObservations&Results:********’scognitivecommunicationskillswereassessedusingstandardizedmeasurements.TheArizonaBatteryforCommunicationDisordersofDementia(ABCD;Bayles&Tomoeda,1993)wasadministeredon07/01/15and07/06/15toassess********’sexpressive,receptive,andcognitivelanguageskills.Maximumverbalredirectionwasneededfromthestudentcliniciantomaintainhisattentionandcomplianceduringtheadministrationofthisassessment.TestscoresfortheABCDassessmentshouldnotbereportedforindividualsforwhomthenormativesampleisnotrepresentative.AccordingtoBaylesandTomoeda(1993),“TheABCDwasstandardizedonAlzheimer’sdiseasepatients,itssubtestaredesignedtoevaluatethementalstatus,verbalepisodicmemory,visualspatialconstruction,andlinguisticexpressionandcomprehension,allofwhichcanbeimpairedinadultswithheadinjuryandotherneurologicaldisorders.”Theassessmentprovidedinformationaboutthe********’slanguageperformanceincludinghisdifficultieswithinhisabilitytoexpressandcomprehendlanguage,cognitiveabilities,orientationskills,memoryskills,andtheabilitytorecallinformation.TheScalesofCognitiveAbilityforTraumaticBrainInjury:NormalEdition(SCATBI;Adamovich&Henderson,1992)wasusedtomeasure********’scognitivecommunicationskills.Thetestwason3/04/15,3/09/15,and3/23/15atIona’sSpeech,Language,andHearingClinic.Maximumverbalredirectionwasneededfromthestudentcliniciantomaintainhisattentionandcomplianceduringtheadministrationofthisassessment.TheresultsoftheSCATBIassessmentareasfollows:
SCATBI StandardScore PercentileRank Range
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Perception/Discrimination 74 4% Severe-1.5and-2.0standarddeviationsbelowthe
meanOrientation 75 5% Severe
-1.5and-2.0standarddeviationsbelowthe
meanOrganization 76 6% Severe
-1.5and-2.0standarddeviationsbelowthe
meanRecall 77 6% Moderate-severe
-1and-1.5standarddeviationsbelowthe
meanReasoning 81 10% Moderate-severe
-1and-1.5standarddeviationsbelowthe
meanMean=100,1SD=15pointsabove/belowthemean.TheScalesofCognitiveCommunicationAbilityforNeurorehabiliation(SCCAN;Milman&Holland,2012)wasadministeredatIonaCollege’sSpeech,Language,andHearingClinicon07/08/15and07/15/15toassess********’scognitivecommunicativeandlanguageprocessingabilities.Maximumverbalredirectionwasneededfromthestudentcliniciantomaintainhisattentionandcomplianceduringtheadministrationofthisassessment.TheresultsoftheSCCANassessmentareasfollows:
SCANN RawScore PercentageScore RangeOralExpression(OE) 9 47% N/AOrientation(OR) 5 42% N/AMemory(ME) 12 63% N/A
SpeechComprehension(SP) 9 69% N/AReadingComprehension(RD) 6 50% N/A
Writing(WR) 4 57% N/AAttention(AT) 6 38% N/AProblemSolving 9 39% N/ATotalRawScore 42 N/A SeverCognitive
Impairment*Thetotalrawscorewas42indicatingaseverecognitivecommunicationimpairment.OrientationNormalorientationdependsoneffectiveintegrationofseveralcognitiveprocesses,includingattention,memory,andperception.Impairmentsoforientationareacommondifficultyofbraininjuryandmayresultfromdisruptiontoanyofthesebasicprocesses(Milman&Holland,2012).ABCD
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TheMentalStatusSubtestwasadministeredtoassess********’sgeneralknowledgeandorientationtotime,place,andperson(Bayles&Tomoeda,1993).********wasinstructedtolistentosomequestionsreadbythestudentclinicianandanswerthemcarefully.Hedemonstrateddifficultywithshorttermmemoryquestions.Forexample,whenasked,“Whatistheplaceweareinrightnow?”and“Whatmonthisthis?”********responded,“Idon’tknow.”********accuratelyansweredsomelongtermmemoryquestions.Forexample,whenasked,“Inwhatyearwereyouborn?”Theclientresponded,“1983.”Whenasked,“Inwhatmonthwereyouborn?”Heresponded,“May.”Additionally,heidentifiedtheappropriatemonththatIndependenceDayiscelebratedandthecurrentPresidentoftheUnitedStates.SCATBIThecalculatedstandardscoreforhisOrientationportionoftheSCATBIisbelowthemeanstandardscoreof100.********’sOrientationstandardscoreof75fallsbetween-1.5and-2.0standarddeviationsbelowthemeanindicatingasevereperformance.IntheOrientationsubtest,hiscognitiveprocessesofbasicorientationintimeandspacewereassessed.********demonstrateddifficultyansweringquestionsregardinghisbasicorientationsuchashiscurrentage,date,andlocation.Hewouldfrequentlyrespondwith,“Idon’tknow.”Thestudentclinicianprovided********withmultiplechoiceoptionstoassistinansweringthequestion.Givenmultiplechoiceoptions,theclientcontinuedtodemonstratedifficultyansweringquestionsregardinghisorientation.Forexample,hewasasked,“Whatpartofthedayisit?”andgiventhemultiplechoiceoptionsof,“morning,afternoon,orevening.”********thenrespondedwith,“Idon’tknow.”SCCANIntheareaofOrientation,********accuratelyanswered42%ofthequestionsandreceivedarawscoreof5.TheOrientationsubtestwasadministeredtoassesshisawarenessofpersonalinformation,place,andtime(Milman&Holland,2012).Hedemonstrateddifficultyansweringquestionspertainingtohisorientationandawarenessskills.Forexample,whenasked,“Whatcityarewein?”Theclientrespondedwith,“NewYork.”********wasthenprovidedwiththecue,“AreweinNewRochelle?”********thenresponded,“No!”Heaccuratelyidentifiedhisfirstandlastname,howhewasfeeling,thestatehewascurrentlylocatedin,andthecurrentPresidentoftheUnitedStates.AttentionNormalattentionallowsustofocusonasingletask,maintainmultiplebitsofinformationinourconsciousnesssimultaneously,shiftbackandforthbetweendifferentactivities,anddoallofthisinarelativelytime-efficientmanner(Milman&Holland,2012).SCCANIntheareaofAttention,Antonyaccuratelyanswered38%ofthequestionsandreceivedarawscoreof6.TheAttentionsubtestwasadministeredtoassesstheclient’sattentionusingacombinationofverbalandnonverbalvisuospatialitems(Milman&Holland,2012).Theclientdemonstrateddifficultyattendingtotaskswithintheassessment.Forexample,theclientviewedavisualofamapoftheUnitedStatesandwastheninstructedtoidentifythestatesofOregonandFlorida.HeaccuratelyidentifiedthestateofFlorida,butdidnotidentifythestateofOregon.Additionally,********wasshownavisualofpictureofroostersanddogs.Hewasinstructedtocirclealloftheroostersandunderlineallofthedogsonthestimuluspage.Theclientdidnotappropriatelycirclealloftheroostersandunderlineallofthedogs.Memory
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Memorycanbedefinedasthestorageandretrievalofnewinformationandexperiences(Milman&Holland,2012).ABCDTheStoryRetellingImmediateSubtestwasadministeredtoevaluatetheclient’sepisodicmemoryskillsbyassessinghisabilitytorecallverbalinformationintheformofastory(Bayles&Tomoeda,1993).********wasinstructedtolistentoashortstoryandthenimmediatelyrecallthestorybacktothestudentclinicianafterhearingit.Theclientthendemonstratedgreatdifficultybyresponding,“Idon’tknow.”Hewasinstructedtorememberthestorybecausehewouldbeinstructedtorecallthestoryagainlaterduringthesession.TheStoryRetellingDelayedSubtestwasadministeredtoassesstheeffectofdelayon********’sabilitytorecallverbalinformation.Theclientwasinstructedtorecalltheshortstoryagainafterapproximatelya30minutedelay.Theclientthenresponded,“No.”TheWordLearningSubtestwasadministeredtoassesstheclient’sepisodicmemoryskillsbyevaluatinghisabilitytofreerecall,cuedrecall,andrecognitionofsixteenwords(Bayles&Tomoeda,1993).Theobjectofthissubtestwasfor********torememberasetofwordsinthecontextofthetest,notacquirenewwords(Bayles&Tomoeda,1993).Hewasinstructedtopairavisualstimuluswordwiththeverbalnameofthecategorytowhichthestimulusbelongs.Thisprocedureassiststheclientinestablishingarelationbetweenthestimulusandthecategorytowhichitbelongs(Bayles&Tomoeda,1993).********accuratelyidentified13/16itemswhenpresentedwiththevisualstimulusandwhenthevisualstimuluswasimmediatelyremovedfrom********’sfieldofview.Forexample,whenasked,“Showmethepartofthehumanbody.”********accuratelypointedtothepictureofthehead.Thevisualstimuluswasthenremovedfromtheclient’sfieldofviewandasked,“Whatwasthepartofthehumanbody?”********accuratelyresponded,“Head.”TheWordLearningSubtestFreeRecallwasadministeredaftera20seconddistraction.********wastheninstructedtonameasmanywordsashecouldfromthefourpagesthathejustsaw.Hedemonstrateddifficultyrecalling16wordsbyrespondingwith,“Idon’tknow.”TheWordLearningSubtestCuedRecallwasadministeredtoassesshisabilitytorecallthe16wordswhenprovidedwithcues.Thestudentclinicianprovidedacategorycueforthemisseditems.Forexample,“Whichwasthemusicalinstrument?”********accuratelyresponded,“Trumpet.”Givenaverbalcategorycue,********accuratelynamed6/16words.Lastly,theRecognitionofLearnedWordswasadministeredtodeterminethenumberofstimuluswordsthattheclientrecognized.********waspresentedwithavisualstimulusofawrittenwordandtheninstructedtoanswer“yesorno”ifherecognizedthewordfromthepageshewaspreviouslyexposedto.Hedemonstrateddifficultywiththistaskbyaccuratelyrecognizing2/48words.Ofthe48wordsusedintherecognitiontask,16aresemanticallyrelatedtoastimuluswords,and16areunrelated.SCATBIIntheareaofRecall,********’ssemanticmemory,episodicmemory,immediaterecall,delayedrecall,recallwithinterference,andlong-termmemoryskillswereassessed.ThecalculatedstandardscoreforhisRecallportionoftheSCATBIisbelowthemeanstandardscoreof100.********’sRecallstandardscoreof77fallsbetween-1and-1.5standarddeviationsbelowthemeanindicatingamoderate-severeperformance.Hedemonstrateddifficultiesrecallinggraphicelementsbyrecalling2/6picturesofobjectsinagrouppicture.********accuratelycompletedwordretrievaltasksbynaming5/8itemsgivenvisualcuesbythestudentclinician.Hedemonstrateddifficultieswithimmediate,delayed,andcuedrecallwiththeuseofanauditorytape.Forexample,theclientwouldnotrespondwhenaskedtorepeattherecordedwords
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followingatone.********demonstrateddifficultiesrecallingverbalwordsreadbythestudentclinicianbyrecalling2/6words.Hedidnotprovidearesponsewhenaskedtogeneratewordsthatbeganwiththeletter“r”and“d.”Hedemonstrateddifficultieswithimmediaterecalloforaldirectionsgivenbythestudentclinician.Forexample,thedirectionswere,“Closethisbookletandturnitovertothebackcover.”********wouldfollowonepartofthetwostepcommandbyclosingthebookletandnotturningitover.Hedemonstrateddifficultiesintherecalloforalparagraphswhenpresentedwithastimulustape.********hadtolistentoashortstoryandthenanswerquestionsbasedonthestory.Hedidnotanswerthequestionsfollowingtheshortstoryincludingthequestionswithmultiplechoiceoptions.SCCANIntheareaofMemory,********accuratelyanswered63%ofthequestionsandreceivedarawscoreof12.TheImmediateRecallsubtestwasadministeredtoassesshisabilitytorecallverbalandvisuospatialinformationimmediatelyafterithasbeenpresented(Milman&Holland,2012).********demonstrateddifficultiesrecallingvisuals.Forexample,hewasinstructedtorememberavisualofafacewithinthestimulusbook.Afterremovingthepicturefrom********’spresentfieldofviewandfollowingadelayoftwoseconds,hewasasked,“WhichfacedidIaskyoutoremember?”Heinaccuratelypointedtoadifferentvisualofaface.Additionally,heviewedavisualofpillswithinthestimulusbook.********wasimmediatelyaskedtorecallthepillsandinaccuratelypointedtodifferentpills.TheDelayedRecallsubtestwasadministeredtoassesshisabilitytorecallverbalandvisuospatialinformationafteradelayofseveralminutes(Milman&Holland,2012).********demonstrateddifficultiesrecallingverbalandvisualinformationthatwasinstructedforhimtorememberatthebeginningoftheassessment.Forexample,hewasinstructedtoindicatethevisualofthefacethatthestudentclinicianaskedhimtorememberatthebeginningoftheassessment.********inaccuratelypointedtoavisualoffacethatwasdifferentfromthevisualtarget.ProblemSolvingProblemsolvingincludesconceptformation,reasoning,andexecutivefunction(Milman&Holland,2012).SCATBIIntheareaofReasoning,********’scognitiveprocessesofconvergentthinking(relevantandmissinginformationinvisuallyoraurallypresentedinformation),deductivereasoning(drawingconclusionsaboutagivensituation),inductivereasoning(formulationofasolutionbasedondetailsthatleadtoaconclusion),anddivergentreasoning(generationofuniqueabstractconcepts)wereassessed.ThecalculatedstandardscoreforhisReasoningportionoftheSCATBIisbelowthemeanstandardscoreof100.********’sReasoningstandardscoreof81fallsbetween-1and-1.5standarddeviationsbelowthemeanindicatingamoderate-severeperformance.Hepresenteddifficultieswithfiguralreasoning(analogies).Forexample,hehadtoidentifythepicturethatwasmissingfromagroupofchoicesshownatthebottomofthepage.Heidentified1/5ofthepicturesthatweremissing.Hedemonstrateddifficultieswithconvergentreasoning(centraltheme)bynotidentifyingthemainideaofthreeshortstores.Hedisplayeddifficultieswithdeductivereasoning(elimination)bytheinabilitytoidentifyanobjectgivencluesfromthestudentclinician.********presenteddifficultieswithinductivereasoning(opposites)bynotdeterminingtheoppositeofawordgivenbythestudentclinician.Forexample,hewasread“enter,entrance,”andthestudentclinicianrespondedwith,“Idon’tknow.”Hedisplayeddifficultieswithdivergentreasoning(homographs)bynotproducingtwosentencescontainingdifferentmeaningsofagivenwordfromthestudentclinician.********
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successfullycompletedadivergentthinkingtask(idioms)byidentifyingthemeaningbeyondthewords.Forexample,thestudentclinicianread,“rainingcatsanddogs”andheresponded,“rainingheavy.”********presenteddifficultieswithadditionaldivergentthinkingtaskssuchasproverbsandverbalabsurdities.SCCANIntheareaofProblemSolving,********accuratelyanswered39%ofthequestionsandreceivedarawscoreof9.TheVisualProblemSolvingsubtestwasadministeredtoassesshisproblemsolvingskillsbyavarietyofvisuospatialtasks(Milman&Holland,2012).Overall,********accuratelyrespondedtomostofthevisualproblemsolvingquestions.Heaccuratelymatchedshapesandsequencedpatterns.Hedemonstrateddifficultywhenidentifyingitemsthatwere“different”inafieldoffourpictureswithinthestimulusbook.Forexample,********wassimultaneouslyshownapictureofthreefruitsandonevegetableandasked.“Lookatthesefourpictures.Whichonedoesnotgowiththeothers?”Herespondedbypointtooneofthefruitsinthepicture.TheNumericProblemSolvingsubtestwasadministeredtoassesstheclient’sproblemsolvingskillsbyavarietyofnumerictasks(Milman&Holland,2012).********demonstrateddifficultywithhisproblemsolvingskillspertainingtonumericaltasks.Forexample,********wasinstructedtototalthecostofasoupfor$2.00andagrilledsandwichfor$3.99.Heincorrectlyresponded,“$5.00.”Additionally,hewasinstructedtototalthecostof$25.00and$33.50.********thenincorrectlyresponded,“$58.00.”TheConnectedSpeech&ProblemSolvingsubtestwasadministeredtoassess********’sproblemsolvingskillsbyavarietyofverbaltasks(Milman&Holland,2012).********demonstrateddifficultywithhisproblemsolvingskillspertainingtoverbaltasks.Forexample,********wasasked,“Whataretwotypesofaccidentsthatcouldhappeninthekitchen?”Hethenincorrectlyresponded,“Food.”Additionally,********wasasked,“Howarealakeandanoceandifferent?”Hethenresponded,“Idon’tknow.”Perception&DiscriminationABCDTheSpeechDiscriminationScreeningTasksubtestwasadministeredtoscreen********forspeechdiscriminationproblems(Bayles&Tomoeda,1993).********wasinstructedtolistentosomewordsproducedbythestudentclinicianandidentifyiftheywerethesameordifferent.********demonstrateddifficultywiththistaskbyaccuratelyidentifying7/18ofthewords.Forexample,whengiventheverbalwords,“thin/shin,”********inaccuratelyidentifiedthewordsasbeingthesame.Additionally,whengiventheverbalwords,“gum/gum,”********inaccuratelyidentifiedthewordsasbeingdifferent.SCATBIIntheareaofPerceptionandDiscrimination,********’scognitiveprocessesofperception,attention,anddiscriminationofenvironmentalandphonemicsoundswereassessed.Thecalculatedstandardscorefor********’sPerception/DiscriminationportionoftheSCATBIisbelowthemeanof100.HisPerception/Discriminationstandardscoreis74,whichfallsbetween-1.5and-2.0standarddeviationsbelowthemeanindicatingasevereperformance.Hedemonstratedsignificantdifficultywhenpresentedwiththestimulustapetodiscriminatebetweensounds,andnon-wordpairs.Forexamplewhen********wasaskedtoidentifythesoundofabellonanaudiorecording,hedidnotrespond.Whenhewasaskedtoidentifywordspairsthatwerethesameordifferent,heidentified2/5wordpairsthatweredifferentsuchas“Zug/Zum”and“Fim/Fid.”Hesuccessfullyidentifiedwordsthatwerethesameordifferentsuchas“Soup/Soon”and“Tick/Tick.”Heidentifiedshapesbypointingwhenpresentedwithvisual
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stimuli,butdemonstrateddifficultywhenaskedtodiscriminatebetweensizeandcolorsoftheshapes.Hesuccessfullyidentifiedpicturedobjectsbypointingwhenpresentedwithvisualstimuli.ReadingNormalreadingrequiresadequateattentiontovisualinformation,perceptionoflinguisticallyrelevantinformation,andtheassociationofwrittenletters,words,andstringsofwordswiththeirappropriatesoundandmeaning(Milman&Holland,2012).SCCANIntheareaofReading,********accuratelyanswered50%ofthequestionsandreceivedarawscoreof6.TheReadingsubtestwasadministeredtoassesshisreadingskillsbyusingavarietyoftasksinwhichspokenand/orvisualstimuliarematchedtoreadingtargets(Milman&Holland,2012).********’sreadingwasassessedatthelevelofsigns,singlewords,sentences,andconnectedtext.Inthefirstsetofitems,readingmaterialsarepresentedinisolation(Milman&Holland,2012).********accuratelyidentifiedthesigns,“stop,poison,wheelchair.”Heaccuratelyidentifiedthewords,“no,yes,door,floor,window,chair.”Hedemonstrateddifficultywithhisreadingskillsatthesentencelevel.Forexample,heinaccuratelymatchedapictureinafieldoffourvisualswiththecaption,“Anotherwindyday.”Additionally,heinaccuratelymatchedapictureinafieldoffourvisualswiththesentence,“Thebirdthat’seatingtheappleisred.”Toassesstheeffectsofattentionandperceptionontheclient’sreadingskills,thesecondsetofitemsrequiresexamineestoreadtextthatisembeddedincontextandlocatedindifferentspatialquadrants(Milman&Holland,2012).********demonstrateddifficultieswiththeeffectsofattentionandperceptiononhisreadingskillsattheconnectedtextlevel.Forexample,********viewedapictureofpagefromaphonebookandwasinstructedto,“FindthephonenumberforEmmaSussman.”********inaccuratelyselectedadifferentphonenumber.Additionally,********wasinstructedtoviewapictureofamenuand“Pointtothesoupofthedayandthechickendinner.”Heinaccuratelypointedtoonedifferentitemonthemenu.ABCDTheReadingComprehensionsubtesttoevaluate********’sreadingcomprehensionskillsatthewordlevelandsentencelevel(Bayles&Tomoeda,1993).Toassesshisreadingcomprehensionskillsatthewordlevel,********wasshownsomewordsandpicturesandinstructedtoreadeachwordandpointtothepicturethatbestrepresentsthewords.Heaccuratelyreadthewords,“bed,bugs,throwing,policeman,complaining,boy,ball,memorizing”andsimultaneouslypointedtotheappropriatematchedpictures.Heinaccuratelyreadtheword,“waiting”as“venting”andpointedtotheincorrectpicture.Toassesstheclient’sreadingcomprehensionskillsatthesentencelevel,********wasshownsomesentencesandinstructedtoreadeachsentenceandanswerthequestionunderit.********demonstrateddifficultyreadingthesentencesandansweringtheproceedingquestionsbyaccuratelyanswering3/7questions.Forexample,********accuratelyreadthesentence,“Thescoutscomplainedaboutthebugs.”Thenheinaccuratelyansweredthequestion,“Whatdidn’tthescoutslike?”byresponding,“Complaining.”WritingNormalwritingassumestheintentandabilitytoformulateamessage,theretrievalanappropriatevisualrepresentation,andadequateperceptual-motorskillstoproducethedesiredwrittenmessageinthecorrectspatiallocation(Milman&Holland,2012).ABCD
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TheGenerativeDrawingSubtestwasadministeredtoassess********’sabilitytogenerateanaccuratedrawingofanameableobject(Bayles&Tomoeda,1993).********wasinstructedtodrawakite,bucket,andadigitalclock.********demonstrateddifficultywiththiswritingtask,asheinaccuratelydrewthe3objects.********wasthengivenvisualcuesoftheobjectsandinstructedtocopythedrawingoftheobject.Again,herespondedbyinaccuratelydrawingthethreeobjects.TheFigureCopyingsubtestwasadministeredtoassesshisabilitytocopyfigures(Bayles&Tomoeda,1993).Theclientwasinstructedtocopythreefiguresinthespacenexttothem.********demonstrateddifficultywithfigurecopyingbyaccuratelycopyingthefirstfigureofacirclewithahorizontalandverticallinethroughit,butinaccuratelycopiedtheadditionaltwofigures.SCCANIntheareaofWriting,********accuratelyanswered57%ofthequestionsandreceivedarawscoreof4.TheWritingsubtestwasadministeredtoassesshiswritingskillsofcopying,writingtodictation,writtennaming,andwrittenpicturedescription(Milman&Holland,2012).Writingwasassessedatthelevelsofisolatedletters,isolatedwords,andsentences(Milman&Holland,2012).********accuratelywrotedownisolatedwordssuchas“dog,********,newspaper.”********demonstrateddifficultywheninstructedtowritedownsentencessuchas,“TheappointmentisWednesdayat11”bywriting“Theappointmentisat11.”LANGUAGEReceptiveLanguageABCDTheFollowingCommandssubtestwasadministeredtoassess********’sabilitytoperformone,two,andthreestepcommands(Bayles&Tomoeda,1993).********wasinstructedtofollowsomeverbaldirections.********accuratelyfollowed5/9verbalcommands.Forexample,********followedonestepverbalcommandssuchas,“Wave,Lookup,Shutyoureyes.”Hedemonstrateddifficultywhenfollowingmulti-stepcommandssuchas,“Clap,thenpoint”and“Cough,smile,thenwhistle.”TheComparativeQuestionssubtestwasadministeredtoassessauditorycomprehensionofcomparativequestions(Bayles&Tomoeda,1993).********wasinstructedtoanswerquestionswithyesorno.Heaccuratelyanswered5/6ofthequestions.Forexample,whenasked,“Issupperearlierthanbreakfast?”********appropriatelyanswered,“No.”SCCANIntheareaofReceptiveLanguage,********accuratelyanswered69%ofthequestionsandreceivedarawscoreof9.TheSpeechComprehensionsubtestwasadministeredtoassess********’sabilitytofollowcommands,matchspokenlanguagetopictures,andansweringyes/noquestions(Milman&Holland,2012).Comprehensionwasassessedatthelevelsofsinglewords,sentences,idioms,anddiscourse-levelcommunications(Milman&Holland,2012).********accuratelyfollowedonestepverbaldirectionssuchas“Raiseyourhand”and“Pointtothetable.”Hedemonstrateddifficultywithfollowingmulti-stepcommands.Forexample,wheninstructedto“Showmeyourthumbandpointtothefloor.”********respondedbyonlypointingtothefloor.********accuratelymatchedspokenlanguagetopictures.Forexample,heaccuratelypointedtopicturesofthekangarooandthecalculator.Additionally,heaccuratelypointedtothepicturesthatmatchedthephrases,“Shehasagreenthumb”and“Therhinocerosischasedbythekangaroo.”********accuratelyansweredyes/noquestions.Forexample,whenasked,“Areyousittingdown?”Heappropriatelyanswered,“Yes.”Whenasked,“Areyoustandingup?”Heaccuratelyanswered,“No.”
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ExpressiveLanguageOralexpressionrequiresthatthespeakerhavetheintenttocommunicatesomemessage,beabletoretrievewordsassociatedwiththemessage,andhavetheabilitytoarrangethesewordsintomeaningfulstrings,whicharearticulated(Milman&Holland,2012).ABCDTheRepetitionSubtestwasadministeredtoevaluate********’sabilitytorepeatnonmeaninfulphrasesthatarecontrolledforlength(Bayles&Tomoeda,1993).********wasinstructedtorepeatsomephrasesthatthestudentclinicianinitiallysaidaloud.********demonstrateddifficultyrepeatedphrasesasthenumberofsyllablesincreased.Forexample,********accuratelyrepeatedthephrase,“Runningstoryparcel.”Hehaddifficultyrepeatingthephrase,“Hersmileswallowsshinydeckmallets”byproducing,“Hersmiledeckmallets.”TheGenerativeNamingSemanticCategorySubtestwasadministeredtoevaluatetheclient’sabilitytogenerateexemplarsfromasemanticcategory(Bayles&Tomoeda,1993).********wasinstructedtonameitemsinthecategoriesofanimalsandtransportation.Hedemonstrateddifficultywithgenerativenamingbynaming3items(“dog,cats,humans”)forthecategoryofanimalsand2items(“bus,train”)forthecategoryoftransportation.TheConfrontationNamingSubtestwasadministeredtoevaluatehisabilitytonamepicturedobjects(Bayles&Tomoeda,1993).********wasinstructedtoviewpicturesofobjectsandnameeachone.Heaccuratelynamed15/20oftheobjectsinthegivenpictures.Forexample,********named,“Pencil,hanger,whistle,toothbrush,funnel,snail,acorn,wreath,comb,umbrella,mailbox,dart,porcupine,tennisracquet,dominoes.”Hedidnotaccuratelyname,“lattice,stethoscope,broom,pen,abacus.”TheConceptDefinitionSubtestwasadministeredtoassesstheclient’sknowledgeofconceptbyprovingadefinition(Bayles&Tomoeda,1993).********wasinstructedtoviewsomewordsandprovidedefinitionsforthem.Hedemonstrateddifficultywiththistaskbyprovidingresponseswithminimaldetailsforthewords.Forexample,********respondedwiththedefinitionof“blows”whenshownapictureoftheword,“whistle.”Additionally,herespondedwith“goodtoeat”whenheviewedapictureoftheword,“acorn.”TheObjectDescriptionSubtesttoevaluatetheclient’sabilitytogeneratemeaningfuldescriptorsofacommonobject(Bayles&Tomoeda,1993).********wasinstructedtodescribeanobject(nail)ascompletelyaspossible.********demonstrateddifficultywiththistasksbynamingitandprovidingminimaldetailsabouttheobject.Forexample,hesaid,“It’ssharp,metal,andhard.”SCCANIntheareaofExpressiveLanguage,********accuratelyanswered47%ofthequestionsandreceivedarawscoreof9.TheOralExpressionsubtestwasadministeredtoassesshisrepetition,productionofautomaticspeechsequences,naming,sentenceproduction,anddiscourse-levelcommunication(Milman&Holland,2012).********accuratelyrepeatedsingleswordssuchas,“No,Jackie,Asprin,Tums,Neosporin.”********accuratelynamedphysicalobjectssuchas,“Table,Chin.”Heaccuratelynameddescriptionsofobjectssuchas,“Whatanimallookslikeahorsebuthasblackandwhitestripes?”asherespondedwith,“Zebra.”********demonstrateddifficultywithoralexpressioninconnectedspeech.Forexample,heinaccuratelysangthesong,“HappyBirthday.”PRAGMATICSThe“AssessmentofPragmaticSkills”wasadministeredon7/13/15atIonaCollege’sSpeech,Language,andHearingClinic.The“AssessmentofPragmaticSkills”isappropriatetoassessavarietyofpragmaticbehaviors(Shipley,2009).AccordingtoBrookshire,traumaticallybrain-injuredpatientsexhibitpragmaticdifficulties(Brookshire,2007)
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********appropriatelyrespondstogreetings.Forexample,whenasked,“Hi!Howareyou?”********responded,“I’mfine.”Hedemonstrateddifficultymakingrequests.Forexample,********wasinstructedtodrawacircle,butwasnotimmediatelyprovidedapencil.Hedidnotrequestapenciltocompletethetask.********demonstrateddifficultydescribingevents.********wasasked,“Whatdidyoudothismorning?”Hereplied,“Idon’tknow.”Hedemonstrateddifficultytakingturnsinconversation.Forexample,********wasinstructedtoalternatelyrecitethealphabetwiththestudentclinicianandhedidnotcompletethetask.Additionally,********demonstrateddifficultyfollowingverbalmultistepcommands.Hewasdirectedtoturnhispaperoveranddrawahappyface.********respondedbyonlyturninghispaperover.********madeappropriateeyecontactthroughouttheassessment.Heaccuratelyrepeatedthreesentencesthatthestudentcliniciansaid.********haddifficultyattendingtotasksthroughoutthesessionbyfrequentlyreplying,“Idon’tknow”tothepresentedactivities.Hedemonstrateddifficultymaintainingtopicofconversation,roleplaying,sequencingactions,andcategorizing.Heaccuratelydefinedwords,butprovidedminimaldescriptions.Forexample,whenaskedtodefinetheword,“scissors,”********respondedwith“cutpaper.”RESULTS********isa32yearand2montholdmalewhocommunicatesverballyandpreferstospeakinsinglewordsandphrases.HewasevaluatedatIonaCollege’sSpeech,LanguageandHearingclinicon3/04/15,3/09/15,&3/23/15,07/01/15,07/06/15,07/08/15,07/13/15,and07/15/15.********presentsasfriendlyandsocial.Heengagedinalltaskspresentedandrequiredmaximumredirectionthroughouttheevaluation.********’smedicalhistorywasremarkableforavehicularaccidentofJanuary2011.Asaresult,hesufferedfromaTraumaticBrainInjuryandvisualproblems.Acompleteaudiologicalexaminationisrecommendedinordertoinvestigateapossiblestructural/functionaletiologyof********’scompleteauditorysystem.Oralperipheralexaminationrevealedinadequatestructuralandfunctionalintegrityofthespeechandswallowingmechanisms.********’svocalpitch,loudness,resonance,andqualityareinconsistentforhisageandgender.Acompleteevaluationbyanotolaryngologist(ENT)isrecommendedatthistime.Disfluentpatternswerejudgedtobewithinnormallimits.Articulationerrorswerejudgedtonegativelyimpact********’sabilitytoeffectivelycommunicatewithothers.Basedonclinicaljudgment,********’sspeechisintelligible50-60%ofthetimeduringconversationalspeech.Accordingtotheresultsoftheassessment,********presentedwithmixeddysarthriacharacterizedbyarticulation,fluency,andvoicedifficulties.TheresultsoftheFDA-2assessmentrevealedthat********demonstratescharacteristicsofamixedupperandlowermotorneuronlesion.********demonstratescognitivecommunicationdeficitscharacterizedbydifficultiesinorientation,attention,memory,problemsolving,executivefunctions,perception/discrimination,reading,writing,auditorycomprehension,andsocialskillsAccordingtotheresultsoftheassessment,********presentedwithaseverecognitivecommunicationimpairment._____________________________ClinicalCSDStudent____________________________Speech-languagePathologist
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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAppendixMClinical Practice Resources
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http://www.asha.org/Certification/2014-Speech-Language-Pathology-Certification-Standards/Council for Clinical Certification in Audiology and Speech-Language Pathology of the American Speech-Language-Hearing Association. (2013). 2014 Standards for the Certificate of Clinical Competence in Speech-Language Pathology. Retrieved [date] from http://www.asha.org/Certification/2014-Speech-Language-Pathology-Certification-Standards/. https://www.asha.org/Code-of-Ethics/TheCodeofEthicsisvitalforourmemberstoabidebyprofessionalethicstosupportcollegialandpublictrust. http://www.asha.org/Practice/ethics/ConfidentialityConfidentialityrelatedtoresearch,clientinformation,verbalcommunication,studentprivacy,peersandcolleagueshttp://www.asha.org/practice/reimbursement/hipaa/HealthInsurancePortabilityandAccountabilityActhttp://www.asha.org/Certification/2014-Speech-Language-Pathology-Certification-Standards/http://www.asha.org/policy/SP2016-00343/ScopeofPracticeinSpeech-LanguagePathologyhttp://www.asha.org/policy/about/Reviewdocumenttonavigateandsupportbestpracticepatternsandstandardshttp://www.asha.org/practice/reimbursement/coding/new_codes_slp.htmlhttps://www.asha.org/practice-portal/http://www.op.nysed.gov/prof/slpa/speechlic.htmlResourceforNewYorkStatelicenserequirementsforspeech-languagepathology&audiologyhttp://www.asha.org/academic/accreditation/accredmanual/section8.html
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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAppendixNResources AmericanSpeech-Language-Hearing-Association(www.asha.org) Hedge,M.N.,&Davis,D.(2005).ClinicalMethodsandPracticuminSpeech-LanguagePathology4thEd.SanDiego,CA:DelmarLearningShipley,K.G,&McAfee,J.G.(2009).AssessmentinSpeech-LanguagePathology:Aresourcemanual.(5thEd.).CliftonPark,NY:DelmarLearning.Roth,F.P.,&Worthington,C.K.(2011).Treatmentresourcemanualforspeech-languagepathology(5thEd.).Albany,NY:ThompsonDelmarLearning. Guilford,A,Graham,S,&Scheuerle.(2007).TheSpeech-LanguagePathologist:FromNovicetoExpert.PearsonEducation.UpperSaddleRiver,NJ
Contributions:
AmandaScheriff,MeghanK.MurphyJessicaScaringellaDorothyLeoneJenniferGeromettaDianeFerrero-PaluzziNancyVidal-FinnertyJhovanaFigueraAnnaWyludaDocumentupdate-MariaArmiento-DeMaria,Fall2018;Spring2018