In the clinical practicum instruction I provide for assessments of individuals with complex communication disorders, we apply a multiple-phase process: (1) information gathering through record review, interview, surveys\/checklists, and observation with familiar partners in familiar surroundings (by video if distance prohibits on-site visits), (2) direct observation at the campus clinic via structured “naturalistic” opportunities to review current communication (receptive, expressive, and pragmatic language; means of communication; purposes of communication; sensory and\/or motor, seating and positioning considerations; literacy; partner-interactions, etc.), (3) direct observation at the campus clinic via structured “naturalistic” opportunities for what strategies and supports may effect meaningful change in the individual’s communication opportunities and effectiveness, and according to what features (e.g., size, symbol representation, organization, etc.); \u00a0and (4) a review of findings. \u00a0There is considerable overlap among the phases and it requires multiple sessions to complete. \u00a0 I find that students have a sense of the principles involved and frequently have practiced these ideologies through case study example projects for courses. \u00a0But having a real person to think about and face, a team to work within, a family or school to report to, and, most importantly, the genuine hope to truly help an individual, all add a profound stress on how to think all of this through. \u00a0After talking with students, the following is an email I send to review the principles we discussed. \u00a0This example is for a preteen young woman with complex sensory and motor needs in addition to no verbal communication and mixed reports about minimal language (e.g., both making choices to convey wants and answering yes\/no questions are in question).<\/p>\n
“We’ve talked about how the assessment plan for our first session here on campus needs to reflect what unanswered questions you feel you need to directly observe, and what strategies\/supports you would like to consider for review (no tech, low tech, high tech). \u00a0Much like plans for intervention, this should include your objective (what you want to learn), rationale (why\/how what you learn will inform next steps), the activity or structured event, whatever materials are needed to complete activity, means of communication, and data collection. \u00a0Different from intervention at the clinic, I also need to know who is doing what.<\/p>\n
When we met at the very beginning, we said that we needed to start from what we know now and hypotheses based on our observations and what the literature\/research base would inform as relevant for her age\/experience. \u00a0We want to consider our objectives for how we are going to learn what we need to know, and then develop activities that will allow us opportunities to gather information. \u00a0When we talked earlier, I wanted to expand on that piece with some examples but I know it can be difficult to remember everything. \u00a0My apologies for the long email but I hope this can be a reference of my thought process and how it leads to specific questions\/objectives.<\/p>\n
For example: Accordingly, assessment\u00a0questions\/objectives may include (but are not limited to): At present, CLIENT has extremely limited means of communication and it is not clear what types of references will be most beneficial\/effective for her. (4). \u00a0Provide structured opportunities for observation and\u00a0assessment\u00a0of organization (e.g., categorical, event, PODD): \u00a0given a review of options, what is parental reaction? \u00a0What are observable indicators of ease of use for partner to augment input and make means of expression available? \u00a0Accuracy? \u00a0What can we provide for home trial — for example, a simple book of references based around her reported key partners, interests, activities (categorical); a book based around concepts organized for her daily routine (event based); a book based around conversational sequences common for her life events and\/or teens (PODD).<\/p>\n Those are just examples, but please refer to the materials I have provided for what Beukelman & Mirenda<\/a> considers the key areas for\u00a0assessment, the information and references compiled by the National Joint Committee for the Communication Needs of Persons with Severe Disabilities<\/a>; and the published materials such as the Communication Matrix<\/a>; \u00a0Functional Communication Profile, Revised<\/a>; TECEL<\/a>; Social Networks<\/a>; and AAC Profile<\/a> (among others) as means of structuring or focusing our efforts. \u00a0Again, always start with your objective (what do you wish to learn), and we can build activities around that.”<\/p>\n It’s a long process and has been argued that may not well match what can be accomplished outside of a University clinic environment. \u00a0I hear that argument, and know that there is valid concern on whether my approach authentically prepares clinicians for different environments. \u00a0That said, I feel that it is my mandate to align my practices as closely as possible with what is taught in the courses as best practice — that to do otherwise perpetuates poor practices elsewhere. \u00a0So I strive to be an example, sounding board, model, coach, etc. towards that goal and hope that students will adapt and advocate over time to the circumstances they face to raise the expectations and practices elsewhere.<\/p>\n End blip.<\/p>\n","protected":false},"excerpt":{"rendered":" In the clinical practicum instruction I provide for assessments of individuals with complex communication disorders, we apply a multiple-phase process: (1) information gathering through record review, interview, surveys\/checklists, and observation with familiar partners in familiar surroundings (by video if distance prohibits on-site visits), (2) direct observation at the campus clinic via structured “naturalistic” opportunities to … Continue reading 10.17.13 — Supervisory Notes, Talking about 2nd phase of assessment w\/examples<\/span>
\nRationale: \u00a0Based on interview and parent completion of surveys\/checklists, determine CLIENT’s receptive and expressive vocabulary. \u00a0Observations and parental report indicate that CLIENT has an extremely limited vocabulary. \u00a0No tech: \u00a0Siegel and Cress’ (2002) Communication Signal Inventory from Exemplary Practices for Beginning Communicators <\/i><\/a>(p. 36-38)\u00a0<\/i>to determine what behaviors\/patterns\/signals familiar partners successfully cue into. \u00a0Multimodal (no tech, low tech, high tech): The PSU research on early intervention<\/a> with beginning communicators (with young children) and early research with older individuals who are at beginning levels of communication suggest in-context support of vocabulary and benefits of social sequences (aka, joint action routines). \u00a0The UW AugComm Continuum of Communication Independence<\/a> discusses a need for a clear and reliable signal for acceptance and rejection as foundational for building yes\/no.<\/p>\n
\n(1). \u00a0Provide structured opportunities for observation of CLIENT’s receptive vocabulary, expressive behaviors\/signals\/signs.
\n(2). \u00a0Provide structured opportunities for observation and\u00a0assessment\u00a0of supports\/interventions to expand her vocabulary with symbolic means.
\n(a). \u00a0Given instruction and coaching on partner assisted scanning consistent with Linda Burkhardt’s research<\/a>; please particularly note information re: Rett Syndrome since that has been suggested as the closest comparable profile): \u00a0what is parental reaction; based on observations, what is sense of vision\/motor obstacles; observable behaviors of reaction from CLIENT?; observable indicators of potential?; if yes, journals\/data collection to be sent home for specific targets?
\n(b). \u00a0Given instruction and coaching on principles of intervention outlined by Light & Drager research<\/a>, adapted for older individuals who are beginning communicators: \u00a0what is parental reaction; observable behaviors of reaction from CLIENT?; observable indicators of potential?; if yes, journals\/data collection to be sent home for specific targets? \u00a0Will require provision of some materials (e.g., printed symbols\/photographs; recommendations for apps).<\/p>\n
\n(3). \u00a0Provide structured opportunities for observation and\u00a0assessment\u00a0of symbolic representation: \u00a0signs\/gestures, actual objects, photographs of discrete items, photographs of scenes\/contexts; picture symbols; text; photographs, picture symbols, or text which have been modified for high contrast, etc. \u00a0What would we need to know about vocabulary\/concepts that she currently understands in order to be able to set this up; or, in the absence of that information, what kinds of teaching\/structure would we need to put in place for a valid\u00a0assessment? \u00a0What are observable behaviors of reaction from CLIENT? \u00a0Are there distinctions in engagement (interacting at all, without specifying whether or not was ‘correct’), versus accuracy (seeking a specific answer)? \u00a0What are observable behaviors to indicate processing for # of options presented: \u00a0one at a time w\/partner assisted scanning? \u00a0choice of 2? \u00a0more? \u00a0Presentation in vertical versus horizontal? \u00a0Size of symbol?<\/p>\n