Healthcare Intervention Strategies

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Questions and Answers

What does Evidence-Based Practice (EBP) integrate?

Clinical expertise only

Best research results only

Personal opinions and anecdotal evidence

Client perspective and external evidence (correct)

What is the primary purpose of intervention in language disorders according to ASHA's Code of Ethics?

To provide therapy without evidence

To eliminate all language disorders

To change the environment

To show changes in language behavior (correct)

Which of the following is NOT a component of the PICO elements used in EBP?

Intervention

Problem

Cost (correct)

Outcome

According to McCauley & Fey (2006), what is vital for setting intervention goals?

Assessment results Signup and view all the answers

In developing an intervention plan, which aspect is essential according to the content provided?

Carefully considering and planning Signup and view all the answers

What is one of the intended products of intervention?

The context and environment Signup and view all the answers

Why is the involvement of scientific evidence important in intervention planning?

It ensures therapy methods are appropriate Signup and view all the answers

What is the primary goal of primary prevention in language disorders?

To avoid the disorder entirely Signup and view all the answers

Which level is NOT included in the intervention goals according to McCauley & Fey?

Immediate goals Signup and view all the answers

Which of the following best describes secondary prevention?

Identifying and intervening early to reduce the severity Signup and view all the answers

Which practice is commonly associated with tertiary prevention in speech-language pathology?

Rehabilitation services to enhance functional competence Signup and view all the answers

What is a key component of the speech-language pathologist's role in prevention?

Conducting research to identify risk factors Signup and view all the answers

What is a key characteristic of the clinician-directed approach?

The clinician sets the tools and frequency of reinforcement. Signup and view all the answers

In planning a language intervention program, which step should the speech-language pathologist prioritize first?

Identifying specific goals and objectives Signup and view all the answers

Which of the following is a disadvantage of the clinician-directed approach?

Limited generalization to natural settings. Signup and view all the answers

What type of activity involves the SLP using a motivated context like a game?

Drill Play Signup and view all the answers

Which approach is considered the most natural on the continuum of intervention approaches?

Child-Centered Approach Signup and view all the answers

In the clinician-directed approach, what is the primary focus of drill-based activities?

Controlling the presentation of stimuli and responses. Signup and view all the answers

What is a primary benefit of using a clinician-directed approach with children who have severe disabilities?

It maximizes opportunities for language form practice. Signup and view all the answers

What is a characteristic of the continuum of naturalness in intervention activities?

Activities can range from fully natural to highly structured. Signup and view all the answers

What is a defining aspect of the drill method within clinician-directed activities?

The clinician selects a target and provides structured reinforcement. Signup and view all the answers

What is one of the main advantages of the child-centered approach?

It allows for a more naturalistic and realistic learning environment. Signup and view all the answers

In the child-centered approach, what role does the clinician play during sessions?

The clinician follows the child's lead and arranges activities accordingly. Signup and view all the answers

Which language facilitation strategy involves modeling comments on a child's actions?

Self talk Signup and view all the answers

Which key aspect is NOT part of the child-centered approach?

Directly instruct Signup and view all the answers

What is a potential disadvantage of the child-centered approach?

It may not be effective for all children, especially those who require more direct guidance. Signup and view all the answers

How does the child-centered approach typically encourage communication from children with ASD?

By providing a comfortable, natural environment for interaction. Signup and view all the answers

What method does the child-centered approach employ to naturally elicit speech from children?

Arranging activities that capitalize on children's interests. Signup and view all the answers

Which language facilitation strategy provides commentary on a child's actions in real-time?

Parallel talk Signup and view all the answers

What is the primary goal of the hybrid approaches in language therapy?

To maintain clinician control over selected activities. Signup and view all the answers

Which of the following best describes the technique of expansions in language therapy?

Rephrasing the child's utterances by adding grammatical markers and semantic details. Signup and view all the answers

What is the key characteristic of focused stimulation?

Arranging the context to tempt the child to produce targeted forms without direct requirements to respond. Signup and view all the answers

In vertical structuring, what method is typically used to elicit specific language forms from the child?

Providing nonlinguistic stimuli like pictures to prompt responses. Signup and view all the answers

Which component is NOT part of milieu communication training?

Implementation of strict behavioral modifications. Signup and view all the answers

What is the main focus of script therapy in language interventions?

Developing consistent routines or scripts to provide familiarity. Signup and view all the answers

In what way do imitations benefit language development in children?

They increase the likelihood of the child imitating the clinician. Signup and view all the answers

What is one of the characteristics of using expansions in language therapy?

Adding grammatical and semantic details to the child's utterances. Signup and view all the answers

Study Notes

The Purpose of Intervention

Intervention can have various goals:
- Changes in language behavior that would not occur without intervention
- Eliminate the underlying problem causing the disorder
- Change the disorder itself
- Teach compensatory strategies
- Change the environment

Developing Intervention Plan

Intervention plan should be carefully considered and planned, similar to the assessment process
Use evidence-based practice (EBP)

Evidence Based Practice

EBP uses the best available research results to make decisions about client care
Integrates:
- Clinical expertise
- Scientific evidence
- Client perspective

Forming Clinical Questions for EBP

Use the four “PICO” elements:
- Patient or Problem
- Intervention being considered
- Comparison treatment
- Outcome

Products of Intervention: Setting Goals

Goals should be based on assessment results
Three levels of intervention goals:
- Lower priority: Forms and functions used in 50% to 90% of required contexts.
- Medium priority: Forms that clients use correctly sometimes but not always or in all required contexts.
- Higher Priority: Forms and functions that the client does not use at all or not demonstrate understanding of in receptive task formats.

Intervention Approaches

Continuum of naturalness:
- Least natural: Clinician-directed approach
- Most natural: Child-centered approach
- Hybrid Approaches

Clinician-Directed Approach

Highly controlled and specified
Clinician chooses the tools, methods, and reinforcement
Less natural
Example: Drill or discrete trail interventions

Clinician-Directed Approach: Pros & Cons

Pros:
- Maximizes opportunities for child to produce target forms
- Provides highly structured, clinician-controlled environment
- Effective in eliciting wide range of language forms
- May be beneficial for children with severe disabilities
Cons:
- May limit generalization to natural settings

Types of Clinician-Directed Activities

Drill: SLP selects target, explains it, provides stimuli, reinforces correct responses.
Drill Play: Similar to drill, but incorporated within a fun activity.
Modeling: SLP models the target response using a third person (e.g., parents) for the child to imitate and then reinforce.

Child-Centered Approach

Child drives the interaction
Clinician follows the child's lead
Naturalistic setting
Minimal to no tangible reinforcement
No requirements for child to respond
Minimal use of prompts or shaping
Focuses on observation, waiting, and listening to elicit communication

Child-Centered Approach: Pros & Cons

Pros:
- Simple and accessible model for child
- Suitable for uncooperative or very young children
- More naturalistic
- May be useful for eliciting comments from children with ASD
- Generalization effect
Cons:
- Some children may not respond to this approach
- Difficult to keep data
- Not optimal for establishing all behaviors
- Can be time consuming

Language Facilitation Strategies

Self-talk: Modeling the appropriate sounds, words, or sentences that describe the actions being performed.
Parallel talk: Providing self-talk for the child.
Imitation: Imitating what the children says to increase the chance the child will imitate the clinician.
Expansions: Repeating what the child says adding grammatical markers and semantic details.
Extensions: Comments that add semantic information to the child’s comments.
Buildups and breakdowns: Expanding child utterances then breaking them down into smaller phrases.
Recast sentences: Similar to expansions, but with different sentence structures.

Hybrid Approaches

Targets specific language goals
SLP maintains control in selecting activities and materials, but chooses materials that encourage child interaction
SLP models and highlights targeted forms

Forms of Hybrid Approach

Focused stimulation: SLP provides many models of targeted forms in a naturalistic context, without requiring a specific response.
Vertical structuring: Expanding on the child's utterances to highlight target structures.
Milieu communication training: Uses operant principles in natural settings to enhance communication.
- Components:
  - Environmental arrangement
  - Responsive interaction
  - Conversation-based contexts
Script therapy: Developing routines and narratives with the child to create comfort and predictability.

Prevention of Language Disorders

Levels of prevention:
- Primary: Prevents the disorder entirely
- Secondary: Identifies and intervenes early
- Tertiary: Provides rehabilitation

Primary Prevention of Language Disorders

Primary prevention: Reducing the incidence of communication disorders
Role of the SLP:
- Wellness promotion
- Advocacy for public policy that promotes wellness
- Participation in research to identify risk factors

Secondary and Tertiary Prevention of Language Disorders

Secondary prevention:
- Early identification and intervention
- Newborn hearing screening
- Community and kindergarten screenings
Tertiary prevention:
- Rehabilitation to reduce disability and increase adaptive competence
- The most frequent level of intervention by SLPs.

Conclusion

Language intervention planning and evaluation require careful consideration of the desired outcomes.
SLPs must develop goals and objectives that are:
- Long-term goals (LTGs)
- Short-term goals (STGs)
- Objectives
Choose appropriate stimuli, reinforcement, context, and timing for effective outcomes.

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Description

This quiz explores the purpose of intervention in healthcare, focusing on the development of intervention plans and the importance of evidence-based practice. Participants will learn how to formulate clinical questions using the PICO elements and set effective intervention goals.