Intervention Planning and Evidence-Based Practice

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Questions and Answers

What is a characteristic of the Clinician-Directed Approach?

It emphasizes the use of open-ended questions.

It involves highly controlled and specified interventions. (correct)

It relies primarily on child-led exploration.

It allows for spontaneous play-based activities.

Which intervention approach is considered most natural?

Drill-based activities

Clinician-directed approach

Hybrid approach

Child-centered approach (correct)

What is a potential disadvantage of the Clinician-Directed Approach?

It has limitations in generalization to natural settings. (correct)

It limits the opportunities for reinforcement.

It provides too little structure.

It is ineffective for children with severe disabilities.

In which type of clinician-directed activity does the SLP provide reinforcement within a motivated event?

Drill Play Signup and view all the answers

Which of the following is a pro of the Clinician-Directed Approach?

It provides an environment for extensive form production. Signup and view all the answers

What is the main goal of 'drill' in clinician-directed activities?

To provide a predetermined training stimulus. Signup and view all the answers

The hybrid approach in intervention activities varies along which of the following?

Levels of structure and naturalness. Signup and view all the answers

What is a primary characteristic of the Child-Centered Approach?

The child decides the material and activities. Signup and view all the answers

What is a common feature of the activities in the Clinician-Directed Approach?

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

What does the clinician do in the Child-Centered Approach when a child demonstrates communication behavior?

Waits for the child to respond and then reacts appropriately. Signup and view all the answers

Which of the following is NOT a key component of the Child-Centered Approach?

Direct teaching Signup and view all the answers

What is a disadvantage of the Child-Centered Approach?

It can be time-consuming. Signup and view all the answers

Which language facilitation strategy involves matching the clinician's actions to the child's actions?

Self talk Signup and view all the answers

Which of the following is a potential benefit of the Child-Centered Approach?

Encourages children to speak without fear of corrections. Signup and view all the answers

What is a common misconception about the Child-Centered Approach?

Children view it as strictly educational. Signup and view all the answers

Which of these strategies emphasizes commenting on the child's actions?

Self talk Signup and view all the answers

What is the primary goal of the imitation technique in language therapy?

To enhance interaction by modeling language Signup and view all the answers

Which hybrid approach involves arranging the context to tempt the child to produce targeted forms?

Focused Stimulation Signup and view all the answers

What is the unique component of Vertical Structuring compared to other language facilitation techniques?

Using specific nonlinguistic stimuli to elicit language Signup and view all the answers

Which component is NOT part of Milieu Communication Training?

Exclusive focus on academic skills Signup and view all the answers

How does script therapy support language development?

By developing routines or scripts for consistency Signup and view all the answers

Which technique involves expanding a child's utterance and then breaking it down into smaller components?

Buildups and breakdowns Signup and view all the answers

What is a distinguishing feature of hybrid approaches in language therapy?

Selecting activities that encourage spontaneous language production Signup and view all the answers

What does the term 'expansions' refer to in language intervention techniques?

Adding grammatical markers and semantic details to the child's speech Signup and view all the answers

What is the main purpose of intervention in addressing language disorders?

To change language behavior through intervention. Signup and view all the answers

Which of the following is NOT a consideration when developing an intervention plan?

Random selection of strategies. Signup and view all the answers

What does Evidence-Based Practice (EBP) emphasize in the context of interventions?

Integrating clinical expertise with the best available evidence. Signup and view all the answers

What does the PICO model in Evidence-Based Practice stand for?

Patient, Intervention, Comparison, Outcome. Signup and view all the answers

Which of the following elements should NOT be included when setting goals for intervention?

Concerns related to the client's family. Signup and view all the answers

What is one key product of intervention when setting goals?

Assessment results for guiding objectives. Signup and view all the answers

Which service delivery model aims to change the environment in the context of intervention?

Consultative model. Signup and view all the answers

When evaluating intervention outcomes, what is the primary requirement implied by ASHA’s code of ethics?

To show that intervention has led to changes that would not occur otherwise. 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 activity is NOT typically associated with the role of speech-language pathologists in secondary prevention?

Implementing wellness promotions Signup and view all the answers

What is the most common level of prevention engaged by speech-language pathologists?

Tertiary prevention Signup and view all the answers

Which of the following best describes the role of speech-language pathologists in the planning and evaluation of language intervention programs?

They must consider the overall outcome, as well as specific goals and objectives. Signup and view all the answers

What is a key focus of secondary prevention in language disorders?

Identifying and intervening early in the disorder's development Signup and view all the answers

Study Notes

The Purpose of Intervention

Intervention goals are to change or eliminate underlying problems, change disorders, teach compensatory strategies, change the environment, and ultimately, to change language behavior.
The purpose of intervention should be determined before developing an intervention plan.

Developing Intervention Plan

Intervention plans should be carefully considered and planned.
The plan should incorporate evidence-based practice principles.
Evidence Based Practice (EBP) is a method of making clinical decisions using the best available, unbiased research results, clinical expertise and client perspective.

Evidence Based Practice

The "PICO" elements are used to formulate clinical questions for EBP:
- P - Patient or Problem
- I - Intervention being considered
- C - Comparison treatment (e.g., prevailing approach or no treatment)
- O - desired Outcome

Products of Intervention: Setting Goals

Intervention goals are categorized into three levels:
- Intend Products: Objectives
- Process Used: Intervention Approaches
- Contexts, or environments: Where the intervention is taking place

Objectives

Goal selection is a vital aspect of intervention.
Assessment results serve as the primary source for goal setting.
Goals can be categorized into three levels of priority:
- Lower Priority: Forms and functions used in 50% to 90% of required contexts.
- Mid Priority: Forms and functions used in 10% to 50% of required contexts.
- High Priority: Forms that clients do not use at all and do not demonstrate understanding of in receptive task formats.

Process Used

There is a continuum of naturalness in intervention approaches.
Intervention approaches vary in their naturalness.
Some activities are highly natural, closer to real-life situations (e.g., play at home).
Others are highly structured and controlled (e.g., drill-based activities in a clinic).

Intervention Approaches

Clinician-Directed Approach
- Highly controlled and structured.
- Clinician chooses tools, methods, reinforcement, and acceptable forms.
- Examples: Drill, discrete trial interventions.
- Pros: Maximizes opportunities for producing target forms, provides structure and reinforcement, effective in eliciting language forms, may be effective for children with severe disabilities.
- Cons: Generalization to natural settings may be limited.

Clinician-Directed Approach: Types of Activities

Drill: Target selected, response explained, stimuli presented in order, correct responses reinforced.
Drill Play: Similar to drill, but integrated within a motivating event (e.g., game).
Modeling: Target selected, response modeled by a third person, child imitates the model, correct responses reinforced.

Child-Centered Approach

Child-driven, clinician follows the child's lead.
The child chooses materials, clinician provides models when appropriate.
No tangible reinforcement or prompting.
The clinician observes, waits, and listens to the child, then responds using language facilitation techniques.
Known as: Indirect language stimulation, Language facilitation, Facilitative play, Pragmaticism, Developmental or developmental, pragmatic approaches.
Pros: Naturalistic, provides the lead for the child, motivating, useful for eliciting comments from children with ASD, promotes generalization, therapy is play and fun.
Cons: Some children may not respond, difficulties in keeping data, some behaviors can not be established, time consuming (sometimes).

Language Facilitation Strategies

Self talk: modeling comments on actions.
Parallel talk: providing self talk for the child.
Imitations: imitating what the child says.
Expansions: repeating what the child said, adding grammatical markers and semantic details.
Extensions: adding semantic information to the child's comments.
Buildups and breakdowns: expanding child's utterances, then breaking it down into phrases.
Recast sentences: rephrasing child's utterances into a different type.

Hybrid Approaches

Combine elements of clinician-directed and child-centered approaches.
Target specific language goals by providing controlled stimuli and responding to the child's communication.
Examples of hybrid approaches:
- Focused Stimulation: arranging contexts with stimuli to tempt the child to produce target forms.
- Vertical Structuring: a form of expansion used to highlight target structures.
- Milieu Communication Training: applies operant principles to semi-naturalistic settings (environmental arrangement, responsive interaction, conversation-based contexts).
- Script Therapy: developing routines or scripts with the child.

Prevention of Language Disorders in Children

Levels of Prevention:
- Primary: Avoid the disorder entirely.
- Secondary: Identify and intervene early.
- Tertiary: Provide rehabilitation.

Primary Prevention

Reduces the incidence of communication disorders.
Includes:
- Wellness Promotion: promoting healthy communication development.
- Advocacy of Public Policy: promoting policies that support communication wellness.
- Research: identifying risk factors for communication disorders.

Secondary and Tertiary Prevention

Secondary Prevention: Early identification and intervention.
- Newborn Hearing Screening
- Community Screening (e.g., kindergarten screening).
Tertiary Prevention: Rehabilitation to reduce disability.
- The most common level engaged by SLPs.

Conclusion

Language intervention program planning and evaluation involves a series of decisions.
SLPs need to consider general outcomes, specific goals and objectives.
Effective plans involve selecting appropriate stimuli, reinforcement, context, and timing to achieve optimal outcomes.
Long-term goals (LTG) are broken down into short-term goals (STG) and objectives.

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Description

This quiz explores the essential components of intervention planning in clinical settings, focusing on the purpose of intervention and how to develop effective intervention plans. It highlights the importance of evidence-based practice (EBP) and the use of PICO elements to guide clinical decision-making.