Assessment response log #4

Tyler, A. A. & Tolbert, L. C. (2002).  Speech-language assessment in the clinical setting.  American Journal of Speech-Language Pathology, 11, 215-220.

TAP            The topic of this article is an evaluation process that relies heavily on standardized language testing and complete parent interview.  The intended audience for this reading is the student in Communication Disorders or the practicing SLP.  The purpose is to inform the reader of this author’s assessment process and the reasons behind them. 

Claims·         Parent questionnaire information is very important in planning an assessment.  Also, parents should be encouraged by the clinician to stay in the assessment room during the evaluation.   ·         Despite time limits a multimedia approach of both standard and non-standard testing should be used.  However, standardized tests are most important during an assessment.  Receptive and expressive language are a few of the most important things to assess.  Receptive language is the most beneficial.  Phonological awareness testing does not need to be done in an evaluation. Evidence

• The organization of the assessment is dependant on the information that is gathered in the parent interview that is sent to the client a week before the evaluation.  Questions regarding development (motor, speech-language, social-emotional) as well as medical and family history are included in the questionnaire.  Because it is sent out a week before the evaluation, the parent has a chance to fill out the information completely; giving the clinician better information.  If needed, information gathered on the questionnaire is clarified and explained by the parent at the beginning of the evaluation.  This is so the clinician can get a better idea of what the problem is and it’s prognosis for change.  Parents are encouraged to stay for the entire evaluation because some children are more comfortable with their parents present.  This may cause them to be more open allowing the clinician to get better information.  This situation may put the parent at ease as well.  It is also important to be able to continue an interactive dialog with the parents throughout the evaluation.  They can tell the clinician if what he/she is observing is out of the ordinary or normal behavior for the client.         
• Non-standardized tests provide the clinician with lots of useful information about the nature of the problem.  But, standardized tests are important to decide if a problem exists with the client by comparing them to normative samples.  Scores are helpful information for parents.  They allow the parent to understand their child’s performance in relation to the child’s peers of the same page.  It also helps to get payment from third-party payers and services from outside agencies.  Receptive language is most important to assess because expressive language can simply be assessed from the language sample that is obtained.  The PLS-3 can be administered when testing language because it is relatively easy for younger children, used in the school system often, and has high concurrent validity.  But the expressive section of the test should be administered last in case the child’s tolerance for testing is low or time runs out.         

ConnectionsText-to-self – The assessments and social histories that I conducted while working at Prestera were all for adults; unless I was covering for the girl in the office beside mine.  The structure of it seemed to be set in stone.  But, the longer I worked there and the more familiar I became with it, the more comfortable I felt changing the flow to fit my client or my preferences.  I also talked to my coworkers and found out that they did the same thing.  They changed the flow of assessments according to what they believed was best for extracting information and gaining a clearer understanding of the patient’s progress and state of mind.  They used their own theory to guide how they approached assessment. 

Text-to-text – The focus on the parent interview in this article made me think about what we learned from our Diagnostics textbook.  We were taught in this class that it was important to do the parent interview at the very beginning of the evaluation.  The author of this article seems to feel as though the flow of the assessment should be a little more lax.  She does say that it is typically done in the beginning.  But, if the child is immediately playing and talking, then the questions for the parent should wait until later so the clinician can take advantage of the child’s mood.  This is a more child-directed approach than we learned in class.  I think it would work much better.    

Text-to-world – I hope that when I begin doing assessments here I will eventually feel more comfortable as I did at Prestera.  I am sure at first I will need lots of structure and a format to follow.  As I get more experience here and especially when I start practicing, it will be exciting to be able to do an assessment according what I believe is most important.  One day I will prescribe to a theory that fits my beliefs and tailor my evaluations to that theory.  Getting all these different examples helps me to understand that assessment practices are not completely set in stone.