WWU College of Humanities & Social SciencesCommunication Sciences & Disorders 457: Clinical Processes

Instructor: Jill Hunt-Thompson; email: Jill.Hunt-Thompson@wwu.edu Office Hours: AW 203; Posted weekly; please sign up for appointmentsTA: Laurel Martin (office hours posted weekly outside cubicle 3rd floor AE; please sign up for appointments)Text: Haynes, W., and Pindzola, R. (2012). Diagnosis & evaluation in speech pathology. (8th ed.) Englewood Cliffs, N.J., Allyn & Bacon Inc. Notes and texts from your prerequisite courses (CSD 251, 352, 354, 356, 361, 373, 451) should be reviewed as the content pertains to 457 topics. Note: please bring a pack of 3X5 index cards to class (you can share). The cards will be used intermittently throughout the quarter.

Course Objectives:Of great importance to me is your development as a critical thinker and your ability to assign research-based theories and principles to a dynamic clinical process. This involves integrating these theories and principles to the identification, prevention, assessment, and subsequent treatment of those who present with articulation, phonology, language, literacy, voice, and or fluency disorders. Additionally it involves your ability to integrate and synthesize evidence and your application of evidence-based practice to each aspect of the clinical process. Opportunities to support teamwork and meaningful communication dialog are provided. I am dedicated to your learning and will provide you with opportunities to apply the content of this course. Refer to assignments and additional information presented in class, sent via email and or on Canvas.

Student Responsibilities: Students are expected to arrive on-time and prepared for each class. This means that readings and assignments (written and/or oral) are completed as appropriate. Points for assignments submitted late will reflect a loss of 2 points per day beyond the specified due date/time. You are responsible for lecture material as well as all of the information in assigned readings (even if not reviewed in class). You are expected to ASK for clarification, question what you hear and read, and participate in class and small group discussions (in and outside of the class period). You are expected to review your prerequisite course work and make application to the content being discussed. You are to conduct yourself with integrity and honesty. Unless otherwise stated by the instructor, ALL written assignments (including examinations) are to be the work and product of each individual student. Please recognize your peers and instructor deserve an environment that promotes learning. This includes, but is not limited to, insuring that personal cell phones and pagers are on an inaudible mode; the receipt of and or routing of text messages is restricted to before and or after the class period; individuals allow for lectures and dialog during class discussions without interruption or distractive comments; and respect is shown to all members. Note: cell phones, iPods, iPads, and any other electronic communication devices cannot be removed from backpacks or purses or other locations prior to, during, and or after you leave the classroom while an exam(s) or other graded writing assignment is in process. This also applies to any student who is in the process of taking a test or quiz and is doing so in a location outside of our designated classroom. Please read the University catalog regarding academic integrity, WWU Academic Honesty Policy and Procedure document, and its Plagiarism Policies and Guidelines document at http://www.wwu.edu/dos/office/conduct/honesty.shtml. It is your responsibility to check your email and the Canvas site regularly. You will be advised when Canvas has been opened for you to access. You are reminded that you cannot use the CSD Department printers located on the 2nd and 3rd floors of AE.

Course Assignments: The assignments are designed to provide students with the opportunity to apply course content to client scenarios while applying APA format to each task as appropriate. Each assignment is summarized in this syllabus and will be explained in-class and or via email communication and or Canvas. It is expected that students will take advantage of all learning opportunities and contribute to class discussions as they pertain to the assignments and course content. Please be aware that several of your assignments may have a corresponding student

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performance review summary sheet and or rubric that either you or your instructor develops. As applicable, the summaries and rubrics will be routed via email attachments and or Canvas (unless student generated). Please be sure to attach the respective rubric to your written submission(s). Of importance is your review of the behaviors identified on each as these are the behaviors that will be evaluated. You are strongly encouraged to use the rubric(s) as a means to objectively self-evaluate your work prior to submissions. The instructor and or TA will use the summary and its corresponding rubric as one means of providing you with feedback on your written work. Throughout the term, you will be given opportunity to complete assignments that are similar to those that are graded through writing lab exercises. You are encouraged to complete each and to pursue additional support and feedback as needed prior to your graded submissions. You are encouraged to develop and maintain a portfolio throughout the quarter. Its content should reflect the clinical process and will be used in CSD 458 and CSD 459; additional content may be added at your discretion. Examples regarding content and portfolio design will be provided in class.

Quizzes and class exercises may be assigned point value at the discretion of the instructor. Additionally, a variety of classroom-based assessment techniques will be used throughout the term and points may or may not be assigned.

N O T E S :

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C S D 4 5 7 : S Y L L A B U Sdate T o p i c R e a d i n g9/25 Orientation & baselineScreening & assessment

9/27

IntroductionScreening & Assessment Processmap

Chapter 1: Introduction to Diagnosis and EvaluationEvidence-Based Practice http://ncepmaps.org/index.php;http://www.asha.org/Members/ebp/intro.htmhttp://www.asha.org/policy/type.htmhttp://www.asha.org/policy/; http://blog.asha.org/

10/2 Case history, Interviewmap

Chapter 2: Interview; Chapter 12: Multicultural Issues in Assessment: Popular and professional trends; Cultural differences in perception of disabilities; http://www.asha.org/practice/; Interviewing and counseling issues.

10/7 Writing Lab

10/8Scientific methodology, psychometricsmap

Chapter 3: Psychometric Considerations in Diagnosis and Evaluation; Chapter 12: Multicultural Issues in Assessment: Popular and professional trends; Cultural differences in perception of disabilities; Interviewing and counseling issues

October 10-11 WSLHA convention, Everett www.wslha.org

10/14Oral motor examination (OME), map

Chapter 9: Motor Speech Disorders, Dysphagia, and the Oral Exam; refer to your A/P, phonology, and language texts and notes. In-class observation, OME exercise, self-reflection

10/17 Writing lab

10/18Screening & assessment: Speech sound disorders,map

Chapter 6: Assessment of Phonological Disorders; Chapter 12: Multicultural Issues in Assessment: Cultural differences in the incidence and prevalence of disorders; refer to Chapter 4 in your Phonology course text

10/24

Screening & assessment: Languagemap

Chapter 4: Assessment of Children with Limited Language; Chapter 5: Assessment of School-aged & Adolescent Language Disorders; Chapter 12: Multicultural Issues in Assessment: Language assessment the most problematic area; Non-standardized approaches in multi-cultural assessment; refer to your language course text & previous assignments.

10/29 Voice, fluency, rate, cluttering, audition; map

writing application re: assessment plan

10/30 Consultation, report, cover letter

WWU Speech-Language-Hearing Clinic assessment report and cover letter formats; best practice

10/31 Application: assessment plan

intervention

10/29INTERVENTION:a processmap

Students, bring your client portfolio information to each contact. Review chapters in part 2 and 3 of your CSD 373 text: Assessment and remediation of articulatory and phonological disorders. Review your texts, articles from your Language Disorders I and II.

11/4Pre-treatment interview: in-class exercise, map SOAP

Students: arrive with the content areas you want to pursue in your interview with client/caregiver and explain WHY you want to pursue that information.

11/7

Tentative Treatment Focus (TTF), baseline, quarter treatment objective (QTO),map, SOAP

Exercise:

November 11 (Monday) Veteran’s Day HolidayNovember 14-16 ASHA convention, Chicago www.asha.org/asha201311/14 Instructional objectives Exercise:

11/18Approaches, delivery systems, instructional plans, map

Bring your phonology text book to each contact; clinical process, integration of content; exercise:

November 28-29 (Thursday-Friday) THANKSGIVING HOLIDAYdate T o p i c R e a d i n g

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11/26 Professional writing, SOAP

Clinical process, integration of content; exercise:

11/30 Clinical process, integration of content

Exercise:

12/3 Exit conference12/4 Professional writing,

Treatment Progress Summary (TPS), cover letter

WWU Speech-Language-Hearing Clinic TPS report and cover letter formats

ASSIGNMENTSObservations (out of class): Diagnostic (2) and Treatment (3)Description: Refer to class handouts for each observation type. Students each submit their own observations. These can be completed directly on the respective protocol IF there is enough room AND the writing is legible OR the student may use word processing. Further information will be discussed in class. Students are expected to conduct themselves during the observation as though they were in the presence of the clients’ and or their family member(s). Therefore, you are expected to adhere to Clinic policies and procedures. Information viewed and written is CONFIDENTIAL. Remember to have your observation log initialed by the TA prior to leaving the observation setting. Submit those observation reports to JHT’s mailbox on 2nd floor no later than 48 hours after the actual observation. Students may submit work earlier than due date.

There will be additional in-class observations throughout the quarter. You are to document those minutes on your log sheet and submit the corresponding writing exercise as directed. Refer to assignment information for due dates of in-class observations as they have specific due dates. The 5 out of class contacts and the in-class observations should yield at least 5 hours of observation. You are encouraged to keep a separate log for CSD 457 so that accrued observation hours can be turned in with each respective summary. Do not wait and route for signatures at the end of the term. Please route hard copies of all signed observation logs to JHT’s mailbox by December 5th at noon. Students are to keep their originals. Value: 5pts each (unless otherwise specified). Due Dates: sign-up sheets will be routed in class based upon schedules.

You are reminded that you are to accrue a minimum of 25 hours of supervised observations and to document and verified each by completing an observation form. You are to route it to each respective supervisor for his/her signature by placing both the observation summary and your log in his/her mailbox. It is suggested that you route your materials to the supervisor’s mailbox that is on the same floor as his or her office. You MUST include your mailbox number on both forms if you expect to receive them back in a timely manner. Students need to submit a hard copy of their quarter schedule by September 26th at 8a.m. so observations can be arranged. Observation sites will be announced.

Client PortfolioDescription: Students will develop a client portfolio this term. The portfolio is intended to serve as a resource as they enter their first clinical practicum. Students will process a “client” from the initial case history through the assessment and intervention process. Client assignments will be made at the onset of the quarter and students in each group are responsible for completing their own work. Students are expected to use APA writing when appropriate to the assignment(s). As students develop their portfolio content, they are encouraged to utilize content of lectures, class discussions, course text, previous courses’ texts, and other available resources. Please note: content for Assessment and Intervention are listed below; specific due dates and values are reported. Students can submit their work earlier than due dates; late submissions will lose 2 points per day beyond due date. All assignments should be included in the portfolio for your CSD 458 experience. Content of the portfolio is outlined below; label each accordingly. Note, those content items with an asterisk are sections to include in your portfolio but do not have a corresponding 457 assignment. PORTFOLIO CONTENT: Students, submit your assignments and if applicable, its corresponding rubric by the due date. Plan to file all assignments in its respective section of your portfolio. You will continue to develop this resource in CSD 458. Refer to the “module” information that follows. These represent the sections of your portfolio with additional subsections for each.

MODULES:

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I. ASHA documents: links will be provided in class and or via Canvas and or email. Please download a copy of ASHA Code of Ethics, Notice of Privacy Practices for Western Washington University Speech-Language-Hearing Clinic, Privacy and Confidentiality Agreement for Client Confidential, Restricted and Proprietary Information. Copy and sign two copies of the latter; route one to the instructor as directed and put the original in your portfolio. Additional documents will be routed for you to download via email attachment and or Canvas. Optional: You may decide to include a section in your portfolio that includes website resources. For example: http://www.asha.org/public/ . Value: no points but valuable resource. Due: throughout quarter as directed

II. Multicultural issues in the assessment and or intervention process. Choose an SLP or audiology/aural rehabilitation journal article (2010 to present) about a multicultural issue that addresses a specific issue in the assessment OR intervention process. Write an abstract of the article and how you might apply the information to your future service delivery. You may find the WWU Writing Center online resources helpful as you work through this and subsequent assignments. The link: http://libguides.wwu.edu/content.php?pid=296743&sid=2984398. The following resource may also be helpful as you write the abstract: https://owl.english.purdue.edu/owl/resource/656/1/. You are encouraged to review your notes, handouts, and resources provided through your library course and previous writing intensive course lab(s). You are familiar with a variety of search engines to facilitate your research of journal articles. One link to WWU library: http://library.wwu.edu/collections.Value: 15pts. Due: no later than 12/01/2013 at 8am.

You are to complete the online ASHA Self-Assessment for Cultural Competence to include the Cultural Competence Checklists. Please complete the three checklists and place in your portfolio. You can access the PDF forms through this link: http://www.asha.org/practice/multicultural/self/. In addition, please complete the Cultural Competence Awareness Tool as well. Access is via same link.

III. ASSESSMENT Module 1. Visual map/representation : Design a visual representation of the assessment process. This

representation should be thorough, clear, concise, and provide you with the information that applies to the assessment process. You should be able to use this as a future reference. Information, examples, and discussion regarding options provided in class. Value: no points but valuable resource.

2. In-class Observation: Using professional terminology, complete the observation summary specific to the interview. Value: 5 pts. Due: 10/11/13 at noon.

3. Given your client and his/her case history, summarize your interview and assessment plan for this individual. Provide your rationale for all of your decisions. You will explain your position within your group. Value: no points. Due: 10/30/13 at 8am

4. Oral Motor Examination (OME) : a) In-class Observation: using professional terminology, complete the observation summary specific

to the OME. Value: 5 pts. Due: 10/21/2013 at 8amb) You will each conduct one in-class OME. Bring your text book(s), a penlight, and small mirror to

class for the OME date(s); gloves and tongue depressors are provided. Summarize this experience from the perspectives of the clinician and the client and discuss what you learned having participated in this process. Summary is not to exceed 1 single-spaced page. Academic writing is expected. Additional information will be provided in class. Value: 5 pts; Due Dates: OMEs performed in-class during the class period(s)10/15,16; self-reflection/summary due 10/21/13 at 8am.

5. Client’s Communication Assessment Report : Content of the assessment report and format information is to be placed in the portfolio. A copy of the scenario client’s report will be routed for use during the intervention module. Not graded.

6. Out-of class observations (2): Using professional terminology, complete the observation summary. Value: 5pts EACH. Due: a minimum of 48hrs post observation.

IV. INTERVENTION Module

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1. Visual map/representation : Design a visual representation of the intervention process with a reference to the assessment process. Include the initial referral for therapy through the exit conference, report, cover letter, and administrative duties (as per this Clinic). Information provided in class. Value: no points assigned but valuable resource.

2. Pre-treatment interview :

a) In-class observation : Using professional terminology, complete the observation summary. Value: 5pts; Due: at conclusion of class-period

b) This interview is conducted at the onset of the treatment term. Include information in your portfolio for reference. Not graded

3. Tentative Treatment Focus (TTF ) : Given your client’s communication status, identify ONE TTF and provide your rationale for selecting this as his/her treatment focus. Be prepared to discuss your rationale during class period(s). Remember to address variables presented in this and previous courses in decision process. Value: no points but valuable exercise. Due: see syllabus

4. *Baseline protocol : Include information in your portfolio. Not graded

5. Quarter Treatment Objective (QTO ) : Given your client’s baseline performance (as cited by your instructor in class), apply the data to your decision regarding your client’s QTO. Write your client’s QTO for a quarter of treatment and rationale for your decision. Use academic writing and include a minimum of two references; not to exceed 2 pages in length (2 one-sided pages or 1 double-printed page). Value: 10 pts. Due for grading: 11/25/2013 at 8am .

6. Lesson plan (LP ): Given your client’s baseline performance (as cited by your instructor), write his/her LP for the first instructional objective and respective delivery system. Value: 10pts. Due: 11/25/2013 at 8am

7. Data Protocol : Given your client’s baseline performance (as cited by your instructor), develop your data protocol for the first instructional objective and respective delivery system. Value: 10pts. Due: 11/25/2013. If you combine the LP and protocol into one document value is a total of 20 points.

8. *SOAP : Include information in your portfolio.

9. *Exit Conference : Include information provided in class.

10. *Treatment Progress Summary (TPS) : Include information in your portfolio.

11. *Cover Letter : Include information in your portfolio.

In-class exercisesDescription: Students are expected to complete all assignments (in- and out-of class) throughout the term. These, as well as all other assignments, serve as learning markers. Specific assignment descriptions will be announced in class, and or via emails and or Canvas. Due Date(s): Announced in class. Value: Points range from 1 to 5 per assignment.

QuizzesDescription: The instructor reserves the right to quiz students on their presenting competencies specific to course content and its integration into the screening, assessment, and intervention process. Given this, students are encouraged to remain current on their readings, understanding of lectures and discussions, and when applicable, completion of in- and out-class exercises. There may be a quiz every other week; cumulative content covered on quizzes. Value: Quizzes will be between 1 and 5 points each. Due Date(s): At the end of class period or as specified by the instructor.

Course Grade Assignment Evaluation Criteria: Your final course grade is assigned based on the percentage of your total cumulative points and the total possible for each assignment. Borderline grades may be impacted (positively or negatively) by your participation in small group and class discussions. You earn the grade that corresponds to the percentage. Remember, late assignments lose 2 points per day past the due date/time. All assignments are due at the beginning of the respective class period at 8a.m. unless otherwise indicated in the syllabus.

Grade scale rubric

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same duedate

Point range Letter grade Point range Letter grade93-100 A 77-79.9 C+

90.9-92.9 A- 73-76.9 C87-89.9 B+ 70-72.9 C-83-86.9 B 65-69.9 D80-82.9 B- <-64.9 F

GROUPS: To facilitate your understanding and application of the clinical process a variety of learning and teaching strategies will be used. One includes your work within a group setting with each group assigned a “client” (scenario). It is understood that not all students embrace working in groups for a variety of reasons such as, some members do not do their share, are unprepared or do not contribute, use the work generated by others, are lazy, do not allow others to share their perspective, need to be in control, lack positive pragmatic skills. I get it. I understand. I don’t like working in those types of groups either. You and the other members will agree to what constitutes a positive group experience-all will participate in this process. You and the other members need to take responsibility and agree to follow-through with the expectations. Group time will be provided in class. These groups are to promote cooperative dialog, support ideas, and be a “sounding board” for discussions. While your group is assigned a client, you are each that client’s clinician. Exercises are designed to promote the writing skills needed by clinicians who provide SLP services with suggestions and examples of those required of our graduate clinicians at this site. Each student is to submit his or her own work. All group members are expected to participate in the process. Groups are student assigned with a maximum of 9 and a minimum of 7 members.

Group 1 Group 2 Group 3

Group 4 Group 5 Group 6

Group 7 Group 8 Group 9

Student Communication Screening: It is important to recognize that as clinicians we represent to our clients target models of communication. If we present with a communication difference that negatively impacts this model, it is often necessary for us to modify our model through therapy. Your communication may have been screened in your introductory CSD course(s) and you may have received specific recommendations. Please note that your communication will be screened this quarter or next in CSD 458. If schedules permit, it may be possible for you to have your hearing tested as well. The examiner(s) will review with you the results of your screening and discuss recommendations following your appointment(s). Pending your permission, your program advisor and appropriate clinic personnel will be advised of the screening and or hearing test results and recommendations. Please be aware that this does not impact your final course grades in CSD 457 or 458 and your participation in CSD 459 is not impacted by your screening results. Additional information will be provided in class.

Learning Markers-outcomes; ASHA certification standards:This course is designed to accomplish the following learning markers/outcomes and related ASHA certification standards:1. Learning Objective: The student will appreciate the cultural bases of human communication and will apply that information given hypothetical case scenarios.

Standard: IIIB: Basic Human Communication Process Evidence Source: in-class discussion

2. Learning Objective: The student will discuss how etiological, anatomical/physiological, acoustic, psychological, developmental, linguistic and cultural factors relate to the prevention, identification, assessment, and treatment process and will apply that information to hypothetical case scenarios.

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Standard: IIIC: Articulation, receptive and expressive language (phonology, morphology, syntax, and pragmatics), social aspects of communication (including challenging behavior, ineffective social skills, lack of communication opportunities)

Standard IIID: Knowledge of the principles and methods of prevention, assessment, and intervention for people with communication disorders.

Evidence source: in-class discussion; application cards (CATs); class projects; self- and peer review.

3. Learning Objective: The student will identify and interpret the salient components of a case history protocol for children and adult populations and will apply that information to hypothetical case scenarios.

Standard IIID: Knowledge of principles and methods of prevention, assessment, and intervention for people with communication disorders.

Standard IVB: Skill in oral and written or other forms of communication sufficient for entry into graduate study.

Evidence source: in-class discussion; develop/write summary of content; self- and peer review; revision of written summary; quick quizzes

4. Learning Objective: The student will identify the salient components of an interview (pre-assessment), generate an efficient and effective interview and will demonstrate interview strategies given hypothetical case scenarios.

Standard IIID: Knowledge of the principles and methods of prevention, assessment and intervention for people with communication disorders

Standard IVB: Skill in oral and written or other forms of communication sufficient for entry into graduate study

Evidence source: in-class discussion; develop/write interview; summarize content; self- and peer written review; revision of written summary; rubric; quick quizzes

5. Learning Objective: The student will identify the salient components of an oral peripheral examination, conduct oral peripheral examinations, and will recognize the differences among participants’ oral mechanisms.

Standard IIID: Knowledge of principles and methods of prevention and assessment Evidence source: in-class discussion; in and out of class small group oral examinations

6. Learning Objective: The student will critique the validity and reliability of commonly used phonology, speech, and language communication assessment tools and will provide rationale for their application as they apply evidenced based practice to hypothetical case scenarios.

Standard IIID: Knowledge of principles and methods of prevention and assessment Standard IVB: Skill in oral and written or other forms of communication sufficient for entry into

graduate study Evidence source: in-class discussion; CATs; class project; self- and peer review; rubric

7. Learning Objective: The student will discuss strategies that support identification, prevention, assessment, and treatment recommendations and will provide rationale for their application as they apply evidenced based practice to hypothetical case scenarios.

Standard IIIC: Articulation, receptive and expressive language (phonology, morphology, syntax, and pragmatics), social aspects of communication (including challenging behavior, ineffective social skills, lack of communication opportunities)

Standard IIID: Knowledge of principles and methods of prevention and assessment Evidence source: in-class discussion and presentation; CATs; quick quizzes; written project

8. Learning Objective: The student will critique the validity and reliability of commonly used speech, phonology, and language approaches and will provide rationale for each as they apply evidenced based practice to hypothetical case scenarios.

Standard IIID: Knowledge of principles and methods of prevention and assessment Standard IVB: Skill in oral and written or other forms of communication sufficient for entry into

graduate study Evidence source: in-class discussion and presentation; CATs; quick quizzes; written project

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9. Learning Objective: The student will explain strategies to develop individual treatment plans, generate specific treatment objectives, and will provide rationale for each as they apply evidenced based practice to hypothetical case scenarios.

Standard IIID: Knowledge of principles and methods of prevention and assessment: articulation, phonology, and or language intervention

Standard IVB: Skill in oral and written or other forms of communication sufficient for entry into graduate study

Evidence source: in-class discussion and presentation; CATs; quick quizzes; written project

10. Learning Objective: The student will develop data protocol reflecting one of several observational recording strategies, record responses, analyze responses and will determine and write subsequent (measurable) treatment objectives based upon hypothetical case scenario and responses.

Standard IIID: Knowledge of principles and methods of prevention and assessment: articulation, phonology, and or language intervention

Evidence source: in-class discussion; CATs; self- and peer review; written project

11. Learning Objective: The student will have knowledge of and will appreciate the standards of ethical conduct.

Standard: IIIE Demonstrate knowledge of standards of ethical conduct. Evidence source: in-class discussion; ASHA web-search; examination

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