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Flashcards in Assessment Deck (39)
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1
Q

Define Assessment.

A

Assessment is an organised, goal directed evaluation.

Patterson and Chapey, 2008

2
Q

Purpose of assessment

A
For diagnosis:
Strengths and weaknesses
Auditory comprehension
Speech production
Reading Comprehension
Writing
Pragmatic, cognition, mood etc. if required

Determine type of aphasia.

Background and medical information should also be gathered.

Informs intervention-areas to focus on

Establish theoretical explanation of what’s gone wrong with reference to PALPA language processing model.

Information for family/carers- strengths and weaknesses, advice on how to facilitate communication.

Prognosis

Measurement of change and monitoring

Helps plan therapy

Ascertain what strategies will support them

Provide information relating to the individual’s capacity- adults with incapacity act 2000- if they are incapable? or just need AAC to convey decisions.

3
Q

What framework should we consider when assessing?

A

ICF WHO

4
Q

What does the ICF WHO consider?

A

The impact on the individual.
Components: impairment, activity and participation, personal and environmental contextual factors.
Gives us a more hollistic view of the PwA

5
Q

Impairment Based Assessment.

Comprehensive Diagnostic Batteries

A

Boston Diagnostic Aphasia Examination

Western Aphasia Battery-Revised

6
Q

BDAE

A
  • performance across language modalities
  • allows diagnosis of aphasia to be made.
  • Normally just do little bits of it- quite big.
  • does give a comprehensive picture of deficits and retained abilities.
7
Q

Western Aphasia Battery-Revised

A
  • full battery and bedside screening

- differential diagnosis and aphasia type.

8
Q

When are comprehensive diagnostic batteries inappropriate?

A

Innapropriate for acute stage aphasia.

PwA should be neurologiclally stable- this is normally 3 months post stroke.

9
Q

What should be considered if doing a comprehensive battery?

A

It takes time and will require several sessions.
Fatigue
Emotional effects
PwA’s performances fluctuate and may change dramatically on a day to day basis- ideally for this reason any assessment should be completed within a week.

10
Q

What do acute stages refer to?

A
Aphasia= early days- first 4 to 6 weeks
Stroke= first week.
11
Q

What are used in the acute stages to assess?

A

Screening tests

Informal assessments.

12
Q

Name a screening test.

A

Aphasia Screening Test.

13
Q

Assessment of aphasia - informal.

A

It may not always be appropriate to use formal assessments in the hospital environment or in acute stages of recovery.
Instead SLT may use informal techniques or only use certain parts of formal assessments informally.

14
Q

If we don’t have a lot of information from the referral what should we do?

A

Over prepare for the assessment. :)

Prepare for multiple possibilities

15
Q

Screening in hospital- what is important practically?

A

It has to be practical- you can’t carry loads of stuff around the hospital-, in terms of ease and infection control.

16
Q

What may help you develop a hypothesis?

A

If the area of stroke is is provided.

17
Q

In screening- what should be assessed?

A

The 4 communication modalities at a basic level:

  1. Auditory Comprehension
  2. Reading Comprehension
  3. Verbal Expression
  4. Written Expression
18
Q

In terms of screening what should we prepare for?

A

A range of impairment severity.

19
Q

Name comprehension screening in terms of severe aphasia.

A

picture/object matching
Y/N questions
1-2-3 stage commands
single word level.

20
Q

Name comprehension screening in terms of mild aphasia.

A

complex sentence level, conversation level, higher level language abilities.

21
Q

Name expression screening in terms of severe aphasia.

A

might have none at all, use of gesture, reliable Y/N

22
Q

Name expression screening in terms of mild aphasia.

A

Conversation level expression, higher language.

23
Q

What is it not necessary to do?

A

not necessary to start at most basic level and carry on to the highest.
Causes patient distress, harms rapport and waste of time, little benefit.

Instead pitch at a level you think might be appropriate and adjust up or down.

24
Q

How can medical information be gathered?

A

From medical notes
getting to know me forms
MDT members

25
Q

What 2 things should you consider whilst screening?

A

Consider environment- busy, noisy, quiet, visitors, personal belongings to use
Consider individual- alertness, attention, distractibility, are they reading paper, facial/limb weakness, distressed, are they trying to interact with others on the ward- if so how?

26
Q

How is introductory conversation a useful part of assessment?

A

Use different types of questions and see if patient is able to respond.

Open question- hard e.g. “tell me about your family”

Y/N question- easy e.g. “are yo married”

Specific question- hard e.g. “how many children do you have”

Say wrong info and see if they agree e.g. “is your wife’s name elaine?”

Make use of pictures, cards and newspapers e.g. “who’s this?”

Typical conversation topics are good- adapt how you present them and strategies used- pictures, drawing, repetition, gestures etc.

27
Q

What is the Comprehensive Aphasia Test- CAT?

A

More detailed than a screening test, not as detailed as a battery.

28
Q

Name the 3 components of the CAT

A

3 components:

  1. comprehensive assessment of language components
  2. screen for associated cognitive deficits
  3. brief investigation of everyday life disability
29
Q

CAT clinical application

A
Diagnosis of impairment
Overall severity
Investigates disability as well as impairments.
Indicates meaningful intervention goals
Allows monitoring
Indicates areas for further assessment.
30
Q

When is the CAT performed?

A

3-6 post onset if medically stable.

Takes 2 sessions approx 45-1 hr long.

31
Q

When assessing what’s important?

A

Encourage patient throughout.

32
Q

What is an expansion of the brief investigation of daily everyday life disability in the CAT?

A

The Communication Disability Profile.

33
Q

What does The Communication Disability Profile assess?

A

Impact.

34
Q

Name a psycholinguistic test

A

PALPA :)
assesses an area of language in depth.
performance viewed in relation to language processing model- PALPA.

35
Q

How many tests does the PALPA have?

A

60!

tests are selected based on hypothesis from screen.

36
Q

Specific function tests

A

Boston Naming Test
Reading comprehension Battery for aphasia

These assess one area of language in greater depth

37
Q

Impairment based assessment remains popular because…

A

They are reliable, valid and explicit.

Ideally they should be standardised in order to see how a pwa is performing in relation to norms.

38
Q

What should be noted in terms of performance?

A

Poor performance doesn’t always mean aphasia, could be dementia, other cognitive issues, may lack motivation or have attention and sensory difficulties.

39
Q

Assessment is only a …

A

Snapshot :) in a certain situation and time.