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SchoolofArtsandSciencesDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicHandbookPolicyandProcedureManual

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TableofContentsIntropages3-11AppendixA-StudentConcernsandGrievancespage12AppendixB-ProfessionalCodeofConduct-ClinicPoliciespages13-34AppendixC-ElectronicMessageExchangepages35-39AppendixD-StudentClinicianRequirementspages40-58AppendixE-ProceduralSafeguardspages59-66AppendixF-ClinicAssignmentspages67-99AppendixG-ProfessionalWriting-HelpfulHintspages100-104AppendixH-GradingPolicypages105-124AppendixI-ClinicalSupervisionpages125-134AppendixJ-MediaSpecialistHandbook-StudentGuidelinespages135-142AppendixK-ClinicFormsSpring2018pages143-178AppendixL-DocumentationSamplespages179-209AppendixM-ClinicalPracticeRessourcespages210-211AppendixN-Resourcepage212

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TheIonaCollegeSpeech,LanguageandHearingClinichasassembledaClinicHandbooktosupporttheclinicalstudentsuccessinone’sclinicalpracticumexperienceattheIonaCollegeSpeech,LanguageandHearingClinic.TheClinicHandbookisnotintendedtoreplaceCollegePolicieslistedintheIonaCollegeUndergraduateandGraduateCatalog’sbuttosupplementthestudent’sprogramrequirements.GraduateCSDHandbookbuttosupplementthestudent’sprogramrequirements.

TheIonaCollegeCommunicationSciencesandDisordersprogramiscurrentlyanaccreditationcandidateforagraduateprograminspeechlanguagepathologyfromtheCouncilonAcademicAccreditation.TheClinicHandbookandtheGraduateCSDHandbookisnotintendedtoreplacetheIonaCollegeGraduateCatalog.TheGraduateCatalogdetailstheofficialrequirementsforcompletionoftheMaster’sDegree.TheGraduateCatalogisavailableonlineat:https://www.iona.edu/iona/media/Documents/Student%20Life/SFS/14-15GraduateCatalog.pdfTheClinicHandbookisalivingdocumentandmaybemodified,withnoticeatthediscretionoftheChairperson,ClinicDirectorand/orProgramDirectorPolicies,proceduresandinformationdocumentedmaybeupdatedand/orchangedaccordingly.Clinicalstudentswillbenotifiedviaupdatedwrittendocument

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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicThishandbookprovidesinformationpertainingtopolicy,procedureandrequirementsduringaone’spracticumexperienceincludingobservations,on-siteandoff-sitepracticum.ThishandbooksupportsboththeundergraduatestudentsandtheCSDstudents:SpeechLanguagePathologyandAudiologyMajorsClinicalPracticeinSpeech/LanguagePathologyI SCS418ClinicalPracticeinSpeech/LanguagePathologyII SCS419ClinicalPracticeinSpeech/LanguagePathologyIII SCS420MAinCommunicationsandDisordersThishandbookmaybeusedforthefollowingcoursesinconjunctionwiththegraduatehandbookPracticum1 CSD610Practicum2 CSD611Practicum3 CSD612

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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAccreditationTheMAprograminspeech-languagepathologyatIonaCollegeisaCandidateforAccreditationbytheCouncilonAcademicAccreditationinAudiologyandSpeech-LanguagePathology(CAA)oftheAmericanSpeech-Language-HearingAssociation,2200ResearchBoulevard#310,Rockville,Maryland20850,(800)498-2071or(301)296-5700.Candidacyisa"pre-accreditation"statuswiththeCAA,awardedtodevelopingoremergingprogramsforamaximumperiodoffiveyears.ComplaintProceduresRegardingAccreditationAnyquestionsregardingtheprogram'saccreditationstatusorcompliancewithaccreditationstandardsmaybedirectedtotheCouncilonAcademicAccreditation(CAA)atthefollowingaddress:CouncilonAcademicAccreditationAmericanSpeech-Language-HearingAssociation2200ResearchBoulevardRockville,MD20850-3289Phone:(800)498-2071(ASHAMembers),(800)638-8255(Non-members)Fax:(301)296-8580http://www.asha.org/academic/accreditation/

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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesFacultyandStaff

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DepartmentofSpeechCommunicationStudiesFacultyIonaCollege715NorthAve.NewRochelle,NY10801Attn:18PresidentStreetOffice:(914)633-2168Fax:(914)633-2393

JenniferGerometta,Phd,CCC-SLPChair,SpeechCommunicationStudiesDepartmentAssistantProfessorjgerometta@iona.eduDianeFerrero-Paluzzi,PhDAssociateProfessorInterimAssociateDeanoftheSchoolofArtsandSciencedferrero-paluzzi@iona.eduDorothyLeone,PhD,CCC-SLPCSDGraduateProgramCoordinatorAssistantProfessordleone@iona.eduMinJungKim,PhD,CCC-SLPAssistantProfessormkim@iona.eduMichelleVeyvoda,PhD,CCC-SLP,TSHHAssistantProfessormveyvoda@iona.eduNancyVidal-Finnerty,PhD,CCC-SLPAssistantProfessornvidalfinnerty@iona.eduLouisBankstonAdministrativeAssistant|Billinglbankston@iona.edu

DepartmentofSpeechCommunicationStudiesClinicalStaffIonaCollege715NorthAve.NewRochelle,NY10801Attn:IonaCollegeSpeech,Language&HearingClinicat83CloveRoadReception:(914)712-1990Fax:(712)-738-1056

MariaArmiento-DeMaria,MA,CCC-SLP,TSHHClinicDirectormarmientodemaria@iona.eduJacquelineMcDonagh,MS,CCC-SLP,TSSLDAssistantClinicDirector;On-SiteCoordinatorjmcdonagh@iona.eduMatthewCriscuola,MS,CCC-SLP,TSHHInterimOff-SiteCoordinatormcriscuola@iona.eduJenniferCronin-Komosinski,MA,CCC-SLPClinicalSupervisorjcroninkomosinski@iona.eduHanaSpatz,MS,CCC-SLP,TSSLDClinicalSupervisorhspatz@iona.eduMindyGarbarinoAdministrativeAssistantmgarbarino@iona.eduPeterConsadoriMediaSpecialistpconsadori@iona.edu

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DepartmentofSpeechCommunicationStudies715NorthAvenueNewRochelle,NY10801Office:(914)633-2168FAX(914)633-2393SpeechLanguage&HearingClinic@83CloveRoadOffice:914-712-1990Fax(914)738-1056ClinicDirector(914)712-1990TheDepartmentofSpeechCommunicationsStudiesatIonaCollegeprovidesanon-siteclinicalpracticumexperienceforundergraduateSpeech-LanguagePathologyandAudiologystudentsandgraduatestudentsregisteredintheCommunicationSciencesandDisordersMasterofArtsprogram.Whileourclinicservesasatrainingopportunityforourstudents,everycaseiscloselysupervisedwithaclinicalteachingcomponent.SupervisionisconductedbycertifiedspeechlanguagepathologistsandaudiologistwhoaremembersoftheAmericanSpeech-Language-HearingAssociation,holdaCertificateofClinicalCompetenceandlicensedinNewYorkState.Theclinicprovidesprofessionalspeechandlanguageservicesincludingassessmentandtreatmentwithinateachingclinicenvironment.Servicesareprovidedtoindividualswithawiderangeofcommunicationdisordersanddelaystobothchildrenandadults.Servicesincludebutnotlimitedtoarticulationandphonologicaldisorders/delays,dysphagia,languagedelays,traumaticbraininjury,aphasia,voice,cognitive-communication,hearing,andfluencydisorders.Clientsaretypicallyreferredbyphysicians,schoolpersonnel,privatepracticeandbyclient’sthemselves.Audiologydiagnosticservicesareavailableforbothchildrenandadults.TheseservicessupportourlocalcommunityandneighboringresidentsaswellasprovideaclinicaleducationopportunityforourstudentsDianeFerrero-Paluzzi,PhDInterimAssociatesDeanoftheSchoolofArtsandScienceandthecoordinatoroftheSpeakers’Center,providesservicesintheareasofaccentreduction,communicationapprehension,regionaldialect,speechassignments,andvocalcoaching.TheSpeech,Language&HearingClinicandTheSpeakers’CenteratIonaCollegedoesnotdiscriminateinthedeliveryofclinicalservicesbasedonraceorethnicity,gender,age,religion,nationalorigin,sexualorientation,ordisability.

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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicVisionStatementThevisionoftheSpeech,Language&HearingClinicstrivestoprovideaprofessionalclinicalteachingexperienceforourstudentsandqualityservicestothecommunityweserve.MissionStatementTheSpeech,Language&HearingClinicprovidesapre-professionalexperienceattheonsiteclinicforourclinicalstudents.Thegoaloftheclinicistoprovidestudentclinicians'anopportunitytointegrateacademicsintoclinic,developclinicalknowledge,andskills,conductresearch-basedtherapyandpromotecriticalthinkingskills.Additionally,ourclinicalinstructorsarededicatedtoteachvaluesvitaltotheprofession.Clinicalinstructionincludesethicalbehavior,professionalcollaboration;enhanceknowledge,afocusonclinicalservicesandintegratingproblemsolvingskillsforthepurposesofdiagnosticandtherapeuticplanning.Studentswilldevelopeffectiveoralandwrittencommunicationaswellasproblemsolvingskillsintheirinitialpracticumexperiencenecessaryasafutureclinician.Duringthispre-professionalexperiencestudents,willbegintheprocessofpersonalself-evaluationandpre-practicumresponsibilitiestoadvocatefortheindividualwithacommunicativedisordersanddelays.Thesupervisee-supervisorcollaborationprocessisestablishedbythehighestqualityofservicetoindividualswithcommunicationdisordersacrosstheagespan.ValueStatementThecommunityattheSpeech,Language&HearingCliniciscommittedtothefollowingvalues:Service: Providethehighestqualityservicetoindividualsacrosstheagespanwith

communicationdisordersanddelays.Education: Provideourstudentswithpre-professionalclinicalexperiencetodeveloptheir

academicknowledgebase,integrateclinicalservices,andbeeffectiveclinicalinstructorsforourfutureprofessionals.

Communication: Provideasupportiveenvironmentthatallowsthedevelopmentofideasand

individualgrowth.Collaboration: Provideaprofessionalenvironmentthatincludestheessentialsofateam

approachtotreattheclient,supportingclientfamilies,andtoincludetheclientsintheirtherapyprogram.

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PositionStatementAllClinicalStudentsandCertifiedSpeechLanguagePathologistsattheIonaCollegeSpeech,Language&HearingClinicarerequiredtofollow:

§ ASHACodeofEthics§ Speech,Language&HearingClinicPoliciesandProcedures,§ ConfidentialityRequirements§ HealthInsurancePortabilityandAccountabilityAct(HIPAA)

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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAMessagefromtheClinicDirectorMariaArmiento-DeMaria,M.A.,CCC-SLP,TSHHWelcometoclinicalpracticum!Thisisanexcitingopportunitywhileyoutransitionandintegrateacademicsintoyourpracticumstudentexperience.Clinicalteachingandsupervisionisahands-onexperiencethatprovidesyou,theclinicalstudent,professionalguidancetodevelopeffectiveclinicalskillsforyourfutureprofession.Thepartnershiptheclinicalstaffwillextendincludesthedevelopmentofprofessionalproblemsolvingskills,independence,andempathy,enhancingprofessionaljudgmentwhileparallelingpersonaljudgment.Thisprocesswilldevelopyourpre-professionalclinicalskillsasacommitted,dependablestudentprofessionalthatcandocumentandcommunicatewithclients,families,professionals,andsupervisors.Eachstudentwilldevelopskillsattheirownindividualpace.Ilookforwardtowatchingyourgrowthasyourprogressduringyourclinicalexperience.

Prof.Armiento-DeMaria

QualitiesforaSuccessfulStudentClinician“BehaviorqualitiesthatareconsistentwithASHAincludeadesiretohelpotherswithintegrity,honesty,andrespect.Professionalqualitiesthatshouldbeobservedincludebutnotlimitedtomeetingallclinicalappointments,deadlines,workingcooperativelywithpeersandsupervisors,actingresponsibleforclinicmaterialsandequipment,preparedforallclinicsessions,maintainingaprofessionaldress.”(AccordingtoHedge,M.N.,&Davis,D.(2005).Clinicalmethodsandpracticuminspeech-languagepathology4thEd)

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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAppendixAStudentConcernsandGrievances-UpdatedSpring2018Ifstudentshaveaconcernorgrievanceduringtheirclinicalpracticumthefollowingstepsarerequiredintheorderdocumented:§ ContactyourimmediateClinicalSupervisortodiscussthesituation.

§ Ifthesituationisnotresolved,contacttheClinicDirectorandameetingwillbescheduledand

completedwithClinicDirector,MariaArmiento-DeMaria.

§ IfdeemedappropriateameetingbetweentheClinicalSupervisor,StudentandClinicDirectorwillbecompleted

§ Ifthesituationisnotresolved,ameetingwillberecommendedwithDr.DorothyLeone,PhDCCC-SLPCSDProgramDirectorand/orDr.JenniferGerometta,ChairPersonoftheSCSDepartment

Iftheissueisnotresolvedtothestudent’ssatisfactionbytheChairand/orCSDProgramDirectorthen,andONLYthen,canthestudentrequestameetingwiththeappropriateoffices:IonaCollegeDean’sOfficeSchoolofArts&Science715NorthAvenueNewRochelle,NY10801

JosephStabile,Ph.D.Dr.KatherineZaromatidisAssociateDeanDirectorofGraduateStudies,SchoolofArts&Science(914)-633-2253(914)633-2375jstabile@iona.edukzaromatidis@iona.edu

Thefollowingcontactnumbersmaybehelpful:

IonaCollegeCounselingCenterSameulRudinAcademicResourceCenterSpellmanHallAmendHall914.633.2038 914.633.2217

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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAppendixBProfessionalCodeofConduct-ClinicPolicies

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalCodeofConduct PROFESSIONALCODEOFCONDUCTAllclinicalinstructorsandstudentclinicianswillfollowandadheretothehigheststandardsofprofessionalbehavior.AllindividualsactiveintheSpeech,Language&HearingClinicwillbeexpectedtofollowASHA’sCodeofEthics,standardsimplementedbytheCouncilonAcademicAccreditation,PoliciesandProceduressetforthattheSpeech,Language&HearingClinicandIonaCollege.StudentswillbeinstructedtoreviewASHA’sScopeofPracticeandASHA’sPreferredPracticePatterns.Studentswillbeexpectedtomaintainaccuratedocumentation,followConfidentialityGuidelinesandHIPAApractices.StudentsshouldpresentthemselvesasmembersoftheprofessionalcommunityIN,WHICHtheyaspire.ProfessionalPracticeGuidelines:Studentswilldemonstrateappropriateprofessionalskillswhilecommunicatingwithsupervisors,faculty,peers,staff,andclientfamilies.StudentswilldemonstrateappropriateprofessionalskillsbyfollowingHIPAArequirementsandadheringtoconfidentialinformationwiththeclientandtheclient’scaregivers.Sensitiveinformationwillnotbedivulgedthroughconversationand/orclientrecords.Studentswilldemonstrateappropriateprofessionalskillsbyfollowingtheirclinicalresponsibilities.Personalsituationsmayariseduringthepracticumexperience.Ifthisdoesoccur,everyeffortshouldbemadenottocompromisetheclient’scourseoftreatmentorthestudentclinician'spracticumexperience.Inasmuch,itistheresponsibilityofthestudenttoinformaClinicalSupervisororClinicDirectorawareofanyunforeseeninstance.Thus,theclient’sandtheclinicalstudentsexperiencecanbesupportedtomeettheneedsofthestudentandtheclient.Clinicalpracticumstudentswilllearntoprioritizetheirclinicalduties,academicrequirements,andpersonalsituations.Allclinicalstudentsareexpectedtoaskquestions,requesthelp,andclarifyanyconcernsthroughouttheirclinicalexperience.Furthermore,studentsareexpectedtobepreparedforallsessions,arriveontime,participateincleanupandorganizationoftheclinic.Studentswilldevelopprofessionalknowledgeandskillstogainindependenceandwillexpectedtotakeresponsibilityfortheiractions,respondtofeedbackpositively,shareinformation,andactasateammember.Pleasebeawareofyourowncommunicationstyle.Itisimportanttobuildrapportwithyourclientandtheirfamilies.Understandthatyoumustbeflexiblewithyourcommunicationbecausewhatmightworkforoneclientmaynotworkfortheother.Nonverbalandverbalcommunicationsarebothpowerfulandshouldbeusedwiththoughtfulness.Bemindfulofthemessageyouaresending!

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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicEthicsPolicy

ASHA IonaCollegePrincipleofEthics1:Individualsshallhonortheirresponsibilitytoholdparamountthewelfareofpersonstheyserveprofessionallyorwhoareparticipantsinresearchandscholarlyactivities,andtheyshalltreatanimalsinvolvedinresearchinahumanemanner.

TitleIXoftheEducationAmendmentsof1972ProhibitingSexDiscriminationinEducation:IonaCollegedoesnotdiscriminatebasedonsexinitseducationalprogramsoractivities.StudentParticipationinEstablishedReligiousObservances:ItisthepolicyofIonaCollegethatstudentsshouldnotexperienceadverseorprejudicialeffectsasaresultoftheirreligiousbeliefsorpractices.FamilyEducationalRightsandPrivacyActof1974:IonaCollegecomplieswiththisAct,protectstheprivacyofeducationalrecords,establishedtherightofstudentstoreviewtheirrecords,andprovideguidelinesforcorrectionofinaccurateormisleadingdatathroughformalorinformalhearings.

PrincipleofEthics2:Individualsshallhonortheirresponsibilitytoachieveandmaintainthehighestlevelofprofessionalcompetenceandperformance.

IonaCollegeMissionStatement:SchoolofArts&ScienceTheSchoolofArts&SciencesupportsthemissionofIonaCollegethroughitscommitmenttofosteringacademicexcellenceandintellectualinquiryintheliberalartstradition.Throughitsdiverseprogramsandwiththecareandcommitmentofacommunityofteachers-scholars,theSchoolofferscoursesofstudythatareacademicallychallenging,androotedinliberalartseducation.Infurtheranceofthesecommitments,theSchoolstrivesto:provideaneducationthatiscurrent,student-centered,outcome-based,andinvolvesanappropriatemixofclassroom-basedinstruction,independentresearch,andinternshiporpracticalexperience;equipstudentswiththeskillsnecessaryforsuccessinarapidlychangingenvironment:criticalthinking,effectiveoralandwrittencommunication,problemsolving,collaborativelearning,ethicaldecisionmaking,scientific,technologicalandaestheticliteracy;

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instillinstudentsthehabitsofmindenablingthemtopossessourmostprecioushumanheritage:thoseideas,beliefs,writings,andcreativeexpressionsthatarethebasisofintellectual,cultural,andmoraldevelopment;deepenstudents'self-awareness,reflectiveness,andcommitmenttoacoreofvaluesthatwillilluminateboththeirpersonalrelationshipsandtheirrelationshiptoapluralisticsocietywiththequalitiesofintelligence,tolerance,decency,compassion,andappreciationofculturesothersthantheirown;recruit,retain,andsupportthedevelopmentofafacultyofexceptionalteacher-scholarswhosepedagogyisinformedbyresearch,experience,andscholarship.(Revised,December2012)AttendancePolicy:Studentsareexpectedtoacceptpersonalresponsibilityforabsences,andareresponsibleforfulfillingallrequirementsandcompletingallassignmentsmadeineachcourse.

PrincipleofEthics3:IndividualsshallhonortheirresponsibilitytothepublicwhenadvocatingfortheunmetcommunicationandswallowingneedsofthepublicandshallprovideaccurateInformationinvolvinganyaspectoftheprofessions.

IonaCollegeMissionStatement

PrincipleofEthics4:Individualsshallupholdthedignityandautonomyoftheprofessions,maintaincollaborativeandharmoniousinterprofessionalrelationships,andaccepttheprofessions’self-imposedstandards.

IonaCollegeMissionStatement

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalCodeofConductAnyfamiliesorclientswishingtoshowgratitudeforservicesshouldbeforwardedtoyourimmediateClinicalSupervisor.Itissuggestedthattheclinicalstudentsintrainingnotacceptgifts.Clientfamiliesarewelcometomakedonationstotheclinic.OffsiteActivitiesPersons’mayrequestoutsideactivitiesfromourstudentclinicians.Examplesofactivitiesmayincludebabysitting,actingasatutorinrelationtospeechandlanguageservices,orevenprovidingservicesathome.ThesetypesofactivitieswillputastudentatriskbyviolatingtheASHACodeofEthicsandPoliciesandProceduressetforthattheSpeech,Language&HearingClinic.Ifastudenthasaquestionaboutaspecificactivity,pleasefollowupwiththeClinicDirectortodiscusstheactivityanddetermineiftheactivitywouldbeaviolation.CONFIDENTIALITYClinicstudentswillberequiredtocompleteclinicpaperworkontheEMRsystem:Medicat.ThefollowingformsmustbedocumentedusingMedicat:ClientContactForm,LessonPlans,SOAPnotes,progressreports,andevaluations.AdditionalGuidelinestoFollow:

§ Donotdiscussyourclient/patient’snameinpublicareas§ Donotdiscussyourclientinpublicareas§ DiscussionsofclientsforthepurposesofinterventionsandideasmusttakeplaceinONLYprivate

areasofthedepartment§ Donotleaveclientreports,lessonplansorotherwrittendocumentationunattended§ AllfilesandwrittendocumentationmustbeplacedinthelockedcabinetintheCopy/PrintRoom

intheSpeech,LanguageandHearingClinic§ Draftsofanywrittendocumentationmustbeshredded§ Refertoyourclientbytheirinitialsandor“theclient”inclassdiscussions§ Followofficerulesaboutcheckingoutclientfolders§ Ifastudentneedstostepawayfromtheircomputerscreen,computersmustbelockedpriorto

thestudentleaving§ Obtainwrittenconsentfromtheclientorlegalguardianoftheclienttoaudiotape,videotapeor

takeaphotograph

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalCodeofConductClientChartAllclientsreceivingservicesattheIonaCollegeSpeech,Language&HearingClinichaveaSessionClientChartlockedinthecopy/printroom.Allchartsand/orfilespertainingtoclientsaffiliatedwiththeIonaCollegeSpeech,Language&HearingClinicMUSTfollowHIPAARegulations,ConfidentialityGuidelinesandsignin/outproceduresCharts/filesareNOTpermittedoutsideoftheIonaCollegeSpeech,LanguageandHearingClinicAuthorizationisrequiredfordocumentationtobecopiedortransferredtoanothersiteorperson.Seeyourimmediatesupervisorforprocedureguidelines.Sign-OutProcedureSessionClientChartsarelockedintheCopy/PrintRoomdesignatedfilingcabinet.Whenyouneedtoreviewand/orretrieveachartONLYauthorizedclinicstaffpersonnelareauthorizedtoreleasetheserecords.Also,notestudentsarerequiredtosignin/outthecharts,timeandreason.AllSessionClientChartsmaybereviewedONLYintheclinic.Allchartsmustbereturnedthesamedayofsignout.ChartsnotreturnedasperclinicalpoliciesandprocedureswillbefurtherquestionedtodetermineiftherewasabreachinHIPAAregulationsand/orConfidentialitypolices.

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ProcedureforSessionClientChartsDesignatedclinicalstaffassociatesONLYhavetheauthoritytoreleaseaclient’schart:AdministrativeAssistantandClinicalSupervisors.StudentcliniciansDONOThavetheauthoritytoremovecharts.AnIonaCollegeSpeech,Language&HearingClinicrepresentativeSCSrepresentativemustbepresentinorderforastudentcliniciantocheckouttheCharts.ChartingGuidelines

DesignatedChartCheckOut/InHours

ChartCheckOutHoursaredesignated.StudentCliniciansmustprioritizetheirtimeforpaperworkandmeetings.ChartsareNOTALLOWEDoutsidetheclinicspace

ClinicalStudents ClinicalStudentsMUSTSIGNOUT

CHARTandSIGNINCHARTOfficeSpace ClinicalStudentsDONOThave

permissiontoremovechartsfromtheSpeech,Language&HearingClinic

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalCodeofConductWHATISHIPAA?HIPAAstandsfortheHealthInsurancePortabilityandAccountabilityAct,whichwasimplementedin1996.Thisactcreatednationalrulesregardingtheprivacyofhealthcareinformation.Patientaccesstorecords,patienteducationregardingprivacy,andreceivingpatientconsentbeforethereleaseofinformationisincludedunderthisact.HIPAAalsoestablishedformatsfortheelectronictransmissionofclinicaldata.WhatisthePrivacyRule?TheprivacyruleofHIPAAenablestheprotectionofindividuallyidentifiablehealthinformationcontainedinapatient’smedicalrecord,includingbothhardandsoftfiles.Thisinformationincludesapatient’sname,address,SocialSecuritynumber,financialdata,etc.ThecompliancedateforthisRulewasineffectonApril14,2003.Howdoesthisaffectme?Asastudentclinician,youmustabidebythesefederallawstosecureclientconfidentiality.PleaserefertotheConfidentialityAgreement.HowwillIknowwhatIcanandcannotdo?YouwillreceiveacopyofyourConfidentialityAgreement,specifyingtheregulations.HowwillIinformtheclientsofourclinicpractices?ClientswillbegivenaNoticeofPrivacyPracticestoread.Theywillthensignthisnotice,documentingthattheyhavebeeninformed.FormoreinformationaboutHIPAA,visit:https://www.hhs.gov/hipaa/index.html/https://www.cms.gov/index.htmlhttps://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalCodeofConductConfidentialityAgreementI_____________________________________________________understandthataspartofmyclinicalpracticumattheIonaCollegeSpeech,Language&HearingClinic,orasanemployeeintheDepartmentofSpeechCommunicationStudies,Imustprotecttheprivacy,securityandintegrityofclientsandtheirrecordsatalltimes.Iagreetoabidebyallstateandfederallawsandregulationsgoverningtheconfidentialityofindividualhealthrecordsandinformation.IagreethatIwillnotbehaveinsuchawayastocauseabreachofconfidentialitythatincludesbutisnotlimitedto:OpenDiscussion:Discussinginformationcontainedinfilesordistributingfilestoothers;Discussingaclient’sconfidentialinformationwithanotherstudentorfacultymemberwhereitcanbeoverheardbyotherclientsandindividualsnotinvolvedinthecareofthatclient(e.g.,discussingaclientinahallwayorwaitingarea);Discussingaclientwithfriends,otherclients,otherprofessionals,oranyone,insideoroutsidetheClinicnotdirectlyinvolvedinthecareofthatclientorinaconsultativeroleregardingtheclient’scare.ReleaseofInformation:Releasingclientrecordswithouttheclient’sconsentunlessrequiredbylaw.(Consentmustbegivenbywrittenrelease,orbyfaxedandsignedmemo,andmustspecifywhichpartsoftherecordmaybereleased.)

§ RecordsManagementandStorage:§ Leavingrecordsunsecuredinanopenareawhereindividualsnotinvolvedinthecareofthat

clientcanviewthem;§ RemovingclientfoldersfromtheClinicorDepartmentareaswhereindividualsnotinvolvedin

thecareofthatclientcanviewthem;§ Leavingcomputerworkstationscreenswithidentifiableclientinformationunattendedor

unlockedsothatanyonemayvieworaccessotherclient’sconfidentialinformation; § Leavingreports,treatmentplansorsessionplansinprintersorgarbagewithoutbeing

shredded;§ Savingidentifiableclientinformationoncomputerdiskorharddrive;§ Transmittingreportswithidentifiableconfidentialinformationviaemail;§ Makingcopiesofclientinformationorreports;

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§ Removinganyreportsorrawdatafromtheclientfolder;§ Maintainingvideotapesofclientsessionsaftertheendoftheclinicalassignmentoutsideofthe

clinic/department.DisciplineforanemployeeshallbeimposedinaccordancewithCollegepolicies.Thismayincludeterminationforviolatingstateorfederallaws.DisciplineforastudentshallbeimposedinaccordancewithCollegepolicies.Coursegrademaybedroppedoneletterforeachoffense,clinicalclockhourswillnotbeawardedforthatassignmentand/orareportplacedinthestudent’spermanentrecord.IunderstandthatImaybesubjecttolegalactionifIviolatestateorfederalstatutesregardingprotectedhealthinformation.Iagreetoabidebyallthestatementscontainedinthisdocument.Signature________________________________________________Date____________________________

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalCodeofConductPolicyCLINICALPROFESSIONALCODEOFCONDUCTPOLICYupdatedforSpring2018AnystudentinviolationoftheProfessionalCodeofConductand/orProfessionalGuidelinesincludethefollowing:FirstOffense

§ AmeetingwiththeClinicalSupervisorandClinicDirectorwillbeconducted.

§ Awrittenwarningwillbecompletedandplacedinthestudent’sfolder.

§ Aclinicalfocusplanwillbeimplemented.

§ Clinicgrademaybeloweredafullgrade.

§ CaseloadmaybereassignedSecondOffense:

§ AmeetingwiththeClinicalSupervisorandClinicDirectorwillbeconducted.

§ Apermanentletterwillbeplacedinthestudent’sfolder.

§ Studentwillbeautomaticallyremovedfromtheirtherapyassignmentandfailclinic.

§ Aclinicalexperiencethatisnotsuccessfullycompleted,theclinicalhourswillnotbeaccrued

§ ACommitteeMeetingmaytakeplaceasdeterminedbytheSCSDepartmentChairorCSDProgramDirector.

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalCodeofConductClinicExitProcedureClinicExitProcedure:UpdatedforSpring2018Attheendofeachsemester,CLINICEXITMeetingsarearequirement.TheSLPthatsupervisesyouandyourclientwillemailyoutoscheduleaFIRMCLINICEXITMEETINGDATEThefollowingprocedureswillbeconductedduringtheCLINICEXITMEETING:

§ SessionClientChartreview

§ SessionClientChartreview(alldocumentsnotedinthesessionclientchartoutlinemustbefiledatthetimeoftheClinicExitMeeting)

§ AllpaperworkandchartsmustbereadyforreviewfortheClinicalSupervisor.

§ AlldocumentsneedtobefiledaccordinglyfortheClinicalSupervisortosubmitagradeandsignoffonClinicClockHours.ThereisNOEXCEPTIONforANYpaperworktobemissing.Anypaperworknotcompletedwillbeconsideredlateand/orwillnotcounttowardshours.SeeClinicExitPolicyforfurtherdetails.

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalCodeofConductClinicExitPolicyCLINICALPROFESSIONALCODEOFCONDUCTPOLICYatthetimeoftheCLINICEXIT-updatedforSpring2018Thefollowingviolationsincludebutnotlimitedto:ViolationsIncludebutnotlimitedto:

§ NotParticipatingintheClinicExit§ Chartsnotreadyforreview§ MissingDocumentation§ ProgressReportnotcomplete

SpecialNote:AnymissingdocumentationmayberecoveredONLYatthetimeoftheClinicExitMeetingifdeemedappropriatebyclinicexitmeetingsupervisorFirstOffense

§ Clinicgradewillbeloweredbyafullgradeasdemonstratedbytheviolationlevel§ ClinicFailurewillbewarrantediftheProgressReportisnotcompleted.§ ClinicFailurewillbewarrantedifdocumentationisinaccurate§ AmeetingwiththeClinicalSupervisorandClinicDirectorwillbeconducted.§ Aclinicalexperiencethatisnotsuccessfullycompleted,theclinicalhourswillnotbeaccrued§ WrittenDocumentationofthespecificoffensewillbeplacedinthestudent’sfile§ ACommitteeMeetingmaytakeplaceasdeterminedbytheSCSDepartmentChairorCSDProgram

Director.

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalCodeofConductSummary

ProfessionalCodeofConductViolationSummary

______________________________________________________ClinicalStaff Date

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicThefollowingexamplesareconsideredprofessionalcodeofconductprocedureviolationsthatmayincludetheEMRsystem,SessionClientChartandClinicFlashDrive

§ ScreenShotofdocumentation§ Removingsessionclientchartsfromtheclinic§ LeavingcomputerunattendedwithclientchartopenontheEMRsystemand/orsessionclientcharts

unattended.§ Notfollowingsignout/signinprocedures§ Notshreddingdraftsoflessonplans,reports§ AllidentifyinginformationMUSTBEremovedwithelectronicmessaging§ Filesmustbereviewedintheclinic§ Noportionofthefilemaybecopiedorphotographedorscannedorscreenshot

FirstOffense

§ AmeetingwiththeClinicalSupervisorandClinicDirectorwillbeconducted.§ Awrittenwarningwillbecompletedandplacedinthestudent’sfolder.§ Aclinicalfocusplanwillbeimplemented.§ Clinicgrademaybeloweredafullgrade.§ Caseloadmaybereassigned

SecondOffense:

§ AmeetingwiththeClinicalSupervisorandClinicDirectorwillbeconducted.§ Apermanentletterwillbeplacedinthestudent’sfolder.§ Studentwillautomaticallyfailclinic.§ Aclinicalexperiencethatisnotsuccessfullycompleted,theclinicalhourswillnotbeaccrued§ ACommitteeMeetingmaytakeplaceasdeterminedbytheSCSDepartmentChairorCSDProgram

Director.

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicWrittenDocumentationPolicyWrittenDocumentationPolicy(documentsincludingclientcharting)-updatedforSpring2018Thefollowingviolationsincludebutnotlimitedto:

§ Latesubmission§ Followingwrittendocumentationprocedures§ Providinginaccuratedocumentation§ Falsifyingrecords§ Plagiarism§ RemovingrecordsfromtheClinic§ Breachofconfidentialityguidelines§ BreachofHIPAAregulations

OnlyOffense

§ AmeetingwiththeClinicalSupervisorandClinicDirectorwillbeconducted.§ Clinicgradewillbeloweredbyafullgrade§ Accrualofclinicalclockhourswillbeforfeited§ WrittenDocumentationofthespecificoffensewillbeplacedinthestudent’sfile§ Caseloadmaybereassigned

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicWrittenDocumentationExtensionRequestWrittenDocumentationExtensionRequest-UpdatedSpring2018AWrittenDocumentationExtensionmayberequestedinadvance.StudentsmayrequestpermissioninwritingtotheirprimarySLPonthecasetorequestforanextension.Anextensionmayincludebutnotlimitedtoclassconflict,studentabsence.ItisatthediscretionoftheSLPtograntawrittendocumentationextension.Ifgrantedaduedatemustbedocumented.WrittenExtensionwillNOTbegrantedpastthelastdayofclinicclients.WrittenExtensionwillNOTbegrantedforprogressreportsorclinicexitmeetings

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClockHourPolicyClockHourPolicy-UpdatedSpring2018

Studentsparticipatingasastudentclinicianareeligiblefortheaccrualofclockhoursachievingthefollowingcriteria:ClinicalClockhoursareawardedbasedonthefollowingtwocriteria:

1. ClinicalStudentsmustaachieveaminimalFinalGradeofBinclinicAND

2. ThediscretionoftheprofessionalSLPtoprovidesignatureandASHAcredentialstoapproveclockhours.Awarding/grantingofclockhoursisatthediscretionanddelegationoftheclinicalsupervisor,basedonprofessionalclinicaljudgment/rationalandinaccordancewithASHAguidelines.

ImportantProtocol:

§ ClockHourswillNOTbeawardedtoclinicalpracticumstudentsreceivingagradebelowa“B”foraclinicalcourse.

§ Studentcliniciansareresponsibleforcomputingclockhoursandcompletingtheclockhourform

§ Studentsareresponsibleforkeepingtheoriginalcopyoftheirclinicaldocumentationforpersonalrecords.Theclinicisnotresponsibleforstudentclinicaldocumentation

ClockHourGuidelinesEligibilitytoaccrueclockhoursisbasedupontheguidelinesdocumentedinthefollowingdocument:

Council for Clinical Certification in Audiology and Speech-Language Pathology of the American Speech-Language-Hearing Association. (2013). 2014 Standards for the Certificate of Clinical Competence in Speech-Language Pathology. Retrieved [date] from http://www.asha.org/Certification/2014-Speech-Language-Pathology-Certification-Standards/.

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicCSDStudentsHourRequirementsAspertheCouncilforClinicalCertificationinAudiologyandSpeech-LanguagePathologyoftheAmericanSpeech-Language-HearingAssociation.(2013).2014StandardsfortheCertificateofClinicalCompetenceinSpeech-LanguagePathology.Retrieved[date]fromhttp://www.asha.org/Certification/2014-Speech-Language-Pathology-Certification-Standards/.Applicantsmustcompleteaminimumof325ofthe400clockhoursatthegraduatelevel(StandardVD)duringsupervisedclinicalexperienceswithvarioustypesofpopulations,communicationdisorders,differencesanddisabilitiesRecommendedHourRequirement:ChildSpeechDiagnostic (10hoursRecommended)ChildLanguageDiagnostic (10hoursrecommended)AdultSpeechDiagnostic (10hoursRecommended)AdultLanguageDiagnostic (10hoursrecommended)ChildLanguageTherapy (10hoursrecommended)ChildSpeechTherapy (10hoursrecommended)AdultLanguageTherapy (10hoursrecommended)AdultSpeechTherapy (10hoursrecommended)

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicStudentClinicAttendancePolicy

StudentClinicAttendancePolicy-updatedSpring2018

Procedures:Clinicalstudentsareresponsibletocontactandinformtheclientand/orcaregiverofacancellationthatrelatestothestudentclinicianpersonalconflictand/orillness.Ifpossible,providetheclientand/orcaregiver24-hournotice.ClinicalstudentsareresponsibletoemailtheirPrimarySLPandCCtheClinicDirectorofacancelledsessionBYtheStudentClinician.Itisbestpracticetoprovidea24-houradvancednotice.StudentClinicAttendancePolicy-UnexpectedCancellation-updatedFall2018Ifstudentsarecancellingduetounexpectedsicknessorunforeseencircumstance.Itisthestudent’sresponsibilitytoemailthefamilyandcopytheimmediateSLPandMrs.Garbarinoofthecancellation.Ifthereisnotaresponsebackfromthefamilyconfirmingthatthestudentcliniciancancelledthesession–thestudentmustcontactMrs.GarbarinoandrequestMrs.Garbarinotocallthefamily.Allstudentcancellationsrequiredocumentationandthestudentisrequiredtomake-upthesessionAllstudentcliniciansarerequiredtoprovidedocumentationforanabsencethatwillbefiledaccordingly.ClinicalStudentsarerequiredtoconductamakeupsessionViolationsoftheStudentClinicAttendancePolicyIncludebutnotlimitedto:

§ NoShowNoCalltoclinicalsession

§ Cancellationswithoutdocumentation

§ TwoormorecancellationswithorwithoutdocumentationsClinicalStudentsinviolationoftheClinicalAttendancePolicythefollowingwilloccur:OnlyOffense

§ AmeetingwiththeClinicalSupervisorandClinicDirectorwillbeconducted.

§ Awrittenwarningwillbecompletedandplacedinthestudent’sfolder.

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§ Aclinicalfocusplanwillbeimplemented.

§ Clinicgrademaybeloweredafullgrade.

§ Caseloadmaybereassigned

DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicStudentClinicAttendancePolicy-AdvancedNoticeStudentClinicAttendancePolicyAdvancedNotice-updatedSpring2018Studentswhohaveanadvancedconflictwithascheduledsessionmustfollowthestepsbelow:

1. CompleteawrittenrequesttotheClinicDirectoratleast10businessdaysinadvance2. Documentationmustaccompanythewrittenrequesttocancelasessionduetoastudentcancelingthe

session3. Studentsmusthaveamakeupsessionalreadyscheduledforthecancelledsession

ViolationsoftheStudentClinicAttendancePolicyAdvancedNoticeIncludebutnotlimitedto:§ NoShowNoCalltoclinicalsession

§ Cancellationswithoutdocumentation

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClientAttendancePolicyClientAttendancePolicy-UpdatedSpring2018 Procedures:StudentCliniciansareexpectedtocalltheclientand/orcaregivertofollowupiftheclientisnotpresentwithin15minutesoftheirtreatmenttime.StudentCliniciansareexpectedtoreporttoyourimmediateClinicalSupervisorifthefollowingsituationsarepresented:

§ IfachildclientisbeingpickedupfromsomeonethatisnotfiledontheIonaCollegeSpeech,Language&HearingFormorapersonthathasNOTbeenintroducedtothestudentclinicianpriortotherapysessions,thestudentclinicianmustbringtheclienttotheprimarySLPonstaff.TheprimarySLPwillberesponsiblefortheimmediatefollowuptothefamily.

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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAppendixCElectronicMessageExchange

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ELECTRONICMESSAGETRANSMISSIONThefollowingstatementMUSTBEINCLUDEDinanyemailexchangerelatingtoclinic(i.e.Ifcontactingfamiliesand/orotherprofessionalsthatrelatestoyourcase):Thiselectronicmessagetransmissioncontainsinformationthatmaybeproprietary,confidentialand/orprivileged.Theinformationisintendedonlyfortheuseoftheindividual(s)orentitynamedabove.Ifyouarenottheintendedrecipient,beawarethatanydisclosure,copyingordistributionoruseofthecontentsofthisinformationisprohibited.Ifyouhavereceivedthiselectronictransmissioninerror,pleasedeleteitandanycopies,andnotifythesenderimmediatelybyreplyingtotheaddresslistedinthe“From:”field.Protocol:StudentCliniciansmustcopytheprimarySLPwithallclinicbusinessemailsthatdirectlyrelatetotheclientundertheSLP’ssupervision/licensureProf.A-DmustbecopiedonallclinicbusinessemailsEmailAccountNames:AllclinicalstudentsarerequiredtousetheirIONAemailaddressduringcontactwithaclinicalsupervisor.Emailswillnotberespondedtoifusingapersonalemailaddress.E-mailConfidentiality:Studentsusingemailstoexchangeandrequestclinicalinformation(includingstudentpeer,supervisor,orfaculty)mustcontinuetofollowconfidentiality,privacyandHIPAAguidelines.ReportdraftssuchasSOAPnotes,progressreportsareNOTpermittedtobetransmittedelectronically.Ifrequestingspecificinformationaboutaclient,removeallidentifyinginformationE-mailEtiquette:TheIonaCollegeSpeech,Language&HearingClinicsupportstheuseofe-mailwithasetofrulesrelatedtoprofessionalresponsibility.Thefollowingguidelinesarerecommendedwhenstudentsusee-mailtocommunicatewithClinicalStaffforon-siteandoff-sitesupervisors:

§ Studentsareexpectedtorespondtoe-mailsentbyClinicalStaff.

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§ AClinicalStaffpersonnelisresponsibleforprovidinginformationouttoastudentandstudentshavetheresponsibilitytoreadtheemail

§ ClinicalStaffpersonnelisnotresponsibleforundeliverablee-mailsduetofullmailboxesorincorrectforwardingaddresses.

§ Studentsshouldcheckinyourclutterand/orspaminboxesaswell

§ Expectaresponseinnolessthan3businessdays.

§ Clinicalstaffreservestherighttorespondonlytoe-mailsthathavesubjectheadingsaswellasthosethathaveasignature/identification.

§ Clinicalstaffarenotrequiredtorespondtoe-mailsduringweekends,holidaysorvacations.

§ Beconciseandproofread,spell-checkandgrammar-checkyoure-mail.

E-mailBody

§ Writemessageswithadescendingorderofimportance,i.e.,themostimportantpointyouwanttomakewouldbefirst,nextcomesthesecondmostimportant,thethirdimportantpointafter,andsoon.

§ Beconciseandbullet-pointyourthoughtswhenpossible.§ Createanelectronicsignaturetobeinsertedattheendofyoure-mailsotherecipientknowswhoyou

are.§ Ifyouwouldlikearesponsetoyourmessage,saysointhebodyofthee-mail.Readerstendtoanswer

e-mailifasked.§ Proofread,spellcheckandgrammarcheckyoure-mail.

E-mailLength

§ E-mailisnotasubstituteforofficehours.Studentsareexpectedtobeconciseintheire-mails,bulletingquestions,answers,andideas.

§ Keepe-mailmessagesasshortaspossiblewithamaximumof300wordsorupto5pointsorquestions.Remember,shortermessagestendtobeansweredquickerthanlongerones.

§ Studentsmustcheckwiththeiracademicinstructorsandclinicalstaffregardingindividualpreferencesfore-maillength.

E-mailAttachments

§ Attachmentsmustbeappropriatetothesubjectdiscussed.Donotattachanythingthatisnotexplainedinthee-mailbody.E-mailResponseTimeAlthoughe-mailisquickandconvenient,studentsmustbereasonableintheirexpectationsregardingtheresponsetimefromsomeonetowhome-mailwassent.

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§ Donotexpectresponsesduringweekends,holidaysorvacationperiodsfromfacultymembersandstaff.§ Donotexpectorrequirearesponsefromanyoneinlessthanatleast3businessdays.

E-mailTips

§ Ifyouareexpectingaresponse,saysointhebodyofthetext.Shouldyounotreceivearesponseto

yourmessage,itisnotwisetoassumethepersonreceivedthemailandisignoringyou.Givetheappropriateamountoftime(72hours)andthene-mailtherecipientagainaskingifs/hereceivedthefirstmessage.

§ Donotexpectaresponsefromifthereisnosignatureenteredinyourmessage.§ Makesureifyousayyouareattachingadocumentorfiletoyoure-mail,youhavedoneso.It’savery

commonmistaketoforgetaboutaddingattachments.§ Donotwriteinallcapsasthisconsidered“electronicyelling”andverypoorform.§ Donotassumeallabbreviationsareunderstood.Somethinglike“BTW”isoftenusedtoabbreviate“by

theway”howeveritcannotbeassumedthattheabbreviationisuniversallyunderstood.Unlesspreviouslyusedbythee-mailrecipient,definetheabbreviation.

§ Confidentialinformationshouldneverbediscussedinemail.Ifyouarereferringtoaclientneverusetheperson’sname;onlyinitialsareappropriatetouse.Consider

§ ItisnotwisetogossipaboutanyoneinE-MAIL,asyouneverknowtowhomitmaybeforwarded.§ Confidentialinformationshouldneverbediscussedine-mail.Ifyouarereferringtoaclient,donotuse

theperson’sname.Initialsareappropriatetouse.§ Proofreadyoure-mailformistakes§ E-mailisawrittendocument:itisforeverinprint.

Warnings

§ Youmustinformyourdirectsupervisoranye-mailinterruptionofcommunication.§ Limitemailstonomorethanoneperday.§ Donotexpectclinicalstafftorespondtoyoure-mailifitisnotsigned,orhasanunidentifiableaccount

name.§ Donotexpectfacultytorespondtoe-mailwithoutsubjectheadings.§ Utilizeonlysimpleandcommonlyavailablefontsinyoure-mail–notallcomputershavethesame

exactfontsets.§ Itisinappropriatetouse“fun”fontsforacademicallyandprofessionallyrelatedcommunications.§ Donotsendoutunsolicitedjokes.

ElectronicDevices:

§ ThereisZEROTOLERANCEforpersonalcellphone,IPAD,ANDLAPTOPuseinaprofessionalenvironment.Useofthesedeviceswillbeinterpretedasabreachinconfidentialityand/orHIPAARegulations.Ifoneisfoundguilty,thisisconsideredaFederalOffense.

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§ AwrittenrequesttouseelectronicsforpurposefultherapytargetsmaybegrantedONLYIFthestudentrequeststhepermissioninwriting.TheClinicalStaffwillreviewtherequestandapproveordisapprovetherequest.

§ ComputeruseattheSpeech,Language&HearingClinicislimitedtoclinicrelateduseandclinicdocumentationviatheassignedclinicflashdriveONLY.§ Texting,personalphonecallsand/orpersonalemailsareNOTpermittedduringclinicorclasstime.§ SocialNetworkingisprohibitedonanysiteduetorisksofprivacy,unauthorizedpicturesandstatementsrelatedtotheclinic,clients,clinicalstafforstudentpeers.

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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAppendixDStudentClinicianRequirements

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SchoolofArts&ScienceSpeech,Language&HearingClinic

Student:_________________________Semester:_________________________

ON-SITECLINICREQUIREMENTS

(updated 8/16/18)

DocumentationRequiredTypeofWritten

DocumentationSubmittedDate

ReceivedSupervisorInitials

VerificationofClinicalObservationHours(25hours) ¨ Logs¨ VerificationLetter

ChildAbuseSeminar ¨ CertificateDated:

ProofOfLiabilityInsurance ¨ Policydates:

ProofofVaccinationorImmunitytoMeasles,Mumps,&Rubella

¨ MMRVaccinationCertificate¨ MedicalExemption¨ ReligiousExemption

ProofofTuberculinSkinTest(RequiredAnnually)DateofResults:

¨ PPDCertificate¨ MedicalExemption

EssentialFunctions ¨ SignedForm

CPRCertification ¨ CertificateDated:

ConfidentialityAgreement(RequiredAnnually) ¨ SignedForm

HandbookAgreement ¨ SignedForm

SocialMediaAgreement ¨ SignedForm

IDBadgeAgreement ¨ SignedForm

On-LineHIPAAtraining/certificate ¨ SignedForm

UNDERGRADUATESTUDENTFEESONLY:$55.00CLINICFEEAND

$30.00HANDBOOKFEE(SEEPROF.A-DFORANYSTUDENTFEECONCERNS)

PrimarySupervisorSignature(fileiscomplete): ______________________

Supervisor’sASHA#: ______________________RecordofCommunications:_______________________________________________________________________________________

_______________________________________________________________________________________

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_______________________________________________________________________________________

_______________________________________________________________

ResourcesWorkshopResourceswww.iona.edu/Academics/School-of-Arts-Science/Departments/Education/Certification-and-Workshop-Information/Workshops.aspxhttp://www.nysmandatedreporter.org/ StudentLiabilityInsurancewww.proliability.com/professional-liability-insurance/speech-language-pathologists/american-speech-language-hearing-associationwww.hpso.com/individuals/professional-liability/healthcare-professions-coveredHerearethelinksthatsomestudentshavepassedalongCPR/AEDcoursehttps://cpraedcourse.com/?version=v1ChildAbuseSeminarhttp://www.nysmandatedreporter.org/TBSkinTestIonaWellnessCenterlocatedat760NorthAvenuePPDprovided

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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicFingerprintingTheIonaCollegeCampusSafetyandSecuritydoesnothavethecapabilitytoperformdigitalfingerprintinginhouse.ThefingerprintingsystemapprovedbytheStateofNewYorkhasmovedtoadigitalformat(Livescan)andIwouldreferallstudentstoMorphoTrustthatneedtobefingerprinted.ThefollowinglinkdetailsalltheirlocationswithinNewYorkState.http://www.l1enrollment.com/locations/?st=nyThislistwillprovidestudentsanopportunitytohavethefingerprintingcompletedclosetotheirhomesoratseverallocationswithinWestchesterCounty.Thedirectionsforfingerprintingcanbefoundatthislink:http://www.highered.nysed.gov/tsei/ospra/

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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicConfirmationofClinicalPracticumHandbookI_______________________________(printname)confirmthatIhavereceivedtheIonaCollegeSpeech,Language&HearingClinicHandbookon___________________(date).IcertifythatIhavereadthedocumentedpoliciesandprocedureslistedinthehandbookandunderstandtheinformation.ThisdocumentmaybemodifiedatthediscretionoftheDepartmentofSpeechCommunicationStudiesIacknowledgethatIamresponsibleforthismaterialandwillcontinuetoreviewthehandbook_______________________________(signname)___________________(date).IunderstandthatitismyresponsibilitytocontacttheClinicDirectororaClinicalSupervisors’foranyadditionalinformation._______________________________(signname)___________________(date)________________________________________________________________StudentSignature,date

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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicSocialNetworkingPolicyI_______________________________(printname)usesocialnetworking(texting,Facebook,twitter,LinkedInetc).BysigningbelowcertifiesthatIwillNOTnametheIonaCollegeSpeech,Language&HearingClinicoroff-siteaffiliationsinmypersonalnetworkingcitesthatdeemstheclinic,clients,students,staffand/ordepartmentinanynegativecontext.IfIdopublishanyinformationthatrelatestoapracticumexperienceIamsubjecttofederalregulationsinviolationofHIPAAandConfidentialityPolicyandProcedures.Furthermore,IamatriskforviolatingtheASHACodeofEthicsandriskbeingexpelledfromtheSpeechCommunicationDepartment________________________________________________________________StudentSignature,date

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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicESSENTIALFUNCTIONSFORCLINICALPRACTICUMSTUDENTSINTHEIONACOLLEGESPEECH,LANGUAGEANDHEARINGCLINIC1.TheSpeech,LanguageandHearingClinicatIonaCollegeiscommittedtotheeducationofallqualifiedIonastudents,includingstudentswithdisabilitieswho,withorwithoutreasonableaccommodation,arecapableofperformingtheessentialfunctionsrequiredoftheprogram.ItisthepolicyofIonaCollegetocomplywiththeAmericanswithDisabilitiesAct,Section504oftheCivilRightsRestorationActof1973,and all state and local requirements regarding individuals with disabilities. Under these laws, nootherwisequalifiedandcompetentstudentwithadisabilityshallbedeniedaccesstoorparticipationinservices, programs, and activities solely on the basis of the disability. In accordance with federalregulations established by the Americans with Disabilities Act (ADA), the following standards aredescribedtoassisteachstudentinevaluatinghisorherprospectforacademicandclinicalsuccess.Whenastudent’sabilitytoperformiscompromised,thestudentmustdemonstratealternativemeansand/orabilitiestoperformtheessentialfunctionsdescribed.Sensory/ObservationalAbilitiesStudentsmustbe capableof acquiringadefined levelof required informationaspresented througheducationalexperiences inbothbasicartsandsciencesandclinicalsciences.Toachievetherequiredcompetencies intheclassroomsetting,studentsmustperceive,assimilate,and integrate informationfromavarietyofsources.Thesesourcesincludeoralpresentation,printedmaterial,visualmedia,andlive demonstrations. Consequently, students must have the potential to demonstrate adequatefunctionaluseofvisual, tactile,auditoryandothersensoryandperceptualmodalities toenablesuchobservations and information acquisition necessary for academic and clinical performance. Studentsmust have adequate sensory and observational abilities to recognize disorders of speech fluency;abnormal articulation; abnormal voice, resonance, and respiration characteristics; oral and writtenlanguagedisordersintheareasofsemantics,pragmatics,syntax,morphology,andphonology;signsofhearing disorders; signs of cognitive disorders; and signs of abnormal social interaction related tocommunicationdisorders. Inaddition, studentsneed tobeable tovisualizeanatomic structuresanddiscriminatefindingsonvarious imagingstudies,aswellastodiscriminatetext,numbers,tables,andgraphs associated with diagnostic instruments and tests. Furthermore, students should have thepotentialtodevelopsufficientsensory(visualandauditory)functionandmotorcoordinationtosafelyandaccuratelyassessandremediatepatientsusingtheequipmentandmaterialsoftheprofession.

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CommunicationAbilitiesEffective communication is critical for students to build relationships with faculty, advisors, fellowstudents, coworkers, clients, and their significant others in the student’s various roles of learner,colleague,consultant,andleader.Studentsmustbeabletogather,comprehend,utilizeanddisseminateinformation effectively, efficiently and according to professional standards. Students are required tocommunicateproficiently inbothoralandwrittenEnglish,ata levelsufficienttomeetcurricularandclinicaldemands.Studentsmustbeabletoelicitinformation,gatherinformation,anddescribefindingsverballyandinwritingandthiscommunicationshouldbecomprehensiblebypatients,professionals,andlaypersons. In accordance with a technical report developed by ASHA’s Joint Subcommittee of theExecutiveBoardonEnglishLanguageProficiency(seeStudentsandProfessionalsWhoSpeakEnglishwithAccents and Nonstandard Dialects: Issues and Recommendations available athttp://www.asha.org/policy/TR1998-00154.htm),studentsandprofessionals“whospeakanonstandarddialectorwhospeakwithanaccent”must,whenmodelingisnecessary,be“abletomodelthetargetphoneme,grammaticalfeature,orotheraspectofspeechandlanguagethatcharacterizestheclient'sparticularproblem.”Studentsmustbeabletocommunicateeffectivelyandsensitivelywithpatientsandcolleagues,includingindividualsfromdifferentculturalandsocialbackgrounds;thisincludes,butisnotlimitedto,theabilitytoestablishrapportwithpatients.Furthermore,studentsmusthavethepotentialto effectively communicate judgments and treatment information and to observe, recognize andunderstandnon-verbalbehavior.InaccordancewithaprofessionalissuesstatementdevelopedbyASHA(see Cultural Competence in Professional Service Delivery available athttp://www.asha.org/policy/PI2011-00326.htm),studentsandprofessionalsmustdemonstrate“culturalcompetence” to be able to deliver clinically competent services to individuals with communicationdisorders.MotorAbilitiesStudentsmust possess themotor functions needed tomanipulate testing and treatmentmaterials,manipulateequipment(suchasprostheses,devices,orbedcontrols),orprovidegeneralandemergencytreatmenttoclients.Themotorcapacitiesusuallyincludethephysicalstrengthandcoordinationtosafelyhandleandmoveclients;performgeneralandemergencyprocedures;ordirectclientsinvariouspracticesettings,accordingtotheneedsofprofessionalpracticeinspeech-languagepathology.Intellectual/CognitiveAbilitiesStudentsmust demonstrate critical thinking skills so that they can problem-solve creatively,masterabstract ideas, and synthesize informationpresented in academic, laboratory and fieldwork settings.Studentsmustbeabletocomprehend,retain,integrate,synthesize,andapplyinformationsufficienttomeetcurricularandclinicaldemands; identifyrelevantfindingsfromhistory,evaluation,anddatatoformulateadiagnosis,prognosis,andmanagementplan;andsolveproblems,reason,andmakesoundclinicaljudgmentsinpatientassessment,diagnosticplanning,andtherapeuticplanningconsistentwiththeprinciplesofevidence-basedpracticeinspeech-languagepathology. Insomeareas,thisrequirescomprehensionof three-dimensional relationshipsandunderstandingof the spatial relationshipsofstructures.Studentsmustdevelopandexhibitasenseofmedicalethics,andalsorecognizeandapplypertinentlegalandethicalstandards.BehavioralandSocialAbilitiesStudents must demonstrate emotional stability and di display mature, empathic, and effectiveinterpersonalrelationshipswithstudents,patients,andhealthcareworkers.Studentsmustbeableto

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toleratephysicallyandemotionallytaxingworkloadsandtofunctioneffectivelyunderstress.Theymustbeabletoadapttochangingenvironments,displayflexibility,andfunctioninthefaceoftheuncertaintiesinherentintheclinicalsetting.Studentsmustexhibittheabilityandcommitmenttoworkwithindividualsinanintensesettingtomeettheneedsofpeopleofdiversecultures,agegroups,socioeconomicgroupsandchallengeswithoutbias.Theseindividualsmaybeseverelyinjured;theymaybelimitedbycognitive,emotionalandfunctionaldeficits;andtheirbehaviormaycreateattimesanaversivereaction.Theabilitytointeractwiththeseindividualswithoutbeingjudgmentalorprejudicediscriticalinestablishingone’sprofessionalism and therapeutic relationship. Students must be able to manage the use of timeeffectively and systematize actions to completeprofessional and technical taskswithin realistic timeconstraints.Studentsmustalsobeabletoacceptappropriatesuggestionsandconstructivecriticismand,if necessary, respond by modification of behavior. Compassion, integrity, concern for others,interpersonalskills, interestandmotivationareallpersonalqualitiesthatarecritical tocompletetheprofessionalprograminspeech-languagepathology.ProfessionalResponsibilityStudentsmusthavethecapacitytomeetthechallengesofanymedicalsituationthatrequiresareadinessforimmediateandappropriateresponsewithoutinterferenceofpersonalormedicalproblems.Thismayrequireancillarytraining(e.g.,CPR,firstaid,infectioncontrol,evacuationprocedures).Itiseachstudent’sresponsibilitytoattendandbeabletotraveltoandfromclassesandclinicalassignmentsontime,andpossess the organizational skills and stamina for performing required tasks and assignments withinallottedtimeframes.Thisinvolvesfrequentoral,written,andpracticalexaminationsordemonstrations.Thestudentmusthavetheabilitytoperformproblem-solvingtasksinatimelymanner.Studentsmustexhibit adherence to policies of the College, their program, and clinical sites. This includesmattersrangingfromprofessionaldressandbehavior,toattendingtotheirprogram’sacademicschedule,whichmaydiffer from theCollege’s academic calendar andbe subject to changeat any time.During theiracademictenure,studentsmustlearnanddemonstrateknowledgeofandcommitmenttothecodeofethicsoftheirprofessionandbehaviorthatreflectsasenseofrightandwronginthecontextofcare.Students are expected to take initiative to direct their own learning. They are required to workcooperativelyandcollaborativelywithotherstudentsonassignedprojects,andparticipatewillinglyinasupervisoryprocessinvolvingevaluationofabilitiesandreasoningskills.AsstudentsintheM.A.programwith a concentration in Speech-LanguagePathology, they accept and complywith theDepartment’smission in that they strive to become clinicianswho “utilize evidence-based practice; adhere to thehighestpersonalandprofessionalethicalstandards;employcriticalthinkingandselfanalysis;recognizethevalueofadvancedandcontinuingeducation;demonstrateempathy,altruism,andaccountabilityintheirclinicalpractice;andaspiretoprovideexceptionalqualityofserviceforadiversityofpersonsofallageswithcommunication,swallowing,andbalancedisordersinanequitableandinclusivemanner.”NOTES:

• IonaCollegeisanEqualOpportunity/AffirmativeActionInstitutionandiscommittedtosocialjustice.TheCommunication Sciences and Disorders Program fully supports that commitment and expects tomaintainapositiveclinicalandlearningenvironmentbaseduponopencommunication,mutualrespect,andnondiscrimination.Ourfacilitydoesnotdiscriminateonthebasisofrace,sex,age,disability,veteranstatus,religion,sexualorientation,color,ornationalorigin.TheIonaCollegecommunityiscommittedtocreating and fostering a positive learning andworking environment based on open communication,mutualrespect,andinclusion.

• Studentswithadisabilitywhoanticipatetheneedforanytypeofaccommodationinordertoparticipate

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in class or clinic are encouraged tomake appropriate arrangements with the Director of AcademicSupport(914-633-2226).

• StudentswhoarereturningtotheCSDprogramafteramedicalissue/leave,mustcontacttheAssistantDean for Student Academic Services (914-633-2207) and provide medical documentation andnotificationofanydisabilitiesand/oraccommodationsrequired.

• FormoreinformationonIonaCollege’sPolicyonAccommodationsforStudentswithDisabilities,pleaseseetheOfficeoftheOmbudspersonpageontheIonaCollegewebsiteathttp://www.iona.edu/About/Administrative-Offices-Departments/Office-of-the-Ombudsperson.aspx1.ThematerialinthissectiononEssentialFunctionshasbeenadaptedfrom:AmericanSpeech-Language-HearingAssociation.(1998).StudentsandprofessionalswhospeakEnglishwithaccentsandnonstandarddialects:Issuesandrecommendations[TechnicalReport].Availablefromwww.asha.org/policy.AmericanSpeech-Language-HearingAssociation.(2011).Culturalcompetenceinprofessionalservicedelivery[ProfessionalIssuesStatement].Availablefromwww.asha.org/policy.Hayes,L.,etal.(2005).Essentialfunctionschecklist.CommunicationSciencesandDisorders,CollegeofHealthProfessions,MedicalUniversityofSouthCarolina,Charleston,SC.Katz,J.R.,Woods,S.L.,Cameron,C.A.,&Milam,S.(2004).Essentialqualificationsfornursingstudents.NursingOutlook,52,277-288.SetonHallUniversity(2011).Standardsforessentialfunctions.Speech-LanguagePathology,SchoolofHealthandMedicalSciences,SouthOrange,NJ.Availableathttp://www.shu.edu/academics/gradmeded/ms-speech-language-pathology/upload/SLP_Essential_Functions.pdfWestVirginiaUniversity(2011).EssentialFunctionsforStudentsintheM.S.PrograminSpeech-LanguagePathology.Morganotwn,WV.Availableathttp://csd.wvu.edu/r/download/148819.

EssentialFunctionsI_______________________________(printname)havereceivedandreviewedtheEssentialFunctionsfortheIonaCollegeSpeech,LanguageandHearingClinic.MysignaturebelowindicatesthatIunderstandtheinformationandthatIamabletoperformallabilitiesdescribed.________________________________________________________________StudentSignature,date

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ClinicalObservationVerificationThisistoverifythat(studentname)____________________________hascompleted___________hoursofclinicalobservationwithintheASHAScopeofPracticeofSpeechLanguagePathologywithintheASHA2014Standards.IhavepersonallyverifiedthateachobservationsupervisorisstatelicensedandholdscurrentlytheCertificateofClinicalCompetencefromtheAmericanSpeech-LanguageandHearingAssociationatthetimeofthestudent’sobservation.ClinicalInstructor:________________________ Faculty: _______________________Signature:________________________ Signature:______________________Date:________________________ Date:______________________ASHA#:________________________ ASHA#:______________________STATE,LICENSE#________________________ STATE,LICENSE#_____________________

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAll student clinicians are strongly encouraged to be members of the National Student Speech LanguageHearing Association. http://www.asha.org/Members/NSSLHA/Pre-Professional-Guidelines/. Please reviewthefollowingguidelinessetforth.ProfessionalGuidelinesoftheNationalStudentSpeech-Language-HearingAssociationPreambleAcademic institutions exist for the transmission of knowledge, the pursuit of truth, the personal andprofessionaldevelopmentofstudents,andthegeneralwellbeingofsociety.Freeinquiryandfreeexpressionareindispensabletotheattainmentofthesegoals.Asmembersoftheacademiccommunity,studentsshouldbeencouragedtodevelopthecapacityforcriticaljudgmentandtoengageinasustainedandindependentsearchfortruth,whileconductingthemselvesinaprofessionalmanner. Freedomtoteachandfreedomtolearnareinseparablefacetsofacademicfreedom.Thefreedomtolearndependsuponappropriateopportunitiesandconditionsintheclassroom,onthecampus,inclinicalfacilities,andinthelargercommunity.Studentsshouldexercisetheirfreedomwithresponsibility.Theresponsibilitytosecureandtorespectgeneralconditionsconducivetothefreedomtolearnissharedbyallmembersof theacademic community. Each collegeanduniversityhas aduty todeveloppolicies andprocedures,whichprovideandsafeguardthisfreedom.Suchpoliciesandproceduresshouldbedevelopedateachinstitutionwithintheframeworkofgeneralguidelinesandwiththebroadestpossibleparticipationofthemembersoftheacademiccommunity.ThepurposeofthisstatementistoenumeratetheprofessionalguidelinesbywhichstudentsbeingeducatedinSpeechLanguagePathologyandAudiologyshouldabide.GuidelineIStudentsshallholdparamountthewelfareofpersonsservedduringclinicalpracticum.A. Students shall adhere to the clinical guidelines establishedby the clinical supervisor and/or educationprogram,consistentwiththestandardsoftheAmericanSpeechLanguageHearingAssociation.B. Students shall seek approval from their clinical supervisor before implementing any aspect of clientmanagement/service.C.Studentsshallidentifythemselvesasstudentcliniciansorinternsthroughouttheirclinicalpracticumexperience.D.Studentsshalluseeveryresourceavailabletoprovidethebestpossiblelearningexperience/service.

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E.Studentsshallfullyinformsubjectsparticipatinginresearchorteachingactivitiesofthenatureandpossibleeffectsoftheseactivities.F.Studentsshalltakeallreasonableprecautionstoavoidinjurytopersonsinthedeliveryofprofessionalservices.G.Studentsshallevaluateservicesrenderedtodetermineeffectiveness.H.Studentsshallabidebylocal/stateregulationstoacceptorrefuseremunerationforspeechlanguageandhearingclinicalservicesconsistentwithpoliciesoftheASHACouncilonProfessionalStandards.Proscriptions

1. Studentsmustnotexploitpersonsinthedeliveryofclinicalservicesandmustnothesitatetorecommendthedismissalofpersonsfromtreatmentwherebenefitcannotreasonablybeexpectedorwherecontinuingtreatmentwouldbeunnecessary.

2. Studentsmustnotguaranteetheresultsofanytherapeuticprocedures,directlyorbyimplication.Areasonablestatementofprognosismaybemadebutonlyifsuchinformationisapprovedbythesupervisor.Cautionmustbeexercisednottomisleadpersonsservedtoexpectresultsthatcannotbepredictedfromsoundevidence.

3. Studentsmustnotusepersonsforlearningexperiencesinamannerthatconstitutesinvasionofprivacyorfailstoaffordinformedfreechoicetoparticipate.

4. Studentsmustnotevaluateortreatcommunicativedisordersoradministerdiagnosticclinicalservicesexceptunder"direct"supervisionofaqualifiedpersonasexplainedinthedocumentsentitled"RequirementsfortheCertificatesofClinicalCompetence"publishedbytheAmericanSpeechLanguageHearingAssociation.

5. Studentsmustnotrevealtounauthorizedpersonsanyclinicalorpersonalinformationobtainedfromindividualsservedbystudentclinicians.

6. Studentsmustnotdiscriminateinthedeliveryofclinicalservicesonthebasisofrace,sex,age,orreligionnationalorigin,disability,orsexualorientation.GuidelineIIStudentsshallmaintainhighstandardsofprofessionalcompetence.A.Studentsparticipatinginaclinicalpracticumexperienceshallpossessrequisiteacademicand/orclinicalqualificationsspecifiedbytheeducationprogram.B.Studentsshallcontinuetheirprofessionaldevelopmentthroughouttheircareersbymaintainingastateoftheartknowledgeofprofessionalpublishedmaterialandattendanceatprofessionalcontinuingeducationcourses.C.Studentsshallmaintainadequaterecordsofclinicalservicesrendered.

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D.Studentsshallmakedecisionsconcerningpersonsreceivingclinicalservicesonthebasisofobjectivedata.E.Studentsshallpresentproductstheyhavedevelopedtotheirprofessionalcolleaguesinamannerconsistentwithhighestprofessionalstandards.Proscriptions1.Studentsmustnotreferanypersonsinneedofclinicalservicestopersonsorprofessionalswhoarenotqualified.2.Studentsmustnotparticipateinactivities,whichmightinitiatedisparagingcommentsaboutspeechlanguagehearingservices,personnel,and/orcolleagues.GuidelinesIIIStudents'statementstopersonsservedandtothepublicshallprovideaccurateinformationaboutthenatureandmanagementofspeechlanguageandhearingdisorders,andabouttheprofessionsandservicesrenderedbyitspractitioners.Proscriptions1.Studentsmustnotmisrepresenttheireducationorcompetence.2. Students' public statements providing information about professional services and productsmust notcontainrepresentationsorclaimsthatarefalse,deceptive,ormisleading.3. Studentsmust not use professional or commercial affiliations in anyway thatwouldmislead or limitservicestopersonsserved.GuidelineIVStudents shallhonor their responsibilities to theirprofessionsand their relationshipswithcolleaguesandmembersofalliedprofessions.A. Students shall strive to assist in maintaining and expanding high professional standards for theireducationalprogram.B.Studentsshallstrivetoincreaseknowledgewithintheprofessionbyconductingresearch.C.Studentsshallseekcreditforprofessionalpublicationswhentheircontributionswarrantit.D.Studentsshallestablishprofessionalrelationswithstudentcolleaguesandmembersofrelatedprofessions.GuidelineVStudentsshallupholdthedignityoftheprofessionsandaccepttheprofessions'selfimposedstandards.A.Studentsshallinformeducationprogramdirectorsofviolationsoftheseprofessionalguidelines.

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B.Studentsshallcooperatewithaprogramdirector'sorothereducationalcommittees'inquiriesintomattersofprofessional conduct related to these professional guidelines and shall follow established university/collegegrievanceproceduresincludingdueprocessprocessesifnecessarytoalleviatethegrievance.

DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicApplicationsCSDGraduateCandidatesStudentName: Date: Schoole-mail: Alt.e-mail: Homephone: Mobilephone: Applicationfor(pleasecheck):□CSD610(Year:_____)□CSD6111(Year:_____)□CSD612(Year:_____) Briefdescriptionofclinicalexperiencetodate:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________PracticumCoursesClass Semester TXHours DXHours Diagnosis/

BackgroundAge

CSD610 CSD611 CSD612

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StudentName: Date: Studentaddress(attimeofoff-siteplacement): ________________________AreyouabletocommunicateinalanguageotherthanEnglish(includingASL)?Ifso,indicatelanguage(s)andlevelofproficiency: ____________ Doyouholdadegree,certificate,orhavetraining/workexperienceinanotherfield?Ifso,pleasedescribe: Whatareyourgoalsforthesemester?(Goalsmayreflectclinicalskillsyou’dliketoimprove,trainingorexperienceyou’dliketohave,orotherareas): Documentneedsforanyrequiredareasand/orexperiences Otherfactorstobeconsidered: ExpectedDateofGraduation: _____________________________Totalnumberofclinicalhourstodate: _____________________________

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StudentSignature Date

SpeechCommunicationStudiesDepartmentIonaCollegeSpeechLanguageHearingClinicUndergraduateApplicationforOn-SiteClinicalRotation StudentName

ExpectedDateofGraduation

CurrentGPA Advisor

Fall2012UndergraduateMajors:PrerequisitesrequiredtoregisterforSCS419SCS420

Class Grade

SCS361 SCS362 SCS418

Provideastatementofinterestwhyyouwouldliketoparticipateinclinic: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________

______________________________________________

StudentSignature,Date

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ClinicalDescription

Prospectivestudentsinterestedinapplyingforanon-siteundergraduateclinicalpracticumwillmeetthefollowingrequirements: ApprovalRequirements

GPARequirement 3.2 RecommendationLetter Favorable

Letter

ClinicalFacultyInterview FavorableInterview

ClinicalPoliciesandProcedures

Studentsapplyingforclinicalpracticummustsubmitthefollowing:applicationandletterofrecommendation.Policyonrecommendationletter:maybecompletedbyfacultyfromanydepartmentoremployer.Letterstodocumentcontactinformationandrelationshiptotheprospectivestudent.Familymembersarenotpermittedtowriteletters.CompleteddocumentstobesubmittedbyMay1foraFallClinicExperienceorbyNovember30thforaSpringClinicExperiencetoMariaArmiento-DeMaria,MA,CCC-SLPClinicalFacultyInterviewswilltakeplaceduringFinalsWeek.Decisionswillbesentviaemail.ProspectivestudentsapprovedMUSTcomplete2semestersofclinicalpracticumunlessnotedbytheChairPersonorClinicDirector.Allstudentsparticipatingon-siteattheIonaCollegeSpeech,Language&HearingClinicwillhaveaminimalmandatorycaseload:2individualclientsOR1individualclientand1Group.CaseloadaccommodationrequestsmustbemadeinwritingandapprovedbyClinicDirectororAsst.ClinicalDirector.Thefollowingrequirementsaremandatedto2weekspriortoaclinicstartdate:

DateCompleted

25hoursofClinicalObservation ChildAbuseSeminar FingerprintingReceipt(ifapplicable) ProofofLiabilityInsurance(MustbeamembertoNSSLHA) ProofofVaccinations:rubella,mumps,hepatitisB Tuberculinskintest(PPD) CPRCertification $55.00ClinicFee $30.00HandbookFee HandbookReviewAgreement SocialNetworkingPolicy

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAppendixEProceduralSafeguards

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProceduralSafeguardsStandardPrecautionsThepurposeofthispolicyistoreducetheriskofoccupationalexposuretothoseinvolvedintheSpeech,Language&HearingClinic.Thisprocedureisdesignedtominimizeanyriskfortransmissionofanycommunicablediseases;cytomegalovirus(CMV),hepatitisB(HBV),herpessimples,tuberculosis,influenza,andacquiredimmunedeficiencysyndrome(AIDS).Themainpotentialhazardisthroughsaliva;however,therearefewreportsoftheseoccurrences.Thefollowingprecautionsaretobeobserved:1.Bloodorotherbodyfluidsfromallclientsshouldbeconsideredinfected.2.Humanbitesarecharacterizedasanincreasedriskforinfection.3.Disposableglovesshouldbewornwhentheclinicianismeetingtheclient’sfaceormouth.4.Removeglovesbypeelingthemofffromthewristandturntheglovesinsideout.5.Handsshouldbewashedimmediatelyafterglovesareremoved.6.Disinfectalltabletopsafterseeingtheclient.7.Tonguedepressors,gloves,orotheritemsplacedinthemouthshouldbeplacedinthegarbage.Resourceshttp://www.asha.org/slp/infectioncontrol/

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProceduralSafeguardsHandHygiene

ThistechniqueistobeutilizedbyEVERYclinicianbeforeandafterEVERYclientcontact.

§ Turnonthefaucet§ Usecontinuousrunningwater§ Wethands.§ Useliquidsoaptolatherhands,wristsandforearms.§ Rubhandsvigorouslyfor60secondswithsoapywater.§ Rinsethoroughly,allowingwatertodrainfromfingertipstoforearms.§ Usepapertowelstodryhands.§ Turnofffaucetswithdrypapertowelsafterdryinghands.

Protocol:

§ Beforebeginningwork§ Beforeandaftereating§ Afterusingthebathroom§ Afterblowingtheirnoseorcoughing§ Aftereachpatientcontact§ Beforeandafterremovinggloves

HandSanitizersarealsoavailable.FollowthesameprotocolastheHandWashingTechniqueResourceshttp://www.asha.org/slp/infectioncontrol/https://www.cdc.gov/handwashing/when-how-handwashing.html

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProceduralSafeguardsInfectionControlTherapyRooms

§ Alltherapyroomsshouldbeequippedwithcleaningproducts,garbagecan,andtissues.IfthisisnotthecasepleasereportthistotheAdministrativeAssistantorSupervisor.

§ Therapyroomsshouldbedisinfectedbyawipe.Thisincludesanyhardsurfacesuchasthetable,chairarmsandbacks,anddoorknobsaftereachsession.

§ Ifanyclientneedsassistancetouseatissueuseglovestoassist.§ Bathroom/Diaperchangingistheresponsibilityofthefamily/caregiver.Bringtheclientwithyouto

notifythefamilymemberiftheclientisreporting/indicatingNEEDStousetherestroomClinicMaterials

§ Alltoysand/orobjectsshouldbecleanedwithadisinfectantwipeimmediatelyaftereachsession.

SANITIZINGCLINICMATERIALGUIDELINES

§ AllclinicmaterialsusedintreatmentaretobesanitizedBEFOREandAFTERsessions.

§ Sanitizingwipesareavailableineachtreatmentroom.

§ Priortosessions,pleaseadheretothefollowing:

1. Wipematerialswithwipes(thisincludestoysandfoammatsifusing)2. Washhandswithsoapandwater.Haveantibacterialhandsanitizeravailableonahigh

shelfintreatmentroomforusethroughoutsessionwhensoapandwaterisnotavailable.

3. Ifyouneedtoleavetreatmentroomforanyreasonwithyourclient(orhaveanactivityplannedforoutsidethetreatmentroom),usehandsanitizeruponyourreturntotreatmentroom.

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4. Ifforanyreasonyourclientbecomesphysicallyillintreatmentroom,orincommonareas(hallway,etc)–pleasealertclinicstaffsothatfacilitiesmaybecontactedtoaddresstheissue.Donglovesandsanitizeallitemsmaterialsclientcameincontactwith–toys/materials;table,chairs.

§ Washhandswithsoapandwaterattheconclusionofyoursession.

***********Aseparatebleachingschedulewillbeprovidedforteamsofstudentsatmidtermandfinaltosignupformaintainingmaterials(Fall,Spring,andSummersemesters).

ProtocolforBleachingMaterials

§ Materialsaretobeplacedinbucketwitha10:1ratioofbleachtowater(thatistosay¼to¾cupbleachpergallonofwater)

§ Itemsshouldbeplacedinawellventilatedspaceonamatorcoveredtabletoairdry

§ Studentcliniciansshouldusegloveswhenengaginginbleachingofmaterials.

OralMotorExaminations/Treatment

§ Handsshouldbepreandpostexam§ NON-LATEXGlovestobeused§ Placetoolsonacleanpapertowel:Penlights,disposablegloves,tonguedepressors,stopwatch,

whistles,ANDSTRAWSetc.§ Disposeofanyitemsnon-permanentitemsinaredplasticbagtobethrownaway.§ Wipeallpermanentitemswithdisinfectantwipes.

Resourceshttp://www.asha.org/slp/infectioncontrol/

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProceduralSafeguardsSafetyProceduresEmergencyExitsFrontEntranceoftheClinicEmergencyDoorLocatedtotherightofthesmallobservationroomEmergencyDoorLocatedinthekitchenetteareaIncasesofemergencies,theclinicalpracticumstudentsshouldfollowtheprocedureslisted:EvacuationActivationofafirealarm/carbonmonoxidealarmand/orlossofelectricalpower,studentcliniciansshouldremovethemselvesandtheirclientsquietlyandquicklyoutofthebuildingusingthenearestexit.Therapyroomdoorsshouldbeclosed.Walkcalmlyandinanorderlyfashion.ThestudentclinicianisrequiredtoleadtheirclienttothefrontentranceoftheSpeech,Language&HearingClinic.Allstudentsarerequiredtostaywiththeirclients.TheClinicalSupervisorwillmeetthestudentsandclientsatthedesignatedarea.AccidentsIntheeventofamajorinjuryoraccident,call911immediately.Intheeventofaminorinjury,afirstaidkitisavailableintheSpeech,Language&HearingClinic.Ifastudentclinicianand/oraclientbecomesillorhasanaccident,notifytheClinicalSupervisorandtheSecurity,immediately.Forallsituations,anincidentreportwillbecompletedbyIonaCollegeSecurityonsiteatthetimeoftheincident.

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ImportantPhoneNumbersNewRochellePoliceDepartmentEmergencies:911Fornon-emergencies:(914)654-2300DepartmentofCampusSafetyandSecurityRobertV.LaPentaStudentUnionPhone:(914)633-2245CampusSafetyAnnex(SpellmanHall)Staffed24-hoursPhone:(914)633-2560Itisimportanttonoteforanystudent,staffand/orclientthatwishestoreceivetransportationbacktothemaincampuscancontactsecurity

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Faculty

GroupTherapy3 Observation Audiology

Room118 116 Group

Therapy GroupTherapy2

GroupTherapy

Suite3 Suite 114

117 2

Emergency

Exit Closet 113

134 121

Restroom

Kitchen/Prep 119

Group GroupTherapy1

Restroom Therapy 112

120 Suite

1

111

EmergencyExit133 Faculty

Therapy

110

ObeservationLab StudentStudy

122 Therapy9 106

109

Closet

123

Therapy6

Therapy

7 Therapy8

125 124 108

Office1

126

Therapy

1

132

Tele/Data Copy/Print Conference

Therapy

2 107 104 Room

131 103 105

Office2

67

127

Therapy

3

130 ReceptionArea

Therapy5

Therapy

4

128 129

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAppendixFClinicAssignments

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments

ClinicalAssignmentswillbeINDIVIDUALIZEDforeachpracticumstudent.Studentcliniciansmayparticipateinoneofthefollowingclinicalactivities.Possibleassignmentsincludebutnotlimitedto:

§ ClinicalObservationsProtocol§ IndividualServiceCaseloadAssignment§ GroupServiceCaseload

ClinicalObservationsClinicalObservations:StudentcliniciansassignedtoONLYclinicalobservationswilldeveloptheirclinicalknowledgeandskillsbyobservingprofessionalmembersofASHA.StudentswillfollowpolicyandprocedureoutlinedintheObservationHandbook.Aclinicalsupervisorwillbeassignedtothosestudentstransitioningtotheon-siteclinic.Thisassignmentwillhelpthestudentacclimateintoaclinicenvironmentasastudentclinician.IndividualServicesIndividualServices:Studentclinicianswillberequiredtoparticipateinweeklyclassinstruction(Undergraduatestudents52minutesweekly,CSDstudents2hoursweekly)forclinicalservicedevelopmentincludingplanning,documentation,andevaluatingclinicalskills.AdditionalstudentswillalsoscheduleofficehourmeetingwiththeirprimarySLP’s.UndergraduateandCSDstudentswhodonothaveclinicalpracticumexperiencewillparticipateinagrouporindividualmeetingswiththeirprimarySLPtoprepareforastudentpracticumrotationstart.GroupServicesGroupServices:Studentcliniciansparticipatewithapeer(s)androtateastheleadclinician.TeammeetingswillbescheduledasdirectedbytheprimarySLP.

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:Preparation

Preparationpriortothestartofclinic:

§ ReviewClinicHandbook§ StudentswillreceiveconfirmationofclientscheduleviaemailfromtheAdministrativeAssistant§ Theclinicalstudentisresponsibleforcontactingtheclientand/orclientfamilytoconfirmschedule

andstartdate.PhoneCallPolicy:StudentsarerequiredtoconductphonecallsintheclinicONLY.Studentsarenotabletosharetheirpersonalphone/contactnumberwiththefamily.Studentsshouldemailthefamilytoscheduleaphonemeeting.ThisphonemeetingmustbeconductedintheclinicONLY

§ Atthetimeoftheinitialphonecallcompletethefollowing:§ Studentsshouldintroducethemselves§ Confirmthesessiondateandtherapyschedulefortheupcomingsemester§ Conductaninformalinterviewonly(duetoHIPAAregulations)andaskthefamilycontactwhatthe

goaloftherapyis.

Providetheclientwiththefollowingofficenumber(s):(914)712-1990or(914)712-1991Thefamiliesshouldbecontactingtheoffice(notthestudentclinician)oremail.Studentsshouldreviewinformationanddevelopknowledgeandskillsofthecommunicationdisorder/delaythatyouareassignedto.Todeveloptherapyservicesanddeterminebaseline,onemusthaveagoodunderstandingofthedisorderordelay.Studentsshouldhaveallpaperwork(i.e.lessonplans,observationforms)necessaryforclinicorganizedandpreparedforsessionclientchart

Ifyouareworkingwithareturningclient.CompleteaChartReview:

§ Client’sname,address,telephone,dateofbirth,chronologicalage,dateoflastspeech-languageevaluation,previoustherapydate

§ Diagnosis§ PertinentBackgroundinformation,medicalhistory,familyhistory,developmentalmilestones,

educationalinformation,social/employmenthistory,education/cognitivelevel,medication§ SummaryofPreviousTherapyandothertreatmentprograms§ Reviewpastvideosessions

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§ Developquestionsforclinicalsupervisor

Ifyouareworkingwithanewclientstudentneedstodevelopknowledgeperthebackgroundprovidedbyclient.Forexample,reviewdevelopmentalnorms,signsandsymptomsofadisorderordelay,expectedageranges,playskills.PhoneCallScenarioCallyourclient:Introduceyourselfandconfirmthesessionschedulefortheupcomingsemester.Thisisalsothetime,toconductan“informalinterview”.Inquiretothecaregiverortheclientwhattheirspecificspeech&languageconcernsare,ifanyprogressorregressionhasbeennoticed,andwhatwouldliketobeworkedonforthesemester.ChildclientscenarioMynameisMariaandIamgoingtobethestudentclinicianfor“Jane”.WearescheduledonTuesdaysandThursdaysfrom3:30to4:00.IfyouhaveafewminutesIwouldliketoaskyousomequestionsabout“Jane”.WhatareyourconcernsforJane’sspeech?HowhasJanedoneoverthesummer?Whatareaswouldyouliketoworkonthissemester?CanyousharewithmeanyspecificlikesthatJanemayhave?AdultclientscenarioMynameisMariaandIamgoingtobethestudentclinicianfor“John”.WearescheduledonTuesdaysandThursdaysfrom3:30to4:00.IfyouhaveafewminutesIwouldliketoaskyou(iftheclientcanadvocateforhimorherself)orthecaregiver(whowillbetheprimarycontactperson)afewquestions.Whatareyourgoalsfortheupcomingsemester?Whatareaswouldyouliketoworkonthissemester?HelpfulQuestionsduringphonecontact:

§ Howwouldyoudescribethespeechorlanguageproblem?§ Hastheclientmadeimprovementsintheirskills?§ Whatactivitieshaveworkedforcarryoverinthehome?§ Hastherebeenanychangesinthehomeorschoolinthepast3months?§ Howistheclient’shealth?Anychanges?§ Whatismotivatingfortheclient?§ Whatareyourgoalsfortheupcomingsemester?§ AllcallsarerequiredtobeloggedontheClientContactSheet

Requirement:EachtimeyouattempttocalltocontactaclientfamilythismustbeloggedontheClientContactSheetwithabriefdescription.SeeExampleBelow

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SchoolofArtsandSciencesDepartmentofSpeechCommunicationStudiesIonaCollegeSpeech,Language&HearingClinicClientContactForm

ClientName DOB MorF Guardian/ContactPerson

Address City,State,ZipCode PhoneNumber CellPhone EmailAddress

DateCorrespondence/InformationDisclosed/CommentsInitials

1/12/17 SpoketoMrs.Snowat9:00amtoconfirmtheclinicschedule

MA-D

3/15/17 Voicemailwasprovidedat11:15tocancelthesessionduetosnowclosure

MA-D

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:BaselineData

PlanningpriortoyourfirstsessionBASELINEDATAmustbedevelopedtoidentifyareaofneedsandjustifyspecifictherapytargets.

§ Baselinedataiscollectedduringthefirsttwoinitialsessions:confirmwithinstructorand/orimmediatesupervisor

§ CompileadatacollectionstrategyRESEARCH

§ Preliminaryspeechandlanguagediagnosisforasolidknowledgebaseofthepreliminarycommunicationdisorderand/ordelay

§ TypesoftherapyplanningCREATE

§ Behaviormanagementstrategy§ “ToDoList”foreachtherapysession

DocumentationPreparationTheLessonPlanforthescheduledsessionmustbeupdatedinMedicatpriortoyourscheduledsession(LessonPlanduedateswillbeannounced).YourimmediateSLPSupervisormayrequireaspecifictimedateforreviewandchangesrequiredaccordingly.SessionClientChartsMustbepreparedpriortoeachsession.SeeClinicFormAppendixtoreviewthemostuptodatecriteria

LessonPlans:PriortoeachsessionthelessonplanmustbeuploadedintoMedicatwithallheadingdocumentedpriortothescheduledsession.

Itisimportanttonote:

§ EachsessionMUSTbeaccountedfor-cancelledsessionsbyclientorstudent,schoolclosingsandholidays

§ LessonplansarerequiredforALLsessions.Therearenoexceptions

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AlldocumentationMUSTbecompletedattheIonaCollegeSpeech,Language&HearingClinicviaMedicat

IfthereisanunforeseencircumstancewiththeEMRsystemthatdoesnotallowtheusertologon,thestudentclinicianMUST

§ InformprimarySLPofthecase§ Pertinentdocumentsmustbecompletedinahardformat(handwrite)§ BlueInkmustbeused§ FiledocumentsintheClientSessionChart§ UploadpertinentdocumentsintoEMRsystemafterEMRsystemisrestored.

DURINGTHESESSIONTheSessionClientChartisexpectedtobecompletedwithalldocumentationforSLP’stoprovideappropriatefeedbackofthesession.DATATRACKINGDURINGSESSIONTotrackprogress,datamustbecompletedforeachsession.Datatrackingisarequirement.Studentcliniciansmayusedatachartsfromtheirtextbookand/ornarrativenotebookstyletocollectdata.Datatrackingisnotpermittedonanypersonaldevicesorlaptopsinthetherapyrooms.AlldatacollectionformsMUSTbefiledundertheSupervisorFeedbackFormafterthesessioniscomplete.ScanningDocumentsIfdeemedappropriateandapprovedsuchas

§ DocumentsthattheclientfamiliesdonotsubmitviaMedicatClientPortal§ Documentsrelatedtoclinicsession(ifEMRsystemisdown)

Studentswillberequiredtodothefollowing:

§ ReceivewrittenpermissionfromSLPtoscananduploaddocuments-MediaSpecialistmustbecopiedonthisinorderforameetingtobescheduled.

§ SetupameetingwiththeMediaSpecialisttocompletethescanninganduploadingprocess§ RouteinMedicatthedocumentsthatwerescannedtoyourSLP§ EmailyourSLPthatthishasbeencompletedsotheSLPcansign/lockthedocument

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:TreatmentSessionsStudentCliniciansuseguidelinesbelowtosupportsessionpreparationandself-evaluationasaclinicalstudent.

FrameworkforTreatmentSessionsSelfEvaluationforStudentSessions

OrganizationMaterialsOrganizedUnderstandhowtousethematerialsCreateActivityMapCreateaTo-DoListBehaviorManagementPlanDevelopedRoomSetup

Wasthereenoughmaterials?WasIconfidentwiththematerials?Didtheclientunderstandtheproceduresofthesession

TimeAppropriatestart&endtimeConsistentpaceforclient’sneedsMaintainingtopicandtask

Wasanytimewastedduringthesession?Wasthepaceappropriatefortheclient?DoIneedtochangethepaceofpresentation?DidIstayontaskDidtheclientstayontaskWhatwasdonefortransitionDidIprovideampleopportunitiesformyclienttorespond?

PresentationClient/GuardianispartofthetherapyplanningProvidecleardirectionsModelingofexpectedresponsesAgeappropriatematerialsTypeofreinforcementSessionClosure

Isthebehaviormanagementplansuccessful?Wasthereinforcementspecific?WerethematerialsIused&languageageappropriatefortheclient?DidIprovidespecificinformationfortheimportanceofactivities?HowdidImodelthepreferredresponses?HowdidIclosethesession

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ClientSpecific

ActivitiesrelatedtotheclientsdailyinterestActivitieschallengingfortheclient

DidIrelatetotheclientasapersonalaswell?DidIresearchtheclientsculturalbackgroundDidIgivehomeworktoincludethefamilysupport

Environment&ManagementRapportestablishedSupportclientRe-DirectedClient

DoIhaveapositiverapportwiththeclient&family?DidIgivetheclientenoughtimetorespond?DidItalktoomuch?Wasmyclientinterestedintheactivities?WhatdidIdotoredirectclientwhenofftask?

HOMEWORKAllclientsshouldhaveaHomeworkFolder.ThepurposeofaHomeworkFolderistoprovidethefamilyand/orcaregiverthenecessarytoolstocarryovertechniquesusedfromthesessions.Thisalsosupportsdocumentationofprogress,servicequality,andcarryoveroutsideoftheclinicsetting.Attheendofeachsemester,studentcliniciansshouldbeprovidingacarryoverhomepackettosupportskillsthathavebeenlearned.SUBMISSIONOFDOCUMENTATIONAFTERTHESESSIONTheDailyProgressNote(SOAPNote)mustbecompletedtodocumentthesessionconducted.TheProgressNote(SOAPNOTE)mustbecompletedthesamedaybythecloseofclinic.Theorderofsubmissionforeachsessionincludeslessonplan,SOAPnoteanddatasheet.ToorganizesubmissionofSOAPnotes,reviewsandrewrites.ClinicalStudentsarerequiredtocompletetheSOAPNOTEROUTINGREPORT.Thisformshouldbeplacedonlefthandsidetosupportnotereviews.

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Processofsessionnote/SOAPnotereviewsLessonplanswillbeviewedbytheprimarySLPonthedayofthesession.PleaseseeyourprimarySLPforalternativesubmissionrequirementsifneeded.TheSLPwillreviewthelessonplanatthetimeofthesession.SOAPnoteswillbereviewedbasedontheprimarySLP’sscheduleAllrewritesrequireameetingwiththeprimarySLPClinicalMeetingswiththeprimarySLPwillincludebenotlimitedto:

§ Re-writealessonplan,discusstherapyplanning,supportwrittendocumentationforknowledgeandskilldevelopment.

§ Areasofneedisspecifictoeachstudent§ Ameetingisrequiredtoreviewtheneedsoftherewrite.StudentsareREQUIREDto

setupameetingwiththeprimarySLPassoonaspossible.Thelongerastudentwaitstoscheduleameetingafuturerewritescanaccumulateandaclientchartisnotcurrent.

§ ItisexpectedstudentscontacttheirSLPwithinaweektoscheduleameeting§ Ifunabletoscheduleameeting,emailyourimmediatesupervisorforanalternative

meetingtime§ AtthetimeofthemeetingtheSLPwillprovideaduedatewhentherewriteisdue§ Theupdatedlessonplanand/orSOAPnotemustbesubmittedwiththeoriginal

documentsfromthatsession.§ Theupdatedlessonplanand/orSOAPnoteshouldhaveaREWRITEHEADING§ Therewritemustalsoincludesignature,dateandtimeofcompletingtherewrite

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:GroupRotationClinicalstudentsparticipatinginaGroupRotationattheIonaCollegeSpeech,Language&HearingClinicwilljoin2to3studentclinicianswithamaximumof5clientspergroup.ThegoalofGroupTherapyistoprovideanopportunityforclientstocarryoverstrategiesand/or,developnewskillsinapeerenvironment.Eachstudentclinicianwillleadatherapysession.Theleadclinicianisresponsibleforthecompletedlessonplan;SOAPnoteandmaterials.Allstudentswillberequiredtomeetasateamtodesignatespecificspeech-languagetargetsthattheleadclinicianwilladdress.Thiscommunicationisimportantforthetransitionanddevelopmentforthestudentcliniciansandclients.Thesupportingclinicianswillcollectdata,provideindividualizedsupportifdeemedappropriate,andwritesubsequentSOAPnotes.Hoursaccruedfortreatmentserviceswillbedirectclienttimefortheleadstudentclinician.SeeyourprimarySLPforadditionalproceduresrequiredasitpertainstoyourgroup.

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:ProgressStatementsAsdeterminedbytheprimarySLPaprogressstatementmayberequired.Aprogressstatementmaysupportclinicalneeds,progresstodates,performanceoutcomesandrecommendationsforcurrentservices.

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:ProgressReportsProgressReportwillberequiredforeachclient’sreceivingtherapyservicesattheIonaCollegeSpeech,Language&HearingClinic.Thesereportsaredueattheendofeachsemestertosupportservicesbeingprovided,justifyingrecommendationsandprovidingtheclinicalstudentwrittendocumentationopportunitiesconsistentwiththeprofession.AProgressReportDraftdateisscheduledforeachsemester.PleaseseetheClinicCalendarforduedate.ProgressReportAgenda:AProgressReportDraftwillbesubmittedontheduedatedocumentedontheClinicCalendar;theprimarySLPonthecaseawillreviewthedraftandthereportwillbereturnedforrevision.ThestudentclinicianwillbeabletoupdatethereporttoimplementthechangespertheprimarySLP’sfeedback.Additionally,thestudentclinicianhastheopportunitytore-submittheProgressReportDraftonmorethanonesubmission.Thepurposeoftheadditionalsubmissionistodevelopthestudentclinicianswrittendocumentationskillsandtoprovidetheclientwithafullreport.AFinalProgressReportwillhavetheProfessionalssignatureonthereport.TheduedatefortheProgressReportisyourFinalClinicExitmeeting.ThisreportmusthavetheSLP’ssignatureatthetimeoftheClinicExitIftheProgressReportisnotcompletedatthetimeoftheClinicExitthestudentwillbeinviolation(PleaseseeClinicalPolicyforClinicExit)

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:DiagnosticRotationCSDGraduateStudentsandundergraduateSLP-AstudentswhohavecompletedadiagnosticcourseMUSTmeetwiththeprimarySLPtoreceiveclearancetoconductapartialand/orfulldiagnostic.Thisclearanceincludesbutnotlimitedto–asdirectedbytheDiagnosticCourseInstructor,asdirectedbytheprimarySLP,studentdemonstratingknowledgeandskillstocomplete,andjustificationforthediagnostic.Studentswhohavenotcompletedadiagnosticcoursewithintheundergraduateand/orgraduatecurriculummayonlybetrained/clearedbytheSLPandcanshadowthediagnosticwiththeprimarySLPconductingtheassessment. Procedurestofollowpriortotheevaluation:

§ AllconsentformsmustbesignedbytheclientorclientcaregiverincludingthePermissiontoevaluateandAudio/Videotapereleaseformpriortotheevaluation.

§ CompleteandthoroughreviewoftheClient’sChart(ifapplicable)

§ Contacttheclienttodiscussspecificsoftheevaluation,theanticipatedstartandend

dateoftheevaluation.

§ Conductanintakehistorytosupporttypesofassessmentandjustificationtocompletetheassessment

§ Reviewandcompleteathoroughreviewoftheassessmentsandscoringpatterns.

Preparation

§ Studentsneedtobepreparedpriortoevaluation:

§ MeetwithprimarySLPforpreparationfortheevaluationprocess

§ Bepreparedwithanyrequiredmaterialsfortheassessment

§ Theassignedstudentwillcompletetheassessmentwillintroducethemselvestotheclientandcaregiverspresent.

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Specificdirectionsforconductinganevaluation:

§ Anassignedstudentwillconductaninterviewtoobtaininformationforacompletehistoryandanyspecificconcernsrelatingtospeechandlanguageissues.

§ Completetheformalassessmentsandclinicalobservationsasindicated

§ Completeanoralmotorexam.

§ Conductapure-tonehearingscreening.

§ Finalexitinterviewwiththeclientandcaregiversthestatusoftheprogressofthe

evaluationandinformalresultscanbediscussedwiththesupervisorpresent.Thefollowingprocedurestocompleteaftertheevaluation:

§ Allassessments,materials,andequipmentshouldbereturnedtotheclinicandsignedbackin.

§ ReviewtheresultsandcompileadraftreportusingtheEvaluationReportOutline.

§ Acompleteddraftoftheevaluationmustbesubmitted5daysaftertheevaluationis

completed.

§ TheprimarySLPwillreviewandreturntothediagnosticgroup.Apresentationofthewrittenreportandreviewoftherecordedevaluationwillbediscussedattheteammeeting.

§ Afinalreportwithcorrectionsmustbesubmittedwithin1weekwithcorrections.

§ Theformalreportandtestingformsmustbefiledintheclient’sfolder.

§ Completeclinicalpracticumhourforms.

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:AdditionalConsiderationsFamilyMeetingsStudentcliniciansshouldbeupdatingclientfamiliesonaconsistentbasis.Withthatbeing,discusstheseupdateswithinthe60-minutescheduledtherapysession.TheseupdatesmustbedocumentedonSOAPnotes.Foranyrecommendationsviaprogressreportsand/ordiagnosticreportafamilymeetingMUSTtakeplacewiththeprimarySLPpresent.Professionallyprogresstodatemustbesummarizedtogivethefamiliesanopportunitytounderstandstatustodateandanyrelevantinformationpertainingtotherapy.

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:AdditionalConsiderationsEvidence-BasedPracticeEBPPreparedbyDorothyLeoneforIonaCollegeSpeech,Language&HearingClinicHandbookSummer2012

Evidence-BasedPractice(EBP)inSpeechLanguagePathology(SLP)WhatisEBP?“The conscientious, explicit, and judicious integration of 1) best available external evidence from systematicresearch,2)bestavailableevidenceinternaltoclinicalpractice,and3)bestavailableevidenceconcerningthepreferencesofafullyinformedpatient”(Dollaghan,2008).“ThegoalofEBPistheintegrationof:(a)clinicalexpertise/expertopinion,(b)externalscientificevidence,and(c)client/patient/caregiver perspectives to provide high-quality services reflecting the interests, values, needs, andchoicesoftheindividualsweserve”(ASHA,2012).

*Figurefromhttp://www.asha.org/Members/ebp/intro/

How/WhydidEBPstart?NoChildLeftBehind(NCLB)2002:mandatedthatchildrenhadtobeexposedto“scientifically-basedinstructionalstrategies”

ASHA: sessions began to appear at annual convention in 1999; technical report written in 2004 and positionstatementin2005

WhoneedstoknowaboutEBP?

Everyclinicianneedstothinkaboutall3categoriesofEBP,includingresearch,clinicalpractice,andthepatient,foreverysession.

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Speech,Language&HearingClinicEvidence-BasedPracticeEBPPreparedbyDorothyLeoneforIonaCollegeSpeech,Language&HearingClinicHandbookSummer2012

HowcanaclinicianuseEBPtoshapehisorhersession?Foreverysessionplanned,aclinicianmustthinkaboutallthree“corners”ofthetriangle:research,clinicalpractice,andtheclient.At IonaCollege’sSpeech,Language&HearingClinic,cliniciansareprovidedaspacetowritehisorher“rationale.”Therationalemustsupportwhytheclinicianmadecertainchoicesforthetherapyplanandshouldbenotedintheappropriatesection(seefollowingpage).

LongTermGoals__________________________________________________________________________________

Activity/Procedures/Materials__________________________________________________________________________________

ShortTermGoals__________________________________________________________________________________

Rationale/EBP__________________________________________________________________________________________________

WhatisanexampleofaRationale/EBPbox?Building lexicalassociations isanotedstrategy fordevelopingword retrieval skills inadultswhohaveexperienced a neural injury (Brookshire, 2003). Moreover, the client has previously stated that thisstrategyhelpsherrememberadesiredwordorterm.Therefore,continuingtodeveloptheseassociationswilllikelyimprovefluidityoftheclient’sgeneralconversationalskills.Brookshire,R.H. (2003). IntroductiontoNeurogenicCommunicationDisorders,6thedition. St.Louis,MO:Mosby.WhatshouldbewrittenintheRationale/EBPboxonaclinician’ssessionplan?Aclinician’srationaleshouldincludeajustificationforwhyaparticulartherapeuticstrategywaschosen.Therationaleshouldconsiderall3componentsofEBP.

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Let’stakealookateachsentenceintheaboveexample:Sentence#1:Thecurrentbestevidence,theresearch:“Buildinglexicalassociationsisanotedstrategyfordevelopingwordretrievalskillsinadultswhohaveexperiencedaneuralinjury(Brookshire,2003).”Sentence#2:Theclient/patientvalues:Moreover,theclienthaspreviouslystatedthatthisstrategyhelpsherrememberadesiredwordorterm.Sentence#3:Clinicalexpertise:Therefore,continuingtodeveloptheseassociationswill likely improvefluidityoftheclient’sgeneralconversationalskills.Sentence#4:Thecitation(note:mustbecitedwithinthetextandthenfullreferenceinAPAstyleattheendoftherationale):intext:(Brookshire,2003)andthenfollowingfullcitation:Brookshire,R.H.(2003).IntroductiontoNeurogenicCommunicationDisorders,6thedition.St.Louis,MO:Mosby.ReferencesAmericanSpeechLanguageHearingAssociation(ASHA).(2012).Retrievedfromhttp://www.asha.org/Members/ebp/intro/Dollaghan,C.A.(2008).TheHandbookforEvidence-basedPracticeinCommunicationDisorders.Baltimore,MD:PaulH.BrooksPublishingCo.

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:AdditionalConsiderationsInterventionforyourBilingualClientOriginalPreparationbyJenniferGeromettaforIonaCollegeSpeech,Language&HearingClinicHandbookSpring2012UpdatedPreparationbyDr.NancyVidal-FinnertyforIonaCollegeSpeech,Language&HearingClinicHandbookSpring2018

InterventionforYourBilingualClient

TipsforSuccessfulTreatmentwithaBilingualClientv Successful therapy forabilingual ispromotedbyapositive, confident,and relaxedattitudeandbynaturalisticlanguage-facilitatingcontexts.

v The focus for a bilingual child should be to learn language, not necessarily mainstream. Evidencesuggeststhatastrongbaseinthefirstlanguagepromoteslearningasecondlanguage.

v Monitoring phonological change across the two languages is important because it is possible thatintervention provided in one language will generalize to the other language given the interdependencebetweenthetwolanguages.

v Interventionmethodsforbilingualchildrenshouldmirrorthenaturalwaysinwhichbilingualspeakersuselanguage.

v Theclinicianshouldhaveapositiveattitudetowardthechild’snativelanguage.Theclinicianshouldnotdiscourageorbanthechildfromusingtheirnativelanguage.

v Speechtherapyisveryeffectivewhenincludingthechild’sprimarylanguageasmuchaspossible.Ifamonolingualclinicianfeelscomfortable,theymayintegratesomewordsduringtheirsession.

v Amonolingualtherapistshouldnotattempttotreatachildinalanguagethetherapistisnotfluentin.Ifthetherapistwantstolearnafewwordsinthelanguagetogaintrust,demonstratecodeswitching,thatisfine,buttheycannotattempttotreatinthatlanguage.

v Somewaysamonolingualcliniciancanintegratesomeofthewordsintheirsessionthatachildmayuseathomeisbyaskingthechild,parent,orrelativetotranslateafewwords.

v It is important to remember thatone language couldhavemanydifferentdialects. FOREXAMPLEConsonantdeletionmayoccurinacertaindialectandthatdoesnotmeanthatitisaspeecherrorthatneedstobetreated.

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v Itisveryimportanttoinvolvetheparentsinthetherapyinorderforittobesuccessful.

v Parents should encourage their child by reading to them at home, and use language-facilitatingactivities.

TreatingaBilingualClientasaMonolingualClinician:v Mostcertifiedprofessionalsdonotbelievethattheypossesstheknowledgeandskillbasetoworkwithculturallyandlinguisticallydiverseclients,buttheyneedtobeconfidentthatitispossible.v When speaking with an individual who is not a near-fluent English speaker, one might need tocollaboratewithotherprofessionalswhospeaktheindividual'sfirstlanguage.v Interpretersmaybetrainedtoadministertheactivitiesandtranscribethestudent'sresponses.v Therapyshouldonlybeconductedinthelanguagetheclinicianisfluentin.Theclinicianiscapableisimplementingsomewordsintheclient’sL1,butthatistogaintrustortodemonstratecodeswitching.

WHEN WORKING WITH ALL CHILDREN (BILINGUAL AND MONOLINGUAL) WITHPHONOLOGICAL DISORDERS, SLPS NEED TO DETERMINE HOW THEIR GOALSWILL BEIMPLEMENTED.THEREARE3DIFFERENTAPPROACHESIFCLINCIANISBILINGUAL1. VerticalApproach:whenonegoalistaughtatatimeuntilcriterionismet.Maybeusedtofocusonagoalthatisspecifictoonelanguage.

2. HorizontalApproach:IftheClinicianisBilingualinthebothoftheclient’slanguages,morethanonegoalisfocusedonineachsession.MaybeusedtotargetonegoalinLanguage1andonegoalinLanguage2.Iftheclinicianismonolingual,therapyshouldonlybeconductedinthelanguagetheyarefluentin.

3. CyclicalApproach:Anumberofgoalsarebeingaddressed inacyclical fashionbutonlyonegoal isincorporated at a time within a session. This approach would be used to not only rotate targets but alsolanguagesifpossible.

FunFacts:

v Children who are bilingual form a better depth of knowledge understanding word relationships than

monolingualchildren.

v Forexample:theideathatthewordcarandbusarebothconsideredvehicles.

v Bilinguals may encounter an easier time separating both relevant and irrelevant verbal and nonverbalinformationthenmonolinguals.

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v Theaverageageofdementiaonsetmayoccurlaterinbilingualindividuals.

v Bilingualchildrendisplaybetterperformanceindivergentthinkingaswellasinothermeta-cognitiveskillssuchastheprocessingofnewinformation.

v Bilingualshaveincreasedgraymatterdensityneurologicallyinlefthemisphereareasthanmonolinguals.

v Accordingtothe1990census,oneofeverysevenchildrenofschoolageintheU.S.spokealanguageotherthanEnglishathome.Thereisanestimated5.2millionbilingualchildrenthatareenrolledinschoolsintheUS,whichhasbeena61%increasesince1994.Thisincreasingnumberofbilingualchildrenhasresultedinchallengestoprovideassessmentandinterventiontobilingualchildren,especiallywithphonologicaldisorders.

v

Table1-Therapist-IdentifiedSuccessfulPractices

FocusArea Example(s)Given

Client Useofculturallyappropriatetoysormaterials.

Goalsadjustedaccordingtoclientneedssuchaslevelsofdesiredindependenceorimprovedfunctionalcommunicationacross

settings.Targetnon-specificgoalsnotrelatedtolanguagetoassistbuilding

arapport.Forexample,maketheclientfeelcomfortabledemonstratingplayskills.

Exploreclientgoalsregardingacculturationandbilingualism.

Client’sCommunicationCommunity

BecomefamiliarwiththeClient’sbackground,byinvitingtheparentstoobservethesessioninordertocarryoversomeofthe

goalsathomeinL1.Networkingwitheducationalprofessionals.

Culture Useofculturallyappropriatetoysandmaterials.

Individualizetherapytoensurethatculturalandlinguisticdifferencesareacknowledgedandhonored.

Reviewtreatmentplanwithculturalinformantwhoistheparentandensuringapprovaloftheplanbeforeimplementation.

Increasingcommunication,explanations,andbuildrapportwithclients.

Clinician Fortreatmentplanning,usingobservationacrossasmanycontextsaspossible,interviewswithmonoandbilingualteachersandstaff.

Fortreatmentplanning,familyandcommunityreport.Performdynamicandplay-basedassessments,gatherandanalyze

languagesamples.Source:TreatmentofCulturallyandLinguisticallyDiverseClients:WhatAreWeDoingThatWorks?BySusanForinger-Burk and Georgia Hambrecht

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ContactFirstStepsisanOrganizationcreatedfortreatingBilingualChildren.YoumaycontacttheFounderoftheorganizationforanyquestionsinregardstotreatingabilingualclient.

AsktoSpeakwithEvelynSeda:OfficeNumber:(914)663-7070

Resources“Locutour Multimedia Cognitive Rehabilitation.” Fonología En Español: Tratamiento SpanishPhonology:Intervention.LOCUTOUR™COGNITIVEREHABILITATIONMULTIMEDIA.Kohnert,Kathryn,MarnaScarry-Larkin,andElizabethPrice."TheASHALeader."AssessmentandInterventionforBilingualChildrenwithPhonologicalDisorders.Web.27Apr.2012.<http://www.asha.org/Publications/leader/2007/070213/f070213a/>.“TheASHALeader”Bilingualism:Consequences forLanguage,Cognition,Development,and theBrain: “What Clinicians Should Know” By: Viorica Marian, Yasmeen Faroqi-Shah, MargaritaKaushanskaya,HenrikeK.Blumenfeld,&LiSheng.“TheASHALeader”TreatmentofCulturallyandLinguisticallyDiverseClients:WhatAreWeDoingThatWorks?Foringer-Burk,S.,Hambrecht,G.,Thordardottir,E.(2006,August15).LanguageInterventionfromaBilingualMindset.TheASHALeader

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PolishTranslationbyAnnaWyludaforIonaCollegeSpeech,Language&HearingClinicHandbookSpring2018

InterwencjadlaTwojegoklientadwujęzycznego

Wskazówkidotycząceskutecznegoleczeniazapomocąklientadwujęzycznego•Udanaterapiadladwujęzycznegojestpromowanaprzezpozytywne,pewnesiebieispokojnepodejścieorazprzeznaturalistycznekontekstyułatwiającejęzyk.•Celemdwujęzycznegodzieckapowinnobyćuczeniesięjęzyka,niekonieczniegłównegonurtu.Dowodysugerują,żesilnabazawpierwszymjęzykusprzyjanaucedrugiegojęzyka.•Monitorowaniezmianfonologicznychwobujęzykachjestważne,ponieważmożliwejest,żeinterwencjawjednymjęzykuzostanieuogólnionanainnyjęzyk,biorącpoduwagęwspółzależnośćmiędzydwomajęzykami.•Metodyinterwencjidladziecidwujęzycznychpowinnyodzwierciedlaćnaturalnesposobyposługiwaniasięjęzykiemprzezosobyposługującesięjęzykiemdwujęzycznym.•Lekarzpowinienmiećpozytywnenastawieniedoojczystegojęzykadziecka.Lekarzniepowinienzniechęcaćdzieckadokorzystaniazojczystegojęzyka.•Terapiamowyjestbardzoskuteczna,gdywmożliwienajwiększymstopniuwłączasięjęzykpodstawowydziecka.Jeślijednojęzycznyklinicystaczujesiękomfortowo,możewłączyćpewnesłowapodczassesji.•Terapeutajednojęzycznyniepowinienpróbowaćleczyćdzieckawjęzyku,wktórymterapeutaniejestbiegły.Jeśliterapeutachcenauczyćsiękilkusłówwjęzyku,abyzdobyćzaufanie,wykazaćzmianękodu,tojestwporządku,aleniemożepróbowaćtraktowaćwtymjęzyku.•Niektóresposoby,wjakiejednojęzycznyklinicystamożezintegrowaćniektóresłowazichsesji,któredzieckomożeużywaćwdomu,topoprosićdziecko,rodzicalubkrewnegooprzetłumaczeniekilkusłów.•Ważnejest,abypamiętać,żejedenjęzykmożemiećwieleróżnychdialektów.NAPRZYKŁADUsuwaniesklejekmożewystępowaćwpewnymdialekcieinieoznaczato,żejesttobłądmowy,którynależyleczyć.•Bardzoważnejestzaangażowanierodzicówwterapię,abyodnieśćsukces.•Rodzicepowinnizachęcaćswojedziecko,czytającjewdomuiwykorzystującćwiczeniajęzykowe.

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Traktowanieklientadwujęzycznegojakolekarzajednojęzycznego:•Większośćcertyfikowanychspecjalistówniewierzy,żeposiadająwiedzęiumiejętnościpotrzebnedopracyzklientamizróżnicowanymikulturowoijęzykowo,alemusząmiećpewność,żejesttomożliwe.•Podczasrozmowyzosobą,któraniejestpłynniemówcąpoangielsku,koniecznemożebyćnawiązaniewspółpracyzinnymispecjalistamiposługującymisiępierwszymjęzykiemosoby.•Tłumaczeustnimogąbyćprzeszkoleniwzakresiezarządzaniadziałaniamiiprzepisywaniaodpowiedziuczniów.•Terapiapowinnabyćprowadzonawyłączniewjęzyku,wktórymlekarzjestbiegły.KlinicystajestwstaniewprowadzićpewnesłowawL1klienta,alejesttozdobyciezaufanialubzademonstrowaniezmianykodu.PODCZASPRACYZEWSZYSTKIMIDZIECIMI(DWUSTRONNYMIIMONOLINGUALNYMI)ZZABURZENIAMIFONOLOGICZNYMI,SLPSPOTRZEBUJEOKREŚLIĆ,JAKICHCELEZOSTANĄWDROŻONE.TAMSĄ3RÓŻNEPODEJŚCIA,JEŚLICLINCIANJESTDWUDNIOWY1.Podejściepionowe:kiedyjedenceljestnauczanynaraz,dopókiniezostaniespełnionekryterium.Możebyćużywanydoskupieniasięnacelu,któryjestspecyficznydlajednegojęzyka.2.Podejściehoryzontalne:Jeślilekarzjestdwujęzycznywobujęzykachklienta,wkażdejsesjikoncentrujesięwięcejniżjedencel.Możebyćstosowanydoosiągnięciajednegoceluwjęzyku1ijednegoceluwjęzyku2.Jeśliklinicystajestjednojęzyczny,terapiapowinnabyćprowadzonawyłączniewjęzyku,wktórymbieglewłada.3.Podejściecykliczne:Wielecelówjestrozwiązywanychcyklicznie,aletylkojedenceljestwłączonywczasiesesji.Takiepodejściebyłobyużywanedonietylkorotacjicelów,aletakżejęzyków,jeślitomożliwe.Fakty:

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•Dziecidwujęzycznetworząlepszągłębięwiedzy,rozumiejącrelacjesłowoniżjednojęzycznedzieci.•Naprzykład:pomysł,żesłowosamochódiautobussąuważanezapojazdy.•Dwujęzycznemogąnapotkaćłatwiejszyczasoddzielającyzarównoistotne,jakinieistotneinformacjewerbalneiniewerbalne,anastępniejednojęzyczne.•Średniwiekwystąpieniademencjimożewystąpićpóźniejuosóbdwujęzycznych.•Dziecidwujęzycznewykazująlepszewynikiwrozbieżnymmyśleniu,jakrównieżwinnychumiejętnościachmeta-kognitywnych,takichjakprzetwarzanienowychinformacji.•Osobydwujęzycznemająneurologiczniezwiększonągęstośćistotyszarejwobszarachlewejpółkulimózguniżosobyjednojęzyczne.•Wedługspisuz1990r.JednonasiedemdzieciwwiekuszkolnymwUSAmówiłowjęzykuinnymniżangielski.Szacujesię,że5,2milionadwujęzycznychdziecijestzapisanychdoszkółwUSA,costanowiwzrosto61%od1994roku.Tarosnącaliczbadziecidwujęzycznychdoprowadziładowyzwańzwiązanychzocenąiinterwencjądziecidwujęzycznych,zwłaszczazzaburzeniamifonologicznymi..

Tabela1-Zidentyfikowaneprzezterapeutyudanepraktyki

Obsz Podane

Klient

Używanieodpowiednichkulturowozabaweklubmateriałów.

Celedostosowanedopotrzebklienta,takiejakpoziompożądanejniezależnościlubpoprawionafunkcjonalnakomunikacjamiędzy

ustawieniami.Kierujsięniespecyficznymicelaminiezwiązanymizjęzykiem,abypomócwbudowaniurelacji.Naprzykładspraw,abyklientczułsię

komfortowo,demonstrującumiejętnościgry.Poznajceleklientówdotycząceakulturacjiidwujęzyczności.

Społecznośćkomunikacyjnaklienta

Zapoznajsięześrodowiskiemklienta,zapraszającrodzicówdoobserwowaniasesji,abyprzenieśćniektórecelewdomuwL1.Nawiązywaniekontaktówzprofesjonalistamiedukacyjnymi.

Kultura Używaniekulturowoodpowiednichzabawekimateriałów.

Zindywidualizujterapię,abyupewnićsię,żeróżnicekulturoweijęzykowesąuznawaneihonorowane.

Zapoznajsięzplanemleczeniazinformatoremkulturalnym,któryjestrodzicemizapewnijzatwierdzenieplanuprzedjego

wdrożeniem.Zwiększeniekomunikacji,wyjaśnieńibudowaniarelacjizklientami.

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Klinicysta Planowanieleczenia,wykorzystanieobserwacjiwmożliwiejaknajwiększejliczbiekontekstów,wywiadyzmonoidwujęzycznymi

nauczycielamiipersonelem.Doplanowanialeczenia,raportrodzinnyispołeczności.

Wykonujocenydynamiczneiopartenazabawie,zbierajianalizujpróbkijęzykowe.

Źródło:TreatmentofCulturallyandLinguisticallyDiverseClients:WhatAreWeDoingThatWorks?BySusanForinger-Burk and Georgia Hambrecht

Kontakt

Organizacjastworzonadoleczeniadziecidwujęzycznych.MożeszskontaktowaćsięzZałożycielemorganizacjiwprzypadkujakichkolwiekpytańdotyczącychtraktowaniaklientadwujęzycznego.

PoprośorozmowęzEvelynSeda:Numerbiura:(914)663-7070Zasoby

“Locutour Multimedia Cognitive Rehabilitation.” Fonología En Español: Tratamiento SpanishPhonology:Intervention.LOCUTOUR™COGNITIVEREHABILITATIONMULTIMEDIA.Kohnert,Kathryn,MarnaScarry-Larkin,andElizabethPrice."TheASHALeader."AssessmentandInterventionforBilingualChildrenwithPhonologicalDisorders.Web.27Apr.2012.<http://www.asha.org/Publications/leader/2007/070213/f070213a/>.“TheASHALeader”Bilingualism:Consequences forLanguage,Cognition,Development,and theBrain: “What Clinicians Should Know” By: Viorica Marian, Yasmeen Faroqi-Shah, MargaritaKaushanskaya,HenrikeK.Blumenfeld,&LiSheng.“TheASHALeader”TreatmentofCulturallyandLinguisticallyDiverseClients:WhatAreWeDoingThatWorks?Foringer-Burk,S.,Hambrecht,G.,Thordardottir,E.(2006,August15).LanguageInterventionfromaBilingualMindset.TheASHALeader

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SpanishTranslationbyJhovanaFigueraforIonaCollegeSpeech,Language&HearingClinicHandbookSpring2018

Intervención para su cliente bilingüe

Consejos para un tratamiento exitoso con un cliente bilingüe v Terapia acertada para un niño bilingüe es promovida con una actitud positiva, confiada y relajada. Diferentes contextos pueden facilitar un lenguaje más natural.

v Lo más importante para un niño bilingüe debe ser aprender el idioma, no necesariamente el idioma convencional. La evidencia sugiere que una base fuerte en la primera lengua promueve el aprendizaje de una segunda lengua.

v Las dos lenguas deben ser monitoreadas porque cambio fonológico a través de los dos idiomas se pueden presentar, es posible que la intervención provista en una lengua sea generalizada a la otra lengua dada la interdependencia entre los dos idiomas.

v Métodos de intervención para niños bilingües deben reflejar las formas naturales en que hablantes bilingües utilizan el idioma.

v El logopeda debe tener una actitud positiva hacia la lengua materna del niño. El logopeda no debe desalentar o prohibir al niño usar su lengua materna.

v La terapia del lenguaje es muy eficaz cuando se incluye la lengua primaria del niño tanto como sea posible. Si un logopeda monolingüe se siente cómodo, él o ella podría integrar algunas palabras durante la sesión.

v El logopeda monolingüe no debe intentar tratar a un niño en un lenguaje que no es fluido para él. Si el logopeda quiere aprender algunas palabras en la lengua del cliente para ganar confianza y cambiar de una lengua a otra está muy bien, pero él no debe intentar tratar al niño en ese idioma.

v El logopeda monolingüe puede preguntar a los padres del niño que traduzcan algunas palabras. Estas palabras pueden ser integradas durante la sesión.

v Es importante recordar que una lengua puede tener muchos diversos dialectos. Por ejemplo, supresión de consonante puede ocurrir en un cierto dialecto y eso no significa que es un error de expresión que debe ser tratado.

vPara que la terapia sea un éxito, es muy importante incluir a los padres.

v En la casa los padres podrían leer libros a sus niños para estimular el habito por la lectura, facilitando diferentes actividades.

Tratar a un cliente bilingüe con un logopeda monolingüe: v Muchos profesionales certificados, no creen que ellos posean los conocimientos y habilidades necesarias para trabajar con clientes que poseen diferente cultura y lengua, pero ellos necesitan estar confiados que trabajar con estos niños es posible.

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v Cuando se hable con un cliente que no habla inglés, un profesional que hable la lengua de la persona, podría colaborar v Intérpretes pueden ser entrenados para administrar las actividades y transcribir las respuestas de los estudiantes.

v la Terapia debe realizarse sólo en el lenguaje que el logopeda maneja con fluidez. Podría ser que el logopeda sea capaz de implementar algunas palabras en L1 del cliente, pero eso lo podría utilizar para ganarse la confianza o demostrar código cambio con el cliente.

CUANDO SE TRABAJA CON TODOS LOS NIÑOS CON TRASTORNOS FONOLÓGICOS (BILINGÜES Y MONOLINGÜES), LOGOPEDAS NECESITAN DETERMINAR CÓMO SE APLICARÁN SUS METAS.

EXISTEN 3 ENFOQUES DIFERENTES SI EL LOGOPEDA ES BILINGÜE

1. Enfoque vertical: cuando se enseña una meta en un tiempo hasta que se cumple el criterio. Se puede utilizar para centrarse en un objetivo que es específico a una lengua.

2. Enfoque horizontal: Si el logopeda habla en los dos idiomas del cliente, más de un objetivo está

enfocado en cada sesión. Puede utilizarse para alcanzar una meta en lengua 1 y otra en la lengua 2. Si el logopeda es monolingüe, la terapia debe realizarse sólo en la lengua que es fluida para el logopeda.

3. Enfoque cíclico: varias metas se abordan de manera cíclica, pero sólo uno de los objetivos se incorpora a la vez dentro de una sesión. Este enfoque se utiliza para girar no sólo objetivos sino también idiomas si es posible.

Datos divertidos: v Los niños que son bilingües interiorizan más el conocimiento entendiendo la relaciones de las palabras más que los niños que hablan una sola lengua.

v Por ejemplo: la idea de que la palabra coche y autobús son considerados vehículos.

v niños Bilingües pueden encontrar que es más fácil separar la información relevante e irrelevante, verbal y no verbal más que niños monolingües.

v La edad promedio de inicio de la demencia puede ocurrir más tarde en individuos bilingües.

v Niños bilingües muestran mejor desempeño en el pensamiento divergente, así como otras habilidades metacognitivas tales como el procesamiento de nueva información.

v Personas Bilingües han aumentado la densidad de materia gris neurológicamente en áreas del hemisferio izquierdo más que los monolingües.

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v Según el censo de 1990, uno de cada siete niños en edad escolar en los Estados Unidos habla un idioma diferente al inglés en casa. Hay un estimado 5,2 millones de niños bilingües que están inscritos en las escuelas en los Estados Unidos, esta cifra ha aumentado un 61% desde 1994. Este creciente número de niños bilingües ha dado lugar a desafíos al proporcionar evaluación e intervención a niños bilingües, especialmente con trastornos fonológicos.

Tabla 1 - logopeda-identificar prácticas exitosas Enfoque Zona Ejemplos dados Cliente Uso de materiales o juguetes culturalmente apropiados.

Objetivos adaptados según las necesidades del cliente tales como los niveles de independencia deseada o la mejora de la

comunicación funcional a través de los ajustes.

Apunte metas no específicas no relacionadas con el lenguaje para ayudar a construir una relación. Por ejemplo, haga que

el cliente se sienta cómodo demostrando habilidades de juego..

Explorar objetivos del cliente con respecto a su cultura y a su bilingüismo.

Comunidad de la comunicación del cliente

Familiarizarse con los antecedentes del cliente, invitando a los padres para observar la sesión para llevar algunos de los

objetivos en el país en L1.

Trabajo en la red con profesionales de la educación. Cultura Uso de materiales y juguetes apropiados culturalmente.

Individualizar el tratamiento para asegurar que las diferencias culturales y lingüísticas sean reconocidas y

honradas.

Revise el plan de tratamiento con el informante cultural que es el padre y asegurese de opener la aprobación del plan

antes de la implementación.

Incrementar la comunicación, explicaciones y construir una buena relación con los clientes.

Fonoaudiólogo Para la planificación del tratamiento, es bueno utilizar la observación en diferentes contextos, tantos como sea posible, entrevistas con profesores mono y bilingües y

personal.

Para la planificación del tratamiento informe a la familia y a la comunidad.

Realizar evaluaciones dinámicas y basadas en análisis del lenguaje

Fuente: tratamiento de clientes cultural y lingüísticamente diversos: ¿Qué hacemos que funcione? Por Susan Foringer-Burk y Georgia Hambrecht

Contacto

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Primeros pasos es una organización creada para el tratamiento de niños bilingües. Para cualquier duda en lo que respecta al tratamiento de un cliente bilingüe puede comunicarse con el fundador de la organización.

Pedir hablar con Seda de Evelyn: número de oficina: (914) 663-7070

Recursos "Rehabilitación cognitiva Multimedia de Locutour." Fonologia En Español: fonología española Tratamiento: intervención. LO C UTO U R™ Rehabilitación cognitiva M U L T I M E D I a. Kohnert, Kathryn, Marna Scarry Larkin y el precio de Elizabeth. "El líder ASHA". Evaluación e intervención para niños bilingües con trastornos fonológicos. Web. 27 de abril de 2012. <http://www.asha.org/Publications/leader/2007/070213/f070213a/ >. " El líder de ASHA "Bilingualism: consecuencias para el lenguaje, cognición, desarrollo y el cerebro:"Lo que los médicos deben saber" por: Viorica Marian, Yasmeen Faroqi-Shah, Margarita Kaushanskaya, Henrike K. Blumenfeld y Sheng Li. "El líder ASHA" tratamiento de clientes cultural y lingüísticamente diversos: ¿Qué hacemos que funcione? Foringer-Burk, S., Hambrecht, G., Thordardottir, E. (2006, 15 de agosto). Lenguaje la intervención de una mentalidad bilingüe. El líder ASHA

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicClinicAssignments:AdditionalConsiderationsClinicPolicyGuidelines

§ Iftheclientislate,thestudentclinicianisrequiredtoinformthePrimarySLP.Callclientiftheyhavenotarrivedbythefirst15minutesofthesession.

§ ThePrimarySLPshouldbenotifiedifaclienthas3unexcusedabsences.§ Ifthestudentclinicianmustcancelasession,itistheresponsibilityofthestudentto

notifytheclientassoonaspossibleviatelephoneand/oremailthePrimarySLPandtheClinicDirectoratleast24hoursinadvance.

§ Itisexpectedthatthestudentclinicianispresentatleast15minutespriortothesessionstarttimetogreettheclient.Pleasebeginandendsessionsontimeduetospaceandschedulingconstraints.

§ StudentsdonothavepermissiontoleavetheSpeech,Language&HearingClinicwithaclientunlesswrittenparent/guardianandtheIonaCollegeSpeechLanguage&HearingClinicprovidespermissionwithaSLPpresent

§ Providetheclient/clientfamiliestheappropriateConsentPackageandtheCaseHistoryForm.

§ ThestudentclinicianmustreviewandsigntheConfidentialityAgreementForm.Otherwisestudentswillnotbetreatingclients.

§ AllchartingwillberandomlycheckedforHIPAApurposesandConfidentialityGuidelines.§ Undergraduatestudentsarerequiredtoobserveclinicsessionsiftheirclientcancels.Itis

recommendedtheCSDgraduatestudentcliniciansobserveaclinicsessioniftheirclientcancels.

§ ClientsareNOTtobeleftinthetherapyroombythemselves.Ifthestudentneedstoleaveforanyreason,theclientmustcomewiththeclinicalstudent.

§ StudentCliniciansarenotpermittedtoassistaclientwiththerestroom.Iftheclientisaminorinformthefamily.Iftheclientisanadultinformthecaregiver.

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Tosupportclinicalknowledgeandskilldevelopmentstudentclinicianshavetheopportunitytohave

§ MeetingswithyourprimarySLP§ CompleteMidtermReviewwithyouprimarySLP§ CompleteVideoReviewsandanalyzeclinicalskills§ InformtheprimarySLPiffamiliesarerequestinganyreportstobemailedout/copied.

Authorizedpersonnel(primarySLP,ClinicDirectorandAdminAsst)mustauthorizetoconsiderreleaseofreports.

OfficeHourMeetingsStudentswillbeexpectedtoparticipateinmeetingswiththeirprimarySLPThegoalofthesemeetingsforthestudentclinicianistodemonstratetheirclinicalideas,askquestionsandshowcasetheirknowledgeandskillstodate.AsharedcommunicationbetweentheSLPandstudentclinicianwillsupportthestudentprogressforclinicaldevelopment.Studentswillbeexpectedtoaskquestions,shareexperiences,anddevelopclinicalskills.Thisdevelopsones'clinicalknowledgeandthisfurtherdemonstratesone'sknowledgethroughoralcommunication.TheOfficeHourMeetingswillfurtherprovideanopportunityfortheclinicalstudentstodemonstratetheirabilitytointegrateacademicsintoclinic,shareanddeveloptheirclinicalknowledgeandskills,followingclinicalprocedures,ConfidentialityGuidelines;andSafetyProcedures.Thus,furtherdemonstratingone’slearningskills,anddevelopingproblemsolvingandclinicalskills.OfficeHourMeetingsincludebutarenotlimitedtolectures,reviewofwrittendocumentation,ANDDEVELOPMENToflessonplans,videoreviews,andtherapyideas.OfficeHourmeetingsareatimeforopendiscussions.Pleaseaskquestions.ProfessionalConductduringOfficeHourMeetingsStudentsareexpectednottotextduringOfficeHourMeetings.YouwillbeASKEDTOleave.Useoflaptopswillneedadvancedpermission.

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAppendixGProfessionalWriting

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalWriting

AmericanSpeech-Language-HearingAssociation.(2016).Codeofethics[Ethics].Availablefromwww.asha.org/policy/.

PrincipleofEthicsIIndividualsshallhonortheirresponsibilitytoholdparamountthewelfareofthepersonstheyserveprofessionallyorparticipantsinresearchandscholarlyactivitiesandshalltreatanimalsinvolvedinresearchinahumanemanner.RulesofEthicsOIndividualsshallprotecttheconfidentialityandsecurityofrecordsofprofessionalservicesprovided,researchandscholarlyactivitiesconducted,andproductsdispensed.Accesstotheserecordsshallbeallowedonlywhendoingsoisnecessarytoprotectthewelfareofthepersonorofthecommunity,islegallyauthorized,orisotherwiserequiredbylaw.Professionalwritingskillsfortheclinicalstudentisadevelopmentalprocess.Inordertodevelopwritingskills,theclinicalstudentmustparticipateintheprocess.Studentscanbuildtheirwritingrepertoirebyusingtheirtextasareference,reviewclientfiles,andrefertotheirtextbooks.ExpectationsforProfessionalWritingSkillsincludeOrganizedThoughts;GrammaticallyCorrectSentences;NoSpellingErrors;NeatandClean;DevelopingprofessionalterminologySLP’sassignedtotheclientcasewillberesponsibleforreviewingwrittendocumentationandprovidingsupportforwrittendevelopmentexpectations.StudentsarerequiredtomeetwithaSLPifare-writeisrequired.

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalWriting:GoalWritingHelpfulHintsLongTermGoals:

§ TheLongTermGoalrepresentswhatyouwanttoachievefortheclientandtheskillstobeaccomplishedforthedurationoftreatment.

§ TheLongTermGoalrepresents

o Whatyouwanttoimproveo ThepurposeofwhyyouwanttoimprovethespecificS/LDelay;Impairment;

Deficit(SpecificS/LDelay;Impairment;Deficito Wheretheseskillswillbeshowcased

Whatisthespeechandlanguageissue+whyyouwanttoachieveit+wherewillclientusetheirskillsExample:

§ Toimproveexpressivelanguageskillsforfunctionalcommunicationinandoutsideofclinic

§ Toimprovearticulationskillsforfunctionalintelligibilityinandoutsideofclinic§ Toincreasesafetyandefficiencyofswallowingtomaintainadequatehydrationand

nutritionalneedsShortTermGoals/ObjectivesThesegoalsarethestepstohelpachievetheLongTermGoal.Inordertomeasureprogress,shorttermgoalsshouldbemeasurable.

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TheGoal-OutlineQuestion(AccordingtoLannyButler,MS,OTR)Who+willdo+what+underwhatcircumstances+towhatcriteria+howoften?Who? TheclientWillDo? Will(produce,identify,complete)What? Theactionexpectedbyclient(atphraselevel,/k/in

initialpositionofwords)UnderWhatCircumstances? TasktobeperformedToWhatCriteria? Howwellthetaskwillbeperformed(80%ofthe

time,4outof5trials)HowOften? Within/consecutive4sessionsTheclient(who)willread(willdo)sentencelevelmaterial(what)atanindependentlevel(circumstance)80%ofthetime(criteria)within4sessions(howoften)

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DepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicProfessionalWriting:DailyProgressNote SOAPNOTESS:SubjectiveInitialobservationpertainingtotheclientwhichincludesbutnotlimitedtoclientbehavior,motivation,anycomplaints,mentalstatus,impressionoftheclients’behaviorO:ObjectiveDataobtainedduringeachsessionperthetaskpresentedwithinthesession.Theresponsesofthetreatmentgoals.A:AssessmentProfessionaljudgmentofthesession;includetheclient’sresponse,effectivenessand/orchallengesofthetreatmentprovided.Whatwasdoneclinically?Mayalsoincludepreviousprogresstocomparesessionstoaddressclients’needs,training,teammeetings,andconferences.Includethecommunicationdiagnosis.P:PlanPlanoftreatmentfornextsession.Recommendationsforfurtherconsultationsand/orchangesingoalplanning.Examples:S:Theclienteasilytransitionedintothesession.Hewasalertandparticipatedinallactivitiespresented.Theclientreportsfollowthroughwiththehomeprogram.O:Theclientrespondedtosimpleyes/noquestionswith60%accuracy;followed1stepand2steprelateddirectionswith75%accuracy;andrespondedtosentencecompletiontasks80%accuracywithmoderatephonemiccueing.A:Theclienthasmaderelativeprogresstodateintheareasofauditorycomprehensionandverbalexpression.Hecontinuestopresentwithnon-fluentaphasiacharacterizedbyapraxiaandwordretrievaldifficulties.ImprovementnotedviaadaptingMITtreatment.P:Toimproveauditoryandverbalexpressionskillsforimprovedfunctionalcommunicationskills.

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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAppendixHGradingPolicy

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Speech,Language&HearingClinicGradingPolicy ClinicalPracticumisasupervisedprogramthatsupportsspeech-languagepathologystudentstoworkwithindividualsthatarediagnosedwithacommunicationand/orswallowingdisorderordelays.Thepurposeofateachingclinicistosupportthestudent’sintegrationofacademics,clinic,andresearchinatherapytobeginthepracticalapproachforclinicalservices.Studentswilldevelopandintegrateknowledgeandskills,demonstrateASHACodeofEthicsanddeveloptheirclinicalapproachaspartoftheirfutureprofession.GradinginClinicalPracticumisbasedoncompetencylevelofindependenceofknowledgeandskillsofcommunicationdisordersanddelays.Thegoalis“Independentandeffectiveclinicalknowledge,skills,andperformance”.Thislevelofindependenceissupportedbyaseriesofclinicalpracticumexperiences.Theinitialphaseinclinicalpracticumforsomestudentcliniciansmayincludefeelingsofbeingoverwhelmed,anxious,nervous,andthoughtsof“notknowingwhattodo”,“Idon’tknowwhattodo”,“Tellmewhattodo”.Thesefeelingsarevalid,normalandexpected.Theclinicalsupervisor’sresponsibilityistoprepare,guideanddevelopclinicalskillswiththestudentclinicianwhohascompletedspecificcoursework.Duringastudent’sclinicalprogression,itisexpectedthatthestudentstakeresponsibilityoftheirclinicalexperience.Responsibilityincludesinitiatingquestionsfordevelopmentandknowledge,aconsistenteffortintheplanningprocess,carryingoversuggestionsbysupervisors,preparingmaterials,completingalldocumentation,andadheringtoprofessionalstandards.Constructivecriticismispartoftheprocessofclinicalpracticum.Thepurposeoffeedbackisconstructiveandnotpersonal.Thisisanopportunityforstudentclinicianstodeveloptheirskillsandlearntoself-evaluatetheirownclinicalskills.Studentcliniciansthatarenotopentofeedbackorimplementthefeedback,maylimittheirclinicalgrowthandindependence.Studentcliniciansaregiventheopportunitytodeveloptheirskillsandprovidetheclinicalsupervisortheevidenceoftheirparticipation,knowledge,growth,andskillsinpracticum.Studentcliniciansalsoneedtotakeresponsibilityfortheclinicaldevelopmentandparticipatewithandinclinicalinstruction.Independencedoesnotmeancompletinganddevelopingplanofcareonyourown.Independenceintheteachingclinicsettinginvolvesdiscussionswithyour

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SLP,sharingmaterials,EBP,probingquestionsfordevelopmentknowledgeandskills,andconsistentlyevaluatingyourselfasaclinicianThetherapyprocesswithaclientiscontinuous,developing,andproblemsolving.Inasmuch,thestudentclinicalprocessinpracticumiscontinuous,developing,andproblemsolving.Clinicalgradingisevaluatedonratingstoincludeskillsofstrength,areasofneededimprovement,progress,emergingskillsandskillsnotevident. PracticumGradingisevaluatedusingaratingscaletoassessmultipleclinicalareas.MidtermReviews:Studentswillbeexpectedtoevaluatetheirclinicalskillsindependentlyandproviderationalesfortheirskilllevelforeachskillbeingevaluated.TheevaluationcompletedbytheStudentisNOTtheMidtermGrade.Theevaluationistheinitialprocessofevaluationone’sclinicalskills.Theprimaryclinicalsupervisorwillreviewtheevaluationandre-evaluateeachclinicalskill.Studentswillparticipateinamidtermreviewtodiscussclinicalskills,areasofstrength,areasofneededimprovement,progress,emergingskills,andskillsnotevident.Final:Theprimaryclinicalsupervisorwillcompletethepracticumassessmentforthefinalclinicalpracticumgrade.(Seeinstructor/syllabitodetermineweightofgradingforspecificcourse)InaccordancewiththeCouncilforClinicalCertificationinAudiologyandSpeech-LanguagePathology’s(CFCC)2014standardsandtheCAA’s2017standardsprofessionalcompetenciesforclinicaldevelopmentissupportedbyformativeandsummativepracticesalongwiththeAnderson’sContinuumSupervisionModelisintegratedinordertoevaluatetheknowledgeandskilldevelopmentduringone’spracticumexperience.2017CAAofASHAstandards:

§ Standard3.1.1BProfessionalpracticecompetencies:accountability,integrity,effectivecommunicationskills,clinicalreasoning,evidence-basedpractice,concernforindividualserved,culturalcompetence,professionalduty,collaborativepractice

§ Standard3.1.3BIdentificationandpreventionofSpeech,LanguageandSwallowingDisordersandDifferences:Principlesandmethodsofidentificationofcommunicationandswallowingdisordersanddifferences

§ Standards3.1.4BEvaluationofspeech,language,andswallowingdisordersanddifferences:Articulation,Fluency,Voiceandresonance,Receptiveandexpressivelanguage(phonology,morphology,syntax,semantics,pragmatics,prelinguisticcommunication,andparalinguisticcommunication)inspeaking,listening,reading,writing,andmanualmodalities,Hearing,Swallowing,Cognitiveaspectsofcommunication,Socialaspectsofcommunication,Augmentativeandalternativecommunicationneeds

§ Standards3.1.5BInterventiontominimizetheeffectsofchangesinthespeech,language,andswallowingmechanisms:Articulation,Fluency,Voiceandresonance,Receptiveandexpressivelanguage(phonology,morphology,syntax,semantics,pragmatics,prelinguisticcommunication,andparalinguisticcommunication)inspeaking,listening,reading,writing,andmanualmodalities,Hearing,Swallowing,

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Cognitiveaspectsofcommunication,Socialaspectsofcommunication,Augmentativeandalternativecommunicationneeds

§ Standards3.1.6B:GeneralKnowledgeandskillsapplicabletoprofessionalpractice:Ethicalconduct,integrationandapplicationofknowledgeoftheinterdependenceofspeech,language,andhearing;Engagementincontemporaryprofessionalissuesandadvocacy;Processesofclinicaleducationandsupervision;Professionalismandprofessionalbehaviorinkeepingwiththeexpectationsforaspeech-languagepathologist;Interactionskillsandpersonalqualities,includingcounselingandcollaboration;Self-evaluationofeffectivenessofpractice

(Seemoreat:https://caa.asha.org/wp-content/uploads/Accreditation-Standards-for-Graduate-Programs.pdf)

2014CFCCStandards:

§ StandardIV-C:Theapplicantmustdemonstrateknowledgeofcommunicationandswallowingdisordersanddifferences,includingtheappropriateetiologies,characteristics,anatomical/physiological,acoustic,psychological,developmental,andlinguisticandculturalcorrelatesinthefollowingareas:articulation,fluency,voiceandresonance,includingrespirationandphonation,receptiveandexpressivelanguage(phonology,morphology,syntax,semantics,pragmatics,prelinguisticcommunicationandparalinguisticcommunication)inspeaking,listening,reading,writing,hearing,includingtheimpactonspeechandlanguage,swallowing(oral,pharyngeal,esophageal,andrelatedfunctions,includingoralfunctionforfeeding,orofacialmyology),cognitiveaspectsofcommunication(attention,memory,sequencing,problem-solving,executivefunctioning),socialaspectsofcommunication(includingchallengingbehavior,ineffectivesocialskills,andlackofcommunicationopportunities),andaugmentativeandalternativecommunicationmodalities

§ StandardIV-D:ForeachoftheareasspecifiedinStandardIV-C,theapplicantmusthavedemonstratedcurrentknowledgeoftheprinciplesandmethodsofprevention,assessment,andinterventionforpeoplewithcommunicationandswallowingdisorders,includingconsiderationofanatomical/physiological,psychological,developmental,andlinguisticandculturalcorrelates.

§ StandardIV-E:Theapplicantmusthavedemonstratedknowledgeofstandardsofethicalconduct.§ StandardIV-F:Theapplicantmusthavedemonstratedknowledgeofprocessesusedinresearchandofthe

integrationofresearchprinciplesintoevidence-basedclinicalpractice.§ StandardIV-G:Theapplicantmusthavedemonstratedknowledgeofcontemporaryprofessionalissues.§ StandardIV-H:Theapplicantmusthavedemonstratedknowledgeofentrylevelandadvanced

certifications,licensure,andotherrelevantprofessionalcredentials,aswellaslocal,state,andnationalregulationsandpoliciesrelevanttoprofessionalpractice.-

§ StandardV-A:Theapplicantmusthavedemonstratedskillsinoralandwrittenorotherformsofcommunicationsufficientforentryintoprofessionalpractice.

§ StandardV-B:heapplicantforcertificationmusthavecompletedaprogramofstudythatincludedexperiencessufficientinbreadthanddepthtoachievethefollowingskillsoutcomes:(1.Evaluation2.Intervention3.InteractionandPersonalQualities)

§ StandardV-C:Theapplicantforcertificationinspeech-languagepathologymustcompleteaminimumof400clockhoursofsupervisedclinicalexperienceinthepracticeofspeech-languagepathology.Twenty-fivehoursmustbespentinclinicalobservation,and375hoursmustbespentindirectclient/patientcontact.

§ StandardV-D:Atleast325ofthe400clockhoursmustbecompletedwhiletheapplicantisengagedingraduatestudyinaprogramaccreditedinspeech-languagepathologybytheCouncilonAcademicAccreditationinAudiologyandSpeech-LanguagePathology.

§ StandardV-E:SupervisionmustbeprovidedbyindividualswhoholdtheCertificateofClinicalCompetenceintheappropriateprofession.Theamountofdirectsupervisionmustbecommensuratewiththestudent'sknowledge,skills,andexperience,mustnotbelessthan25%ofthestudent'stotalcontactwitheach

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client/patient,andmusttakeplaceperiodicallythroughoutthepracticum.Supervisionmustbesufficienttoensurethewelfareoftheclient/patient.

§ StandardV-F:Supervisedpracticummustincludeexperiencewithclient/patientpopulationsacrossthelifespanandfromculturally/linguisticallydiversebackgrounds.Practicummustincludeexperiencewithclient/patientpopulationswithvarioustypesandseveritiesofcommunicationand/orrelateddisorders,differences,anddisabilities.

Seemoreat:http://www.asha.org/Certification/2014-Speech-Language-Pathology-Certification-Standards/

CouncilforClinicalCertificationinAudiologyandSpeech-LanguagePathologyoftheAmericanSpeech-Language-HearingAssociation.(2013).2014StandardsfortheCertificateofClinicalCompetenceinSpeech-LanguagePathology

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Speech,Language&HearingClinicClinicalFocusPlanPolicyCFPDocumentUpdatedFall2018byJackieMcDonaghSpring2018byJessicaScaringella

CLINICALFOCUSPLANPOLICYANDPROCEDURE–INSTRUCTIONALAPPROACH

Purpose ToprovideadditionalsupporttoClinicalPracticumStudentCliniciansonan

individual or small group basis. There are two types of plans: (1) anInstructionalApproach isused to target improvementofKnowledgeandSkillsjudgedtobebelowexpectationsbythereferringClinicalSupervisor(s);and (2)aMentoringApproach isused tosupportStudentClinicianswithhigherlevelskillswhoseektodevelopmoreadvancedKnowledgeandSkills.ThisdocumentaddressestheInstructionalApproach.

Responsible ClinicDirectorParties: AssistantClinicDirector|OnSiteCoordinator ClinicalSupervisors Procedure: ThefollowingstepssummarizeproceduresfortheClinicalFocusPlan

(CFP)–InstructionalApproach:

(1) The Clinical Supervisor(s) identifies specific areas to betargeted for improvement and specifies a time frame (i.e.,improvement within four weeks), based on the followingcriteria:TheStudentClinicianisfunctioningataLevelOneorLevel Two on Knowledge and Skills identified in the gradingrubric,theStudentClinicianrequestsadditionalsupportwithself-expressed areas of difficulty, or substantial difficultyintegrating into/managing clinical expectations. the StudentCliniciandemonstratesadditionalsupportinadditiontoIftheStudent Clinician has more than one Clinical Supervisor, allsupervisorsconfertodiscussidentifiedneeds,eitherinpersonorviae-mail.

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(2) TheClinicalSupervisor(s)informstheStudentClinicianoftheareas needing improvement during a face-to-face meeting,andmaintainswrittendocumentationofthemeetingcontentand Student Clinician response (See Appendix E: Record ofMeetingsand Instruction).TheClinicalSupervisormakes therecommendationforaClinicalFocusPlan.

(3) TheClinicalSupervisornotifiestheAssistantClinicDirectorbye-mail that a referral is being made, and attaches thecompletedClinicalFocusPlanReferralformtothee-mail(SeeAppendix A). If there is more than one direct ClinicalSupervisor,theprimarysupervisorconferswithallotherdirectClinicalSupervisorsviae-mailpriortocompletingthereferralformtoseekinputregardingareasofKnowledgeandSkillthatfall below expectations. The names of all direct ClinicalSupervisorswillbelistedonthereferralform.

(4) TheAssistantClinicDirector|OnSiteCoordinatormeetswith

the student to develop specific goals for the Plan based onneeds determined by the direct Clinical Supervisors, to beachievedatthe80%levelofmastery(seeAppendixB:SampleGoals).

(5) ThewrittenCFPispreparedbytheAssistantClinicDirector|On Site Coordinator according to the format provided (seeAppendixC:CFP)andissignedbybothparties.

(6) The original written CFP is retained by the Assistant ClinicDirector|OnSiteCoordinator,andcopiesareprovidedtothestudent,ClinicalSupervisor(s),andClinicDirector.

(7) The Student Clinician is instructed to make copies of thewrittenCFPandtoplaceacopyofthesignedCFPinthechartofeachclient.

(8) TheAssistantClinicDirector|OnSiteCoordinatorschedulesand holds weekly meetings with the Student Clinician toprovide direct instruction in targeted areas to facilitateprogress towards Plan goals, and maintains writtendocumentation of the meetings, to be filed in the StudentClinician’s individualadvising file (SeeAppendixD:RecordofMeetingsandInstruction).

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(9) TheAssistantClinicDirector |On SiteCoordinator developswritten Action Step assignments to be completed by theStudentClinicianeachweek (seeAppendixE: SampleActionSteps),whichare recorded in the top sectionof the InterimActionReportform(seeAppendixF).

(10) After completing each assignment, the Student Cliniciancompletes awritten InterimActionReport (seeAppendix F),whichisdiscussedwiththeAssistantClinicDirector|OnSiteCoordinator during the weekly follow-up meeting. Afterreviewoftheassignment,thereportissignedbybothparties.

(11) TheStudentClinicianplacesacopyofthesignedInterimActionReportinhis/herstudentchart.

(12) TheClinicalSupervisor(s)informtheAssistantClinicDirector|On SiteCoordinator inwritingof any concerns that ariseorotherareasforstudentdevelopmentthatareidentifiedafterinitiationoftheCFP.

(13) The Assistant Clinic Director | On Site Coordinator provides

specificperiodicwrittenupdatestotheClinicalSupervisor(s)(e.g.,after4instructionalmeetingswiththeStudentClinician)and to the Clinic Director regarding the Student Clinician’sresponse to intervention and progress towards goals, andrequestsfeedbackfromtheClinicalSupervisor(s)onprogressdemonstratedtowardsgoals.

(14) Methodsofevaluationwillincludethefollowing:

(a) Direct Supervisor assessment of student performance in

targetedgoalareas,bydirectobservationduringmeetingsandtreatmentsessions;and(b) DirectSupervisorandAssistantClinicDirector|OnSiteCoordinatorassessmentofwrittenwork(e.g.,clinicaldocumentation,writtenassignments,lessonplans,etc.).

Assessmentofprogressmayinclude,butisnotlimitedto,thefollowing:studentperformanceonActionStepassignments;student preparation for meetings with the Supervisors, asevidenced by active, collaborative participation; studentdevelopment and implementation of long- and short-termgoalsandlessonplansthataresupportedbyappropriateEBP

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sources;andstudentintegrationofacademicknowledgeandEBPintotreatmentplanningandimplementation.

The Assistant Clinic Director | On Site Coordinator and thedirectClinicalSupervisor(s)willcollaboratetodeterminethefollowing:(a) MeasurablestudentprogresstowardsCFPgoalsandlevel

ofmasteryachievedforeachgoal;

(b) Whethergoalshavebeenmet;

(c) Whethertherearegoalsthatrequiremoretimetoachievemastery;

(d) Whether there are additional concerns or areas for

identifiedasneedingdevelopment;and

(e) DispositionofthePlan:

1- ExtensionofthePlanisrecommendedtoallowmoretime for mastery of goals or to address recently-identifiedareasneedingdevelopment,or

2- DischargeofthePlanisrecommended,withgoalsmet.

(15) TheAssistantClinicDirector|OnSiteCoordinatorpreparesasummaryreport(seeAppendixG)upondischargeoftheCFP(i.e.,whengoalsaremet,orattheconclusionofthesemester).Copies of the summary are provided to the direct ClinicalSupervisor(s)andtotheClinic.Goalsaredeemedmetwhen80%masteryisachieved.

ListofAppendices:AppendixA–CFPReferralAppendixB–CFPGoalsAppendixC–ClinicalFocusPlanAppendixD–MeetingLogAppendixE–ActionSteps(Assignments)AppendixF–ActionReportAppendixG–SemesterCFPSummar

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AppendixA–ClinicalFocusPlanReferral–InstructionalApproach

Student: ClinicalSupervisor(s): ReferralCompletedBy: ReferralDate:

ReasonsforReferralUsingthecategoriesbelow(takenfromthegradingspreadsheet),pleaseindicatebycheckmark

allareasinneedofadditionalsupporttofacilitatedevelopmentofknowledgeandskills.A“BelowExpectations”designationisequivalenttoaLevelOneorLevelTwoonthegradingrubric.Intervention/ClinicalSkills BelowExpectationsCompletesathoroughreviewofclient’sfile(formalrecords,casehistory,progressreports)–ReturningClient

MeetswithSLPtopreparefornewclientprogram–NewClient Contactsfamiliestointroducethemselvesasthestudentclinician,confirmsschedule,&gathersfurtherinformationtosupportinitialplanofcare

Developmentofbaselinescreeningappropriateforage,genderandcognitiveskills

Resultsofbaselinedatademonstratespresentknowledgeofcommunicationdelay,disorderorimpairment

Therapydevelopmentisappropriateforcommunicationdisorderand/ordelay

Planofcare(LessonPlan)includesEBP Planofcare(LessonPlan)includesgoalsfromfamily,clientand/orguardian

Priortosessionstart–ispreparedwithmaterialsandgreetsclient Materialsareappropriatefortargets,clientlevelandinterests Adaptsand/ordevelopsnovelinstructionalmaterialsasneeded Sessionstarts&endsontime Providesvisualand/orverbalsupportforsessionorganizationandexpectations

Providesclientwithpurposeofeachactivity(aswellastransitionofactivities)toincludeclientinthedevelopmentofplanofcare

Providesverbalandnon-verbalreinforcementsforfeedbacktoimproveclientsuccessforcommunicationneeds

Providesmanagementandgeneralizationstrategiestoimproveclientsuccessforcommunicationneeds

Recognizesandmanagesclient’sbehaviorforoptimalsessionsuccess Includesmaximumopportunitiesforclienttomeetalltargetspresented

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Studentclinicianaddresseseachgoalthatwasdocumentedforthesession

Thecommunicationdisorder,delayorimpairmentisthefocusoftheplanofcare

Appropriatedatacollectioniscompletedformeasuringperformanceandprogress

Formatpresentedisengagingfortheclient Physicalenvironmentisappropriateforclientneeds Studentclinicianself-evaluatesprofessionalismduringsessionwithanuprightposture,providesdirectionsandisalert

Effectivecommunicationwiththeclient/familytodiscussspeechlanguageprogresstodate,goals,needs

Followsthroughwiththespeechlanguagepathologisttoimproveknowledgeofskills,problemsolveclientneeds,anddevelopclinicalskills

InterpersonalQualities BelowExpectationsMeetingswithspeechlanguagepathologist:studentdemonstratescommitmentforseekingsupportandclarification

Meetingswithspeechlanguagepathologist:studentcomespreparedwithquestionsand/oragenda

Meetingswithspeechlanguagepathologist:studentcommitstomeetingswithsupervisors

Meetingswithspeechlanguagepathologist:communicateseffectivelywithSLPfordevelopmentofprofessionalknowledge

Relatescomfortablywithclientandmaintainsconfidentimage Appropriatebehaviorisestablishedandmaintained Respondsappropriatelytopsychologicalandphysicalneeds Modifiesinteractionalstyletoenhancestudentclinicianeffectiveness Demonstratesanunderstandingandincorporatesclient’sculturalbackgroundandsocio-economicstatus

Oralcommunicationskillsareeffectivewiththeclient/clientfamilyincludinginterpretationofclinicalterminologyandprovidingupdatedinformationabouttheclient’stherapyprogram

Takesinitiativetodevelopclinicalknowledgeandskillsfortherapeuticpractices

Managesclinicaldemandswitheaseandflexibility Collaborateswithotherprofessionalsincasemanagement Demonstratesemotionalmaturityandahealthyindependenceintheclinicsetting

Professionalism BelowExpectations

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Maintainsaprofessionalappearanceandfollowsthedresscode(refertohandbookforguidelines)

DiscussionofclientsfollowHIPAAregulations Languageusedintheclinicisprofessionalandtopicsareappropriateforabusinessenvironment

Establishedrapportwithclientsandfamiliestoexpressconcernsanddiscusstherapyprogram

Ontimeforsessionsincludinggreetingtheclientandinitiatesapromptstarttimeofthesession

Attendsandparticipatesinmeetingsthatrelatetoclinicaldevelopment Dependableandcommitted:sessionsarepreparedandorganized Demonstratesthebestinterestsfortheclient:anadvocatefortheclientneedsincludingwithinthesession’sbestpractices

Consistentinitiative:resourceful,asksquestions,andimplementsSLP’srecommendations

Professionalresponsibilityisconsistentwithinitiatingcontactwithasupervisor,self-evaluatesownskillsandtakesresponsibilitywithoutblamingothersand/orexternalfactors

Demonstratesrespectfortheprofessionandclinicwhilemaintainingaprofessionaldemeanorandbehavioratalltimes

Communicateseffectivelyusingappropriaterate,pitchandvolumewithclients,families,professionals,andpeers–communicationisorganized,articulatewithappropriateuseofgrammar

DemonstratesknowledgeofASHAstandardsandappliesASHA’sCodeofEthics

Followsonsiteclinicalproceduresincludingconfidentialityguidelines,HIPAAregulations,safetyproceduresandtimeframeofprojects

AcademicandClinicalBase BelowExpectationsUsesacademics&EBPtodevelopbaselinedataprotocolandsubsequenttreatmentprogram

Understandingthenatureofthecommunicativedisordersanddifferencesanddemonstratesviasession,discussion,andwrittenformat

Courseworkapplied,integratesdevelopmentalcharts,and/orresearchmethods

Observedintheclinicpreparingforpracticum:practicesassessmentsandtreatmenttechniques

Demonstratesanunderstandingofacademics&EBPtogeneralizetheinformationintotheclinicalsetting

LearningSkills BelowExpectationsSeeksclarification,problemsolvesandproposessolutions

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Receivessuggestionswithoutresistance Promptlyandeffectivelyincorporatessupervisor’sdirectives Demonstratesanunderstandingoftheclient’scommunicationskillsandtakesinitiativetosuggestnewtherapyapproaches

Self-evaluationtomeetpre-professionalgoals.Identifiesareasofstrength&areasthatrequireimprovement

WrittenDocumentation BelowExpectationsInitialdraftsofwrittendocumentationrepresentbestefforts Submitsdocumentationontime Consistentlyfollowsclinicguidelines,formatfordocumentationpurposes

WrittendocumentationprogressionisevidencedbyapplicationoftheSLP’srecommendations

Reportingisorganized,neat,andcomplete Documentationisproofreadwithappropriategrammar,clearsentencestructure,andnospellingerrors

Includesahighlevelofprofessionalterminology Writesclearbehaviorallong-termandshort-termobjectivesforclients Informationisorganizedandconcisewithconsistentinterpretationofinformation

AdditionalInformation:

Pleaseincludeadditionalinformationregardingaboveindicatedareaswhichcurrentlyfallbelowexpectations.Discussareasofimprovementandpossiblegoalstobetargeted.Pleaseindicate

whatattemptshavebeenmadesofarwhichwereunsuccessfulinordertosupportimplementationofClinicalFocusPlan.

Speech-Language

PathologistSignature,Credentials,Date

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AppendixB–SampleGoalsforClinicalFocusPlan,InstructionalApproach

Theplanmustspecifyexpecteddateofachievement,andthecriterionlevelformastery(e.g.,80%accuracy). Goals should be tailored specifically to the individual student clinician in order toimproveknowledgeandskillsinareasofimprovement.Goalsshouldbemeasurableandclearlywritten.SampleGoalsAddressingPreparation/SessionImplementation:

o Thestudentclinicianwillpreparematerialsforallsessionsatleast24hourspriortothescheduledsession;materialsmustbeappropriateforclientage,skills,andgoaltargets.Thestudentclinicianshouldappearcomfortableusingthematerialsduringthesession,andtheformatofsessionsmustbeengagingtotheclient.

o Thestudentclinicianwilldevelopandexecuteorganized,engaging,client-specificsessionswhichsupportandtargettheclient’sneedsinafunctionalway.Thestudentclinicianwillconductorganizedsessionsevidencedbyincludingandinformingtheclientoftransitions,utilizingage-appropriatetransitionsbetweenactivities,providingvisualand/orverbalsupportforsessionorganizationandexpectations,andincludingtheclient/client’sfamilyintheplanofcare.

o Thestudentclinicianwillimproveinherutilizationaswellasvariationofengagingandmotivatingage-appropriatematerialstokeeptheclient’sinterestthroughoutthesessionandtoeffectivelytargetspeechandlanguagegoals.

SampleGoalsAddressingWrittenDocumentation:

o Thestudentclinicianwilldemonstrateimprovementintheareaofwrittendocumentation,specificallyintheareasofmechanics(e.g.,grammar,syntax,spelling),clinicallanguageandterminology,andcontentwhichreflectsappropriateclinicalreasoningandanalysis.Thestudentclinicianwillproofreadallwrittendocumentationentirelypriortosubmission.

o Thestudentclinicianwilldevelopanddocumentappropriate,measureablelong-termandshort-termgoalsforallclients,adjustingandmodifyingbasedonclients’performance,throughoutthesemesterutilizingsupportingdata.

o Thestudentclinicianwilldemonstrateimprovedandaccuratedatacollectionskills.Thestudentclinicianwillanalyze/interpretdataaccuratelytodetermineclient’sleveloffunctionandprogresstowardgoals.

o Thestudentclinicianwilldevelopappropriate,measureablelong-termandshort-termgoalsfortheclient,adjustingandmodifyingbasedonclientperformance,throughoutthesemesterutilizingsupportingdata.

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SampleGoalsAddressingEBP:

o Thestudentclinicianwillincludeandappropriatelydocumentevidence-basedpractice(EBP)resourceswithinallwrittendocumentation(e.g.,lessonplans,SOAPnotes,progressreports/statements)inordertoaccuratelyjustifygoals,therapystrategies,and/ortechniquestosupportapplicationofacademicsandEBPintotheclinicsetting.

o ThestudentclinicianwilleffectivelyimplementthedocumentedEBPintosessionsinordertodemonstrateunderstandingofapplicationofacademicsandEBPintoclinicsessions.

o Thestudentclinicianwillconductappropriateresearchrelatedtoclientcommunicationdisorder(s)suggestedbyclinicalsupervisor(s)priortoweeklyCFPmeetings,and(1)mustcometoCFPmeetingspreparedtodiscusstheseresearchfindings,and(2)mustprovidetheCFPsupervisorwithappropriatewrittendocumentationoftheresearchconducted.

SampleGoalsAddressingTherapyApproaches/Implementation:

o Thestudentclinicianwillimproveknowledgeandskillsinallninescopesofpractice,withanincreasedfocusonassignedclients’diagnoses,inordertoincreaseapplicationofacademiccontentintotherapeuticpractice.

o Thestudentclinicianwilldemonstrateknowledgeandapplicationofvarioustreatmentapproachesandmethodsinordertovarytreatmentactivitiesandtargetmultiplegoalswithinsessions.

SampleGoalsAddressingInterpersonalSkills/SupervisorFeedback:

o Thestudentclinicianwillimplementallsupervisorfeedbackandsuggestionsprovidedviawrittenandverbalmodalitiesintowrittendocumentationand/ortherapysessionswithnomorethanonerevisionoftheoriginal.Thestudentclinicianwillactivelyandindependentlyseekclarificationduringin-personmeetingsasneededinordertoimplementfeedbackandsuggestionsaccurately,efficiently,andimmediately.

o Thestudentclinicianwilldevelopprofessionalcommunicationskillsandacceptanceofsitepoliciesandproceduresinordertoprepareforoff-siteplacement.Thestudentclinicianwillseeksupervisorsupportduringin-personmeetings,asopposedtoinappropriatetimes(e.g.,whenasupervisorisactivelysupervising,withoutaskingthesupervisorifshehastimetomeet,etc.).Meetingsshouldbescheduledasperclinicpolicy/procedure.

o Thestudentclinicianwilltakeinitiativeinschedulingmeetingswithsupervisorsforsupportonaregularbasis(atleast1-2meetingsweekly)andwillutilizemeetingsastheprimarymeansofcommunicationwithSLP.

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o Thestudentclinicianwillobservesessionstargetingrelatedspeechandlanguagegoalswithintheclinicatleastonetimeperweekandkeepalogoftheseobservations.

SampleGoalsAddressingClinicPolicies/Procedures:

o Thestudentclinicianwilladheretoallonsiteclinicalprocedures,including,butnotlimitedto,maintaininganorganizedandcompletechart,completingdocumentation(e.g.,attendancelog,SOAPnoteroutingsheet)onaregularbasis,andadheringtoallduedates.

o ThestudentclinicianwillsubmitlessonplansforMondaysessions,intheirentirety,byWednesdays5:00pm,inordertobereviewedatanearlierdatebySLP.ThestudentclinicianwillobtainapprovalfromthesupervisingSLPpriortoimplementationofthelessonplan.ThestudentclinicianshouldattendweeklymeetingsonWednesdayswiththeprimarysupervisorinordertodiscusstheplanandhavethelessonplanapproved.

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AppendixC:ClinicalFocusPlan

Student: Student’sName

ClinicalSupervisor(s): NameofClinicalSupervisor(s)DesignatedClinicalFocusPlanSupervisor: NameofDesignatedCFPSupervisorImplementationDate: DateofImplementation–Whendidtheplanbegin

ThewrittenClinicalFocusPlanestablishedwiththeStudentClinicianmustincludespecificgoals.ThePlanmustspecifyexpecteddateofachievement,andthecriterionlevelformastery(80%).

STUDENTCLINICIANKNOWLEDGEANDSKILLS

Studentclinician’sspecificgoalsshouldbelistedhere.

GENERALGOALSFORDEVELOPMENTOFKNOWLEDGEANDSKILLS

AcquisitionofKnowledgeandSkillsrelatedto:

1- Evidence-BasedPracticeresearch2- Datacollection,analysisandinterpretation3- Identificationofappropriatetreatmentapproaches,activitiesandmaterials4- Writtenclinicaldocumentation

AdherencetoallClinicPoliciesandProcedures,andtospecificpoliciesandproceduresoftheClinicalFocusPlan:

1- StudentClinicianwilladheretoallclinicpoliciesandprocedures2- StudentClinicianwillmaintainacopyofthesignedCFPintheSessionClientChartforeach

client.3- StudentClinicianwillcompleteweeklyActionStepsassignedbytheclinicalfocusplan

supervisor,anddocumentcompletioninaweeklyCFPInterimActionReport.4- StudentClinicianwillattendaCFPweeklymeetingwiththeclinicalfocusplansupervisor,and

proactivelyscheduleregularmeetingswithallsupervisorstodiscusstreatmentplanningandimplementation,andclientprogress.

StudentClinicianwillmaintainanorganizedandcompleteSessionClientChartforeachclientandmaintainalldocumentationutilizingtheMedicat(EMR)systemappropriately.

STUDENT-FOCUSEDGOALSFORDEVELOPMENTOFKNOWLEDGEANDSKILLS

Thestudentclinicianshouldselectgoalsforhim/herself.Whatdoesthestudentclinicianaimto

improveonthroughoutthesemester?

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METHODOFEVALUATION

Howwillthestudentclinicianbeevaluated?

Collaborative:TheDesignatedClinicalSupervisorandalldirectClinicalSupervisorsparticipateinstudentassessmentthroughcollaborativein-person,emailand/ortelephonecommunication.Allsupervisorswillcollaborativelydetermineprogresstowardgoals.Methods:

1- Directobservationduringtreatmentsessions(remoteorpush-in)andmeetings2- Assessmentofwrittenwork/assignments

EXPECTEDDATETOACHIEVEGOALS

BywhendoestheCFPSupervisorexpectthestudentclinicianwillachievethegoalsoutlinedintheCFP?

EXAMPLE:BytheendoftheSpring2018semester

CONSEQUENCEIFPLANISNOTACHIEVEDIfCFPgoalsandplanofactionbenchmarksarenotmet(includingALLsupervisorsuggestions),StudentClinicianisatriskforfailureofthiscourse.FailureofthiscoursemayresultintheStudentCliniciannotobtainingclinicalclockhoursandpossibleneedtorepeatthecourseandon-siteplacementduringthefollowingsemester;needtorepeatthiscoursemayresultinadelayingraduation.FailuretomeetthegoalsandPlanofActionforthisCFPmayalsoresultinareductioninclientcaseloadforthecurrentandfuturesemesters.

STUDENTCLINICIAN DATE

CLINICALFOCUSPLANSUPERVISOR DATE

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AppendixD–RecordofMeetingsandInstruction

STUDENT: IMPLEMENTATIONDATE: CLINICALSUPERVISOR(S): DESIGNATEDCFPSUPERVISOR:

MeetingRecord

DATE GRP 1:1 INSTRUCTIONPROVIDED INITIALS

DESIGNATEDCLINICALSUPERVISOR DATE

AppendixE–SampleActionSteps

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Writtenweeklyassignments(ActionSteps)areassignedbytheClinicalFocusPlanSupervisor.

ListedbelowaresampleActionSteps;itisanticipatedthatotherActionStepswillbedevelopedthatarespecifictothegoalsoftheCFP.

AftercompletingEBPresearch,consultwiththeclinicalsupervisorstoselecttwotreatmentapproacheswhichmaybeimplementedintotherapysessionswiththeassignedclients.Writeasummaryforeachtreatmentapproachthat(1)includesabriefrationaleforuseofthetreatmentapproach,and(2)describeshowtheapproachisimplementedinclinicalpractice.Bepreparedtoverballydiscusseachtreatmentapproachanditsrelevancetoimplementationwithintheclinicsetting.Usinginformationprovidedinperson/viawrittenhandouts,andimplementingclinicalsupervisor(s)feedback,revisetwoshorttermgoals:consultwiththeclinicalsupervisorstoclarifyanyfeedbackasneeded;reviewterminology(e.g.,“within”or“by”and“across”or“over),accuracylevelaveragedforallsessionsversuscriterionachievedateachofmultipleconsecutivesessions.ModifyeachgoaltofittheSMARTgoaloutlineasdiscussedintheCFPmeeting.ReadASHAdocumentsrelatedtotheASHACodeofEthicsandASHAStandards,includingScopeofPracticeforSpeech-LanguagePathologistsandEvidence-BasedPractice(linksprovidedtoASHAwebsiteinCFPmeeting).Provideawrittensummaryofeachdocument(i.e.,whatdidyoulearn)andbepreparedtodiscussintheCFPmeetingscheduled01/22/18.CommunicateeffectivelyandinatimelymannerwithallClinicalSupervisors,followingClinicPoliciesandProcedures,adheringtoallappropriatetimeframes.ObserveatleastonesessionconductedintheclinicwithpermissionfromtheCFPsupervisor,clinicdirector,andprimarysupervisor.Maintainrecordoftheday/timeofthesessionandnoteatleast3observationswhichcanbeimplementedintofuturesessions(i.e.,whatdidyoulearn,whatideasdidyougather).Thesessionmustbeviewedinitsentirety,fromstarttofinish.Bringthesenotes(writteninanyformatpreferred)totheCFPmeetingscheduled01/22/18.ReviewthelessonplanforclientALon01/17/18.Implementallsupervisorfeedbackintoarevisedlessonplan.Seekclarificationviain-personmeetingswiththedirectsupervisorasneededifanyfeedbackisunclear.BringboththecorrectedandtherevisedcopiesofthelessonplansfortheCFPmeetingscheduled01/22/18.

AppendixF–InterimActionReport-Sample

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STUDENT:

STUDENT’SNAME

IMPLEMENTATIONDATE:

CLINICALSUPERVISOR(S):

DESIGNATEDCFPSUPERVISOR:

ASSIGNEDACTIONSTEPS

1- StudentClinicianwillresearchtreatmentapproaches(TraditionalApproach,CyclesApproach)andprovideawrittensummaryofeachandhowthetreatmentapproachesmaybeimplementedwiththeclient.Anyformatpreferredbythestudentclinicianmaybeutilized(e.g.,bulletpoints,chart,paragraphs).

2- StudentClinicianwillciteEBPinalllessonplansandSOAPnotestosupportgoalsandtreatmentapproaches/strategies.TheEBPshouldspecificallystateandexplain:

a. whythetreatmentapproachisappropriatefortheclient/diagnosisb. howtheresearchsupportstheanalysisandinterpretationofdatacollected

3- Studentclinicianwillreviewsupervisor’sfeedbackonlessonplanstodateandimplementallfeedbackprovided,followingupwithdirectclinicalsupervisorviain-personmeetingsasneededinordertoseekclarification.

DateDue:10/23/17

STUDENT DOCUMENTATION OF ACTION STEP COMPLETION

1- ReviewofwrittenlessonplansandSOAPnotes2- Writtensummariesoftheselectedtreatmentapproaches(separateattachment)

STUDENTDOCUMENTATIONOFRESEARCHEFFORTS–INCLUDEURLS/CITATIONS

Includeaseparateattachmentlistingcitationsforallresourcesconsulted,usingpropercitationformat.Incompletecitationswillnotbeaccepted(e.g.,providingonlyURLs).

STUDENTCLINICIAN DATE

DESIGNATEDCLINICALSUPERVISOR DATE

AppendixG–ClinicalFocusPlanSummaryReport

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STUDENT:STUDENT’SNAMEIMPLEMENTATION:07/17-08/04/17CLINICALSUPERVISOR(S):LISTEACHSUPERVISORDESIGNATEDCLINICALSUPERVISOR:M.A.,CCC-SLP,TSSLD

MeetingDates 07/14/17,07/17/17,07/21/17,07/28/17,08/04/17

SupervisorFocusedGoalsToDate

Listallsupervisor-initiatedgoalswhichweretargetedthroughouttheClinicalFocusPlan.

AssignedActionSteps

ListeachActionStepwhichwasaddressedthroughouttheClinicalFocusPlan.Theseshouldbecopiedfromeachassignmentprovidedtothestudentclinicianandincludedates.

ProgresstoGoals

Restateeachgoal,theneachsupervisorshoulddocumentimpressions,approximatelevelofmastery,andsupportingdetails.Forexample:

Goal:Thestudentclinicianwilldemonstrateimprovementintheareaofwrittendocumentationintheareasofmechanics(e.g.,grammar,syntax,spelling),clinicallanguageandterminology,andcontentwhichreflectsappropriateclinicalreasoningandanalysis.Thestudentclinicianwillproofreadallwrittendocumentationinitsentiretypriortosubmission.

SLPSomeimprovementisnoted,althougherrorsingrammar,syntaxandsemanticspersist.Basedondiscussionsduringmeetingswiththestudent,itappearsthatshedoesnotrecognizetheseerrors.Attimes,syntaxandsemanticsobscureherintendedmeaning,especiallyinwrittenanalysesofprogresstowardsgoalsanddiscussionofremainingdeficits.Iestimatethatthecurrentlevelofmasteryisapproximately75%.

SLPThestudentclinicianimprovedintheareaofwrittendocumentationintheareaofmechanics,asevidencedbyreviewofclientactivecharts.However,writtendocumentationcontinuestopresentwithsomeerrorsingrammar,suchasincompletesentences.TheCFPsupervisorhasdiscussedstrategies,suchasreadingaloud,inordertoproofreadmoreeffectively.Veryminimalspellingerrorswerenotedasthesemesterprogressed.Thestudentclinicianimprovedintermsofuseofclinicallanguageandterminologyoncediscussedandterminologywasintroduced.Contentdoesnotconsistentlyreflectappropriateclinicalreasoningandanalysis.Estimatedlevelofmasteryisjudgedtobe75-80%.

ImpressionsandThoughts

IncludeabriefsummaryofprogresstowardtheCFPandprogresstowarddevelopmentofknowledgeandskills.

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RecommendationWhataretherecommendationsregardingtheCFP?ItisrecommendedthattheCFPcontinue…Dischargeisrecommended…

Submittedby Name,Credentials,&Date

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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAppendixIClinicalSupervisionSkillsforaClinicalSupervisorarebasedonthefollowing:AmericanSpeech-Language-HearingAssociation.(2008).KnowledgeandSkillsNeededbySpeech-LanguagePathologistsProvidingClinicalSupervision[KnowledgeandSkills].Availablefromwww.asha.org/policy.

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ASHA'spositionstatementaffirmsthatclinicalsupervision(alsocalledclinicalteachingorclinicaleducation)isadistinctareaofexpertiseandpractice,andthatitiscriticallyimportantthatindividualswhoengageinsupervisionobtaineducationinthesupervisoryprocess.DevelopingKnowledgeandSkillsAllcertifiedSLPshavereceivedsupervisionduringtheirstudentpracticaandclinicalfellowship;however,thisbyitselfdoesnotensurecompetenceasasupervisor.Furthermore,achievingclinicalcompetencedoesnotimplythatonehasthespecialskillsrequiredtobeaneffectivesupervisor.ASHAdoesnothavespecificrequirementsforcourseworkorcredentialstoserveasasupervisor;however,somestatesorsettingsmayrequirecourseworkand/oryearsofexperiencetoserveasasupervisor.Knowledgeandskillsmaybedevelopedinavarietyofways:participatingincoursesorworkshopsonsupervision,engaginginself-study,participatinginDivision12(AdministrationandSupervision),andgainingmentoredexperiencesundertheguidanceofanexperiencedclinicaleducator.Thefollowing12itemsrepresentcoreareasofknowledgeandskills.Thesuperviseeisanessentialpartnerinthesupervisoryprocess;however,theseareasarepresentedfromtheperspectiveofknowledgeandskillsthatshouldbeacquiredbythesupervisor.

I.PreparationfortheSupervisoryExperience

A.KnowledgeRequired

1. Befamiliarwiththeliteratureonsupervisionandtheimpactofsupervisorbehaviorsonthegrowthanddevelopmentofthesupervisee.2. Recognizethatplanningandgoalsettingarecriticalcomponentsofthesupervisoryprocessbothfortheclinicalcareprovidedtotheclientbythesuperviseeandfortheprofessionalgrowthofthesupervisee.3. Understandthevalueofdifferentobservationformatstobenefitsuperviseegrowthanddevelopment.4. Understandtheimportanceofimplementingasupervisorystylethatcorrespondstotheknowledgeandskilllevelofthesupervisee.5. Understandthebasicprinciplesanddynamicsofeffectivecollaboration.6. Befamiliarwithdatacollectionmethodsandtoolsforanalysisofclinicalbehaviors.7. Understandtypesandusesoftechnologyandtheirapplicationinsupervisi

B.SkillsRequired

1. Facilitateanunderstandingofthesupervisoryprocessthatincludestheobjectivesofsupervision,therolesoftheparticipants,thecomponentsofthesupervisoryprocess,andacleardescriptionoftheassignedtasksandresponsibilities.2. Assistthesuperviseeinformulatinggoalsfortheclinicalandsupervisoryprocesses,asneeded.3. Assessthesupervisee'sknowledge,skills,andpriorexperiencesinrelationshiptotheclientsserved.4. Adaptordevelopobservationalformatsthatfacilitateobjectivedatacollection.5. Beabletoselectandapplyasupervisorystylebasedontheneedsoftheclientsserved,andtheknowledgeandskillofthesupervisee.6. Modeleffectivecollaborationandcommunicationskillsininterdisciplinaryteams.7. Beabletoanalyzethedatacollectedtofacilitatethesupervisee'sclinicalskilldevelopmentandprofessionalgrowth.8. Usetechnologyasappropriatetoenhancecommunicationeffectivenessandefficiencyinthesupervisoryprocess.

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II.InterpersonalCommunicationandtheSupervisor-SuperviseeRelationship

A.KnowledgeRequired

1. Understandthebasicprinciplesanddynamicsofeffectiveinterpersonalcommunication.2. Understanddifferentlearningstylesandhowtoworkmosteffectivelywitheachstyleinthesupervisoryrelationship.3. Understandhowdifferencesinage,gender,culture,socialroles,andself-conceptcanpresentchallengestoeffectiveinterpersonalcommunication.4. Understandtheimportanceofeffectivelisteningskills.5. Understanddifferencesincommunicationstyles,includingcultural/linguistic,generational,andgenderdifferences,andhowthismayhaveanimpactontheworkingrelationshipwiththesupervisee.6. Befamiliarwithresearchonsupervisionintermsofdevelopingsupervisoryrelationshipsandinanalyzingsupervisorandsuperviseebehaviors.7. Understandkeyprinciplesofconflictresolution.

B.SkillsRequired

1. Demonstratetheuseofeffectiveinterpersonalskills.2. Facilitatethesupervisee'suseofinterpersonalcommunicationskillsthatwillmaximizecommunicationeffectiveness.3. Recognizeandaccommodatedifferencesinlearningstylesaspartofthesupervisoryprocess.4. Recognize and be able to address the challenges to successful communication interactions (e.g., generational and/or gender differences andcultural/linguisticfactors).5. Recognizeandaccommodatedifferencesincommunicationstyles.6. Demonstratebehaviorsthatfacilitateeffectivelistening(e.g.,silentlistening,questioning,paraphrasing,empathizing,andsupporting).7. Maintainaprofessionalandsupportiverelationshipthatallowsforbothsuperviseeandsupervisorgrowth.8. Applyresearchonsupervisionindevelopingsupervisoryrelationshipsandinanalyzingsupervisorandsuperviseebehaviors.9. Conductasupervisorself-assessmenttoidentifystrengthsaswellasareasthatneedimprovement(e.g.,interpersonalcommunication).10. Useappropriateconflictresolutionstrategies.

III.DevelopmentoftheSupervisee'sCriticalThinkingandProblem-SolvingSkills

A.KnowledgeRequired

1. Understandmethodsofcollectingdatatoanalyzetheclinicalandsupervisoryprocesses.2. Understandhowdatacanbeusedtofacilitatechangeinclient,clinician,and/orsupervisorybehaviors.3. Understandhowcommunicationstyleinfluencesthesupervisee'sdevelopmentofcriticalthinkingandproblem-solvingskills.4. Understandtheuseofself-evaluationtopromotesuperviseegrowth.

B.SkillsRequired

1. Assistthesuperviseeinusingavarietyofdatacollectionprocedures.2. Assistthesuperviseeinobjectivelyanalyzingandinterpretingthedataobtainedandinunderstandinghowtouseitformodificationof

interventionplans.3. Assistthesuperviseeinidentifyingsalientpatternsineitherclinicianorclientbehaviorthatfacilitateorhinderlearning.4. Uselanguagethatfostersindependentthinkingandassiststhesuperviseeinrecognizinganddefiningproblems,andindevelopingsolutions.5. Assistthesuperviseeindeterminingwhethertheobjectivesfortheclientand/orthesupervisoryexperiencehavebeenmet.

IV.DevelopmentoftheSupervisee'sClinicalCompetenceinAssessment

A.KnowledgeRequired

1. Understandanddemonstratebestpractices,includingtheapplicationofcurrentresearchinspeech-languagepathology,forassessingclientswithspecificcommunicationandswallowingdisorders.2. Understandprinciplesandtechniquesforestablishinganeffectiveclient–clinicianrelationship.3. Understandassessmenttoolsandtechniquesspecifictotheclientsserved.4. Understandtheprinciplesofcounselingwhenprovidingassessmentresults.5. Understandanddemonstratealternativeassessmentproceduresforlinguisticallydiverseclients,includingtheuseofinterpretersandculture

brokers.

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B.SkillsRequired

1. Facilitatethesupervisee'suseofbestpracticesinassessment,includingtheapplicationofcurrentresearchtotheassessmentprocess.2. Facilitatethesupervisee'suseofverbalandnonverbalbehaviorstoestablishaneffectiveclient–clinicianrelationship.3. Assistthesuperviseeinselectingandusingassessmenttoolsandtechniquesspecifictotheclientsserved.4. Assistthesuperviseeinprovidingrationalesfortheselectedprocedures.5. Demonstratehowtointegrateassessmentfindingsandobservationstodiagnoseanddevelopappropriaterecommendationsforintervention

and/ormanagement.6. Provideinstruction,modeling,and/orfeedbackincounselingclientsand/orcaregiversaboutassessmentresultsandrecommendationsina

respectfulandsensitivemanner.7. Facilitatethesupervisee'sabilitytousealternativeassessmentproceduresforlinguisticallydiverseclients.

V.DevelopmentoftheSupervisee'sClinicalCompetenceinIntervention

A.KnowledgeRequired

1. Understandbestpractices,includingtheapplicationofcurrentresearchinspeech-languagepathology,fordevelopingatreatmentplanforandprovidinginterventiontoclientswithspecificcommunicationandswallowingdisorders.2. Befamiliarwithinterventionmaterials,procedures,andtechniquesthatareevidencebased.3. Befamiliarwithmethodsofdatacollectiontoanalyzeclientbehaviorsandperformance.4. Understandtheroleofcounselinginthetherapeuticprocess.5. Knowwhenandhowtoidentifyanduseresourcesforinterventionwithlinguisticallydiverseclients.

B.SkillsRequired

1. Assistthesuperviseeindevelopingandprioritizingappropriatetreatmentgoals.2. Facilitatethesupervisee'sconsiderationofevidenceinselectingmaterials,procedures,andtechniques,andinprovidingarationalefortheiruse.3. Assistthesuperviseeinselectingandusingavarietyofclinicalmaterialsandtechniquesappropriatetotheclientsserved,andinprovidinga

rationalefortheiruse.4. Demonstratetheuseofavarietyofdatacollectionproceduresappropriatetothespecificclinicalsituation.5. Assistthesuperviseeinanalyzingthedatacollectedinordertoreformulategoals,treatmentplans,procedures,andtechniques.6. Facilitatesupervisee'seffectiveuseofcounselingtopromoteandfacilitatechangeinclientand/orcaregiverbehavior.7. Facilitatethesupervisee'suseofalternativeinterventionmaterialsortechniquesforlinguisticallydiverseclients.

VI.SupervisoryConferencesorMeetingsofClinicalTeachingTeams

A.KnowledgeRequired

1. Understandtheimportanceofschedulingregularsupervisoryconferencesand/orteammeetings.2. Understandtheuseofsupervisoryconferencestoaddresssalientissuesrelevanttotheprofessionalgrowthofboththesupervisorandthe

supervisee.3. Understandtheneedtoinvolvethesuperviseeinjointlyestablishingtheconferenceagenda(e.g.,purpose,content,timing,andrationale).4. Understandhowtofacilitateajointdiscussionofclinicalorsupervisoryissues.5. Understandthecharacteristicsofconstructivefeedbackandthestrategiesforprovidingsuchfeedback.6. Understandtheimportanceofdatacollectionandanalysisforevaluatingtheeffectivenessofconferencesand/orteammeetings.7. Demonstratecollaborativebehaviorswhenfunctioningaspartofaservicedeliveryteam.

B.SkillsRequired

1. Regularlyschedulesupervisoryconferencesand/orteammeetings.2. Facilitateplanningofsupervisoryconferenceagendasincollaborationwiththesupervisee.3. Selectitemsfortheconferencebasedonsaliency,accessibilityofpatternsfortreatment,andtheuseofdatathatareappropriateformeasuring

theaccomplishmentofclinicalandsupervisoryobjectives.4. Useactivelisteningaswellasverbalandnonverbalresponsebehaviorsthatfacilitatethesupervisee'sactiveparticipationintheconference.5. Abilitytousethetypeofquestionsthatstimulatethinkingandpromoteproblemsolvingbythesupervisee.6. Providefeedbackthatisdescriptiveandobjectiveratherthanevaluative.

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7. Usedatacollectiontoanalyzetheextenttowhichthecontentanddynamicsoftheconferencearefacilitatinggoalachievement,desiredoutcomes,andplannedchanges.8. Assistthesuperviseeincollaboratingandfunctioningeffectivelyasamemberofaservicedeliveryteam.

VII.EvaluatingtheGrowthoftheSuperviseeBothasaClinicianandasaProfessional

A.KnowledgeRequired

1. Recognizethesignificanceofthesupervisoryroleinclinicalaccountabilitytotheclientsservedandtothegrowthofthesupervisee.2. Understandtheevaluationprocessasacollaborativeactivityandfacilitatetheinvolvementofthesuperviseeinthisprocess.3. Understandthepurposesanduseofevaluationtoolstomeasuretheclinicalandprofessionalgrowthofthesupervisee.4. Understandthedifferencesbetweensubjectiveandobjectiveaspectsofevaluation.5. Understandstrategiesthatfosterself-evaluation

B.SkillsRequired

1. Usedatacollectionmethodsthatwillassistinanalyzingtherelationshipbetweenclient/superviseebehaviorsandspecificclinicaloutcomes.2. Identifyand/ordevelopandappropriatelyuseevaluationtoolsthatmeasuretheclinicalandprofessionalgrowthofthesupervisee.3. Analyzedatacollectedpriortoformulatingconclusionsandevaluatingthesupervisee'sclinicalskills.4. Provideverbalandwrittenfeedbackthatisdescriptiveandobjectiveinatimelymanner.5. Assistthesuperviseeindescribingandmeasuringhisorherownprogressandachievement.

VIII.Diversity(Ability,Race,Ethnicity,Gender,Age,Culture,Language,Class,Experience,andEducation)

A.KnowledgeRequired

1. Understandhowdifferences(e.g.,race,culture,gender,age)mayinfluencelearningandbehavioralstylesandhowtoadjustsupervisorystyletomeetthesupervisee'sneeds.2. Understandtherolecultureplaysinthewayindividualsinteractwiththoseinpositionsofauthority.3. Considercross-culturaldifferencesindeterminingappropriatefeedbackmechanismsandmodes.4. Understandimpactofassimilationand/oracculturationprocessesonaperson'sbehavioralresponsestyle.5. Understandimpactofcultureandlanguagedifferencesonclinicianinteractionswithclientsand/orfamilymembers.

B.SkillsRequired

1. Createalearningandworkenvironmentthatusesthestrengthsandexpertiseofallparticipants.2. Demonstrateempathyandconcernforothersasevidencedbybehaviorssuchasactivelistening,askingquestions,andfacilitatingopenand

honestcommunication.3. Applyculturallyappropriatemethodsforprovidingfeedbacktosupervisees.4. Knowwhentoconsultsomeonewhocanserveasaculturalmediatororadvisorconcerningeffectivestrategiesforculturallyappropriate

interactionswithindividuals(clientsandsupervisees)fromspecificbackgrounds.5. Demonstratetheeffectiveuseofinterpreters,translators,and/orculturebrokersasappropriateforclientsfromdiversebackground

IX.TheDevelopmentandMaintenanceofClinicalandSupervisoryDocumentation

A.KnowledgeRequired

1. Understandthevalueofaccurateandtimelydocumentation.2. Understandeffectiverecord-keepingsystemsandpracticesforclinicallyrelatedinteractions.3. Understandcurrentregulatoryrequirementsforclinicaldocumentationindifferentsettings(e.g.,healthcare,schools).4. Befamiliarwithdocumentationformatsusedindifferentsettings.

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B.SkillsRequired

1. Facilitatethesupervisee'sabilitytocompleteclinicaldocumentationaccuratelyandeffectively,andincompliancewithaccreditingandregulatoryagenciesandthirdpartyfundingsources.2. Assistthesuperviseeinsharinginformationcollaborativelywhileadheringtorequirementsforconfidentiality(e.g.,HIPAA,FERPA).3. Assistthesuperviseeinmaintainingdocumentationregardingsupervisoryinteractions(e.g.,ClinicalFellowshiprequirements).

X.Ethical,Regulatory,andLegalRequirements

A.KnowledgeRequired

1. Understandcurrentstandardsforstudentsupervision(CouncilonAcademicAccreditationinAudiologyandSpeech-LanguagePathology,2004)2. Understandcurrentstandardsformentoringclinicalfellows(CouncilforClinicalCertificationinAudiologyandSpeech-LanguagePathology,

2005).3. UnderstandcurrentASHACodeofEthicsrules,particularlyregardingsupervision,competence,delegation,representationofcredentials,and

interprofessionalandintraprofessionalrelationships.4. Understandcurrentstatelicensureboardrequirementsforsupervision.5. Understandstate,national,andsetting-specificrequirementsforconfidentialityandprivacy,billing,anddocumentationpolicies.

B.SkillsRequired

1. AdheretoallASHA,state,andfacilitystandards,regulations,andrequirementsforsupervision.2. Assistthesuperviseeinadheringtostandards,regulations,andsetting-specificrequirementsfordocumentation,billing,andprotectionofprivacy

andconfidentiality.3. Demonstrateethicalbehaviorsinbothinterprofessionalandintraprofessionalrelationships.4. Assistthesuperviseeinconformingwithstandardsandregulationsforprofessionalconduct.5. Assistthesuperviseeindevelopingstrategiestoremaincurrentwithstandardsandregulationsthroughouttheirprofessionalcareers.

XI.PrinciplesofMentoring

A.KnowledgeRequired

1. Understandthesimilaritiesanddifferencesbetweensupervisionandmentoring.2. Understandhowtheskilllevelofthesuperviseeinfluencesthementoringprocess(e.g.,mentoringismoreappropriatewithindividualswhoare

approachingtheself-supervisionstage).3. Understandhowtofacilitatetheprofessionalandpersonalgrowthofsupervisees.4. Understandthekeyaspectsofmentoring,includingeducating,modeling,consulting,coaching,encouraging,supporting,andcounseling.

B.SkillsRequired

1. Modelprofessionalandpersonalbehaviorsnecessaryformaintenanceandlife-longdevelopmentofprofessionalcompetency.2. Fosteramutuallytrustingrelationshipwiththesupervisee.3. Communicateinamannerthatprovidessupportandencouragement.4. Provideprofessionalgrowthopportunitiestothesupervisee.

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CLINICALSUPERVISIONInaccordancewithASHAandtheCouncilforClinicalCertificationinAudiologyandSpeech-LanguagePathology(CFCC)standards(StandardV-E),supervisionforthestudentswillbeprovidedbyindividualswhoholdtheCertificateofClinicalCompetenceandlicensedinNewYorkState.Supervisionwillbeaminimumof25%ofdirecttreatmenttimethroughoutthetrainingperiod.Supervisionwillbeaminimumof50%ofdirectevaluationtimethroughoutthetrainingperiod.Inadditiontothesupervision,studentswillbeevaluatedthroughmeetings,recordings,writtenreports,discussionswithfamilies,andinteractionsandprofessionalismattheonsiteclinic.Supervisionincludesbutnotlimitedtoobservationoflivetreatmentand/orevaluationsessions,observationsofrecordedsessions,verbalfeedbackandwrittenfeedbackinreferencetothestructureofthesessionaswellaswrittendocumentation,andinformaland/orformalmeetingswiththestudentclinician.ThesupervisorandstudentclinicianswillscheduleaMIDTERMREVIEWtodiscussprogresstodateandareastoimproveandafinalCLINICEXITmeetingtoclosethePermanentClientChart.Supervisionisbasedonthefollowing13tasksaccordingtoAmericanSpeech-Language-HearingAssociation.(1985).ClinicalSupervisioninSpeech-LanguagePathologyandAudiology[PositionStatement].Availablefromwww.asha.org/policy.TasksofSupervisionAcentralpremiseofsupervisionisthateffectiveclinicalteachinginvolves,inafundamentalway,thedevelopmentofself-analysis,self-evaluation,andproblem-solvingskillsonthepartoftheindividualbeingsupervised.Thesuccessofclinicalteachingrestslargelyontheachievementofthisgoal.Further,thedemonstrationofqualityclinicalskillsinsupervisorsisgenerallyacceptedasaprerequisitetosupervisionofstudents,aswellasofthoseintheClinicalFellowshipYearoremployedascertifiedspeech-languagepathologistsoraudiologists.Outlinedinthispaperare13tasksbasictoeffectiveclinicalteachingandconstitutingthedistinctareaofpractice,whichcomprisesclinicalsupervisionincommunicationdisorders.Thecommitteestressesthatthelevelofpreparationandexperienceofthesupervisee,theparticularworksettingofthesupervisorandsupervisee,andclientvariableswillinfluencetherelativeemphasisofeachtaskinactualpractice.Thetasksandtheirsupportingcompetencieswhichfollowarejudgedtohavefacevalidityasestablishedbyexpertsintheareaofsupervision,andbybothselectandwidespreadpeerreview.Thecommitteerecognizestheneedforfurthervalidationandstronglyencouragesongoinginvestigation.Untilsuchtimeasmorerigorousmeasuresofvalidityareestablished,itwillbeparticularlyimportantforthetasksandcompetenciestobereviewedperiodicallythroughqualityassuranceprocedures.MechanismssuchasPatientCareAuditandChildServicesReviewSystemappeartoofferusefulmeansforquality

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assuranceinthesupervisorytasksandcompetencies.Otherproceduresappropriatetospecificworksettingsmayalsobeselected.Thetasksofsupervisiondiscussedabovefollow:

1. Establishingandmaintaininganeffectiveworkingrelationshipwiththesupervise

2. Assistingthesuperviseeindevelopingclinicalgoalsandobjectives

3. Assistingthesuperviseeindevelopingandrefiningassessmentskills

4. Assistingthesuperviseeindevelopingandrefiningclinicalmanagementskills

5. Demonstratingforandparticipatingwiththesuperviseeintheclinicalprocess

6. Assistingthesuperviseeinobservingandanalyzingassessmentandtreatmentsessions

7. Assistingthesuperviseeinthedevelopmentandmaintenanceofclinicalandsupervisoryrecords

8. Interactingwiththesuperviseeinplanning,executing,andanalyzingsupervisoryconferences

9. Assistingthesuperviseeinevaluationofclinicalperformance

10. Assistingthesuperviseeindevelopingskillsofverbalreporting,writing,andediting

11. Sharinginformationregardingethical,legal,regulatory,andreimbursementaspectsofprofessionalpractice;

12. Modelingandfacilitatingprofessionalconduct;and

13. Demonstratingresearchskillsintheclinicalorsupervisoryprocesses.

Resource American Speech-Language-Hearing Association. (1985). Clinical supervision in speech-language pathology and audiology [Position Statement]. Available from www.asha.org/policy. http://www.asha.org/policy/PS1985-00220/

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Speech,Language&HearingClinicCourseCAAStandardsClinicrotationisdesignedtoaddressthefollowing2017CAAofASHAstandards:

§ Standard3.1.1BProfessionalpracticecompetencies:accountability,integrity,effectivecommunicationskills,clinicalreasoning,evidence-basedpractice,concernforindividualserved,culturalcompetence,professionalduty,collaborativepractice

§ Standard3.1.3BIdentificationandpreventionofSpeech,LanguageandSwallowingDisordersandDifferences:Principlesandmethodsofidentificationofcommunicationandswallowingdisordersanddifferences

§ Standards3.1.4BEvaluationofspeech,language,andswallowingdisordersanddifferences:Articulation,Fluency,Voiceandresonance,Receptiveandexpressivelanguage(phonology,morphology,syntax,semantics,pragmatics,prelinguisticcommunication,andparalinguisticcommunication)inspeaking,listening,reading,writing,andmanualmodalities,Hearing,Swallowing,Cognitiveaspectsofcommunication,Socialaspectsofcommunication,Augmentativeandalternativecommunicationneeds

§ Standards3.1.5BInterventiontominimizetheeffectsofchangesinthespeech,language,andswallowingmechanisms:Articulation,Fluency,Voiceandresonance,Receptiveandexpressivelanguage(phonology,morphology,syntax,semantics,pragmatics,prelinguisticcommunication,andparalinguisticcommunication)inspeaking,listening,reading,writing,andmanualmodalities,Hearing,Swallowing,Cognitiveaspectsofcommunication,Socialaspectsofcommunication,Augmentativeandalternativecommunicationneeds

§ Standards3.1.6B:GeneralKnowledgeandskillsapplicabletoprofessionalpractice:Ethicalconduct,integrationandapplicationofknowledgeoftheinterdependenceofspeech,language,andhearing;Engagementincontemporaryprofessionalissuesandadvocacy;Processesofclinicaleducationandsupervision;Professionalismandprofessionalbehaviorinkeepingwiththeexpectationsforaspeech-languagepathologist;Interactionskillsandpersonalqualities,includingcounselingandcollaboration;Self-evaluationofeffectivenessofpractice

(Seemoreat:https://caa.asha.org/wp-content/uploads/Accreditation-Standards-for-Graduate-Programs.pdf)

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Speech,Language&HearingClinicOn-SiteProtocolforSLPsupervisorsSLP'swhoareassignedastheprimarySLPforastudentwillberequiredtoreviewthatstudent’sclinicadvisingfolder,confirmandsignthatthestudentclinicrequirementsareuptodateandthatstudentisreadytobegintheclinicsemester.PrimarySLP’swillberequiredtosendanemailtothestudentsinformingthestudentsthattheyareclearedtostartclinic.PleaseCCallsupervisingSLP’s.SLP'spleasereviewthefollowingguidelinesfromASHA:IssuesinEthics:SupervisionofStudentClinicianASHA-certifiedindividualswhosupervisestudentscannotdelegatetheresponsibilityforclinicaldecisionmakingandmanagementtothestudent.Thelegalandethicalresponsibilityforpersonsservedremainswiththecertifiedindividual.However,thestudentcan,aspartoftheeducationalprocess,makeclientmanagementrecommendationsanddecisionspendingreviewandapprovalbythesupervisor.Further,thesupervisormustinformtheclientorclient’sfamilyofthequalificationsandcredentialsofthestudentsuperviseeinvolvedintheprovisionofclinicalservices. IonaCollegeSpeech,LanguageandHearingClinicSLP'sarerequiredtoreviewandapprovealldocumentationincludingbutnotlimitedto:consentpackages(pleaseseetheAdministrativeAssistantforguidelines),SOAPnotes,progressreports,evaluations,outsidesitereports.IonaCollegeSpeech,LanguageandHearingClinicSLP'sarerequiredtoupholdASHAStandardsforclinicalknowledgeandskillsandASHACodeofEthicsthatrelatetotheclientundertheirlicensureandthestudenttheSLPissupervising

Allsupervisedclinicalactivitiesprovidedbythestudentmustfallwithinthescopeofpracticeforthespecificprofessiontocounttowardthestudent'scertification.Thesupervisororpreceptormustachieveandmaintaincompetencyinsupervisorypracticeaswellasinthedisabilityareasforwhichsupervisionisprovided.TheamountofsupervisionprovidedbytheASHA-certifiedsupervisormustbecommensuratewiththestudent’sknowledge,experience,andcompetencetoensurethatthewelfareoftheclientisprotected.Thesupervisormustalsoensurethatthestudentsuperviseemaintainsconfidentialityofclientinformationanddocumentsallclientrecordsandbillinginformation,ifapplicable,inanaccurateandtimelymanner.

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IonaCollegeSpeech,LanguageandHearingClinicSLP'smustreporttotheClinicDirector,Asst.ClinicDirector,On-SiteCoordinatorand/orAdministrativeAssistantifaclientisassignedthatdoesnotfallundertheSLP'spractice.Differencesmayexistinthetypeandamountofsupervisionofstudentsuperviseesthatisrequiredforteachercertificationinaudiologyandspeech-languagepathology,statelicensureintheprofessionsofaudiologyandspeech-languagepathology,andASHAcertificationinaudiologyandspeech-languagepathology.InstateswherecredentialrequirementsorstatelicensurerequirementsdifferfromASHAcertificationstandards,supervisedclinicalexperiences(includingstudentpracticaforteacherlicensing)willcounttowardormaybeappliedtowardASHAcertificationrequirementsonlyifthoseclinicalexperiencehourshavebeensupervisedbyASHA-certifiedpersonnel.IonaCollegeSpeech,LanguageandHearingClinicSLP'sarescheduledtosupporttherequirementslistedAccordingto2017CAAofASHAStandardV-E:“SupervisionmustbeprovidedbyindividualswhoholdtheCertificateofClinicalCompetenceintheappropriateprofession.Theamountofdirectsupervisionmustbecommensuratewiththestudent'sknowledge,skills,andexperience,mustnotbelessthan25%ofthestudent'stotalcontactwitheachclient/patient,andmusttakeplaceperiodicallythroughoutthepracticum.Supervisionmustbesufficienttoensurethewelfareoftheclient/patient.

Implementation:Directsupervisionmustbeinrealtime.Asupervisormustbeavailabletoconsultwithastudentprovidingclinicalservicestothesupervisor'sclient.Supervisionofclinicalpracticumisintendedtoprovideguidanceandfeedbackandtofacilitatethestudent'sacquisitionofessentialclinicalskills.Theamountofdirectsupervisionmustbecommensuratewiththestudent'sknowledge,skills,andexperience,mustnotbelessthan25%ofthestudent'stotalcontactwitheachclient/patient,andmusttakeplaceperiodicallythroughoutthepracticum.Supervisionmustbesufficienttoensurethewelfareoftheclient/patient.”

IonaCollegeSpeech,LanguageandHearingClinicSLP'sareboundtoreportanychangesinsupervisionrequirementsorneedswithin4sessionsforastudentand/orclient.These4sessionsmayincludeclinicpreparationmeetings,sessionobservation,and/orsubmissionofstudentwork.IonaCollegeSpeech,LanguageandHearingClinicSLP’ssupportsupervisionrequirementincludingminimumrequirementsof25%fortreatmentand50%fordiagnosticswiththeamountandtypeofsupervisionadjustedtomeettheneedsofthestudent.Beginningstudentsreceivemoresupervision;secondyearstudentsaresupervisedlessandexpectedtobemoreindependent.IonaCollegeSpeech,LanguageandHearingClinicSLP'swilladjustneedsofsupervisionbasedonstudent’sclinicalexperience,academiccourseworkandclientneeds.

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SchoolofArtsandSciencesDepartmentofSpeechCommunicationStudiesAppendixJMediaSpecialistHandbookPreparedbyPeterConsadoriforIonaCollegeSpeech,LanguageandHearingHandbookSpring2018

IonaCollegeInformationTechnologyComputerUsePolicy

ThefollowingactionsareprohibitedundertheComputerUsePolicyofIonaCollege.

• Anyattempttomodifyordamagecomputerequipment

• Anyattempttomodifyordamagecomputerornetworksoftware

• Improperuseofthecomputerequipment

• UsinganIDbelongingtoanotheruser

• Unauthorizedreading,useof,ordeletionofprivatefilesoremailbelongingtoanotheruser

• SharinguserIDsandpasswordswithotherusersoranyotherperson

• Anyattempttocircumventsystemprotectionandsecurityfeatures

• Engaginginunauthorizedduplication,alterationordestructionofdata,programsorsoftware

• Transmitting or disclosing data, programs or software belonging to others or duplicating copyrightedmaterials

• Use of computer resources for private purposes, including, but not limited to, the use of computerresourcesforprofitmakingorillegalpurposes

• Maintainingcreditcarddatainanyelectronicformatoroncomputers

• Transmittingcreditcarddatabyemail.For the full Iona College Computer Use Policy visit http://www.iona.edu/Student-Life/Student-Resources/Information-Technology/Information-Policies/Computer-Use-Policy.aspx

ClinicComputers/PrivacyScreens

Theclinichasatotalof29computersthatthestudentsmayuse.Thecomputersaretobeusedonlyforclinicalpurposes.Computersmaynotbereservedatanytime.Thecomputersareonafirstcomefirstservebasis.Studentsmayneveruseacomputerthatanotherstudentisloggedinto.Thestudentmusteitheruse the “shut down” function or “restart” to log into their own account before using the computer.Studentsmayneverchange,installoruninstallanyprogramsonthecliniccomputers.Thecliniccomputersareequippedwithprivacyscreens.Theprivacyscreensallowtheuserofthemachinetoseebutothersnexttothestudentwillnotbeabletoseethescreen.ThesescreenprotectorsmaynotberemovedforanyreasonunlessauthorizedbytheMediaSpecialistoraSupervisor.Ifanyofthepreviouslystatedinstructionsarenotfollowed,itwillbeabreachoftheHealthInsurancePortabilityandAccountabilityAct.AbreachofHIPAAwillbereportedtotheon-siteSupervisorandwillresultinafollowupmeetingwiththeClinicDirector.

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Printing

Therearetwoprintersthatthestudentscanuseintheclinic.Thereisacolorprinterandablackandwhiteprinterthatmaybeusedforclinicalpurposesonly.Toprintcolor,thestudentmustsendtheirprintingjobtotheLanierprinterlocatedintheCopy/Printroom(Room103).Atotaloffivecomputersthatareabletoprinttothatspecificprinter.Thosecomputersaremarkedwithawhitelabelthatreads“PrintAbled”.Theblackandwhiteprintercanbeaccessedbyanyofthe18computersthatareavailabletothestudents.Toprinttothisprinter,thestudentmustsendtheirprintingjobtotheIP191printerlocatedintheConferenceroom(Room105).PleasenotethattheblackandwhiteprintermayonlybeusedforprintingSOAPnotes,LessonPlansandProgressReports.Becausethedocumentsthatarebeingprintedareconfidential,everystudentmust report to theMedia Specialist any problems theymay have printing. The issuemust bereportedatthetimeoftheprintingattemptsothattheMediaSpecialistcanresolveitandthedocumentcanbecollectedbythestudent.Allstudentsareresponsibleforthedocumentsthatareprinted.Atnotimecanadocumentbeleft intheprinter. Ifadocument is left inaprinter, itwillbeabreachoftheHealthInsurancePortabilityandAccountabilityAct.AbreachofHIPAAwillbereportedtotheon-siteSupervisorand will result in a follow up meeting with the Clinic Director.

iPads:Clinic/Personal

StudentsareallowedtousecliniciPadsforclinicalpurposesonlywithintheclinic.TouseaniPadforasession,thestudentmustsignouttheiPadusingadedicatedsignoutsheet.WhensigningouttheiPad,thestudentacknowledgestheprocedureofusingthe iPad in the IonaCollegeSpeech,LanguageandHearingClinic.ForthelistofiPaduseprocedurespleaseseeFormA: iPad/FMsignoutsheetonpage138.

PersonaliPadsarenotallowedtobeusedinIonaCollegeSpeech,LanguageandHearingClinic.

Clientinformationincludingbutnotlimitedtoclinicaldocumentation,identifyinginformation,photos,

videosoraudiorecordingsarenotallowedtobestoredorsavedontoclinicorpersonaldevicesaswell

as apps installed on said devices. It is expected studentswill sign a release understanding clinical

informationwillnotbestoredonanyportabledevices.

If client informationofanykindwas storedonto thedeviceorappsof thedevice, theclient/client’sguardianwillbenotifiedof the incidentbya representativeof the IonaCollegeSpeech, Language&HearingClinic.

PersonalLaptops

Theuseofpersonallaptopsforclinicalpurposesisstrictlyprohibitedintheclinic.

FMReceivers

Thisdeviceusesinfraredtechnologytoallowsupervisorstousetheircomputerstospeaktothestudentswhiletheyareinaclinicalsession.TheReceiversincludeabatterypackreceiverandasingleheadphone.Thebatterypackcanbewornaroundtheneckorplacedinapocket. Eachreceiver is labeledwithanumber.Thisnumbercorrespondswith the therapyroomnumber thestudentwillbeusing for their

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session. The units are stored in a locked cabinet in room 103. If the student is required to use thistechnology,theMediaSpecialistwillprovidethemwithaunit.Thestudentmustsignthereceiveroutonthedesignatedsignoutsheet(seeFormA,pg.138).Thereceivermustbereturnedimmediatelyafterthesessioniscompleted.

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FormA:iPad/FMSignOut

• TheiPadsintheIonaCollegeSpeech,Language&HearingClinicaretobeusedinclinicalsessionsfortherapeuticpurposesonly.• ThestudentmayonlysignoutoneiPadand/orFMdeviceatatime.• ThestudentmaynotleavetheinsideoftheclinicwithacliniciPadorFMdevice.• ThestudentmaynotgivetheiPadorFMdevicetoanotherstudentclinician.• iPadsorFMdevicescannotbeleftunattended.• ThestudentmustreturntheiPadorFMdeviceimmediatelyaftertheirclinicalsessioniscompleted.• iPadcasesmaynotberemovedfromthedeviceatanytime.• NoclientinformationmaybeenteredintotheiPadatanytime.Ifaspecificapprequiresaclientidentifier(ie.Name,DOB,etc.)thestudentistousea

clientspecificnumberthatthestudentcanacquirefromtheAdministrativeAssistant.StudentName iPad

PFMP

iPad/FM#

StudentSignature(Confirmingthatyouunderstandallstepsoftheprocedureabove)

Date TimeOut

StaffInt.

TimeIn

StaffInt.

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Visi-Pitch

TheVisiPitchisopenforallstudentstouseatanytimetheclinicisopen.Studentsmayalsousethesystemduringtheirclinicalsessions.Studentsmustdocumentandadviseasupervisorthattheywillbeusingthesystemduringtheirsession.Thestudentmustbefamiliarwiththesystembeforeusingit.TheVisi-PitchissetupintheFacultyTherapyroom(Room110).ThecomputerthattheVisi-Pitchisinstalledonmustbeturnedoffafteruse.NoclinicaldataisallowedtobestoredorsavedontothisVisi-Pitchcomputer.

Inventory

Studentsareallowedtousetheresourcesthatwehaveintheclinic.Theseresourcesincludebooks,toys,puzzles,cards,boardgames,treatmentmaterials(ex.LARKKit)andworkbooks.Theseitemscanbecheckedouttobeusedfor a student’s session. The studentwill only be allowed to checkmaterials in and out during the designatedinventoryhoursthatarepostedabovethefrontdesk.TocheckoutanitemthestudentwillgetaccesstotheclosetwherethematerialsarestoredandbringthematerialsheorshewouldliketocheckouttotheMediaSpecialist.TheMediaSpecialistwillscantheitemsintotheinventorysystemandgivethestudentatimeand/ordaythattheitemmustbecheckedinby.Thestudentwillbeallowedtocheckoutamaterialasearlyasonedaybeforeuseandthestudentisallowedtocheckinamaterialaslateasonedayafteruse.WeekendsarenotincludedinthecountsoifastudentchecksoutamaterialtobeusedonaFriday,thematerialcanbecheckedinnolaterthanMonday.Whenamaterialischeckedbackintothesystem,thestudentisresponsibleforreturningtheitemtoitsdesignatedroom/cabinet. Ifanitemisnotcheckedbackinbythedatethatwasgiventothemtheitemwillbeconsideredoverdueandemailwillbesentouttothestudent.

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Medicat

MedicatisanelectronicdocumentationprogramthatisusedintheIonaCollegeSpeech,LanguageandHearingClinic.AllcomputershaveaccesstoMedicatandeachuserwillhavetheirownuniquecredentialstologintothesystem.Belowarenotesfortheusersonhowtousethesystem.Ifanyofthestatedinstructionsbelowarenotfollowed,itwillbeabreachoftheHealthInsurancePortabilityandAccountabilityAct.AbreachofHIPAA

willbereportedtotheon-siteSupervisorandwillresultinafollowupmeetingwiththeClinicDirector.

MedicatUserGuideNotes(StudentUsers)

LoggingIn:

1) DoubleClickontheMedicatIconlocatedonthecomputer’sdesktop2) EnteryourusernameandpasswordthatisspecifictoMedicat3) OnceloggedintotheremotedesktopclickonMedicatEHRtolaunchtheelectronicdocumentationprogram.4) Re-enteryourMedicatspecificCredentials.

ChangingYourPassword:

1) Whenyouconnecttotheremotedesktopforthefirsttimeyouwillneedtochangeyourpassword.Clickstartintheprogram.

2) Clickthewords“WindowsSecurity”locatedinthetoprightcornerofthebox3) Select“ChangePassword”4) Changeyourpasswordtomeettherequirementsofthesystem.

CreatingaNoteforaClient:

1) DoubleClickontheMedicatIconlocatedonthecomputer’sdesktop2) EnteryourusernameandpasswordthatisspecifictoMedicat3) OnceloggedintotheremotedesktopclickonMedicatEHRtolaunchtheelectronicdocumentationprogram.4) Re-enteryourMedicatspecificCredentials5) Selectthe“Patient”buttononthetopofthescreen.6) Searchforyourclientusinglastnameorclientnumberusingthesearchbarinthetoplefthadcornerofthe

screen.7) Select“ProgressNote”intheNewsectionofthescreenonthelefthandside.8) Onceselected,anewscreenwillappeartotherightoftheoptionyoujustselected.Selectthe“+”symbolnext

tonoteyouwanttowriteunderthe“Progress”section9) Whenthenotetemplateisselectedanewscreenwillappear.Fillintheinformationasneededtocompletethe

form.10) Whenallinformationhasbeenaddedtothenote,signthenoteusingthe“sign”buttonabovethenoteyou

justcreated.IMPORTANT:DONOTSELECTTHESIGNBUTTONONTHEBOTTOMOFTHESCREEN.Ifthebottombutton is selected, it will lock the note and youwill not be able tomake changes using your Supervisor’sfeedback.

11) Aftersigningthenote,selectthe“summary”sectionofthenoteandaddyourNameandwhatthenoteis.(ex.JaneSmith–SOAPnote)

12) OncethenoteissignedusingtheTOPbutton.SelecttheSLPthatsupervisesyoursessionusingthe“Route”dropdownmenu.IMPORTANT:OTHERUSERSAREINTHISDROPDOWNMENU.PLEASEBESURETOSELECTTHECORRECTUSER.ROUTINGTHENOTETOANYONEOTHERTHANYOURSLPWILLBEABREACHOFHIPAA.

13) OncethecorrectSLPhasbeenselected,click“save”onthebottomofthescreenandthen“close”.14) Complete steps 8-14 when revising any notes using Supervisor’s feedback. Step 11 will not need to be

completedeverytimeyouarerevisinganote.

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AddingaClientContactFormtoClientChart:

1) DoubleClickontheMedicatIconlocatedonthecomputer’sdesktop2) EnteryourusernameandpasswordthatisspecifictoMedicat3) OnceloggedintotheremotedesktopclickonMedicatEHRtolaunchtheelectronicdocumentationprogram.

4) Re-enteryourMedicatspecificCredentials5) Selectthe“Patient”buttononthetopofthescreen.6) Searchforyourclientusinglastnameorclientnumberusingthesearchbarinthetoplefthadcornerofthescreen.7) Select“Form”intheNewsectionofthescreenonthelefthandside8) Doubleclickontheclientcontactformintheboxontheupperlefthandcornerofyourscreen.9) Fillouttheform10) Oncetheformiscompleted,select“Lock”onthebottomtoolbartoaddittothechartViewingAllNotesintheChart:

1) DoubleClickontheMedicatIconlocatedonthecomputer’sdesktop2) EnteryourusernameandpasswordthatisspecifictoMedicat3) OnceloggedintotheremotedesktopclickonMedicatEHRtolaunchtheelectronicdocumentationprogram.4) Re-enteryourMedicatspecificCredentials5) Selectthe“Patient”buttononthetopofthescreen.6) Searchforyourclientusinglastnameorclientnumberusingthesearchbarinthetoplefthadcornerofthescreen.7) Select“AllNotes”intheChartsectionofthescreenonthelefthandside8) Allnotesintheclientschartwillappear9) Clickingoncewillopenthenoteonthebottomofthescreenforyourreview.

148

Speech,Language&HearingClinicClinicFormsAppendixK

149

Speech,Language&HearingClinicAppendixA:SessionClientChartForms

150

Speech,Language&HearingClinicFileOrganization:SessionClientCharts TheSessionClientChartwillbeusedduringthetherapysessiontosupporttheorganizationoftodocumenttosupportoperationsoftheclinic,clientandsessions.TheseSessionClientChartswillbekeptconfidentialandnottoberemovedfromtheclinic.ThesechartsareREQUIREDtobesubmittedforfilingatthecloseoftheclinic.

LeftSideofChart RightSideofChart

ToptoBottomOrder ToptoBottomOrder

SOAPNoteRoutingReport

1. ClientSummaryAttendanceSheet2. MonthlyAttendanceLogwithCorrespondingSessionDates

a. CompletedSupervisor’sEvaluationFeedbackFormb. DataCollectionSheetattached

SupervisorEvaluationFeedbackFormwiththeheadingcompleteanddateofthesessionthatwillbereviewed.IonaCollegeCaseHistoryForm

3. ConfidentialityAgreement4. StudentClinicianDocumentationof

(Absence,Permissions)

IonaCollege,ConsentPackageFormalReports(outsideofIona)Correspondence

__________________________________________StudentClinician,date__________________________________________Speech-LanguagePathologist,dateTheabovesignaturecertifiesalldocumentationwaspresentandcompletedatthetimeofthestudent’sclinicexi

151

SpeechLanguage&HearingClinicSOAPNoteRoutingofReport

StudentName: Client:SemesterSessionDate SC:SOAP

CompletionSLPIRDate Re-WriteorTherapy

PlanningSLP&SCMeetingDate

Re-WriteDue SLPFinalSOAPNoteApproved

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Speech,Language&HearingClinicSupervisorsEvaluationFeedbackForm

StudentClinician: SLP ClientInitials: Date

SupervisionWrittenFeedbackEvaluation SuggestedSLPAssessmentoftheSession SLPCommentsClinicianClientRelationship�Warm�Respectful�Engaging�ProfessionalEmpathy�Interestintreatmentsession�ProfessionalDemeanor�AppropriateDressCode�Appropriaterapportandfollowupwithfamily�Respectingculturalbackground&client’sage�ClientengagedandrespectingclinicianEffectivenessofMaterialsandProcedures�Ageappropriatematerials�Languageisunderstoodandmeetstheneedsoftheclient�Datarecorded�Clearandconcisedirections/informationprovided:Clientunderstandswhatisexpected�Timeisusedeffectivelyandefficiently�Homeassignmentsprovided/feedbacktofamiliesSetup�ActiveChartavailableandfollowingprocedures�Sessionsetuppriortosession/sessionsetuporganized�Documentationisclearlywritten�ASHACodeofEthicspresentedDiagnostic�Appropriateprocedurespresented�Administrationisinaccordanceofprocedures�AgeappropriateInformalassessmentImplementationofGoals�TargetsreflectedasindicatedbyLTG&STG’s�Gooduseofmaterials&sessionstructuretomeetmultipletargets&responses�Objectivesareappropriateforclientsleveloffunction�Provideselicitation,modelsbehaviors/targets,discriminatestargets�Strategiesincluding(i.e.Auditory/Visualstimulation)�Feedbacknotedviapositive/corrective:Consistent&appropriatereinforcement�Feedbacknotedviapositive/corrective:Consistent&appropriatereinforcement�Flexibilitymeetingclient’sneeds�Transitionsappropriate&informativefortarget/goaltransitions�Clinicianvs.clienttalk:Efficienttimegivenforclienttorespond�Clinicianunderstandsclientsbehavior�Appropriatebehaviormanagementused�ImplementingEBPasindicated�HealthPrecautionsused

Howdoesthestudentcliniciandemonstrateanunderstandingofthecommunicationissueoftheirclient?Aretheclient’sneedsbeingmetthroughthetherapysessionimplemented?Howdoesthestudentcliniciantransitiontherapyactivities?Arevisualschedules/TODOlistsbeingimplemented?Describethedirectionsthestudentclinicianuses?Isthelanguageusedbythestudentclinicianunderstoodbytheclient?Describetheuseofdatacollection?WhatcompensatorystrategiesarebeingimplemenWhatchangeswouldyoumake?ted?Aremultisensoryapproachesbeingused?

Anyinteractionwiththefamily?

Studentpresentationofprofessionaldemeanor/rapport;nonverbalpresentationofactiveengagementduringthesessionWhatchangeswouldyoumake?

__________________________________________________________________

153

StudentSignature/DateIhavereviewedtheobservingSpeechLanguagePathologistsrecommendationsandunderstandthatitismyresponsibilitytomeetwithasupervisorifanysuggestion(s)isunclear

154

Speech,Language&HearingClinicAttendanceLogMonth:

DateServicesInitialsSessionMin

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Total#ofTherapySessions:_________Total#ofHours:__________

SLPNotes

STXDXArticulation C:A: C:A: C:A:

Fluency C:A: C:A: C:A:Voice/Resonance C:A: C:A: C:A:Receptive/ExpressiveLanguage

C:A: C:A: C:A:

Hearing C:A: C:A: C:A:Swallowing C:A: C:A: C:A:Cognitive C:A: C:A: C:A:SocialAspectsofCommunication

C:A: C:A: C:A:

Augmentative&ACM C:A: C:A: C:A:Other:Directcontactwithclientandfamilyincounseling

C:A: C:A: C:A:

ASHAMember:__________________________________________ASHANumber:___________________________________________

Signature:

155

Speech,Language&HearingClinicEMRTemplatesClinicFormTemplates

156

SchoolofArtsandSciencesDepartmentofSpeechCommunicationStudiesIonaCollegeSpeech,Language&HearingClinicClientContactForm

ClientNameDOB MorF Guardian/ContactPerson

Address City,State,ZipCodePhoneNumberCellPhoneEmailAddress

DateCorrespondence/InformationDisclosed/CommentsInitials

157

158

Speech,Language&HearingClinic Date:Clickheretoentertext. StudentClinician:Clickheretoentertext.Client:Clickheretoentertext. Frequency:Clickheretoentertext. Session# Clickheretoentertext. DOB:Clickheretoentertext. CA:Clickheretoentertext. SLP/Time:___________________

LongTermGoals:

ShortTermGoals SupportingEvidence:ClinicalResearch,Client/FamilyInput,Clinicalexpertise(procedure,techniques,materials

159

160

Speech,Language&HearingClinic Date:___________________ DailyProgressNote Time:___________________S/LDX: ___________________ ICD-10Code: ___________________

StudentClinician: Date: Time:

SLPInitialReview Date: MeetWithSupervisorto:£Re-write£TherapyPlanning

SLPComments:

SLP&SCMeetingDate: SLPFinalSOAPNoteApprovalDate:

161

Speech,Language&HearingClinicProgressReport(SampleOutlineforProgressReport)

I.BackgroundInformation:IncludethefollowinginformationinNARRATIVEFORM:

• Client’sname• chronologicalage• speech-languagediagnosis• currentlyreceivess/ltherapyatIonaCollegeSL&HClinic,frequency/duration/Sizeofsession;• Pastmedicalhistory,anysignificantissues• Familyhistory:Whodoestheclientlivewith?Familyhistoryofs/ldisorderordelays?primarylanguage

spokenathome• EducationalHistory(ifapplicable);Doestheclientreceiveanyservicesinschool?Ifso,what?• DevelopmentalMilestones&Speech/LanguageMilestones• CorrespondencewithotherprofessionalsoutsideoftheIonaCollegeSL&HClinic;Doestheclientreceive

anyadditionalservicesoutsideoftheclinic(notpreviouslymentionedineducationalhistory)?Anypreviousservicesthatwerediscontinued?Etc.II.StatusatStartofTherapy:Statementindicatingclientscurrentspeech-languageskillsatthestartoftherapy.Reportoninformationcollectedfrombaselinedata.III.TherapyObjectives&ProgresstoDate:Speech–LanguageDiagnosis(i.e.artic,fluency)LTG’s:ListLTGandunderneathgoallistSTGthatcorrespondswiththelong-termgoalUnderEACHSTGINDICATEiftheobjectivewasmetornot:Criterionmet(date)/Criterionnotmet

ClientName: DateofBirth:

Parent(s)/Guardian(s):[Caregiverifapplicable] ChronologicalAge:Address: DateofReport:

PhoneNumber: S/LDx:TherapyPeriod:(StartDate-EndDate) SessionsAttended:(#outof#)Frequency/Duration/Size: StudentClinician:ClinicalSupervisor:(PrimarySupervisor) ClinicalSupervisor:(SecondarySupervisor)

162

Iftheobjectivewasnotmet-provideabriefstatementastowhattheclientisabletodoIV.AdditionalInformation:Discusstherapytargets,reinforcements,strategies,materials,ANDEBP.Discusstheoveralltherapyexperience;successesandchallenges.Ifanyadditionaltestingwasconducted(includingoralmotorexam-listresults.V.StatusattheEndTherapy:Statementindicatingclient’scurrentspeech-languageskillsattheendoftherapy(thisstatementshouldjustifytherecommendations)VI.PrognosisStatement:PredictiveStatement:Whatwillthelikelyoutcomebeduring/aftertherapy?Duetowhatconditions?(Ex:Prognosisisjudgedtobegoodastheclientcompleteshomeworkaftereverysession,carryoverispracticedathomewithparents,clientattendsallsessions,clientismotivatedtoachievegoals)VII.Recommendations:Planforfutureservices;includegoalsthatshouldbetargetedifyouarerecommendingcontinuedtherapy.____________________________________ ______________________________StudentClinician,DateSpeechLanguagePathologist,Date

_______________________________________

ASHA#

_______________________________________ StateLicense

163

Speech,Language&HearingClinicProgressReport(AlternativeOutlineforProgressReport/ChartFormat)

I.BackgroundInformation:IncludethefollowinginformationinNARRATIVEFORM:

• Client’sname• chronologicalage• speech-languagediagnosis• currentlyreceivess/ltherapyatIonaCollegeSL&HClinic,frequency/duration/Sizeofsession;• Pastmedicalhistory,anysignificantissues• Familyhistory:Whodoestheclientlivewith?Familyhistoryofs/ldisorderordelays?primarylanguage

spokenathome• EducationalHistory(ifapplicable);Doestheclientreceiveanyservicesinschool?Ifso,what?• DevelopmentalMilestones&Speech/LanguageMilestones• CorrespondencewithotherprofessionalsoutsideoftheIonaCollegeSL&HClinic;Doestheclient

receiveanyadditionalservicesoutsideoftheclinic(notpreviouslymentionedineducationalhistory)?Anypreviousservicesthatwerediscontinued?Etc.

II.StatusatStartofTherapy:Statementindicatingclientscurrentspeech-languageskillsatthestartoftherapy.Reportoninformationcollectedfrombaselinedata.III.TherapyObjectives&ProgresstoDate:Speech–LanguageDiagnosis(i.e.artic,fluency)ListGoalsinachartformatShortTermGoals InitialStatus/Baseline ChangeinStatusIncludeallmeasurablegoals(i.e.Theclientwill___80%ofthetime)

Includeinitialstartofdata(i.e.73%)

Providemeasurableperformanceofcurrentstatus.(i.e.96%accuracy.CriterionMet)

ClientName: DateofBirth:

Parent(s)/Guardian(s):[Caregiverifapplicable] ChronologicalAge:Address: DateofReport:

PhoneNumber: S/LDx:TherapyPeriod:(StartDate-EndDate) SessionsAttended:(#outof#)Frequency/Duration/Size: StudentClinician:ClinicalSupervisor:(PrimarySupervisor) ClinicalSupervisor:(SecondarySupervisor)

164

IV.AdditionalInformation:Discusstherapytargets,reinforcements,strategies,materials,ANDEBP.Discusstheoveralltherapyexperience;successesandchallenges.Ifanyadditionaltestingwasconducted(includingoralmotorexam-listresults.V.StatusattheEndTherapy:Statementindicatingclient’scurrentspeech-languageskillsattheendoftherapy(thisstatementshouldjustifytherecommendations)VI.PrognosisStatement:PredictiveStatement:Whatwillthelikelyoutcomebeduring/aftertherapy?Duetowhatconditions?(Ex:Prognosisisjudgedtobegoodastheclientcompleteshomeworkaftereverysession,carryoverispracticedathomewithparents,clientattendsallsessions,clientismotivatedtoachievegoals)VII.Recommendations:Planforfutureservices;includegoalsthatshouldbetargetedifyouarerecommendingcontinuedtherapy._________________________________ __________________________________StudentClinician,DateSpeechLanguagePathologist,Date

_______________________________________ ASHA#

_______________________________________

StateLicense

165

Speech,Language&HearingClinicProgressStatement

Client Diagnosis DOB Freq/Dur CA #Ofsessionsattended DOR ClinicalSupervisor StudentClinician DateApproved

InitialAssessmentandFunctionalLevel(atstartofservice):PertinentBackgroundInformationNarrativeSummarytodateincludingbutnotlimitedtohistoryandjustificationofservicestodate PresentLevelofPerformance

WNLMildModSevereN/AArticulation Fluency(rate,typical/nontypicaldisfluencies) Voice(pitch,intensity,quality)andresonance Language(Auditory,Verbal,Reading,Writing) Hearing(informal,formal) Swallowing Cognitive(orientation,memory,problem-solving) SocialAspectsofCommunication(sociallanguage) Augmentative&AlternativeCommunicationModalities OralMotor(Structure,Function)

AdditionalObservationonlevelofperformance

NarrativeSummaryindicatingpertinentinformationcontributingtoperformance/progresstodate

ProgressAchievedtoDate:

Currentskillstodate

166

Recommendations:Statementindicatingrecommendationsalongwithjustification

STUDENTCLINICIAN DATE

SUPERVISOR DATE

167

SPEECH,LANGUAGE&HEARINGCLINICDIAGNOSTICREPORT(CHILD)(SampleOutlineforDiagnosticReport/CHILD)*DiagnosticReportshouldincludebutisnotlimitedtothefollowing:

BackgroundInformation:NAMEOFCLIENTisaCHRONOLOGICALAGEwasseenforaspeechandlanguageevaluation(duetoconcernsof/Todetermineprogresstodate).ThisclientwasreferredfortheevaluationbyNAMEonDATEforREASON.PertinenthistorywasobtainedviainterviewbyNAMEandactedasareliableinformantandthecasehistoryformofDATE.Prenatalbirthhistorywasreportedas________.NAMEOFCLIENTwastheproductof____weekgestationperiodvia(vaginal/C-sectiondelivery)atBIRTHWEIGHT.Medicalhistorywasreportedas_______(IncludeanyinformationsuchasNICUstay;earinfections,foodallergies,asthma)FamilyhistoryTheclientcurrentlyliveswith(Reportfamilymembers,siblings,grandparents,andbabysitter).Theprimarylanguagespokenathomeis___________andNAMEOFCLIENTisexposedto(secondarylanguage;ifapplicable,discusstheirabilitytoread,write,speakandlisteninsecondarylanguage)Developmentalmilestoneswerereportedas_________(includegross,fine,andspeechmilestones)NAMEOFCLIENTcurrentlyattends(EDUCATIONALINFORMATION).NAMEOFINFORMANTreported(discussanyissueswithschool/receivinganysupport/informationfromschool).Pastservicesinclude(indicatecourseofevaluationsthroughEarlyIntervention,CPSE,private,schoolandhistoryoftreatmentandfrequency).

ClientName: DateofBirth:

Parent(s)/Guardian(s)/Informant(s): ChronologicalAge:

Address: DateofReport:

PhoneNumber: StudentClinician:

ClinicalSupervisor:(PrimarySupervisor) ClinicalSupervisor:(SecondarySupervisor)

168

Parent/ClientConcern:Mr./Mrs.Reportedconcernswith(i.e.speech/languagedevelopment,articulation,sounds,followingdirections…anyexamplethattheparentreports).Discussanyissuesofbehaviorwhenmakingwantsandneedsknown(i.e.biting,hitting,useofgestures,yes/noresponses)ClinicalObservation:NAMEOFCLIENTeasilyestablishedarapportwiththeunknownexaminerandparticipatedinallactivitiespresented.Spontaneoususeoflanguagewascharacterizedby_______.He/Herwasabletomakeherwantandneedsknownvia________Intelligibilitywasjudgedtobe_________.Theclientwasabletoattendto_______.Processingskillswerejudgedtobe___________forunderstandingoflanguageandfollowingdirectionswithincontext.FormalTestingListEachAssessmentUsed/ConductedNameofformalassessment(abbreviations)i.e.GoldmanFristoeTestofArticulation-3(GFTA-3)InformalTesting8(ifnotusingorinadditiontoaformalmeasure).ListEACHinformalmeasureused/conductedHearing/AuditoryFunctionInformalhearingacuitywasjudgedtobewithinnormallimitsattheconversationalspeechlevelindicatinghearingtobewithinnormallimitsviaoneandthreefeetdistances.(Theclientturnedwhenhis/hernamewascalled;clientlookedtowardsthewindowwhenanenvironmentalnoisewasoutside;clientrespondedtobells/whistles).HearingwasjudgedtobewithinnormallimitsinaquietenvironmentbasedoninformalobservationArticulationTheFORMALASSESSMENTwasusedtoevaluatearticulationskillsattheonewordlevel.Soundswereassessedintheinitial,medial,andfinalpositionsofwords.Resultsoftheevaluationindicatedthefollowing:

RawScore StandardScore PercentilePerPercentileRank

AgeEquivalent

Meanstandardscore= 100StandardDeviation= +/-15Thefollowingtablesummarizesarticulationerrors

IncludeerrorsinallpositionsIndicateandreferencewhensoundsareexpectedtobepresentatcurrentage

169

ThefollowingtableindicatesphonologicalprocessesIncludedevelopmentaland/ornondevelopmentalphonologicalprocesses

IndicateagewhenprocessesareexpectedtoageoutIntelligibilityduringconnectedspeechwasjudgedtobe______________characterizedby__________________.Mr./Mrs._________reportthattheyareabletounderstandNAMEOFCLIENT%ofthetimewithcontextknownorunknown.INFORMANTfurtherindicatedthatanunknownlistenerisabletounderstandCLIENT%ofthetimewithcontextknownorunknown.Thisexaminerwasabletounderstandconnectedspeech%ofthetimewithcontextknown/unknown.AccordingtoEBP/SOURCE(ex:BowenorGard,Gillman,Gorman)achildofAGEintelligibilityshouldbeunderstood%ofthetimebytheircaregivers.Voice:Clinicalobservationindicatedpitch,quality,intensity,&resonancewerejudgedtobe_____________________.(SeparateEvaluationforaformalvoiceassessmentifapplicable)Fluency:Clinicalobservationrevealedrateofspeechanddisfluentpatternstobe____________________________.(SeparateEvaluationforaformalvoiceassessmentifapplicable)OralMotorExamAnoralperipheralexamination(informalorformal)wascompletedandrevealedthattheoralmechanismisintactforcommunicationandfeedingpurposes.Theresultsoftheevaluationindicatedthatfacialsymmetrywasjudgetobe_____;tonewasalsonotedtobe__________;labialstructureandfunctionwasjudgedtobe_______characterizedby_______;lingualstructureandfunctionwasjudgedtobe________characterizedby___________.Intraoralexaminationrevealedhard/softpalatestructureandfunctiontobe_________;frenulumtobe________;dentitionwasjudgedtobe________;andsecretionswere__________.Observationofbreathingrevealed_________/appropriateforthecoordinationofrespirationandphonation.LANGUAGETheNAMEOFFORMALASSESSMENTwasadministeredtoevaluate_____________________.Theassessmentiscomposedof__________________.The_______isusedtoevaluate___________.Theresultsoftheevaluationareasfollows(examplesofsometablesandassessments)PreschoolLanguageScale–5

Subscale RawScore StandardScore %ileRank AgeEquivalentAuditoryComprehension ExpressiveCommunication TotalLanguage

Mean= 100

170

StandardDeviation= +/-15ClinicalEvaluationofLanguageFundamentals-4thEditionCELF-5Subtest RawScore StandardScore %ileFormulatedSentences WordStructure Concepts&FOLLOWINGDirections

CELF-5CoreLanguage:Mean=100;StandardDeviation=+/-15CELF-5Subtest: Mean=100;StandardDeviation=+/-3PeabodyPictureVocabularyTest-4thEditionRawScore StandardScore Percentile

Mean=100StandardDeviation= +/-15ResultsofLanguageSample=MLU(UseanddiscussEBP)ForyoungerchildrenalsodiscussPlaySkills(UseandiscussEBP)Discussoverallresults/performanceoftheassessment?Weretheskillsjudgedtobewithinnormallimits?Whatwastheclientabletodo?Whatspeechandlanguageareaswerecompromised?ProvideexamplesoferrorsResultsofauditorycomprehensionindicatesLEVELofDelay/ImpairmentcharacterizedbyResultsofexpressionlanguageindicatesLEVELofDelay/ImpairmentcharacterizedbyResultsofvocabularyskillsindicatesLEVELofDelayResultsofplayskillsindicatesLEVELofDelayPRAGMATICLANGUAGEPragmaticskillsindicatehowoneintegrateslanguageusewithinsocialcontexts.NAMEOFCLIENTwasableto(useappropriateeyecontact,initiate,participate&turn-takewithinaverbalexchange;judgenon-verbalcuesaccordingly;codeswitchwithdifferentcommunicationpartners)Results:NAMEOFCLIENTisaCHRONOLOGICALAGEwasseenforaformalspeechandlanguageassessmentduetoconcernsof____________________.Theresultsoftheevaluationindicatedsummarizefindingsofformal,informal,andobservationresults.Accordingtotheresultsoftheevaluationtheclientpresentswith___________characterizedby___________________.

171

RecommendationsProvidespecificrecommendationsfortherapyservicesItisrecommendedthatNAMEOFCLIENTreceivespeechandlanguageservicestwotimesperweektoimprove(Recommendanystrategiesand/orotherprofessionals)Theresultsoftheevaluationwerediscussedwith_______________.The____________________agreewiththeresultsoftheevaluationandrecommendationsfortreatment._______________________________________________________StudentClinician,DateClinicalSupervisor,Date

172

SPEECH,LANGUAGE&HEARINGCLINICDIAGNOSTICREPORT(ADULT)(SampleOutlineforDiagnosticReport/ADULT)*DiagnosticReportshouldincludebutisnotlimitedtothefollowing:

BackgroundInformation:NAMEOFCLIENTisCHRONOLOGICALAGEwasseenforaspeechandlanguageevaluation(duetoconcernsof__________)(todetermineprogresstodate).ThisclientwasreferredfortheevaluationbyNAMEonDATEforREASON.Theclientidentifiersincluded(client’sname,dateofbirth,address).Theclientwasaccompaniedby(NAMEOFSUPPORT)whowaspresentduringtheevaluation.PertinenthistorywasobtainedviainterviewbyNAMEandactedasareliableinformantandthecasehistoryformofDATE.Theclientdescribedhis/hersspeechandlanguagefunctioningas________________.Pertinentmedicalhistoryisremarkablefor______________onDATE.Thecasehistoryreporton/theclientreported__________________(courseofimpairment,hospitalstays,homecare,pasttherapy)PertinentSocial/EmploymentHistorywasreportedthattheclientliveswith(orlivesalone/homehealthaide).Theclientisaretired___________________.Theclientreportspreviousspeechtherapyat__________________.Currentmedicationsatthetimeoftheevaluationinclude_____________________.Caregiver/ClientConcern:NAMEOFCLIENTdescribesspeechandlanguagefunctioningas______________.Theclientsgoalfortreatmentinclude___________________________.

ClientName: DateofBirth:

Parent(s)/Guardian(s)/Informant(s): ChronologicalAge:

Address: DateofReport:

PhoneNumber: StudentClinician:

ClinicalSupervisor:(PrimarySupervisor) ClinicalSupervisor:(SecondarySupervisor)

173

ClinicalObservation:NAMEOFCLIENTwasabletomakehis/herswantsandneedsknownvia______________.Theclientwasorientedto(person,place,andtime).AuditoryattentionskillswerejudgedtoLEVELofimpairment(orjudgedtobewithinnormallimits).Problemsolving/reasoningskillswerejudgedtobeLEVELofimpairment(orjudgedtobewithinnormallimits).Patient’sawarenessforsafetyanddeficitarejudgedtobeLEVELofimpairment(orjudgedtobewithinnormallimits).Intelligibilitywasjudgedtobe________________________.FormalTestingListEachAssessmentUsed/ConductedNameofformalassessment(abbreviations)i.e.BostonDiagnosticAphasiaExamination-ThirdEdition(BDAE-3)InformalTesting(ifnotusingorinadditiontoaformalmeasure).ListEACHinformalmeasureused/conductedHearing/AuditoryFunctionInformalhearingacuitywasjudgedtobewithinnormallimitsattheconversationalspeechlevelindicatinghearingtobewithinnormallimitsviaoneandthreefeetdistances.(Theclientturnedwhenhis/hernamewascalled;clientlookedtowardsthewindowwhenanenvironmentalnoisewasoutside;clientrespondedtobells/whistles).HearingwasjudgedtobewithinnormallimitsinaquietenvironmentbasedoninformalobservationArticulationTheclientsspeechintelligibilityisLEVELreducesattheWORD/PHRASE/SENTENCE/CONVERSATIONALLeveldueto_____________________characterizedby(decreasedarticulatoryprecision/decreasedcoordinationofrespirationandphonation/increasedrateofspeech/,decreasedrateofspeech/reducedvocalintensity).Dueto___________________highlyvariablespeecherrors/delayedinitiationofspeechsounds/syllablerepetitions.Voice:Clinicalobservationindicatedpitch,quality,intensity,&resonancewerejudgedtobe___________________.(SeparateEvaluationforaformalvoiceassessmentifapplicable)Fluency:Clinicalobservationrevealedrateofspeechanddisfluentpatternstobe________________________.(SeparateEvaluationforaformalvoiceassessmentifapplicable)

174

OralMotorExamAnoralperipheralexamination(informalorformal)wascompletedandrevealedthattheoralmechanismisintactforcommunicationandfeedingpurposes.Theresultsoftheevaluationindicatedthatfacialsymmetrywasjudgetobe_____;tonewasalsonotedtobe__________;labialstructureandfunctionwasjudgedtobe_______characterizedby_______;lingualstructureandfunctionwasjudgedtobe________characterizedby___________.Intraoralexaminationrevealedhard/softpalatestructureandfunctiontobe_________;frenulumtobe________;dentitionwasjudgedtobe________;andsecretionswere__________.Observationofbreathingrevealed_________/appropriateforthecoordinationofrespirationandphonation.LANGUAGETheNAMEOFFORMALASSESSMENTwasadministeredtoevaluate_______________________.Theassessmentiscomposedof___________________.The____________isusedtoevaluate_____________.Theresultsoftheevaluationareasfollows(examplesofsometablesandassessments)BostonDiagnosticAphasiaExamination-ThirdEdition

BDAE-3Subtest RawScore StandardScore %ile

Mean=100;StandardDeviation=+/-15DiscussabilitytoreadandwriteReadingComprehensionWrittenExpressionPRAGMATICLANGUAGEPragmaticskillsindicatehowoneintegrateslanguageusewithinsocialcontexts.NAMEOFCLIENTpragmaticskillswerejudgedtobeLEVELofimpairmentcharacterizedby(turn-taking,poorresponseelaboration,agitation)Results:NAMEOFCLIENTisaCHRONOLOGICALAGEwasseenforaformalspeechandlanguageassessmentduetoconcernsof_________________.Theresultsoftheevaluationindicatedsummarizefindingsofformal,informal,andobservationresults.Accordingtotheresultsoftheevaluationtheclientpresentswith______________characterizedby_________________________.RecommendationsProvidespecificrecommendationsfortherapyservicesItisrecommendedthatNAMEOFCLIENTreceivespeechandlanguageservicestwotimesperweektoimprove(Recommendanystrategiesand/orotherprofessionals)Theresultsoftheevaluationwerediscussedwith_______________.The_________________agreewiththeresultsoftheevaluationandrecommendationsfortreatment.

175

_____________________________________________________StudentClinician,DateSpeech-LanguagePathologist,Date

176

Speech,Language&HearingClinicRoutingReportFormalClockHourSummaryFormStudentEvaluationFeedbackFormBaselineDataForm

177

SpeechLanguage&HearingClinicRoutingofReportCoverSheet

StudentName: TypeofReport:

� MonthlyProgressStatement � ProgressReport � EvaluationReport

Instructions: ClinicalStudent:pleasedocumentthedate,timeandyourinitialswheneachdraftissubmitted.Eachtimeyousubmitareport,providethepreviousreportthatwasreviewedandattachtheroutingreportcoversheet. Speech-LanguagePathologist:pleasedocumentthedate,timeandyourinitialswhenreturningthedocument.

ClinicalStudentSubmission Speech-LanguagePathologist:Returned/Edited

Draft Date Time Initials Notes Draft Date Time Initials

1st 1st 2nd 2nd 3rd 3rd 4th 4th 5th 5th

FinalReport: FinalSignature:

Copygiventoclient: Approvedby:

178

Speech,Language&HearingClinicClinicClockHourFormSTUDENTCLINICIAN

StudentID# SEMESTER ScreensTreatmentDiagnosticsArticulation C:A: C:A: C:A:

Fluency C:A: C:A: C:A:Voice/Resonance C:A: C:A: C:A:Receptive/ExpressiveLanguage C:A: C:A: C:A:Hearing C:A: C:A: C:A:Swallowing C:A: C:A: C:A:

Cognitive C:A: C:A: C:A:SocialAspectsofCommunication C:A: C:A: C:A:Augmentative&ACM C:A: C:A: C:A: Other:Directcontactwithclientandfamilyincounseling C:A: C:A: C:A:C=EIEarlyIntervention(0-3)(PS)Preschool(3-5);(SA)SchoolAge(5-17);A=Adult(18andolder)TreatmentTotalTime DiagnosticTotalTime

ASHAMemberName

ASHAMemberSignature ASHAMemberNumber StateLicensureNumber Date

179

Speech,Language&HearingClinicStudentEvaluationFeedbackForm

Speech,Language&HearingClinicStudentEvaluationFeedbackForm

ClinicalStudentswillberequiredtocompletethefollowingStudentEvaluationFeedbackFormduedatedeterminedbyyourimmediateSLP).Thepurposeofthisformisfortheclinicalstudenttoviewyourselfasa“clinician”,toevaluateyourclient’sneedsandthestepsneededtoachieveyourgoals.Thisshouldbeusedtohelpyouview“whatyouaredoingclinically”withinyoursessions,toimprovethetherapyanddevelopyourknowledgeandskillsforclinicalapplication.

StudentClinician:Clickheretoentertext.ClientInitials:Clickheretoentertext.DateofSession:Clickheretoentertext.

TheStudentEvaluationFeedbackMUSTincludethefollowing:VideoReview(asassignedbytheSLPandaWrittenSummary(usethefollowingpromptquestionstosupportyourwrittendocumentationalongwithanyadditionalquestionsand/orrequirementsbyyourSLP

§ Arethereinforcersmotivatingtheclient?IFSo-How?

§ AmIdeliveringreinforcersappropriately?IFSo-How?

§ Isthescheduleofreinforcementcontinuousorintermittent?Describe

§ AmIteachingthetargetbehaviorinsmallenoughsteps?Whatarethesteps?

§ HowdidIincludepromptsandscaffoldingduringthissession?

§ AmIpresentingthestimuliwhentheclientisnotpayingattention?Howdoesthissupportfunctionaltherapy?

§ AmIprogrammingasufficientvarietyoftargetbehaviorsduringeachsession?

§ AmIallowingtheclienttomaketoomanyerrorsinarowwithoutmodifyingthetask?

§ AmIprovidingfeedbackregarding/reinforcementswhatisdonewell?Doestheclientunderstandwhytheyareparticipatinginspeechtherapyservices?

§ Isthepatientboredwiththerapymaterials?IfSo-whatdoyouneedtodo?

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§ Isthestudentclinicianboredwiththetherapymaterials?

§ DoIprovideinstructionsclearly?Ifso-How?DidIallowtheenoughtimefortheclienttorespond?

§ DidIprepareenoughmaterialstoaddressandsupporttheclientandgoalsforfunctionaltherapy?

§ WhatisoneimprovementIcouldhavemadetoimprovetoday’ssession?WhatwouldIdodifferently?

§ HowdidIimplementpriorsupervisorfeedbackand/orself-assessment?

§ WhatisoneareainwhichIfeelIimprovedon/induringthesession?

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Speech,Language&HearingClinicFormativeAssessmentStudentEvaluationFeedbackFormFall2018-Spring2019

StudentswillparticipateinaformalStudentEvaluationFeedbackevaluationinordertomonitorcriticalthinking,decision-makingandproblemsolvingskillstosupportknowledgeandskilldevelopmentduringtheirlearningprocess.

InaccordancewithprofessionalstandardsandbaseduponSyllabusprovided,videoreviewsarerequiredforbothUndergraduateandGraduatelevelClinicalPracticumStudents.ThepurposeofthesereviewsistoaddtoFORMATIVEEXPERIENCESofstudentclinicians(developmentasfutureprofessionalsinthefieldofSLP).Assuch,thisexperienceaimstoincreaseStudentClinicians’:

- Developmentofself-analysisskillsandhowstudentclinicianperformanceimpactsclientoutcomes

- Abilitytopresentlongrangegoalsandtreatmentplanningforaclientcaseload.

- ThefollowingarerequiredPERSEMESTER:Two(2)reviewsforUndergraduatestudents

andThree(3)reviewsforGraduatestudents.****Intheeventthatthereisnotconsentforvideorecordingbyclient/clientfamily,alternatearrangementstobedetermined.****Inconjunctionwiththeabovevideorequirement,additionalvideoreviewsmayberequestedatthediscretionofthesupervisingorvideoSLPs.

PROCEDURESFORREVIEWS:

- AvideoisrecordedbySLP.Thestudentclinicianprovidesawrittenanalysisofrecordedsession(tobemaintainedinclientsessionchartuntilthedateofvideoreview).Detailstobeincludedinwrittenportionareincludedinatemplateinstudenthandbook.

- OnceStudentclinicianisinformedviaemailbySLPthatsessionhasbeenrecorded,Studentclinicianthensignsupforvideoreviewdate(providedinafolderinSLPoffice)–studentclinicianmustsignforareviewnomorethan(7)daysfollowingbeinginformedregardingrecording.

- Atvideoreview,Studentcliniciansarerequiredtoprovidewrittenanalysisofsessionandareexpectedtoperformasactiveparticipantsinreviewsession(egconversationalexchangeregardingvariouscomponentsoftreatmentsession–suchasclientbehaviors;clinicianawarenessofgoalsandtreatmentplanning;factorsimpactingachievementofclientgoals.Whatthe“nextstep”intreatmentplanningmaybeconsideredclinically.

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Speech,Language&HearingClinicBaselineCollectionDataFormClient StudentClinician DOB Date CA S/LSkillAddressing

Target 10TrialsofTraining ResultsSpeech-LanguageTarget12345678910Results

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NoteResponses(+)CorrectResponse (-)Incorrectresponse (x)NoResponse (m)Modeled (I)IndependentResponseAdaptedfrom:DiscreteTrialTreatmentRecordingSheet,AppendixL,ClinicalMethodsandPracticuminSpeech-LanguagePathology,p.38

Speech,Language&HearingClinicDocumentationSamplesAppendixLUpdatedSpring2018

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Sample Data Collection

DataCollectionSession#(Date)

ClientArrival:Alert/DistractedOntime/LateClientParticipation:Willing/UnwillinglyAttentive/DistractedSTG#1-Signingfor“me”

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Opportunities Attempts PercentageCorrect

STG#2-Signingfor“alldone”

Opportunities Attempts PercentageCorrect

STG#3-AttentiontoActivityActivity Timeofattention#1 #2 #3 #4 #5 #6 #7 STG#4-Turn-Taking

Opportunities Attempts PercentageCorrect

STG#5-ResponsetoSound

Opportunities Attempts PercentageCorrect

AdditionalObservations:

ActivityNumber1Picture

Sticker

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ActivityNumber2Picture

Sticker

ActivityNumber3Picture

Sticker

ActivityNumber4Picture

Sticker

PictureofReward

BehaviorManagementPlan#1:Thischartisavisualbehaviormanagementplantomaketheclientawareofthescheduleofactivitiesaswellastoassistaclientwithtransitions.Attheendofeachactivityastickerisprovidedtomarkatransitionfromthecurrentactivitytothenext.Therewardpictureservesasmotivationfortheclienttocompleteallactivitiestoreceivethedesiredreward.Itisimportanttocontinuetothestickerawardingthroughoutthesessiontocontinuallyremindtheclientwhatiscomingnextandwhatisexpectedinordertoreceivethereward.BehaviorManagementPlan#2:

1) Printoutpicturesorwordcardsforeachactivity.2) Postthepicturesinorderofoccurrenceonthewallofthesessionroomwithaclothes-

pinattachedtothefirstplannedactivity.

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3) Allowtheclienttomovetheclothes-pinduringtransitionsfromoneactivitytothenext.Thismethodallowstheclienttobepartoftheprogressionofthesessionwhilestillmaintainingaschedule.Theclientisawareofthescheduleandcanreferbacktothepicturesonthewall.Thestudentcliniciancanusethepicturesasreferenceandcanvisuallyobservehowfarthesessionasprogressedbasedonlocationoftheclothespin.BehaviorManagementPlan#3:Usingaposterboard,createacolumnofactivitieslistedinorderofoccurrenceandattachwithVelcro.Atthebottomoftheposterboardattachtwoenvelopes,onelabeled“finished”or“alldone”andtheotherlabeledrewards.Attheendofeachactivityallowtheclienttoremovetheactivitycardandplaceitintothe“finished”envelopetoprovidevisualsupportthattheactivityhasended.Whenallactivitieshavebeenremovedfromtheboard,allowtheclienttopickarewardfromthecorrespondingenvelope.BehaviorManagementPlan#4:FollowingfromtheTEACCHmodel,createacollectionofactivitiesthatyouwouldliketoaccomplishinasessioninpictureorwordformat.Presenttheseactivitycardstotheclienttwoorthreeatatimeandallowtheclienttochoosewhichactivitytoparticipatein.Whentheactivityiscompleteallowtheclienttoplacetheactivitycardintoacanorenvelopelabeled“finished”tovisuallysupporttheendoftheactivity.Continuetocycleofchoosingactivitiesuntilallarecomplete.Thismethodisidealforclientsrequiringvariabilityintransitiontimingand/orisworkingonattentionskills.SampleProgressReport Name:DOB:Parents:CA:Address:DateofReport:S/LDiagnosis:Phone:TherapyPeriod:SessionsAttended:21/25(includingtwomake-upsessions)

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Frequency/Duration:StudentClinician:ClinicalSupervisor:BackgroundInformation:

TheclientcurrentlyreceivesspeechservicestwiceperweekforthirtyminutesessionsattheIonaCollegeSpeechandLanguageHearingClinicandthreetimesperweekforthirtyminutessessionsatschoolinadditiontooccupationalandphysicaltherapies.Theclientisastudentinaself-containedpreschoolclassroomforchildrenwithdevelopmentaldisabilities.

AccordingtothecasehistoryformcompletedbythemotherinFall2012,developmentalmilestonesconsistofthefollowing:sittingat7months,crawlingat9months,standingat20months,walkingat22months,andfeedingselfat22months.Theclientisstillworkingtowardsindependentdressingandindependenttoileting.Themothernotedthatsinglewordusestartedat15months,combiningwordsat20months,andnamingsimpleobjectsat24months.Theclient’smotherstatedthatgesturesaretheprimarymodeofcommunication,butwilluseone-twowordutterancesifencouragebyanadult.Useofsimplequestionsorengaginginconversationshasnotyetbegun.

Theclient’sbirthandmedicalhistoriesareunremarkable,withtheexceptionofhead,foot,andmouthdiseaseat26months.Currentlytheclientfollowsaglutenanddairysensitivediet.

Theclientisanonlychildlivingathomewithbothparents.Alotoftimeisalsospentthegrandmother.EnglishistheprimarylanguagespokenathomethoughKoreanisoccasionallyused.Theclient’sfatherpresentedwithspeechdelaysasachildandbeganspeakingattwoandahalfyearsold.StatusatStartofTherapy: Atthestartoftherapyon9/13/12,theclientdemonstratedtheabilitytoimitateverbalmodels(providedbythestudentclinician)andvisualmodels(manualsignusedbythestudentclinician).Theclientwasabletofollowasimpleonestepdirection,suchas“putin/on”whenprovidedwithmaximalsupportfromthestudentclinician.Atthattime,eyecontactwiththestudentclinicianwasnotobservedandtheclientoftenchosetoparticipateinpresentedactivitiesalone,inaseparatespace,asopposedtoparallelplayorjointattention.Theclientdemonstratedbehavioralstimmingincludingspinning,jumping,andscreamingobservedonthefirstsessionwhenthespacebecameoverwhelmingandduringthesecondsessionwhentherewasnointerestinplannedactivities.TherapyObjectives/ProgresstoDate:

SpeechandLanguageDiagnosis:delaysinexpressive,receptive,andpragmaticlanguage.LongTermGoal#1:Toimproveexpressionofwantsandneedsforfunctionalexpressivelanguageskillsinandoutsideoftheclinic.ShortTermGoal

Theclientwillperformthesignfor“more”withmaximalpromptingbythestudentclinician80%ofthetimewithin2sessions.

(Criterionmet9/25/12)

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ShortTermGoal

Theclientwillperformthesignfor“more”withminimalpromptingbythestudentclinician80%ofthetimewithin4sessions.

(Criterionmet10/16/12)

ShortTermGoal

Theclientwilllabel7outof10givenobjectsorpictureswithmaximalverbalpromptingbythestudentclinician80%ofthetimewithin1session.

(Criterionmet10/18/12)

ShortTermGoal

Theclientwilllabelfacialfeatures(eyes,lips,etc.)whenpresentedwiththevisualcuewithminimalpromptingbythestudentclinician80%ofthetimewithin4sessions.

(Criterionmet11/15/12)ShortTermGoal

Theclientwilllabelprovidedpicturesinabookwithmoderateverbalpromptingbythestudentclinician80%ofthetimewithin4sessions.Notmet;Theclientshowsrecognitionofpicturesthroughpointinggesturesorverbalattempts(ex.Productionofthefirstsoundoftheword).Todatetheclientwillimitatethestudentclinician’sverbalmodelofthetargetpicture60%-70%ofopportunities.

ShortTermGoal

Theclientwillpairthesignfor“more”withtheverbalproductionofadesiredobjectwithmaximalverbalpromptingbythestudentclinician80%ofthetimewithin4sessions.Notmet;Theclientproducesthesignfor“more”withminimalpromptingfromthestudentclinician.Maximalpromptingisneededtoelicitaverbalattachmenttomaketherequestneed-specific.Todatetheclientwillusethesignfor“more”withtheadditionofthespecificverbalizedrequest50%ofopportunities.

ShortTermGoal

Theclientwilllabelbodyparts(head,feet,hands,bellyetc.)whenprovidedwithavisualcuewithmoderateverbalpromptingbythestudentclinician80%ofthetimewithin4sessions.Notmet;implementedonlessonplanfor11/20/12.Goaladdedaftertheachievementoflabelingfacialfeaturestocontinueimprovementonage-appropriatelanguage.

LongTermGoal#2:Toimprovereceptivelanguageskillsforfunctionalcommunicationinandoutsideoftheclinic.ShortTermGoal

Theclientwillfollowaonestepcommandwithmaximalverbalandvisualpromptingbythestudentclinician80%ofthetimewithin4sessions.

(Criterionmet10/04/12)ShortTermGoal

Theclientwillidentifyoneobjectinachoiceoftwowithmaximalverbalandvisualpromptingbythestudentclinician80%ofthetimewithin4sessions.

(Criterionmet10/04/12)

ShortTermGoal

Theclientwillfollowaonestepcommandwithminimalverbalandvisualpromptingbythestudentclinician80%ofthetimewithin4sessions.

(DEEMEDINAPPROPRIATELEVELOFSUPPORTon10/09/12;Changeisbelow)ShortTermGoal

Theclientwillfollowaonestepcommandwithmoderateverbalandvisualpromptingbythestudentclinician80%ofthetimewithin4sessions.

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Notmet;Theclientfollowsaonestepcommandapproximately55%-65%ofopportunities;typicallyrequiresthepairingatheverbalrequestwiththecorrespondingactionbeforesheperformstherequestedcommand.

ShortTermGoal

Theclientwillidentifyoneobjectinachoiceoftwowithminimalverbalandvisualpromptingbythestudentclinician80%ofthetimewithin4sessions.

(DEEMEDINAPPROPRIATELEVELOFSUPPORTon10/09/12;Changeisbelow)ShortTermGoal

Theclientwillidentifyoneobjectinachoiceoftwowithmoderateverbalandvisualpromptingbythestudentclinician80%ofthetimewithin4sessions.Notmet;Theclientwillidentifythetargetobjectinachoiceoftwoapproximately60%oftheopportunities;typicallygrabsbothobjects,requiringpromptingfromthestudentclinician,andthenwillidentifywithonechoice.

LongTermGoal#3:Toimprovepragmaticskillsforageappropriatesocialinteractionsinandoutsideoftheclinic.ShortTermGoal Theclientwillmakeeyecontactwiththestudentcliniciantosignifyarequestwithmaximal

visualpromptingbythestudentclinician80%ofthetimewithin4sessions.(Criterionmet10/04/12)

ShortTermGoal Theclientwillmakeeyecontactwiththestudentcliniciantosignifyarequestwithminimalvisualpromptingbythestudentclinician80%ofthetimewithin4sessions.

(DEEMEDINAPPROPRIATELEVELOFSUPPORTon10/09/12;Changeisbelow)ShortTermGoal Theclientwillmakeeyecontactwiththestudentcliniciantosignifyarequestwith

moderatevisualpromptingbythestudentclinician80%ofthetimewithin4sessions.Notmet;Theclientpairseyecontactwitharequestapproximately40%ofopportunities.Typicallyreliesonavisualreminder,suchasholdingadesiredobjecttothestudentclinician’seyes,asanaidforperformanceofthisgoal.

ShortTermGoal Theclientwillgreet(hiandbye)thestudentclinicianatthebeginningandendofeachsessionwithmaximalverbalpromptingbythestudentclinician80%ofthetimewithin4sessions.Notmet;Theclientinconsistentlygreetsthestudentclinicianatthebeginningofthesessionbutsteadilysays“bye-bye”attheendofthesession.

AdditionalInformation: Theclientiscurrentlyworkingtowardsthedevelopmentofexpressive,receptive,andpragmaticlanguageskills.Eachsessioniscreatedbasedonaroutinethathasbeenset.Thesessionbeginswiththecliententeringtheroom,jumpingonthetrampolineorsittingatthetable(dependentuponbehavioratarrivaltotheclinic)andreadingapre-selectedbook.Aftercompletionofreadingthebookwithacorrespondinginteractiveactivity,afollow-upactivitythatfocusesonasegmentofthebookoccurs.Manytimestheseactivitieswillincludeafocusonanimals,colors,bodyparts,orcounting.Theendofthesessionincludesanart/sensoryactivity,followedby“good-byebubbles”.Thisroutineissupportedwithavisualscheduletoassistwithtransitioningfromoneactivitytothenext. AccordingtotheAmericanSpeech-LanguageHearingAssociation,typicallyanindividualattheclient’sagelevelhasvocabularyofapproximately1,000words,usescomplexsentencescomposedof3-4words,canengageinconversationaboutrelatabletopics(school,activities,interests),andusesthenameofadesiredobjectinatwowordrequest.Receptively,achildofthisagewillfollowatwostepdirection,answer“who”,“what”,and“where”questions,andwill

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understandthedifferenceinmeaningofopposites(big/little,on/off,up/down).Theclientusesgesturesastheprimarymethodformakingarequest.Recentlytheclienthasbegunusingthesignsfor“more”and“eat”independently,withthedevelopmentofaverbalattachmentforaspecificobjectwhenprovidedwithmaximallevelprompting.Typically,onlyonewordutterancesareused,unlessimitatingverbalpromptsprovidedbythestudentclinician.Withtheuseofanestablishedroutine,theclienthasbegunproducingcommonlyusedphrasessuchas“turnpage”,“morestickers”,“bye-byebubbles”,and“popbubbles”withoutprompting.Currentlytheclientisbeginningtolabelpicturesinstoriesandobjectsinactivities(colors,animals,etc.).Engagementinconversationhasnotyetbegun.Theclientwillfollowaonestepdirectionwithminimalvisualpromptingfromthestudentclinician.Whenaskedtochoosebetweenobjects,suchasacolorpaintorsticker,theclientwillrespondwithgesture(pointing,glancing),butdoesnotprovideaverbalanswer.ResearchfromStevenP.ShevlovoftheAmericanAcademyofPediatricsdescribedthepragmatic(social)languageofanindividualoftheclient’sagetoincludeactiveengagementwithpeers,desirefornewexperiences,andpretendplay.Theclientiscurrentlyworkingtowardsdevelopingconsistenteyecontactwhenmakingrequests.Currentlyeyecontactisusedwhensigning“more”butnotwhengreetingthestudentclinician(duringhello/goodbyeroutine).Visualcuessuchasholdingasticker,toy,orfoodtothestudentclinician’seyehaveencouragedanincreaseineyecontact.Manuelsignshavebeenimplementedintothesessiontoincreasetheclient’sattentiontotheactionsofthestudentclinicianfordevelopmentofjointattention.Themasteryofthesesignsisnotanexpectation,butinsteadtheiruseistoincreaseattentivenesstothelanguageusedbythestudentclinician.

Eachsessionincorporatesactivitiesaimedtowardselicitingimprovementofoutlinedgoals.Thedevelopmentaltoylistchart,adaptedfromthebook,TheNewLanguageofToys:TeachingCommunicationSkillstoSpecial-NeedsChildren(1996)bySueSchwartz,listsboardgames,picturematchinggames,sandboxplay,pretendplaykits,andshapesortersasage-appropriatetoysfortheclient’sage.ResearchfromLorraineNicholich(1977)andJaneKatz(2001)describestheplayskillsofachildintheagerangeoftheclienttoincorporate“pretendplaysequenceswithtwoormorechildrenwithatheme,assignedroles,andlanguageappropriatetothescenario”.Currentlytheclientdemonstratesskillsofself-relatedsymbolicplay(playbehaviorthatusesobjectsfortheirtruepurposeandinvolvingonlythechild).Theclientpreferstoplayaloneratherthantogetherwiththestudentcliniciananddoesnotdeviatefromtheoriginalpurposeofatoy.Theclientthoroughlyenjoyssensoryplay(moon-sand,waterplay,andriceboxes)andshapesorterswithcorrespondingcolorthemes.Inaddition,theclientreactswelltoactivitiessuchasfarmanddollhouses,babydolls,puzzles,andbooks.Theclientgreatlyenjoysmusicthereforesing-alongsongshaverecentlybeenaddedwhenrelatedtoactivities.Forexample,theABC’s,OldMacDonald,andHead,Shoulders,Knees,andToes,haveallbeenusedtoelicitlanguagegrowth.Incorporatingpretendplaymodels,workingtowardsfollowingdirectionstocorrespondtoboardgames,andincreasingjointattentionwillallowdevelopmenttowardsage-appropriateplaylevel.

Readingisanactivityusedinallsessions.Thereismuchresearchsupportingtheideaofinteractivereadingasanappropriatemethodforincreasingvocabulary,jointattention,andteachingemergentliteracyskills.ThearticleentitledUsingInteractiveStoryBookReadingtoIncreaseLanguageandLiteracySkillsofChildrenwithAutismSpectrumDisorder(KellyWhalon,MaryFrancesHanline,andJuliannWoods,2007)supportstheuseofinteractivereadingtoelicitspontaneouslanguagewiththenaturalenvironmentdevelopedthroughreadingabook.Eachsessionbeginswithreadingabookwhileacorrespondingactivityparallelstheprogressionofthe

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story.Forexample,whenreadingTheVeryHungryCaterpillar,theclient“fed”thecaterpillarthefoodsinsequencewiththeprogressionofthestory.Storymaps,charactersbeingplacedinorderofthereoccurrence,havealsobeenusedtoparallelthestory’sprogression.Thiscategoryofactivityhasallowedtheclienttodevelopfollowingdirections,increasingattentiontoanactivity,andincreasingvocabularyrepertoire. Sensoryinputthroughartandenhancedactivitymaterialsoccursineverysession.Forexample,storymapcharactersoftenhavesensorymaterialssuchasbuttons,feathers,texturedpaper,orpom-pomsattached.Attheconclusionofeachsession,anartactivityoccurstoallowtheclienttoexploreandelicitspontaneouslanguageinreactiontotheexperience.Theclientthoroughlyenjoyswaterplayandmoonsand.Intheseactivitiesshovelsandminipailsareusedtoallowthewaterormoonsandtobedisplaced,tobepouredovertheclient’shands,ortocreateshapes.Verbalmodelsareincorporatedtodescribewhatthestudentclinicianisdoingorasareactiontowhattheclientdoes.Everysessionalsoendswiththeuseofbubbleswhichencouragesjointattentionwiththestudentclinicianastheclientpopsthebubbles,useshandoverhandtoholdthebubblewand,andsaysgoodbye. Onherfirstsession,theclientdisplayedahighinterestinsparklystickers.Thisinteresttransferredintoabehaviormanagementplantoencourageattentivenessinactivities.Eachsessionisplannedoutthroughpicturesonachart.Aftereachactivityiscompleted,theclientchoosesonestickertoplaceonthechart.Behaviorspecificreinforcementsuchas“goodworkfinishingthepuzzle”or“greatjobsayinghellotoday”correspondswiththestickerbeingplacedonthechart.Thisbehaviormanagementplanallowsthestickerstobeusedinaneffectivewayaswellasprovidingavisualsupportofthesession.Inadditiontothestickers,thetrampolineisalsousedwhennecessary.Whentheclientstrugglestoattendtoanactivityoristired,stimmingbehaviorssuchasbeginningtojump,scream,orspinmayoccur.Thetrampolineisapositivewayfortheclienttoregainattentionandcalmfromoverstimulation. Parentinvolvementisveryimportant.Theclient’sparentscomeintotheroomforallsessions.Atthebeginningofthesemesterengagementinactivitieswouldnotoccurunlesstheparents’weresittingwiththeclient.Nowtheclientisabletositseparately,whiletheclient’sparentssitatthetable,andattendstoallactivities.Thissituationallowsfortheparentstoobserveprogressaswellastoseewhichstrategiesproducesuccess.Carryoverissuccessfulbecausetheclient’sparentsarelearningthroughobservationofthesession.Typicallyattheclient’sageitwouldbeexpectedoftheclienttowelcomenewexperiencesandenvironments,butexpressionofanxietyinnewsituationsrequiresthecorrespondencebetweentheparentsandthestudentcliniciantoassureasuccessfulpatternoftherapysessions. Currentlytheclientpresentswiththeabilitytoindependentlysign“more”whenrequesting(typicallystickers,food,orsensorymaterials)whileusingeyecontactwhenprovidedwithminimalvisualprompting.Theclienthasdemonstratedimprovementinlabeling,usuallyduringreading,aswellaswhenprovidedwithverbalpromptsfromthestudentclinician.Theclientimitatesmosttwoutterancelanguagemodelsprovidedbythestudentclinicianandfollowsmostonestepcommandswhenprovidedwithavisualmodel.Therefore,nextsemesterwillfocusontheclient’sdevelopmentofindependentuseofexpressiveandreceptivelanguageuseinadditiontodevelopmentofage-appropriateplayandsocialskillsforfunctionalcommunication.Recommendations: TheclientshouldcontinuereceivingservicesattheIonaCollegeSpeechandLanguageHearingClinictwiceperweekforthirtyminutesessions.Continuationofserviceswillallowfor

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continualimprovementindevelopingageappropriatelanguageintheareasofexpressive,receptive,andpragmaticlanguage.

SampleLessonPlan

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SampleProgressNote

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ProgressNote

S:Theclientarrivedtothesessionontime,alert,andwillingtoentertheroom.Theclientactivelyengagedinallactivitiespresented.O:Theclientproducedthesignfor“alldone”attheendofactivities57%ofopportunitieswhenprovidedwithhandoverhandmodelingfromthestudentclinician.Whenrequestingtousethetrampolineandduringturn-takingactivitiestheclientproducedthesignfor“me”40%ofopportunitieswhenprovidedwithhandoverhandmodelingfromthestudentclinician.Theclient’sattentiontoactivitiesrangedfrom1-15minutes,withthelongestattentiontimetothewaterplaysensoryactivityandtheshortesttothelegos.Theclientrespondedtonamecallandthestartofthemusicwithagesturalresponseofaheadturn20%ofopportunities.Turn-takingwasnotobservedinthissession.A:Theclientpresentswithdelaysinexpressiveandpragmaticlanguage.Theclientcanmakeachoicebetweentwoobjectswithassistanceofsigningtosignalthebeginningandendinganactivityofchoice.Theclientparticipatesinjointattentionwithanobjectofchoiceandusesmaterialsinself-relatedsymbolicplay.Withtheuseofmaximalverbalandvisualpromptingtheclientwillengageinjointattentionwiththestudentclinician.Forexample,duringwaterplaytheclientusednonverbalgesturestoengagewiththestudentcliniciansuchashandingtheshoveltothestudentclinicianandreachingforthestudentclinician’shandtoaskforhelp.Theclient-centeredstructureofthesessionmeetstheclient’sneedforflexibletransitionsaswellasprovidinganenvironmentrichinmeaningfullanguagemodels.Redirectionoccurscontinuallyinthesessiontomaintaintheclient’sfocusonactivities.Examplesofredirectionincluderepositioningmaterialsinnewwaysandusingbubblestoregaintheclient’sattention.The15minutesensorytimeattheendofthesessionisdeemedanappropriateactivitythroughtheuseofsensoryenhancedmaterialspairedwithmusictomaintaintheattentionoftheclientthroughtheendofthesession.Languagemodelingoccursthroughoutthesessiontodescribeboththeactionsoftheclientandstudentcliniciantoencouragevocalizations.Imitationsofsimplesoundssuchas/b/and/m/havebeenobserved,especiallyintimesofexcitementfortheclient.P:Thecontinueduseofaclient-centeredsessionstructurewithage-appropriatetoysandmaterialswilloccurtoelicitthedevelopmentofageappropriateexpressiveandpragmaticlanguage.Inaddition,thestudentclinicianwillrequestpermissiontospeakwiththeclient’sathomespeechtherapisttodiscussprogressandmethodsusedtocreatesessionplansthatbestmeettheclient’sneeds.

SampleProgressNote

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Sampledatacollection

Samplediagnosticreport

IonaCollege

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Speech,Language&HearingClinicDiagnosticReport

Name:********Bobcombe DateofBirth:05/01/1983Address:131BrooksideAvenue DateofEvaluation:City.State:MountVernon,NY Telephone:914-860-6767 DateofReport: ChronologicalAge:Parents:JuneBobcombeCaregiver:BarbaraGraduateClinician:ClinicalSupervisor:AssessmentMaterials:

- AdultCaseHistoryForms–2/18/15- Oral-PeripheralExamination(OPE)–7/15/15- HearingScreening–7/15/15- ScalesofCognitiveAbilityforTraumaticBrainInjury(SCATBI)–3/04/15,3/09/15,&

3/23/15- ArizonaBatteryforCommunicationDisordersofDementia(ABCD)–07/01/15&07/06/15- ScalesofCognitiveandCommunicationAbilityforNeurorehabilitation(SCCAN)–

07/08/15&07/13/15- FrenchayDysarthriaAssessment:SecondEdition(FDA-2)–7/13/15- AssessmentofPragmaticSkills–07/13/15

BACKGROUNDINFORMATION********wasbornonMay1st,1983andisa32yearand2montholdmale.HewasseenforaspeechandlanguageevaluationatIonaCollege’sSpeech,LanguageandHearingClinictodetermineprogresstodate.HewasreferredtoIonaCollege’sSpeechandLanguageClinicfortreatmentbythespeechsupervisorfromtheBurkeRehabilitationCenter.Mrs.Bobcombeactedasareliableinformantbyprovidingpertinentbackgroundinformationthatwasobtainedviaaninpersonparentinterview.AdditionalinformationwascompiledbythecasehistoryformscompletedbyMrs.Bobcombeon2/18/15.Duringaninpersoninterview,Mrs.Bobcombestatedthat********wasinvolvedinavehicularaccidentinwhichhiscarcollidedwithatree,resultinginaTraumaticBrainInjury(TBI)onJanuary11,2011.DuetotheTBI,theclienthasbeendiagnosedwithaseverecognitivecommunicationimpairmentandmixeddysarthria.MedicalHistoryAfterthevehicularaccident,********washospitalizedtotreataTraumaticBrainInjury.Hesufferedfromaheadinjuryandvisualproblemsduetotheaccident.CurrentmedicationsatthetimeoftheevaluationincludeBaclofentoreducemusclespasms.

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Family,Educational,andSocialHistory********hasreceivedhisBachelorsofArtsDegreeinengineeringandcomputerscienceatHowardUniversityinWashington,DC.HecurrentlylivesathomeinMountVernon,NYwithhismotherandfather.Thereisanunremarkablehistoryofanyspeech,languageandhearingproblemswithinthefamily.Asperthemother’sreport,********’saide,Barabra,spendsmostofthedaywithhim,for12hoursaday,5daysaweek.Mrs.Bobcombeand********’saidearetheprimarycaregiversof********.Hecurrentlyreceivesphysicaltherapyonceaweekwithinhishome.LanguageBackgroundandUseSincethediagnosisofaTraumaticBrainInjuryinJanuaryof2011]hasreceivedspeechandlanguageservicesfromHelenHayesandBurkeRehabilitationCenter.Additionally,hewasattendingSt.Andrewsforgrouptherapy.Mrs.Bobcombereportedthat,“********hasmadetremendousimprovementssincehisaccident.”Shestated,“********haschallengeswithspeech,cognition,thinking,andreasoning,buthehasnodifficultywithswallowing.”Parent/CaregiverConcernMrs.Bobcombereportedconcernswith********’sspeechandlanguagedifficulties.Shesaid********hasdifficultymakinghiswantsandneedsknown.Shebelievesthatstimulatinghisbrainwillresultinapositiveoutcome.Hergoalsareforhimtocommunicatemorecoherently.CLINICALOBSERVATIONS********accompaniedthestudentclinicianintothetherapyroomduringtheevaluation.Theclientwasaccompaniedbyhisaide,Barbarawhowasnotpresentduringtheevaluation.Heestablishedarapportwiththestudentclinicianfromthestartoftheevaluation(07/01/15)totheendoftheevaluation(07/15/15).********wasnotorientatedtoperson,place,ortime.Hesmiledanddemonstratedinconsistentattentionandcompliancethroughouttheactivitiesthatwerepresentedtohim.Auditoryattentionskillswerejudgedtobeseverelyimpaired.Problemsolving/reasoningskillswerejudgedtobeseverelyimpaired.Intelligibilitywasjudgedtobeapproximately50-60%intelligibletoanunknownlistener.Theresultsoftheevaluationaredeterminedtobeanaccuratemeasureofhercurrentspeechandlanguageabilities.HEARING/AUDTIORYFUNCTIONAhearingscreeningisapartofthecompletediagnosticevaluationtoidentifyapotentialperipheralhearinglossthatmayaffectaclient’scommunicativedevelopmentorabilities(Shipley&McAfee,2009).Aninformalhearingscreeningwasobtainedon06/15/15toassessthestructuralandfunctionaladequacyof********’sear.Thehearingscreeningconsistedofapure-toneaudiometricscreening,tympanometry,andanotoscopeexamination.Thepure-toneaudiometricscreeningassessedtheclient’sabilitytohearsingletones,presentedatvaryinglevelsofpitch(500Hz,1000Hz,2000Hz,4000Hz)andintensity(50dB,45dB,40dB,35dB,30dB,25dB,and20dB).********wasinstructedtoraisehishandwhenhehearda“beep”sound.Maximumverbalredirectionwasneededfromthestudentcliniciantomaintain********’sattentionthroughoutthepure-toneaudiometricscreening.********respondedtopuretonespresentedat40dBat1000Hzunilaterallyintherightear,howeverhedidnotrespondto20dB,25dB,30dB,and35dB,40dB,45dB,and50dBat500-4000Hzintheleftear.Atympanometrywasconductedtomeasure

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Antony’smobilityandpressurewithinthemiddleearspace.ThetympanometryresultedinatypeBtympanogrambilaterally,suggestingabnormalmiddleearfunctionandshape.Theotoscopeexaminationwasacquiredtoview********’stympanicmembrane.Thebilateralearcanalsandtympanicmembraneswerenotvisibletothestudentclinician.Resultsofthehearingscreeningindictedthat********’shearingmaynotbewithinfunctionallimitsforconversationalspeechtasks.Afullaudiologicalexaminationisrecommendedatthistimeduetotheresultsofthehearingscreening.VOICE,PHONATION,ANDRESONANCEAnaudio-perceptualanalysisofthevoicewascompletedthroughclinicalobservation.Thefeaturesofvoiceareidentifiedaspitch,quality,loudness,nasalresonance,andoralresonance(Shipley&McAfee,2009).Basedonclinicaljudgment,********’svocalpitch,loudness,resonance,andqualityareinconsistentforhisageandgender.Abnormalpitchandqualityisobservedduringhisspeech.Hepresentswithdifficultieswithvolumeandcontrolofhisvoice.Hisresonanceischaracterizedbyhyper/hyponasaltyspeech.Basedon********’svoicecharacteristics,acompleteevaluationbyanotolaryngologist(ENT)isrecommendedatthistime.FLUENCYAccordingtoShipleyandMcAfee(2009),fluentspeechflowsinarhythmic,smooth,andeffortlessmanner.Allspeakersexperiencemomentsofdisfluency,butdisfluenciesthataffectaspeakerforadequatecommunicationisabnormal(Shipley&McAfee,2009).Duringconversationalspeech,clinicalobservationsrevealed********’sdisfluentpatternstobewithinnormallimits.********demonstratedadecreasedrateofspeechwhenheappearedtobefatigued.Ashisspeechratedecreased,hisspeechintelligibilitydecreased.No“stuttering-like”disfluenciesorsecondarybehaviorswereobservedduringtheevaluation.ORALMOTOREXAMAnoral-peripheralexamination(OPE)wasperformedon6/15/15toassessthestructuralandfunctionaladequacyofspeechandswallowingmechanisms.AnOPEisacriticalcomponentofaspeechandlanguageevaluationtoidentifyanystructuralorfunctionalfactorsthatmayrelatetoacommunicationdisorderordysphagia(Shipley&McAfee,2009).StructureTheresultsoftheevaluationindicatedthat********’sfacialfeatureswerejudgedtobeasymmetricalatrestandinconversationwithabnormaltonicity.Inspectionofthejawandlipsrevealedtohangloweranddeviatetotheleftsideofhisface.********’spalateandoropharyngealstructureswereexaminedtobeunremarkableandsufficientforspeechproduction.Atrest,thetongueDentitionwasobservedtobehealthywithnormalcoloringandpresentedwithaClassIocclusion(normal).Hisfirstmolarontherightsideofhismouthwasmissing.********presentedwithnounexpectedgrowthsorfistula.Intraoralexaminationrevealedhardpalatetobehealthywithnormalcolor,heightandwidth.Thesoftpalateappearedstructurallyhealthywithnormalcoloraswell.ThetonsilswerenotobservedduringtheOPE.

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Function********demonstratedadecreasedlabialfunctioncharacterizedbyalimitedrangeofmotionandcoordinationincludingtheelevationoftheupperlip,retractionofthelowerlip,andprotrusion.Lingualfunctionwasreducedashedemonstratedlimitedandspasticretraction,elevation,depression,andlateralizationmovements.Uponlingualmovementsofprotrusionandretraction,********’stonguedeviatestotheleftside.Lipandtonguestrengthappearedreducedtoopposingpressureandwithinnormallimits.Frenulumwasobservedtobewithinnormallimits.Basedonclinicaljudgment,Hyper/hyponasalitywaspresent.Motorfunctionandstrengthofthejawappearedweak,reduced,andjerky.Notemporarymandibularjoint(TMJ)noiseswerepresent.Adiadochokinesistestrevealed********’sinabilitytoproduce/pə/,/tə/,/kə/anaverageof15-20timeswithin3-5secondsintervals.ThissuggestspossibledamagetotheTrigeminalNerveorCentralNervousSystemaffectingCranialNerveV.DuringthesensorycomponentassessmentofCranialNerveV,********reportedthathecouldnotfeelsensationontheinnerliningofhisrightcheek.ResultsTheoverallresultsoftheOPErevealedinadequatestructuralandfunctionalintegrityof********’sspeechandswallowingmechanisms.DYSARTHRIAASSESSMENTTheFrenchayDysarthriaAssessment,SecondEdition(FDA-2;Enderby&Palmer,1983)wasadministeredtoassess********’sperformanceforthemeasurement,differentialdescription,anddiagnosisofdysarthria.TheFDA-2wasadministeredatIonaCollege’sSpeech,Language,andHearingClinicon7/13/15.Maximumverbalredirectionwasneededfromthestudentcliniciantomaintainhisattentionandcomplianceduringtheadministrationoftheassessment.Thetestisdividedintosevensections:Reflexes,Respiration,Lips,Palate,Laryngeal,Tongue,andIntelligibility(Enderby&Palmer,1983).ReflexesTheReflexessectionoftheFDA-2providescontextualinformationthatinformstheclinicianofgeneraloromotorneuromuscularstatusaffectingbothvoluntaryandinvoluntarycontrol(Enderby&Palmer,1983).IntheareaofReflexes:Cough/Swallow,********’saide,Barbarareportedthathehasnodifficultywithhiscoughanddoesnotchokewhenheiseating.Basedonclinicalobservations,********demonstratesaweakcoughreflexandfoodreminisceremainsinhismouthaftereating.HereceivedaBasedonclinicaljudgment,intheareaofReflexes:Dribble/Drool,********dribbles/droolswhenleaningforwardornotconcentratingandhehassomedegreeofcontrol.RespirationTheRespirationsectionoftheFDA-2providesratingsofrespirationatrestandinspeech(Enderby&Palmer,1983).IntheareaofRespiration:AtRest,********demonstratednodifficultytakingadeepbreathinginthroughhismouthandlettingitoutthroughhismouth.IntheareaofRespiration:InSpeech,********demonstrateddifficultycountingto20asquicklyaspossibleinonebreath.Basedonclinicalobservations,hespokequicklyandhisvoicefaded.Additionally,herequiredfourbreathstocompletethistask.LipsTheLipssectionoftheFDA-2providesratingscalestoassessaclient’slipsatrest,spread,seal,alternate,andinspeech(Enderby&Palmer,1983).IntheareaofLips:Atrest,********’slips

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wereobservedwhenhewasmakingnoattempttospeak.Observationsrevealedthathislipsareslightlydroopingapartandasymmetricalbydeviatingtotheleftsideofhisface,butonlynoticeabletoaskilledobserver.IntheLips:Sealsection,********wasinstructedtoblowairintohischeckandmaintainfor15seconds.Additionally,hewasinstructedtosay“/p//p/”clearly10times.Basedonclinicalobservations,********demonstratedverypoorlipsealduetopressurelostfromonesegmentofhislips.Heisabletoattemptclosure,butunabletomaintain.IntheareaofLips:Alternate,********wasinstructedtorepeat“ooee”10times.Basedonclinicaljudgment,hisshapeofhislipswererecognizableasbeingdifferent.IntheLips:InSpeechsection,********’slipmovementwasobservedduringconversation.********’slipswereobservedtohaveconsistentlypoormovementsacousticallyrepresentedasweakorexplosive.Thereweremanyomissionsoflabialshaping.PalateThePalatesectionoftheFDA-2providesratingscalestoassessaclient’spalateforfluids,maintenance,andinspeech(Enderby&Palmer,1983).IntheareaofPalate:Fluids,********’saideBarbara,reportedthathehasnodifficultydrinkingoreating.InthePalate:Maintenancesection,********wasinstructedtosay“ah-ah-ah”fivetimes.Basedonclinicaljudgment,********palatewasslightlyasymmetricalbutmaintainsmovement.IntheareaofPalate:InSpeech,********wasinstructedtosay“/maypay/”and“nay-bay.”Basedonclinicalobservations,********demonstratedmoderatetogrosshypernasalityandimbalancednasalresonance.LaryngealTheLaryngealsectionoftheFDA-2providesratingscalestoassessaclient’palatefortime,pitch,volume,andinspeech(Enderby&Palmer,1983).DuringtheLaryngeal:Timesection,********wasinstructedtosay“ah”foraslongaspossible.Basedonclinicaljudgment,hecansay“ah”for3to4secondsclearly.IntheareaofLaryngeal:Pitch,********wasinstructedtosingascaleofatleastsixnotes.Basedonclinicalobservations,hedemonstratedminimalchangeinpitch,buthedidshowadifferencebetweenhighandlow.IntheLaryngeal:Volumesection,********wasinstructedtocounttofive,increasingvolumeoneachnumber.Basedonclinicalfindings,hisvoiceproductionwasmostlyeffective,buttherewasnotedoccasionalinappropriateuseofvolumeandpitch.IntheareaofLaryngeal:InSpeech,********’sphonation,volume,andpitchwereassessedinconversationalspeech.Basedonclinicalinterpretations,hisvoiceproductionrequiredeffortandattention,deteriorates,andcanbeunpredictable.TongueTheTonguesectionoftheFDA-2providesratingscalestoassessaclient’stongueatrest,protrusion,elevation,lateral,alternate,andinspeech(Enderby&Palmer,1983).IntheareaofTongue:Atrest,********wasinstructedtoopenhismouthwhilethestudentclinicianobservedhistongueatrest.Basedonclinicaljudgment,histonguewasnoticeabledeviatedtotheleftsideandinvoluntarymovementwereapparent.IntheTongue:Protrusionsection,********wasinstructedtostickhistonguecompletelyoutandretractfivetimes.Basedonclinicalobservations,hevariesinabilityduetohistonguemovementbeingirregularandaccompaniedbynoticeabletremor.DuringtheTongue:Elevationsection,********wasinstructedtopointhistonguetowardthenoseandthentowardthechin,insequence,fivetimes.Basedonclinicalinterpretations,histonguemoveswellinbothways,butmovementislaboredandincomplete.IntheareaofTongue:Lateral,********wasinstructedtomovehistongueoutsideofhismouthfromonesidetoanotherfivetimes.Clinicalobservationsrevealedthat********movedhistonguewellbutslowlyduetothetasktakingatotalof5-6seconds.IntheTongue:Alternate

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section,********said“kala”10timesasquicklyaspossible.The“la”soundwasjudgedtobewellarticulated,butthe“ka”soundispoorlypresented.Additionally,thetaskstookabout10secondstocomplete.DuringtheTongue:InSpeechsection,********’stonguemovementswereobservedduringconversationalspeech.Heproducedcorrectarticulationinconversationalspeech,butslowalternatingmovementsmadespeechlabored.Therewereseveralomissionsofconsonants.IntelligibilityTheIntelligibilitysectionoftheFDA-2provideswordsandshortsentencesforaclienttoreadasanindicationofintelligibility.IntheareaofIntelligibility:Words,********wasinstructedtoread12wordsfromaselectionofrandomcards.Basedonclinicalobservations,8ofthe12wordsthatwerereadwereinterpretedcorrectly.IntheIntelligibility:Sentencessection,********read12sentencecardsthatwereselectedatrandom.7outofthe12wordthathereadwerejudgedtobecorrect.DuringtheIntelligibility:Conversationsection,********andstudentclinicianengagedinaconversationforabout5minutes.Basedonclinicaljudgment,********’sspeechisseverelydistortedanditcanbeunderstoodabouthalfthetime.ResultsBasedonclinicalobservations,theresultsoftheFDA-2assessmentrevealedthat********demonstratescharacteristicsofamixedupperandlowermotorneuronlesion.Thelowestratingscoreswereforallofthelaryngeal,tongue,andliptasks.Thehighestratescoreswereforthepalatalmovementinswallowingandsensorytesting.COGNTIVECOMMUNICATIONClinicalObservations&Results:********’scognitivecommunicationskillswereassessedusingstandardizedmeasurements.TheArizonaBatteryforCommunicationDisordersofDementia(ABCD;Bayles&Tomoeda,1993)wasadministeredon07/01/15and07/06/15toassess********’sexpressive,receptive,andcognitivelanguageskills.Maximumverbalredirectionwasneededfromthestudentcliniciantomaintainhisattentionandcomplianceduringtheadministrationofthisassessment.TestscoresfortheABCDassessmentshouldnotbereportedforindividualsforwhomthenormativesampleisnotrepresentative.AccordingtoBaylesandTomoeda(1993),“TheABCDwasstandardizedonAlzheimer’sdiseasepatients,itssubtestaredesignedtoevaluatethementalstatus,verbalepisodicmemory,visualspatialconstruction,andlinguisticexpressionandcomprehension,allofwhichcanbeimpairedinadultswithheadinjuryandotherneurologicaldisorders.”Theassessmentprovidedinformationaboutthe********’slanguageperformanceincludinghisdifficultieswithinhisabilitytoexpressandcomprehendlanguage,cognitiveabilities,orientationskills,memoryskills,andtheabilitytorecallinformation.TheScalesofCognitiveAbilityforTraumaticBrainInjury:NormalEdition(SCATBI;Adamovich&Henderson,1992)wasusedtomeasure********’scognitivecommunicationskills.Thetestwason3/04/15,3/09/15,and3/23/15atIona’sSpeech,Language,andHearingClinic.Maximumverbalredirectionwasneededfromthestudentcliniciantomaintainhisattentionandcomplianceduringtheadministrationofthisassessment.TheresultsoftheSCATBIassessmentareasfollows:

SCATBI StandardScore PercentileRank Range

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Perception/Discrimination 74 4% Severe-1.5and-2.0standarddeviationsbelowthe

meanOrientation 75 5% Severe

-1.5and-2.0standarddeviationsbelowthe

meanOrganization 76 6% Severe

-1.5and-2.0standarddeviationsbelowthe

meanRecall 77 6% Moderate-severe

-1and-1.5standarddeviationsbelowthe

meanReasoning 81 10% Moderate-severe

-1and-1.5standarddeviationsbelowthe

meanMean=100,1SD=15pointsabove/belowthemean.TheScalesofCognitiveCommunicationAbilityforNeurorehabiliation(SCCAN;Milman&Holland,2012)wasadministeredatIonaCollege’sSpeech,Language,andHearingClinicon07/08/15and07/15/15toassess********’scognitivecommunicativeandlanguageprocessingabilities.Maximumverbalredirectionwasneededfromthestudentcliniciantomaintainhisattentionandcomplianceduringtheadministrationofthisassessment.TheresultsoftheSCCANassessmentareasfollows:

SCANN RawScore PercentageScore RangeOralExpression(OE) 9 47% N/AOrientation(OR) 5 42% N/AMemory(ME) 12 63% N/A

SpeechComprehension(SP) 9 69% N/AReadingComprehension(RD) 6 50% N/A

Writing(WR) 4 57% N/AAttention(AT) 6 38% N/AProblemSolving 9 39% N/ATotalRawScore 42 N/A SeverCognitive

Impairment*Thetotalrawscorewas42indicatingaseverecognitivecommunicationimpairment.OrientationNormalorientationdependsoneffectiveintegrationofseveralcognitiveprocesses,includingattention,memory,andperception.Impairmentsoforientationareacommondifficultyofbraininjuryandmayresultfromdisruptiontoanyofthesebasicprocesses(Milman&Holland,2012).ABCD

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TheMentalStatusSubtestwasadministeredtoassess********’sgeneralknowledgeandorientationtotime,place,andperson(Bayles&Tomoeda,1993).********wasinstructedtolistentosomequestionsreadbythestudentclinicianandanswerthemcarefully.Hedemonstrateddifficultywithshorttermmemoryquestions.Forexample,whenasked,“Whatistheplaceweareinrightnow?”and“Whatmonthisthis?”********responded,“Idon’tknow.”********accuratelyansweredsomelongtermmemoryquestions.Forexample,whenasked,“Inwhatyearwereyouborn?”Theclientresponded,“1983.”Whenasked,“Inwhatmonthwereyouborn?”Heresponded,“May.”Additionally,heidentifiedtheappropriatemonththatIndependenceDayiscelebratedandthecurrentPresidentoftheUnitedStates.SCATBIThecalculatedstandardscoreforhisOrientationportionoftheSCATBIisbelowthemeanstandardscoreof100.********’sOrientationstandardscoreof75fallsbetween-1.5and-2.0standarddeviationsbelowthemeanindicatingasevereperformance.IntheOrientationsubtest,hiscognitiveprocessesofbasicorientationintimeandspacewereassessed.********demonstrateddifficultyansweringquestionsregardinghisbasicorientationsuchashiscurrentage,date,andlocation.Hewouldfrequentlyrespondwith,“Idon’tknow.”Thestudentclinicianprovided********withmultiplechoiceoptionstoassistinansweringthequestion.Givenmultiplechoiceoptions,theclientcontinuedtodemonstratedifficultyansweringquestionsregardinghisorientation.Forexample,hewasasked,“Whatpartofthedayisit?”andgiventhemultiplechoiceoptionsof,“morning,afternoon,orevening.”********thenrespondedwith,“Idon’tknow.”SCCANIntheareaofOrientation,********accuratelyanswered42%ofthequestionsandreceivedarawscoreof5.TheOrientationsubtestwasadministeredtoassesshisawarenessofpersonalinformation,place,andtime(Milman&Holland,2012).Hedemonstrateddifficultyansweringquestionspertainingtohisorientationandawarenessskills.Forexample,whenasked,“Whatcityarewein?”Theclientrespondedwith,“NewYork.”********wasthenprovidedwiththecue,“AreweinNewRochelle?”********thenresponded,“No!”Heaccuratelyidentifiedhisfirstandlastname,howhewasfeeling,thestatehewascurrentlylocatedin,andthecurrentPresidentoftheUnitedStates.AttentionNormalattentionallowsustofocusonasingletask,maintainmultiplebitsofinformationinourconsciousnesssimultaneously,shiftbackandforthbetweendifferentactivities,anddoallofthisinarelativelytime-efficientmanner(Milman&Holland,2012).SCCANIntheareaofAttention,Antonyaccuratelyanswered38%ofthequestionsandreceivedarawscoreof6.TheAttentionsubtestwasadministeredtoassesstheclient’sattentionusingacombinationofverbalandnonverbalvisuospatialitems(Milman&Holland,2012).Theclientdemonstrateddifficultyattendingtotaskswithintheassessment.Forexample,theclientviewedavisualofamapoftheUnitedStatesandwastheninstructedtoidentifythestatesofOregonandFlorida.HeaccuratelyidentifiedthestateofFlorida,butdidnotidentifythestateofOregon.Additionally,********wasshownavisualofpictureofroostersanddogs.Hewasinstructedtocirclealloftheroostersandunderlineallofthedogsonthestimuluspage.Theclientdidnotappropriatelycirclealloftheroostersandunderlineallofthedogs.Memory

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Memorycanbedefinedasthestorageandretrievalofnewinformationandexperiences(Milman&Holland,2012).ABCDTheStoryRetellingImmediateSubtestwasadministeredtoevaluatetheclient’sepisodicmemoryskillsbyassessinghisabilitytorecallverbalinformationintheformofastory(Bayles&Tomoeda,1993).********wasinstructedtolistentoashortstoryandthenimmediatelyrecallthestorybacktothestudentclinicianafterhearingit.Theclientthendemonstratedgreatdifficultybyresponding,“Idon’tknow.”Hewasinstructedtorememberthestorybecausehewouldbeinstructedtorecallthestoryagainlaterduringthesession.TheStoryRetellingDelayedSubtestwasadministeredtoassesstheeffectofdelayon********’sabilitytorecallverbalinformation.Theclientwasinstructedtorecalltheshortstoryagainafterapproximatelya30minutedelay.Theclientthenresponded,“No.”TheWordLearningSubtestwasadministeredtoassesstheclient’sepisodicmemoryskillsbyevaluatinghisabilitytofreerecall,cuedrecall,andrecognitionofsixteenwords(Bayles&Tomoeda,1993).Theobjectofthissubtestwasfor********torememberasetofwordsinthecontextofthetest,notacquirenewwords(Bayles&Tomoeda,1993).Hewasinstructedtopairavisualstimuluswordwiththeverbalnameofthecategorytowhichthestimulusbelongs.Thisprocedureassiststheclientinestablishingarelationbetweenthestimulusandthecategorytowhichitbelongs(Bayles&Tomoeda,1993).********accuratelyidentified13/16itemswhenpresentedwiththevisualstimulusandwhenthevisualstimuluswasimmediatelyremovedfrom********’sfieldofview.Forexample,whenasked,“Showmethepartofthehumanbody.”********accuratelypointedtothepictureofthehead.Thevisualstimuluswasthenremovedfromtheclient’sfieldofviewandasked,“Whatwasthepartofthehumanbody?”********accuratelyresponded,“Head.”TheWordLearningSubtestFreeRecallwasadministeredaftera20seconddistraction.********wastheninstructedtonameasmanywordsashecouldfromthefourpagesthathejustsaw.Hedemonstrateddifficultyrecalling16wordsbyrespondingwith,“Idon’tknow.”TheWordLearningSubtestCuedRecallwasadministeredtoassesshisabilitytorecallthe16wordswhenprovidedwithcues.Thestudentclinicianprovidedacategorycueforthemisseditems.Forexample,“Whichwasthemusicalinstrument?”********accuratelyresponded,“Trumpet.”Givenaverbalcategorycue,********accuratelynamed6/16words.Lastly,theRecognitionofLearnedWordswasadministeredtodeterminethenumberofstimuluswordsthattheclientrecognized.********waspresentedwithavisualstimulusofawrittenwordandtheninstructedtoanswer“yesorno”ifherecognizedthewordfromthepageshewaspreviouslyexposedto.Hedemonstrateddifficultywiththistaskbyaccuratelyrecognizing2/48words.Ofthe48wordsusedintherecognitiontask,16aresemanticallyrelatedtoastimuluswords,and16areunrelated.SCATBIIntheareaofRecall,********’ssemanticmemory,episodicmemory,immediaterecall,delayedrecall,recallwithinterference,andlong-termmemoryskillswereassessed.ThecalculatedstandardscoreforhisRecallportionoftheSCATBIisbelowthemeanstandardscoreof100.********’sRecallstandardscoreof77fallsbetween-1and-1.5standarddeviationsbelowthemeanindicatingamoderate-severeperformance.Hedemonstrateddifficultiesrecallinggraphicelementsbyrecalling2/6picturesofobjectsinagrouppicture.********accuratelycompletedwordretrievaltasksbynaming5/8itemsgivenvisualcuesbythestudentclinician.Hedemonstrateddifficultieswithimmediate,delayed,andcuedrecallwiththeuseofanauditorytape.Forexample,theclientwouldnotrespondwhenaskedtorepeattherecordedwords

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followingatone.********demonstrateddifficultiesrecallingverbalwordsreadbythestudentclinicianbyrecalling2/6words.Hedidnotprovidearesponsewhenaskedtogeneratewordsthatbeganwiththeletter“r”and“d.”Hedemonstrateddifficultieswithimmediaterecalloforaldirectionsgivenbythestudentclinician.Forexample,thedirectionswere,“Closethisbookletandturnitovertothebackcover.”********wouldfollowonepartofthetwostepcommandbyclosingthebookletandnotturningitover.Hedemonstrateddifficultiesintherecalloforalparagraphswhenpresentedwithastimulustape.********hadtolistentoashortstoryandthenanswerquestionsbasedonthestory.Hedidnotanswerthequestionsfollowingtheshortstoryincludingthequestionswithmultiplechoiceoptions.SCCANIntheareaofMemory,********accuratelyanswered63%ofthequestionsandreceivedarawscoreof12.TheImmediateRecallsubtestwasadministeredtoassesshisabilitytorecallverbalandvisuospatialinformationimmediatelyafterithasbeenpresented(Milman&Holland,2012).********demonstrateddifficultiesrecallingvisuals.Forexample,hewasinstructedtorememberavisualofafacewithinthestimulusbook.Afterremovingthepicturefrom********’spresentfieldofviewandfollowingadelayoftwoseconds,hewasasked,“WhichfacedidIaskyoutoremember?”Heinaccuratelypointedtoadifferentvisualofaface.Additionally,heviewedavisualofpillswithinthestimulusbook.********wasimmediatelyaskedtorecallthepillsandinaccuratelypointedtodifferentpills.TheDelayedRecallsubtestwasadministeredtoassesshisabilitytorecallverbalandvisuospatialinformationafteradelayofseveralminutes(Milman&Holland,2012).********demonstrateddifficultiesrecallingverbalandvisualinformationthatwasinstructedforhimtorememberatthebeginningoftheassessment.Forexample,hewasinstructedtoindicatethevisualofthefacethatthestudentclinicianaskedhimtorememberatthebeginningoftheassessment.********inaccuratelypointedtoavisualoffacethatwasdifferentfromthevisualtarget.ProblemSolvingProblemsolvingincludesconceptformation,reasoning,andexecutivefunction(Milman&Holland,2012).SCATBIIntheareaofReasoning,********’scognitiveprocessesofconvergentthinking(relevantandmissinginformationinvisuallyoraurallypresentedinformation),deductivereasoning(drawingconclusionsaboutagivensituation),inductivereasoning(formulationofasolutionbasedondetailsthatleadtoaconclusion),anddivergentreasoning(generationofuniqueabstractconcepts)wereassessed.ThecalculatedstandardscoreforhisReasoningportionoftheSCATBIisbelowthemeanstandardscoreof100.********’sReasoningstandardscoreof81fallsbetween-1and-1.5standarddeviationsbelowthemeanindicatingamoderate-severeperformance.Hepresenteddifficultieswithfiguralreasoning(analogies).Forexample,hehadtoidentifythepicturethatwasmissingfromagroupofchoicesshownatthebottomofthepage.Heidentified1/5ofthepicturesthatweremissing.Hedemonstrateddifficultieswithconvergentreasoning(centraltheme)bynotidentifyingthemainideaofthreeshortstores.Hedisplayeddifficultieswithdeductivereasoning(elimination)bytheinabilitytoidentifyanobjectgivencluesfromthestudentclinician.********presenteddifficultieswithinductivereasoning(opposites)bynotdeterminingtheoppositeofawordgivenbythestudentclinician.Forexample,hewasread“enter,entrance,”andthestudentclinicianrespondedwith,“Idon’tknow.”Hedisplayeddifficultieswithdivergentreasoning(homographs)bynotproducingtwosentencescontainingdifferentmeaningsofagivenwordfromthestudentclinician.********

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successfullycompletedadivergentthinkingtask(idioms)byidentifyingthemeaningbeyondthewords.Forexample,thestudentclinicianread,“rainingcatsanddogs”andheresponded,“rainingheavy.”********presenteddifficultieswithadditionaldivergentthinkingtaskssuchasproverbsandverbalabsurdities.SCCANIntheareaofProblemSolving,********accuratelyanswered39%ofthequestionsandreceivedarawscoreof9.TheVisualProblemSolvingsubtestwasadministeredtoassesshisproblemsolvingskillsbyavarietyofvisuospatialtasks(Milman&Holland,2012).Overall,********accuratelyrespondedtomostofthevisualproblemsolvingquestions.Heaccuratelymatchedshapesandsequencedpatterns.Hedemonstrateddifficultywhenidentifyingitemsthatwere“different”inafieldoffourpictureswithinthestimulusbook.Forexample,********wassimultaneouslyshownapictureofthreefruitsandonevegetableandasked.“Lookatthesefourpictures.Whichonedoesnotgowiththeothers?”Herespondedbypointtooneofthefruitsinthepicture.TheNumericProblemSolvingsubtestwasadministeredtoassesstheclient’sproblemsolvingskillsbyavarietyofnumerictasks(Milman&Holland,2012).********demonstrateddifficultywithhisproblemsolvingskillspertainingtonumericaltasks.Forexample,********wasinstructedtototalthecostofasoupfor$2.00andagrilledsandwichfor$3.99.Heincorrectlyresponded,“$5.00.”Additionally,hewasinstructedtototalthecostof$25.00and$33.50.********thenincorrectlyresponded,“$58.00.”TheConnectedSpeech&ProblemSolvingsubtestwasadministeredtoassess********’sproblemsolvingskillsbyavarietyofverbaltasks(Milman&Holland,2012).********demonstrateddifficultywithhisproblemsolvingskillspertainingtoverbaltasks.Forexample,********wasasked,“Whataretwotypesofaccidentsthatcouldhappeninthekitchen?”Hethenincorrectlyresponded,“Food.”Additionally,********wasasked,“Howarealakeandanoceandifferent?”Hethenresponded,“Idon’tknow.”Perception&DiscriminationABCDTheSpeechDiscriminationScreeningTasksubtestwasadministeredtoscreen********forspeechdiscriminationproblems(Bayles&Tomoeda,1993).********wasinstructedtolistentosomewordsproducedbythestudentclinicianandidentifyiftheywerethesameordifferent.********demonstrateddifficultywiththistaskbyaccuratelyidentifying7/18ofthewords.Forexample,whengiventheverbalwords,“thin/shin,”********inaccuratelyidentifiedthewordsasbeingthesame.Additionally,whengiventheverbalwords,“gum/gum,”********inaccuratelyidentifiedthewordsasbeingdifferent.SCATBIIntheareaofPerceptionandDiscrimination,********’scognitiveprocessesofperception,attention,anddiscriminationofenvironmentalandphonemicsoundswereassessed.Thecalculatedstandardscorefor********’sPerception/DiscriminationportionoftheSCATBIisbelowthemeanof100.HisPerception/Discriminationstandardscoreis74,whichfallsbetween-1.5and-2.0standarddeviationsbelowthemeanindicatingasevereperformance.Hedemonstratedsignificantdifficultywhenpresentedwiththestimulustapetodiscriminatebetweensounds,andnon-wordpairs.Forexamplewhen********wasaskedtoidentifythesoundofabellonanaudiorecording,hedidnotrespond.Whenhewasaskedtoidentifywordspairsthatwerethesameordifferent,heidentified2/5wordpairsthatweredifferentsuchas“Zug/Zum”and“Fim/Fid.”Hesuccessfullyidentifiedwordsthatwerethesameordifferentsuchas“Soup/Soon”and“Tick/Tick.”Heidentifiedshapesbypointingwhenpresentedwithvisual

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stimuli,butdemonstrateddifficultywhenaskedtodiscriminatebetweensizeandcolorsoftheshapes.Hesuccessfullyidentifiedpicturedobjectsbypointingwhenpresentedwithvisualstimuli.ReadingNormalreadingrequiresadequateattentiontovisualinformation,perceptionoflinguisticallyrelevantinformation,andtheassociationofwrittenletters,words,andstringsofwordswiththeirappropriatesoundandmeaning(Milman&Holland,2012).SCCANIntheareaofReading,********accuratelyanswered50%ofthequestionsandreceivedarawscoreof6.TheReadingsubtestwasadministeredtoassesshisreadingskillsbyusingavarietyoftasksinwhichspokenand/orvisualstimuliarematchedtoreadingtargets(Milman&Holland,2012).********’sreadingwasassessedatthelevelofsigns,singlewords,sentences,andconnectedtext.Inthefirstsetofitems,readingmaterialsarepresentedinisolation(Milman&Holland,2012).********accuratelyidentifiedthesigns,“stop,poison,wheelchair.”Heaccuratelyidentifiedthewords,“no,yes,door,floor,window,chair.”Hedemonstrateddifficultywithhisreadingskillsatthesentencelevel.Forexample,heinaccuratelymatchedapictureinafieldoffourvisualswiththecaption,“Anotherwindyday.”Additionally,heinaccuratelymatchedapictureinafieldoffourvisualswiththesentence,“Thebirdthat’seatingtheappleisred.”Toassesstheeffectsofattentionandperceptionontheclient’sreadingskills,thesecondsetofitemsrequiresexamineestoreadtextthatisembeddedincontextandlocatedindifferentspatialquadrants(Milman&Holland,2012).********demonstrateddifficultieswiththeeffectsofattentionandperceptiononhisreadingskillsattheconnectedtextlevel.Forexample,********viewedapictureofpagefromaphonebookandwasinstructedto,“FindthephonenumberforEmmaSussman.”********inaccuratelyselectedadifferentphonenumber.Additionally,********wasinstructedtoviewapictureofamenuand“Pointtothesoupofthedayandthechickendinner.”Heinaccuratelypointedtoonedifferentitemonthemenu.ABCDTheReadingComprehensionsubtesttoevaluate********’sreadingcomprehensionskillsatthewordlevelandsentencelevel(Bayles&Tomoeda,1993).Toassesshisreadingcomprehensionskillsatthewordlevel,********wasshownsomewordsandpicturesandinstructedtoreadeachwordandpointtothepicturethatbestrepresentsthewords.Heaccuratelyreadthewords,“bed,bugs,throwing,policeman,complaining,boy,ball,memorizing”andsimultaneouslypointedtotheappropriatematchedpictures.Heinaccuratelyreadtheword,“waiting”as“venting”andpointedtotheincorrectpicture.Toassesstheclient’sreadingcomprehensionskillsatthesentencelevel,********wasshownsomesentencesandinstructedtoreadeachsentenceandanswerthequestionunderit.********demonstrateddifficultyreadingthesentencesandansweringtheproceedingquestionsbyaccuratelyanswering3/7questions.Forexample,********accuratelyreadthesentence,“Thescoutscomplainedaboutthebugs.”Thenheinaccuratelyansweredthequestion,“Whatdidn’tthescoutslike?”byresponding,“Complaining.”WritingNormalwritingassumestheintentandabilitytoformulateamessage,theretrievalanappropriatevisualrepresentation,andadequateperceptual-motorskillstoproducethedesiredwrittenmessageinthecorrectspatiallocation(Milman&Holland,2012).ABCD

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TheGenerativeDrawingSubtestwasadministeredtoassess********’sabilitytogenerateanaccuratedrawingofanameableobject(Bayles&Tomoeda,1993).********wasinstructedtodrawakite,bucket,andadigitalclock.********demonstrateddifficultywiththiswritingtask,asheinaccuratelydrewthe3objects.********wasthengivenvisualcuesoftheobjectsandinstructedtocopythedrawingoftheobject.Again,herespondedbyinaccuratelydrawingthethreeobjects.TheFigureCopyingsubtestwasadministeredtoassesshisabilitytocopyfigures(Bayles&Tomoeda,1993).Theclientwasinstructedtocopythreefiguresinthespacenexttothem.********demonstrateddifficultywithfigurecopyingbyaccuratelycopyingthefirstfigureofacirclewithahorizontalandverticallinethroughit,butinaccuratelycopiedtheadditionaltwofigures.SCCANIntheareaofWriting,********accuratelyanswered57%ofthequestionsandreceivedarawscoreof4.TheWritingsubtestwasadministeredtoassesshiswritingskillsofcopying,writingtodictation,writtennaming,andwrittenpicturedescription(Milman&Holland,2012).Writingwasassessedatthelevelsofisolatedletters,isolatedwords,andsentences(Milman&Holland,2012).********accuratelywrotedownisolatedwordssuchas“dog,********,newspaper.”********demonstrateddifficultywheninstructedtowritedownsentencessuchas,“TheappointmentisWednesdayat11”bywriting“Theappointmentisat11.”LANGUAGEReceptiveLanguageABCDTheFollowingCommandssubtestwasadministeredtoassess********’sabilitytoperformone,two,andthreestepcommands(Bayles&Tomoeda,1993).********wasinstructedtofollowsomeverbaldirections.********accuratelyfollowed5/9verbalcommands.Forexample,********followedonestepverbalcommandssuchas,“Wave,Lookup,Shutyoureyes.”Hedemonstrateddifficultywhenfollowingmulti-stepcommandssuchas,“Clap,thenpoint”and“Cough,smile,thenwhistle.”TheComparativeQuestionssubtestwasadministeredtoassessauditorycomprehensionofcomparativequestions(Bayles&Tomoeda,1993).********wasinstructedtoanswerquestionswithyesorno.Heaccuratelyanswered5/6ofthequestions.Forexample,whenasked,“Issupperearlierthanbreakfast?”********appropriatelyanswered,“No.”SCCANIntheareaofReceptiveLanguage,********accuratelyanswered69%ofthequestionsandreceivedarawscoreof9.TheSpeechComprehensionsubtestwasadministeredtoassess********’sabilitytofollowcommands,matchspokenlanguagetopictures,andansweringyes/noquestions(Milman&Holland,2012).Comprehensionwasassessedatthelevelsofsinglewords,sentences,idioms,anddiscourse-levelcommunications(Milman&Holland,2012).********accuratelyfollowedonestepverbaldirectionssuchas“Raiseyourhand”and“Pointtothetable.”Hedemonstrateddifficultywithfollowingmulti-stepcommands.Forexample,wheninstructedto“Showmeyourthumbandpointtothefloor.”********respondedbyonlypointingtothefloor.********accuratelymatchedspokenlanguagetopictures.Forexample,heaccuratelypointedtopicturesofthekangarooandthecalculator.Additionally,heaccuratelypointedtothepicturesthatmatchedthephrases,“Shehasagreenthumb”and“Therhinocerosischasedbythekangaroo.”********accuratelyansweredyes/noquestions.Forexample,whenasked,“Areyousittingdown?”Heappropriatelyanswered,“Yes.”Whenasked,“Areyoustandingup?”Heaccuratelyanswered,“No.”

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ExpressiveLanguageOralexpressionrequiresthatthespeakerhavetheintenttocommunicatesomemessage,beabletoretrievewordsassociatedwiththemessage,andhavetheabilitytoarrangethesewordsintomeaningfulstrings,whicharearticulated(Milman&Holland,2012).ABCDTheRepetitionSubtestwasadministeredtoevaluate********’sabilitytorepeatnonmeaninfulphrasesthatarecontrolledforlength(Bayles&Tomoeda,1993).********wasinstructedtorepeatsomephrasesthatthestudentclinicianinitiallysaidaloud.********demonstrateddifficultyrepeatedphrasesasthenumberofsyllablesincreased.Forexample,********accuratelyrepeatedthephrase,“Runningstoryparcel.”Hehaddifficultyrepeatingthephrase,“Hersmileswallowsshinydeckmallets”byproducing,“Hersmiledeckmallets.”TheGenerativeNamingSemanticCategorySubtestwasadministeredtoevaluatetheclient’sabilitytogenerateexemplarsfromasemanticcategory(Bayles&Tomoeda,1993).********wasinstructedtonameitemsinthecategoriesofanimalsandtransportation.Hedemonstrateddifficultywithgenerativenamingbynaming3items(“dog,cats,humans”)forthecategoryofanimalsand2items(“bus,train”)forthecategoryoftransportation.TheConfrontationNamingSubtestwasadministeredtoevaluatehisabilitytonamepicturedobjects(Bayles&Tomoeda,1993).********wasinstructedtoviewpicturesofobjectsandnameeachone.Heaccuratelynamed15/20oftheobjectsinthegivenpictures.Forexample,********named,“Pencil,hanger,whistle,toothbrush,funnel,snail,acorn,wreath,comb,umbrella,mailbox,dart,porcupine,tennisracquet,dominoes.”Hedidnotaccuratelyname,“lattice,stethoscope,broom,pen,abacus.”TheConceptDefinitionSubtestwasadministeredtoassesstheclient’sknowledgeofconceptbyprovingadefinition(Bayles&Tomoeda,1993).********wasinstructedtoviewsomewordsandprovidedefinitionsforthem.Hedemonstrateddifficultywiththistaskbyprovidingresponseswithminimaldetailsforthewords.Forexample,********respondedwiththedefinitionof“blows”whenshownapictureoftheword,“whistle.”Additionally,herespondedwith“goodtoeat”whenheviewedapictureoftheword,“acorn.”TheObjectDescriptionSubtesttoevaluatetheclient’sabilitytogeneratemeaningfuldescriptorsofacommonobject(Bayles&Tomoeda,1993).********wasinstructedtodescribeanobject(nail)ascompletelyaspossible.********demonstrateddifficultywiththistasksbynamingitandprovidingminimaldetailsabouttheobject.Forexample,hesaid,“It’ssharp,metal,andhard.”SCCANIntheareaofExpressiveLanguage,********accuratelyanswered47%ofthequestionsandreceivedarawscoreof9.TheOralExpressionsubtestwasadministeredtoassesshisrepetition,productionofautomaticspeechsequences,naming,sentenceproduction,anddiscourse-levelcommunication(Milman&Holland,2012).********accuratelyrepeatedsingleswordssuchas,“No,Jackie,Asprin,Tums,Neosporin.”********accuratelynamedphysicalobjectssuchas,“Table,Chin.”Heaccuratelynameddescriptionsofobjectssuchas,“Whatanimallookslikeahorsebuthasblackandwhitestripes?”asherespondedwith,“Zebra.”********demonstrateddifficultywithoralexpressioninconnectedspeech.Forexample,heinaccuratelysangthesong,“HappyBirthday.”PRAGMATICSThe“AssessmentofPragmaticSkills”wasadministeredon7/13/15atIonaCollege’sSpeech,Language,andHearingClinic.The“AssessmentofPragmaticSkills”isappropriatetoassessavarietyofpragmaticbehaviors(Shipley,2009).AccordingtoBrookshire,traumaticallybrain-injuredpatientsexhibitpragmaticdifficulties(Brookshire,2007)

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********appropriatelyrespondstogreetings.Forexample,whenasked,“Hi!Howareyou?”********responded,“I’mfine.”Hedemonstrateddifficultymakingrequests.Forexample,********wasinstructedtodrawacircle,butwasnotimmediatelyprovidedapencil.Hedidnotrequestapenciltocompletethetask.********demonstrateddifficultydescribingevents.********wasasked,“Whatdidyoudothismorning?”Hereplied,“Idon’tknow.”Hedemonstrateddifficultytakingturnsinconversation.Forexample,********wasinstructedtoalternatelyrecitethealphabetwiththestudentclinicianandhedidnotcompletethetask.Additionally,********demonstrateddifficultyfollowingverbalmultistepcommands.Hewasdirectedtoturnhispaperoveranddrawahappyface.********respondedbyonlyturninghispaperover.********madeappropriateeyecontactthroughouttheassessment.Heaccuratelyrepeatedthreesentencesthatthestudentcliniciansaid.********haddifficultyattendingtotasksthroughoutthesessionbyfrequentlyreplying,“Idon’tknow”tothepresentedactivities.Hedemonstrateddifficultymaintainingtopicofconversation,roleplaying,sequencingactions,andcategorizing.Heaccuratelydefinedwords,butprovidedminimaldescriptions.Forexample,whenaskedtodefinetheword,“scissors,”********respondedwith“cutpaper.”RESULTS********isa32yearand2montholdmalewhocommunicatesverballyandpreferstospeakinsinglewordsandphrases.HewasevaluatedatIonaCollege’sSpeech,LanguageandHearingclinicon3/04/15,3/09/15,&3/23/15,07/01/15,07/06/15,07/08/15,07/13/15,and07/15/15.********presentsasfriendlyandsocial.Heengagedinalltaskspresentedandrequiredmaximumredirectionthroughouttheevaluation.********’smedicalhistorywasremarkableforavehicularaccidentofJanuary2011.Asaresult,hesufferedfromaTraumaticBrainInjuryandvisualproblems.Acompleteaudiologicalexaminationisrecommendedinordertoinvestigateapossiblestructural/functionaletiologyof********’scompleteauditorysystem.Oralperipheralexaminationrevealedinadequatestructuralandfunctionalintegrityofthespeechandswallowingmechanisms.********’svocalpitch,loudness,resonance,andqualityareinconsistentforhisageandgender.Acompleteevaluationbyanotolaryngologist(ENT)isrecommendedatthistime.Disfluentpatternswerejudgedtobewithinnormallimits.Articulationerrorswerejudgedtonegativelyimpact********’sabilitytoeffectivelycommunicatewithothers.Basedonclinicaljudgment,********’sspeechisintelligible50-60%ofthetimeduringconversationalspeech.Accordingtotheresultsoftheassessment,********presentedwithmixeddysarthriacharacterizedbyarticulation,fluency,andvoicedifficulties.TheresultsoftheFDA-2assessmentrevealedthat********demonstratescharacteristicsofamixedupperandlowermotorneuronlesion.********demonstratescognitivecommunicationdeficitscharacterizedbydifficultiesinorientation,attention,memory,problemsolving,executivefunctions,perception/discrimination,reading,writing,auditorycomprehension,andsocialskillsAccordingtotheresultsoftheassessment,********presentedwithaseverecognitivecommunicationimpairment._____________________________ClinicalCSDStudent____________________________Speech-languagePathologist

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NYSLicense#ASHA#

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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAppendixMClinical Practice Resources

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http://www.asha.org/Certification/2014-Speech-Language-Pathology-Certification-Standards/Council for Clinical Certification in Audiology and Speech-Language Pathology of the American Speech-Language-Hearing Association. (2013). 2014 Standards for the Certificate of Clinical Competence in Speech-Language Pathology. Retrieved [date] from http://www.asha.org/Certification/2014-Speech-Language-Pathology-Certification-Standards/. https://www.asha.org/Code-of-Ethics/TheCodeofEthicsisvitalforourmemberstoabidebyprofessionalethicstosupportcollegialandpublictrust. http://www.asha.org/Practice/ethics/ConfidentialityConfidentialityrelatedtoresearch,clientinformation,verbalcommunication,studentprivacy,peersandcolleagueshttp://www.asha.org/practice/reimbursement/hipaa/HealthInsurancePortabilityandAccountabilityActhttp://www.asha.org/Certification/2014-Speech-Language-Pathology-Certification-Standards/http://www.asha.org/policy/SP2016-00343/ScopeofPracticeinSpeech-LanguagePathologyhttp://www.asha.org/policy/about/Reviewdocumenttonavigateandsupportbestpracticepatternsandstandardshttp://www.asha.org/practice/reimbursement/coding/new_codes_slp.htmlhttps://www.asha.org/practice-portal/http://www.op.nysed.gov/prof/slpa/speechlic.htmlResourceforNewYorkStatelicenserequirementsforspeech-languagepathology&audiologyhttp://www.asha.org/academic/accreditation/accredmanual/section8.html

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SchoolofArts&ScienceDepartmentofSpeechCommunicationStudiesSpeech,Language&HearingClinicAppendixNResources AmericanSpeech-Language-Hearing-Association(www.asha.org) Hedge,M.N.,&Davis,D.(2005).ClinicalMethodsandPracticuminSpeech-LanguagePathology4thEd.SanDiego,CA:DelmarLearningShipley,K.G,&McAfee,J.G.(2009).AssessmentinSpeech-LanguagePathology:Aresourcemanual.(5thEd.).CliftonPark,NY:DelmarLearning.Roth,F.P.,&Worthington,C.K.(2011).Treatmentresourcemanualforspeech-languagepathology(5thEd.).Albany,NY:ThompsonDelmarLearning. Guilford,A,Graham,S,&Scheuerle.(2007).TheSpeech-LanguagePathologist:FromNovicetoExpert.PearsonEducation.UpperSaddleRiver,NJ

Contributions:

AmandaScheriff,MeghanK.MurphyJessicaScaringellaDorothyLeoneJenniferGeromettaDianeFerrero-PaluzziNancyVidal-FinnertyJhovanaFigueraAnnaWyludaDocumentupdate-MariaArmiento-DeMaria,Fall2018;Spring2018