Assessment & Outcome Measures

Objectives Assessment domains Outcome measures CAALMS Instrument Protocol Outcome measures

WHO ICF model Health condition (Disorder/Disease) Body structure and function Activities Participation Environmental factors Personal factors

CAALMS Aphasia, Dysarthria, Apraxia Neurodegenerative conditions (PD, PPA) Function: Language (Spoken, written), Speech (Voice), Swallowing Structure: Muscles Communicating basic needs, socializing with family/friends, talking on the phone Work, Home, etc. Client’s living situation, transportation, Caregivers, etc. Motivation, personal goals

CAALMS Aphasia, Dysarthria, Apraxia Neurodegenerative conditions (PD, PPA) Standardized tests/batteries as well as informal measures (Hearing screening; Bedside swallow exam) Clinician-reported measures; client or caregiver reported measures (Interviews, questionnaires) Client or caregiver reported measures (interviews, QOL scales) When you look at the CHARTR flowsheet – what is the purpose of using these different measures? Client or Caregiver reported measures Client or caregiver reported measures

ALA (mod-sev); ASHA QCL (mild-mod) CAALMS Instruments Aphasia, Dysarthria, Apraxia Neurodegenerative conditions (PD, PPA) CAT, Oral motor exam, Swallow and hearing screening Aphasia needs assessment; CETI ALA (mod-sev); ASHA QCL (mild-mod) Interview; ANA/CETI; ALA/QCL Interview; ANA/CETI; ALA/QCL

First session 1.5 hour protocol Complete- Review Intake paperwork (Go over consent to treat and medical forms) Review Assessment/ Intake process with client and caregiver/ SO or other Oral Motor Exam Hearing Screening Begin Comprehensive Aphasia Battery (CAT) or Western Aphasia Battery (WAB) Quality of Life Assessment (based on severity) Assessment for Living with Aphasia Toolkit (severe-mod) Quality Of Communication Life Scale (ASHA QCL) (mod-mild)

Second session (additional testing based on what info you need) Complete WAB or CAT if needed Interview Aphasia Needs Assessment (can be combined with interview) Communicative Effectiveness Index CETI (for conversational partner) Quality of Life Assessment (based on severity) Assessment for Living with Aphasia Toolkit (severe-mod) Quality of Communication Life Scale (ASHA QCL) (mod-mild) Pyramids and Palm trees

Second session (additional testing based on what info you need) Motor speech emphasis ABA- Apraxia Battery for Adults (ABA-2) Frenchay Dysarthria Assessment Mayo Clinic Perceptual Rating Form The Communicative Participation Item Bank (CPIB)

Interview Ask questions that gives you information about How the diagnosis impacts their daily activities Any other complications that is impacting their ability to progress How has their ability to participate in their social circles been impacted What is their goal(s) for therapy? What have they already tried in the past? What’s worked vs hasn’t? Incorporating their family/friend/caregiver How motivated do they feel about working toward their goal?

Some sample questions So give me a little background about the injury – describe what happened? What are expecting to gain out of this consult? What might be a reason for seeking continued services? Were you involved in any therapy before this? Describe what that was like? How has this injury changed your life? Any trouble communicating your thoughts? Any trouble understanding conversations? Any trouble with reading / writing? What does a typical day look like for you now? Have you noticed any improvement in your abilities since the injury? How has it improved (or regressed?)? What has helped in improving your status? What are some other health conditions that you are experiencing? (Past medical history as well as conditions as a result of the injury) How would you like us to support you in your goals?

Interviewing strategies (Luck & Rose, 2007) Acknowledgement of communication difficulties Interviewer clarification Word, meanings, gestures Supporting conversation strategies Providing choices Using multiple modalities Giving response time Repetition Acknowledging challenges

Interviewing with Aphasia https://www.youtube.com/watch?v=KWVoqM9jmEM

Outcome measures (Frattali, 2013) Intermediate Outcomes that change from session to session letting clinician know that client is benefiting from treatment LSVT - loudness Instrumental Outcomes that activate learning process ; once this is achieved focus can shift to a different goal because individual will learn to improve on his / her own LSVT – loudness beginning to carry over in HW activities Ultimate Social or ecological validity of the treatment is achieved Functional communication (LSVT strategies used automatically across all situations)

Types of data you may collect Session data Maintenance data Impact data