1. Assessment & Outcome Measures

2. Objectives Assessment domains Outcome measures CAALMS Instrument
Protocol
Outcome measures

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

4. 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

5. 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

6. 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

7. 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)

8. 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

9. 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)

10. 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?

11. 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?

12. 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

13. Interviewing with Aphasia

14. 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)

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