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 Parkinson’s Disease (PD) Primary progressive aphasia (PPA)

CAALMS Aphasia, dysarthria, apraxia, neurodegenerative conditions (PD, PPA) Standardized tests/batteries as well as informal measures (hearing screening; clinical swallow exam) Clinician-reported measures; client or caregiver reported measures (Interviews, questionnaires) Client or caregiver reported measures (interviews, QOL scales) Client or caregiver reported measures Client or caregiver reported measures

CAALMS Instruments Aphasia, Dysarthria, Apraxia Neurodegenerative conditions (PD, PPA) CAT, oral motor exam, swallow and hearing screening ANA; CETI ALA (mod-sev); ASHA QCL (mild-mod) Interview; ANA/CETI; ALA/QCL Interview; ANA/CETI; ALA/QCL The Comprehensive Aphasia Test (CAT) Assessment for Living With Aphasia (ALA) Aphasia Needs Assessment (ANA) ASHA Quality of Communication Life Scale (QCL) The Communicative Effectiveness Index (CETI)

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 needed) 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 needed) 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. has not? Incorporating their family/friend/caregiver input 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 you 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? 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 Verbal, 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 LSVT - loudness Instrumental Outcomes that activate learning process; once this is achieved focus can shift to a different goal LSVT – loudness beginning to carry over in HW activities Ultimate Social or ecological validity of the treatment is achieved Functional communication, e.g. LSVT strategies used automatically across all situations

Types of Data Session data Maintenance data Impact data Data can be tracked via percentages, trials, rating scales, checklists, narratives