Data Collection and Documentation UO Clinical Practicum Frank Bender

What are data? Client’s responses to stimuli Measurement of behavior

What Kind of Data Do We Collect? Frequency of occurrence Percentage correct Duration of behavior Rating scores

Baseline Data Contribute to setting treatment goals What area should we focus on? Where do we start? Documentation of behavior change – Outcome Measure Allows comparison of pre-and post-intervention measures May use probe lists of trained and untrained targets Speech/language sample Logs

Session Data Use to Monitor treatment effect & session-to-session progress Plan next session Keep in mind… Collect data systematically Collect generalization data

Planning your data collection… Setting up the room/material Continuous versus intermittent data-taking Record sessions if you need to… Remember - it takes practice …and planning

Planning your data collections… Know your target - clarify target if needed Know criteria for meeting objective Create/select a data collection system Decide on notation system Include examples here. A Good Objective v. Bad Objective Criteria? System Examples Notation Examples

Data Collection & Notation system Select/create a data collection system Event recording Duration recording Interval recording Rating scale Decide on a notation system Numbers Symbols Tallies Transcription

Data Collection System Event Recording Duration Recording Event recording is a process for documenting the number of times a behavior occurs. An observer using event recording makes a tally mark or documents in some way each time a student engages in a target behavior. The observer also records the time period in which the behavior is being observed. Duration recording is used to document the amount of time a student spends engaging in a behavior. A behavior that has a clear beginning and ending can be observed using a duration recording method. Examples of behaviors that may be observed using duration recording include crying, reading a book, writing in class, time spent working on a math assignment, or out of seat behavior. Event Recording: Event recording takes place during a specific time period. Major Advantage of event recording is that it can be easy to implement and can be used while teaching class. Implementation: There are several easy ways to keep track of behaviors as they occur: You can use a wrist counter; make tally marks on a piece of paper, or put paperclips, pennies, or buttons in one pocket and move them to a different "target" pocket as each behavior occurs Disadvantage: Event recording is not as helpful when the behavior of interest occurs at a really high rate or occurs over extended periods of time. Behaviors that may occur at a high rate or over extended periods could include temper tantrums, reading, staring off into space, or talking to peers. In these cases event recording may not be the best measurement choice. Ideal Use: Event recording can be used if your objective is to increase or decrease the number of times a behavior occurs. When the behavior that you are looking at can be easily counted, event recording may be the best method to use since it can be easy to record and in many cases can be completed without interfering with ongoing activities. A behavior can be easily counted when: The behavior has a clear beginning and end so that you can easily tell when the behavior starts and when it ends, and It does not happen at such a high rate that it is hard to document. Duration Recording: Used to document the amount of time a certain behavior is observed. Major advantage: Duration recording is really useful when you are interested in how long a behavior lasts, but it can also record frequency since you are writing down every episode that occurs. For instance, duration recording can tell you that before an intervention was implemented that a student cried three times during the day and that each episode was 30 minutes in length. The student may still cry three times a day after an intervention strategy is implemented but now the length has decreased to 5 minutes in duration. Implementation: Duration recording requires some way of measuring time. A wall clock, wrist watch, or stopwatches are all instruments that can be used to record duration. Sometimes videotaping or audiotape recording can capture what is happening in the classroom and can be reviewed at a later date Disadvantage: It may be time consuming in regards to having to record a session and go back and document the data. Ideal Use: Use duration recording when a behavior occurs at a high rate and tends to include behaviors that are harder to measure using event recording such as pencil tapping, working on an in-class assignment, interacting with peers, or screaming.

Data Collection System Interval Recording Partial Interval Recording Whole interval recording is one type of interval recording method. An interval recording strategy involves observing whether a behavior occurs or does not occur during specified time periods. Whole interval recording means that the observer is interested in behavior that occurs during the entire interval. Partial interval recording is an interval recording method. In partial interval recording, the observer marks down whether a behavior occurs any time during the interval by placing an "X" for occurrence and a "O" for no nonoccurrence. A student may engage in a behavior multiple times during the interval or only once for an "X" to be documented. Interval Recording: Whole interval recording is one type of interval recording method. An interval recording strategy involves observing whether a behavior occurs or does not occur during specified time periods. Whole interval recording means that the observer is interested in behavior that occurs during the entire interval. Advantage: The advantage of the whole interval recording method is that it provides an estimate of the duration of a behavior and provides information about where behaviors are occurring or not occurring within an observational session. Implementation: Once the length of an observation session is identified, the time is broken down into smaller intervals that are all equal in length. For instance, a 10 minute observational session may be separated into 1 minute intervals with ten boxes that are used to record the occurrence of behavior. In whole interval recording, the observer marks down whether a behavior occurs throughout the entire interval by placing an "X" for occurrence and a "O" for no nonoccurrence. Disadvantage: A major disadvantage of whole interval recording is that is requires an observer's undivided attention. Observing and recording data can be challenging, especially if using a stopwatch since the person recording must attend to both the timing of intervals as well as the student. Ideal Use: Whole interval recording means that the observer is interested in behavior that occurs during the entire interval. Examples of ongoing behaviors that can be observed using whole interval recording include writing, walking, reading, or working on a given assignment. Another consideration of when to use Interval Recording is when the behavior that you are looking at is not easily counted, you can measure the behavior by counting the number of time-intervals in which the behavior occurred. A behavior is not easily counted when: (1) It is difficult to tell exactly when the behavior begins or when it ends, or (2) It occurs at such a high rate that it is difficult to keep count. Partial Interval Recording: Observing if a behavior occurs at anytime during an interval phase. Advantage: The advantage of the partial interval recording method is that it provides an estimate of frequency and duration of a behavior, and provides information about where behaviors are occurring across observational sessions. Implementation: Once the length of an observation session is identified, the time is broken down into smaller intervals that are all equal in length. For instance, a 20 minute observational session may be separated into 2 minute intervals with ten boxes that are used to record the occurrence of behavior. In partial interval recording, the observer marks down whether a behavior occurs any time during the interval by placing an "X" for occurrence and a "O" for no nonoccurrence. A student may engage in a behavior multiple times during the interval or only once for an "X" to be documented. Disadvantage: A major disadvantage of partial interval recording is that is requires an observer's undivided attention. Teachers interested in this measurement strategy may need to ask someone else to observe and collect partial interval data for them while they are working with students or engaged in instruction. Partial interval recording documents whether behavior occurred or not but will not provide information about how many times a behavior occurs within the interval. For instance, a student may curse ten times in one interval but only once in another interval. Both intervals will show that the behavior occurred but will not provide information about frequency within the interval. Use: Partial interval recording means that the observer is interested in behavior that occurs or not in any part of the interval and that the behavior usually does not consume the entire interval. Examples of discrete behaviors that can be observed using partial interval recording include swearing, hitting, participating in class discussions, and making positive statements to peers and others.

Data Collection System Rating Scales Outcome Measures A rating scale indicates the degree or frequency of the behaviors, skills and strategies displayed by a client. Rating scales state the criteria and provide three or four response selections to describe the quality or frequency of student work. An outcome measure is the result of a test that is used to objectively determine the baseline function of a patient at the beginning of treatment. Once treatment has commenced, the same instrument can be used to determine progress and treatment efficacy and effectiveness. Rating Scale: A rating scale indicates the degree or frequency of the behaviors, skills, and strategies displayed by a client. Advantage: Effective rating scales use descriptors with clearly understood measures, such as frequency Implementation: To use a light switch analogy, a rating scale is like a dimmer switch that provides for a range of performance levels. Rating scales state the criteria and provide three or four response selections to describe the quality or frequency of student work. Disadvantage: Scales that rely on subjective descriptors of quality, such as fair, good or excellent, are less effective because the single adjective does not contain enough information on what criteria are indicated at each of these points on the scale. Ideal Use: Teachers can use rating scales to record observations and students can use them as self-assessment tools. Teaching students to use descriptive words, such as always, usually, sometimes and never helps them pinpoint specific strengths and needs. Outcome Measures: Advantage: Can provide feedback on the efficacy (benefits under optimal or ideal conditions) and effectiveness (benefits under typical or real world conditions) of an intervention or program. Implementation: Outcome measures is meaningful only if linked to a facility, client, and clinician characteristics (to allow for comparison of “apples to apples), and the various processes of care (to allow us to make comparison statements about the effects of specific interventions). Disadvantage: If it’s a static measure, it may not provide specific information regarding a client’s level of support needed to be successful (e.g., mediated learning within the ZPD). If the measurement methodologies are flawed, then the outcome measure may result in a Type I or Type II error. Ideal Use: (1) Intermediate Outcome: Lets us know, from session to session, whether treatment is benefiting the client. These outcomes allow exploration of the treatment process. (2) Instrumental Outcomes: Outcomes that activate the learning process and allow the clinician to know when to “step up” or begin activities that facilitate the transfer and generalization of a target concept. (3) Ultimate Outcomes: Those that demonstrate the social and ecological validity of our interventions, such as functional communication, employability, ability to learn, social integration, etc. These outcomes are of prime interest to “insurance payers”, regulators, and clients and their families.

Data Collection Practice Tracking productions for the /r/ Male Client Age: 12-1 Let’s Calibrate and Compare Notations What kind of recording are we doing? https://www.youtube.com/watch?v=r36WI0wgbfw

After the session Review collected data immediately after session Occasionally conduct reliability check Include data in your daily note Share data with client and family

Example N will use /m/, /p/ and /b/ correctly in the initial position of 5 words each. N will spontaneously say an average of two words per sentence to communicate her wants & needs at home and in clinic sessions.

Forms of Documentation SOAP note Assessment Report Individual Treatment Plan/Progress Report Discharge Report

SOAP Notes? Subjective information Objective information Assessment of the session Plan for the next session

Subjective Information Comment on how client participated in therapy Important events since last session Medical issues Completion of homework Caregiver/parent training or information provided?

Subjective - Examples Tammy was very active today. She responded positively to reminders to stay in her seat, follow directions, and complete tasks. Mom commented: “Yesterday I heard her say her brother’s name correctly for the first time.” Mom reported that Marc has a bad cough. She plans to take him to the doctor this afternoon. Ali’s mom asked if she could get more pictures to practice at home.

Objective Information Report data related to your session objectives Different ways to report data in O section Narrative Table format Bullets

Example of Objective Data Narrative Production of /sk/ was 75 %correct (15/20) given a verbal model when naming picture cards in a matching game. This compares to 50% (10/20) during last session. Tammy would typically simplify the cluster /sk/ to /k/.

Example of Objective Data Table Format Short Term Objectives Baseline 4/8/08 Previous Session 5/1/08 Current Session 5/5/08 Comments Consonant cluster /sk/, initial position in words given a verbal model 3/10 (30%) 10/20 (50%) 15/20 (75%) Used consonant simplification /k/ for /sk/

Example of Objective Data Bullets Target: Consonant cluster /sk/, initial position in words given a verbal model Accuracy for current session 75% (15/20) Accuracy for last session: 50% (10/15) Error pattern: Consonant simplification (k for sk)

Assessment Analysis and interpretation of data Change from previous session Effectiveness of cues, strategies, activities Explanation of success or difficulties NO NEW information in A section Avoid restating data from S and O sections Avoid “speculating”

Example of Assessment Tammy consistently improved her ability to produce /sk/ given a verbal model over the last week when therapy targeted this sound cluster. Tammy benefits from knowing what is expected from her and remains focused with lots of positive reinforcement.

Plan Plan for next therapy session Be specific about planned adjustments in target level, level of cueing, activities or homework Note client’s homework for next session Note any Additional testing needed Referrals needed

Example of Plan Continue with Cycles approach: New cluster: /sp/ Continue with /sk/ Use picture agenda and simple reward system (stars, stickers) to keep Tammy focused on the task Tammy to use 5 words with /sk/ every day at home. List of games/activities was given to Tammy’s mom.

Use Accurate, Concise, and Informative Language Not very informative More informative JM was not paying attention today. JM kept listening to people talking outside the window and participated in planned activities for only brief periods of time.

Useful and relevant to other clinician Too vague More precise Continue with Cycles Therapy per plan. Continue with Cycles approach: New cluster: /sp/ Continue with /sk/

Use Client/Family-Friendly Language (as appropriate) SLP Language Parent Language The child produced six 3- word-utterances. The child said six sentences that consisted of 3 words.

Write from Client’s Perspective From Clinician’s Perspective From Client’s Perspective The clinician first used a verbal model only, which resulted in 30% accuracy of target sound production. When the clinician added a visual cue, the client was able to respond with 80% accuracy. The client’s accuracy of target sound production was 30% given a verbal model only. Accuracy increased to 80% given a verbal model and visual cues.

Explanation of Technical Terms and Acronyms The Goldman-Fristoe Test of Articulation–2nd Edition (GFTA- 2) is a norm-referenced, standardized test that focuses on how a child says individual sounds by targeting each sound in each word position. The child is asked to name objects in pictures that contain the targeted speech sounds.

Explanation of Technical Terms and Acronyms A Language Sample is a word-for-word record of a child’s speech and language, which is written down by the speech therapist during testing and play activities. An analysis of the language sample shows how long the child’s sentences are and how much of his or her speech is understandable.

SOAPs, ITPs, & Research

Questions?