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3 Models of Diagnosis
- Behavioral model
- Systems model
- Medical model
**pair of glasses to view diagnostic process
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Behavioral Model
- describe client performance on tasks
- don't really look for the markers of a particular disease
- see how deficits impact functionality EDU or social
- the cause of the problem is internal to the client
***goal of intervention is to change client behavior
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Systems Model
- how do deficits impact ability to exist appropriately in the system
- looks at impact of communication problem on client's natural systems, (ie neighborhood, family, classroom, etc)
- cultural context is important to intervention
- figure out what systems encourage/impede comm success
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The Medical model
- classify symptoms in a disease category
- good for classification and explanation
- belief that there is a name for something that is not right
- concerned with what is causing a problem and all the factors associated with it (3 etiological factors)
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Evidence Based Practice (EBP)
- delivering high quality care that is proven
- care that reflects the interest, needs, values, and choices of the client
Facilitated by
- clinician edu and skills
- research with sound methods
- client, caregiver perspectives (values, expectations, and personal circumstances/concerns)
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5 As of Evidence Based Practice
- Ask clinical questions
- Acquire the best evidence
- Appraise the evidence
- Apply evidence to the patient
- Assess the effectiveness/efficiency of the process
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Clinician Requirements for Building Rapport
- be ethical
- be flexible (creative, change on the fly to meet client needs)
- healthy dose of skepticism
- ability to think critically and critique methods and literature
- empathy
- congruence (don't be fake)
- positive and respectful demeanor (don't treat them like a deficit)
- be sensitive
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Rapport for Children
- bring interesting materials
- know their interests
- be fair
- follow their lead
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Rapport for Adolescents
- give breaks
- be authentic
- don't treat them like children
- know their interests
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Rapport for Adults
- be respectful
- be authentic
- learn about their live experiences and values
- do not treat them like their deficit
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Clinician as a Diagnostician
- have an evaluative attitude
- have persistent curiosity
- be objective
- build rapport
- be focused
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Prognosis
- hypothesis for outcome of proposed treatment
- NOT CONSTANT, can change at any time
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Factors Affecting Prognosis
- length of impairment - shorter time dealing with the problem makes the problem easier to fix
- age
- existence of other problems - may precipitate or perpetuate the problem
- reactions of significant others - support received
- client motivation - the more motivated the better
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Initiating Diagnostic Process
- Referral - from self, teachers, family, early intervening services, social service agencies, doctors
- screenings - test to see if within normal limits or more testing needs to be done
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Hearing Screening
- determines if hearing skills are sufficient for normal communication
- CANNOT diagnose hearing loss
- pass/fail results
- refers for further testing if necessary
- pure tones presented at 20-25 dB
- frequencies 500, 1000, 2000, and 4000 Hz
- tested bilaterally
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Hearing Screening Procedures
- prepare client
- place headphones on client
- orient (give practice; present sound at higher dB level so they know what they are looking for)
- present pure tones
- record results
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