Counseling Parents at the Time of Diagnosis: Moving Toward Client-Centered Practice

2020 ◽  
pp. 1-5
Author(s):  
David Luterman
Keyword(s):  
Case History ◽  
Medical Model ◽  
Diagnostic Process ◽  
Separate Entity ◽  
Initial Examination ◽  
Personal Adjustment ◽  
Flow Of Information ◽  
Ultimate Purpose

Purpose The purpose of this article is to present a client-centered model of counseling that integrates information and personal adjustment counseling. Research has indicated that audiologists are more comfortable with counseling that is information based than with personal adjustment counseling. The prevailing model of diagnosis appears to be the medical model in which, first, a case history is taken, then testing and, finally, counseling. This model lends itself to audiologist as expert and the counseling as a separate entity based on information and advice. Further research has indicated parents retain little of the information provided in the initial examination because of their heightened emotions. This article presents a client-centered model of diagnosis in which information is provided within an emotionally safe context, enabling the parents to express their feelings and have the ability to control the flow of information. The ultimate purpose of a client-centered model is to empower parents by making them active participants in the diagnostic process rather than passive recipients. Conclusion The client-centered model has wide implications for the diagnostic process as well as for the training of students.

Evolution of Psychiatric Diagnosis

2018 ◽  
pp. 1-14
Author(s):  
Carol S. North ◽  
Sean H. Yutzy
Keyword(s):  
United States ◽  
Psychiatric Diagnosis ◽  
Psychiatric Illness ◽  
Medical Model ◽  
The United States ◽  
Mental Illnesses ◽  
Diagnostic Process ◽  
Medical Diagnostic ◽  
Washington University ◽  
Over Time

This chapter considers the evolution of psychiatric diagnosis in the United States at length, with references to earlier European contributions. It reviews the medical model in psychiatry movement by the Washington University, St. Louis group in the United States to develop psychiatric diagnosis validity parameters and reliable criteria sets to facilitate communication, research, and clinical application for the major mental illnesses. Challenges to this model are considered and ultimate scientific solidification in DSM-III is reviewed. Over time (33 years), dissent and the continual failure to discover a neurobiological basis for any major psychiatric illness have placed a strain on the medical diagnostic process, and these controversies are reviewed at length. Outlined are the reasons that psychiatry should remain resolute in endorsing what we know scientifically instead of what expert consensus constructs.

Assessment of Improved Techniques for Introducing New Patients to a Therapeutic Community

1967 ◽  
Vol 1 (4) ◽  
pp. 196-202
Author(s):  
N. T. Yeomans ◽  
B. L. Hennessy ◽  
R. G. Hay
Keyword(s):  
Decision Maker ◽  
Case History ◽  
Therapeutic Community ◽  
Personal Adjustment ◽  
The Family ◽  
Therapeutic Programme ◽  
Group Technique

Developments in the community therapeutic programme of Fraser House are described. The Personal Adjustment Record, a research and case-history recording questionnaire, designed by the authors, is introduced. Sending the Personal Adjustment Record to newlyreferred patients before their first attendance was followed by a significant increase in attendance. An Introductory Group technique for welcoming, informing and assessing newly referred patients and families is described. This was followed by a significant increase in the acceptance of therapy. The concept of the family as a group acting as a decision maker for its individual members is introduced.

Our understanding of neural codes rests on Shannon's foundations

2019 ◽  
Vol 42 ◽  
Author(s):  
Charles R. Gallistel
Keyword(s):  
Brain Structure ◽  
Neural Tissue ◽  
Neural Codes ◽  
Flow Of Information

Abstract Shannon's theory lays the foundation for understanding the flow of information from world into brain: There must be a set of possible messages. Brain structure determines what they are. Many messages convey quantitative facts (distances, directions, durations, etc.). It is impossible to consider how neural tissue processes these numbers without first considering how it encodes them.

Misophonia: An Evidence-Based Case Report

2020 ◽  
Vol 29 (4) ◽  
pp. 685-690
Author(s):  
C. S. Vanaja ◽  
Miriam Soni Abigail
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Case History ◽  
Pure Tone ◽  
Physiological Responses ◽  
Evidence Based ◽  
Management Option ◽  
Pure Tone Audiogram

Purpose Misophonia is a sound tolerance disorder condition in certain sounds that trigger intense emotional or physiological responses. While some persons may experience misophonia, a few patients suffer from misophonia. However, there is a dearth of literature on audiological assessment and management of persons with misophonia. The purpose of this report is to discuss the assessment of misophonia and highlight the management option that helped a patient with misophonia. Method A case study of a 26-year-old woman with the complaint of decreased tolerance to specific sounds affecting quality of life is reported. Audiological assessment differentiated misophonia from hyperacusis. Management included retraining counseling as well as desensitization and habituation therapy based on the principles described by P. J. Jastreboff and Jastreboff (2014). A misophonia questionnaire was administered at regular intervals to monitor the effectiveness of therapy. Results A detailed case history and audiological evaluations including pure-tone audiogram and Johnson Hyperacusis Index revealed the presence of misophonia. The patient benefitted from intervention, and the scores of the misophonia questionnaire indicated a decrease in the severity of the problem. Conclusions It is important to differentially diagnose misophonia and hyperacusis in persons with sound tolerance disorders. Retraining counseling as well as desensitization and habituation therapy can help patients who suffer from misophonia.

Perceptual Characteristics of Consonant Production in Apraxia of Speech and Aphasia

2019 ◽  
Vol 28 (4) ◽  
pp. 1411-1431 ◽  
Author(s):  
Lauren Bislick ◽  
William D. Hula
Keyword(s):  
Error Rate ◽  
Error Rates ◽  
Group Differences ◽  
Diagnostic Process ◽  
Apraxia Of Speech ◽  
Contextual Variables ◽  
Error Type ◽  
Type Distribution ◽  
Phonetic Features ◽  
Syllable Position

Purpose This retrospective analysis examined group differences in error rate across 4 contextual variables (clusters vs. singletons, syllable position, number of syllables, and articulatory phonetic features) in adults with apraxia of speech (AOS) and adults with aphasia only. Group differences in the distribution of error type across contextual variables were also examined. Method Ten individuals with acquired AOS and aphasia and 11 individuals with aphasia participated in this study. In the context of a 2-group experimental design, the influence of 4 contextual variables on error rate and error type distribution was examined via repetition of 29 multisyllabic words. Error rates were analyzed using Bayesian methods, whereas distribution of error type was examined via descriptive statistics. Results There were 4 findings of robust differences between the 2 groups. These differences were found for syllable position, number of syllables, manner of articulation, and voicing. Group differences were less robust for clusters versus singletons and place of articulation. Results of error type distribution show a high proportion of distortion and substitution errors in speakers with AOS and a high proportion of substitution and omission errors in speakers with aphasia. Conclusion Findings add to the continued effort to improve the understanding and assessment of AOS and aphasia. Several contextual variables more consistently influenced breakdown in participants with AOS compared to participants with aphasia and should be considered during the diagnostic process. Supplemental Material https://doi.org/10.23641/asha.9701690

Servicing the Senior Swallow: A Family-Centered Private Practice Model of Service Delivery

2020 ◽  
pp. 1-4 ◽  
Author(s):  
Yvette M. McCoy
Keyword(s):  
Older Adults ◽  
Medical Model ◽  
Recovery Process ◽  
Swallowing Disorders ◽  
Current Evidence ◽  
Care Needs ◽  
Skilled Nursing ◽  
Person Centered Care ◽  
Centered Care ◽  
Traditional Medical Model

Purpose Person-centered care shifts the focus of treatment away from the traditional medical model and moves toward personal choice and autonomy for people receiving health services. Older adults remain a priority for person-centered care because they are more likely to have complex care needs than younger individuals. Even more specifically, the assessment and treatment of swallowing disorders are often thought of in terms of setting-specific (i.e., acute care, skilled nursing, home health, etc.), but the management of dysphagia in older adults should be considered as a continuum of care from the intensive care unit to the outpatient multidisciplinary clinic. In order to establish a framework for the management of swallowing in older adults, clinicians must work collaboratively with a multidisciplinary team using current evidence to guide clinical practice. Private practitioners must think critically not only about the interplay between the components of the evidence-based practice treatment triad but also about the broader impact of dysphagia on caregivers and families. The physical health and quality of life of both the caregiver and the person receiving care are interdependent. Conclusion Effective treatment includes consideration of not only the patient but also others, as caregivers play an important role in the recovery process of the patient with swallowing disorders.

School-Based Speech-Language Pathologists' Adherence to Practice Guidelines for Assessment of English Learners

2020 ◽  
pp. 1-12
Author(s):  
Virginia L. Dubasik ◽  
Dubravka Svetina Valdivia
Keyword(s):  
Professional Practice ◽  
Practice Guidelines ◽  
Case History ◽  
English Learners ◽  
Online Survey ◽  
Dynamic Assessment ◽  
Federal Legislation ◽  
Assessment Practices ◽  
Speech Language Pathologists ◽  
School Based

Purpose The purpose of this study was to ascertain the extent to which school-based speech-language pathologists' (SLPs) assessment practices with individual English learners (ELs) align with federal legislation and professional practice guidelines. Specifically, we were interested in examining SLPs' use of multiple tools during individual EL assessments, as well as relationships between practices and number of types of training experiences. Method School-based SLPs in a Midwestern state were recruited in person or via e-mail to complete an online survey pertaining to assessment. Of the 562 respondents who completed the survey, 222 (39.5%) indicated past or present experience with ELs, and thus, their data were included in the analyses. The questionnaire solicited information about respondent's demographics, caseload composition, perceived knowledge and skills and training experiences pertaining to working with ELs (e.g., graduate school, self-teaching, professional conferences), and assessment practices used in schools. Results The majority of respondents reported using multiple tools rather than a single tool with each EL they assess. Case history and observation were tools used often or always by the largest number of participants. SLPs who used multiple tools reported using both direct (e.g., standardized tests, dynamic assessment) and indirect tools (e.g., case history, interviews). Analyses revealed low to moderate positive associations between tools, as well as the use of speech-language samples and number of types of training experiences. Conclusions School-based SLPs in the current study reported using EL assessment practices that comply with federal legislation and professional practice guidelines for EL assessment. These results enhance our understanding of school-based SLPs' assessment practices with ELs and may be indicative of a positive shift toward evidence-based practice.

Holistic Communication Assessment for Young Children With Cleft Palate Using the International Classification of Functioning, Disability and Health:Children and Youth

2020 ◽  
Vol 51 (4) ◽  
pp. 914-938
Author(s):  
Anna Cronin ◽  
Sharynne McLeod ◽  
Sarah Verdon
Keyword(s):  
Young Children ◽  
Cleft Palate ◽  
Case History ◽  
Significant Others ◽  
International Classification ◽  
Assessment Tools ◽  
International Classification Of Functioning ◽  
Speech Language Pathologists ◽  
Holistic Assessment

Purpose Children with a cleft palate (± cleft lip; CP±L) can have difficulties communicating and participating in daily life, yet speech-language pathologists typically focus on speech production during routine assessments. The International Classification of Functioning, Disability and Health: Children and Youth Version (ICF-CY; World Health Organization, 2007 ) provides a framework for holistic assessment. This tutorial describes holistic assessment of children with CP±L illustrated by data collected from a nonclinical sample of seven 2- to 3-year-old children, 13 parents, and 12 significant others (e.g., educators and grandparents). Method Data were collected during visits to participants' homes and early childhood education and care centers. Assessment tools applicable to domains of the ICF-CY were used to collect and analyze data. Child participants' Body Functions including speech, language, and cognitive development were assessed using screening and standardized assessments. Participants' Body Structures were assessed via oral motor examination, case history questionnaires, and observation. Participants' Activities and Participation as well as Environmental and Personal Factors were examined through case history questionnaires, interviews with significant others, parent report measures, and observations. Results Valuable insights can be gained from undertaking holistic speech-language pathology assessments with children with CP±L. Using multiple tools allowed for triangulation of data and privileging different viewpoints, to better understand the children and their contexts. Several children demonstrated speech error patterns outside of what are considered cleft speech characteristics, which underscores the importance of a broader assessment. Conclusion Speech-language pathologists can consider incorporating evaluation of all components and contextual factors of the ICF-CY when assessing and working with young children with CP±L to inform intervention and management practices.

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