The Multidimensional ADHD Rating Scale: A measure of symptoms, impairment, and symptom validity

Purpose Severe dysphagia with weak pharyngeal peristalsis after dorsal lateral medullary infarction (LMI) requires long-term tube feeding. However, no study is currently available on therapeutic effectiveness in severe dysphagia caused by nuclear damage of vagus nerve after dorsal LMI. The purpose of the present investigation was to explore the potential of transcutaneous vagus nerve stimulation (tVNS) to improve severe dysphagia with weak pharyngeal peristalsis after dorsal LMI. Method We assessed the efficacy of 6-week tVNS in a 28-year-old woman presented with persisting severe dysphagia after dorsal LMI who had been on nasogastric feeding for 6 months. tVNS was applied for 20 min twice a day, 5 days a week, for 6 weeks. The outcome measures included saliva spitted, Swallow Function Scoring System, Functional Oral Intake Scale, Clinical Assessment of Dysphagia With Wallenberg Syndrome, Yale Pharyngeal Residue Severity Rating Scale, and upper esophagus X-ray examination. Results After tVNS, the patient was advanced to a full oral diet without head rotation or spitting. No saliva residue was found in the valleculae and pyriform sinuses. Contrast medium freely passed through the upper esophageal sphincter. Conclusion Our findings suggest that tVNS might provide a useful means for recovery of severe dysphagia with weak pharyngeal peristalsis after dorsal LMI. Supplemental Material https://doi.org/10.23641/asha.9755438

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Preliminary Findings on the Use of Session Questionnaires to Improve Clinician-Client Alliance With Special Consideration to Clinical Education

Perspectives on Administration and Supervision ◽

10.1044/aas25.1.50 ◽

2015 ◽

Vol 25 (1) ◽

pp. 50-60

Author(s):

Anu Subramanian

Keyword(s):

Graduate Students ◽

Clinical Education ◽

Clinical Decision Making ◽

Rating Scale ◽

Treatment Effectiveness ◽

Clinical Decision ◽

Added Value ◽

Therapeutic Outcomes ◽

Specific Feedback ◽

Stakeholder Perspective

ASHA's focus on evidence-based practice (EBP) includes the family/stakeholder perspective as an important tenet in clinical decision making. The common factors model for treatment effectiveness postulates that clinician-client alliance positively impacts therapeutic outcomes and may be the most important factor for success. One strategy to improve alliance between a client and clinician is the use of outcome questionnaires. In the current study, eight parents of toddlers who attended therapy sessions at a university clinic responded to a session outcome questionnaire that included both rating scale and descriptive questions. Six graduate students completed a survey that included a question about the utility of the questionnaire. Results indicated that the descriptive questions added value and information compared to using only the rating scale. The students were varied in their responses regarding the effectiveness of the questionnaire to increase their comfort with parents. Information gathered from the questionnaire allowed for specific feedback to graduate students to change behaviors and created opportunities for general discussions regarding effective therapy techniques. In addition, the responses generated conversations between the client and clinician focused on clients' concerns. Involving the stakeholder in identifying both effective and ineffective aspects of therapy has advantages for clinical practice and education.

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AAC Collaboration Using the Self-Anchored Rating Scales (SARS): An Aphasia Case Study

Perspectives on Augmentative and Alternative Communication ◽

10.1044/aac21.4.136 ◽

2012 ◽

Vol 21 (4) ◽

pp. 136-143

Author(s):

Lynn E. Fox

Keyword(s):

Augmentative And Alternative Communication ◽

Rating Scales ◽

Rating Scale ◽

Therapeutic Process ◽

Family Counseling ◽

The Self ◽

Alternative Communication ◽

Her Family ◽

Solution Focused

Abstract The self-anchored rating scale (SARS) is a technique that augments collaboration between Augmentative and Alternative Communication (AAC) interventionists, their clients, and their clients' support networks. SARS is a technique used in Solution-Focused Brief Therapy, a branch of systemic family counseling. It has been applied to treating speech and language disorders across the life span, and recent case studies show it has promise for promoting adoption and long-term use of high and low tech AAC. I will describe 2 key principles of solution-focused therapy and present 7 steps in the SARS process that illustrate how clinicians can use the SARS to involve a person with aphasia and his or her family in all aspects of the therapeutic process. I will use a case study to illustrate the SARS process and present outcomes for one individual living with aphasia.

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Testing the Significance of the Agreement Among Observers

Journal of Speech and Hearing Research ◽

10.1044/jshr.1101.05 ◽

1968 ◽

Vol 11 (1) ◽

pp. 5-17 ◽

Cited By ~ 5

Author(s):

Martin A. Young ◽

Tom D. Downs

Keyword(s):

Rating Scale ◽

Intraclass Correlation ◽

Speech Disorder ◽

Interquartile Range ◽

Speech Pathology ◽

Observer Ratings

Ratings by observers are often used in speech pathology to measure complex speech dimensions; this seems reasonable since a speech “disorder” represents the product of an observer’s evaluation and a speaker’s performance. An index of the validity of these evaluations may be estimated by the amount of agreement among the observers. In this paper, the semi-interquartile range and the intraclass correlation are discussed as possible indices of agreement, and another index is suggested, based on the range of observer ratings. Under the assumption that the distribution of ratings is uniform when ratings are randomly assigned, that is, the observers show no agreement, tables were constructed to indicate the probability of any range for selected numbers of observers and rating scale categories. Some applications for this index concern the training of observers, estimating the number of observers needed, and the construction of master scales.

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Symptom Validity Testing

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2018.novdec03 ◽

2018 ◽

Vol 23 (6) ◽

pp. 14-15

Author(s):

Lee H. Ensalada

Keyword(s):

Memory Deficits ◽

Symptom Validity ◽

Sensory Cues ◽

Validity Testing ◽

Symptom Validity Testing ◽

Tunnel Vision ◽

Blurry Vision ◽

The Common ◽

Fatigue Evaluation ◽

Choice Testing

Abstract Symptom validity testing (SVT), also known as forced-choice testing, is a means of assessing the validity of sensory and memory deficits, including tactile anesthesias, paresthesias, blindness, color blindness, tunnel vision, blurry vision, and deafness. The common feature among these symptoms is a claimed inability to perceive or remember a sensory signal. SVT comprises two elements: a specific ability is assessed by presenting a large number of items in a multiple-choice format, and then the examinee's performance is compared to the statistical likelihood of success based on chance alone. These tests usually present two alternatives; thus the probability of simply guessing the correct response (equivalent to having no ability at all) is 50%. Thus, scores significantly below chance performance indicate that the sensory cues must have been perceived, but the examinee chose not to report the correct answer—alternative explanations are not apparent. SVT also has the capacity to demonstrate that the examinee performed below the probabilities of chance. Scoring below a norm can be explained by fatigue, evaluation anxiety, inattention, or limited intelligence. Scoring below the probabilities of chance alone most likely indicates deliberate deceptions and is evidence of malingering because it provides strong evidence that the examinee received the sensory cues and denied the perception. Even so, malingering must be evaluated from the total clinical context.

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Commentary

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2008.novdec02 ◽

2008 ◽

Vol 13 (6) ◽

pp. 8-8

Author(s):

Richard T. Katz

Keyword(s):

Mental Illness ◽

Behavioral Disorders ◽

Rating Scale ◽

Behavioral Disorder ◽

Sixth Edition ◽

Diagnostic And Statistical Manual ◽

Brief Psychiatric Rating Scale ◽

Psychiatric Rating ◽

Psychiatric Rating Scale ◽

Mental And Behavioral Disorders

Abstract The author, who is the editor of the Mental and Behavioral Disorders chapter of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, comments on the previous article, Assessing Mental and Behavioral Disorder Impairment: Overview of Sixth Edition Approaches in this issue of The Guides Newsletter. The new Mental and Behavioral Disorders (M&BD) chapter, like others in the AMA Guides, is a consensus opinion of many authors and thus reflects diverse points of view. Psychiatrists and psychologists continue to struggle with diagnostic taxonomies within the Diagnostic and Statistical Manual of Mental Disorders, but anxiety, depression, and psychosis are three unequivocal areas of mental illness for which the sixth edition of the AMA Guides provides M&BD impairment rating. Two particular challenges faced the authors of the chapter: how could M&BD disorders be rated (and yet avoid an onslaught of attorney requests for an M&BD rating in conjunction with every physical impairment), and what should be the maximal impairment rating for a mental illness. The sixth edition uses three scales—the Psychiatric Impairment Rating Scale, the Global Assessment of Function, and the Brief Psychiatric Rating Scale—after careful review of a wide variety of indices. The AMA Guides remains a work in progress, but the authors of the M&BD chapter have taken an important step toward providing a reasonable method for estimating impairment.

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Clinical Update: Symptom Validity Testing

Guides Newsletter ◽

10.1001/amaguidesnewsletters.1999.julaug05 ◽

1999 ◽

Vol 4 (4) ◽

pp. 8-9

Author(s):

Leon H. Ensalada

Keyword(s):

Symptom Validity ◽

Validity Testing ◽

Symptom Validity Testing

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Impairment Questions and Answers

Guides Newsletter ◽

10.1001/amaguidesnewsletters.1999.julaug02 ◽

1999 ◽

Vol 4 (4) ◽

pp. 4-4

Keyword(s):

Symptom Validity ◽

Validity Testing ◽

Symptom Validity Testing ◽

Negative Results ◽

Tunnel Vision ◽

Questions And Answers ◽

Blurry Vision ◽

Fatigue Evaluation ◽

Choice Testing ◽

Rule Out

Abstract Symptom validity testing, also known as forced-choice testing, is a way to assess the validity of sensory and memory deficits, including tactile anesthesias, paresthesias, blindness, color blindness, tunnel vision, blurry vision, and deafness—the common feature of which is a claimed inability to perceive or remember a sensory signal. Symptom validity testing comprises two elements: A specific ability is assessed by presenting a large number of items in a multiple-choice format, and then the examinee's performance is compared with the statistical likelihood of success based on chance alone. Scoring below a norm can be explained in many different ways (eg, fatigue, evaluation anxiety, limited intelligence, and so on), but scoring below the probabilities of chance alone most likely indicates deliberate deception. The positive predictive value of the symptom validity technique likely is quite high because there is no alternative explanation to deliberate distortion when performance is below the probability of chance. The sensitivity of this technique is not likely to be good because, as with a thermometer, positive findings indicate that a problem is present, but negative results do not rule out a problem. Although a compelling conclusion is that the examinee who scores below probabilities is deliberately motivated to perform poorly, malingering must be concluded from the total clinical context.

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