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Communication Sciences and Disorders: A Clinical Evidence-Based Approach, 3e
Laura M. Justice and Erin E. Redle

Chapter 6
Communication Assessment and

Intervention: Evidence-Based Practices

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-2

Focus Questions

1. What is evidence-based practice?
2. What is assessment?
3. What is intervention?
4. What are some common approaches

to intervention for communication
disorders?

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-3

Introduction

 People in the field of communication sciences

and disorders fill a variety of roles.
 Key responsibilities include assessment and

intervention, or diagnosis and

treatment

.

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-4

What Is Evidence-based
Practice?
 Integrate knowledge from several

perspectives scientific evidence
 Clinical expertise
 Client perspective
 Definition

 Process by which the clinician integrates
these three areas to arrive at the best plan of
action for a particular client

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-5

What Is Assessment?

 Assessment

 the systematic process of gathering information
about an individual’s background, history, skills,
knowledge, perceptions, and feelings.

 Involves may disciplines with diverse
knowledge, skills, and experiences.

 A test is merely part of a complete
assessment.

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-6

Purposes and Processes of
Assessment
 To identify skills that a person has, and those the

person does not have in

a particular area

of
communication.

 To guide the design of intervention for enhancing a
person’s skills in a particular area of communication.

 To monitor a person’s communicative growth and
performance over time.

 To qualify a person for special services.

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-7

Screening and Referral

 This tasks are completed to identify

those who may require a more
comprehensive assessment.

 Screening: test or task to conduct a
quick check of performance.

 Referral: when a professional’s help is
formally requested.

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-8

Designing and Administering the
Assessment Protocol
 Chart review
 Interviews
 Systematic observation
 Questionnaire/survey
 Formal test
 Instrumentation

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-9

Formal Testing: Norm-Referenced
and

Criterion-Referenced Tests

 Norm-Referenced Test

 Used to compare performance with that of
a same-age peer

 Criterion-Referenced Test
 Used to determine level of achievement in

a particular area

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-10

Norm-Referenced Tests

Standardization
Test must be given in a
uniform and scripted manner so
that it is given in exactly the
same way to everyone who
takes it
Normative sample
A group of individuals who
were given the test to identify
standards of performance at
specific age levels

Standard scores
The index that identifies how a
person’s test performance
compares to that of their
normative peers.
Diagnostic accuracy
The ability of a test to correctly
describe a condition

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-11

Standard Normal Distribution

 Standard Normal Distribution

 Derived from mathematical models of probability regarding
how scores will range from a skill or aptitude that is
assumed to be normally distributed within the population

 Terminology
 Raw Score
 Normal Curve
 Mean
 Standard deviation
 Percentile Rank

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-12

Criterion-Referenced Tests
 Criterion-referenced assessment

 to determine an individual’s level of achievement
or skill in a particular area of communication

 Instruments
 Require establishment of a clear standard of

performance
 Require design of specific tasks
 Must provide clear guidelines for interpretation

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-13

Dynamic Assessment

 Analyzes how much and what types of

support or assistance are needed to
bring an individual’s communicative
performance to a higher level

 Leo Vygotsky’s influence

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-14

Interpreting Assessment Findings

 Steps to interpret assessment findings

 Diagnosis
 Differential Diagnosis

 Determine the severity of the disorder
 Very mild, mild, moderate, severe, and very

severe
 Characterizing the client’s prognosis

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-15

Developing an Intervention
Plan

 Components of an intervention plan:
 Identifying treatment goals
 Describing the possible length and

frequency of treatment
 Describing treatment contexts and

activities

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-16

Monitoring Progress and
Outcomes
 Not a one-shot deal that stops when the diagnosis is

made
 An ongoing process that monitors progress and

outcomes for the client
 Purposes

 Monitor a client’s progress during treatment
 Modify the treatment plan as progress is made
 Determine when a client should be discharged from

treatment

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-17

What Is Intervention?

 Definition

 Refers to the implementation of a plan of
action to improve one or more aspects of
an individual’s communicative abilities.

 Qualities
 Effectiveness
 Efficient
 Feasible

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-18

Purposes of Intervention

 Prevention
 Remediation
 Compensatory

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-19

Intervention Planning

 Goal

 Targeted communication
achievement of an
individual

 Procedure
 The clinician’s plan of

action
 Goal characteristics

 Functional
 Measurable
 Attainable

 Phases
 Phase 1: the professional

sets long-term for a
client, the anticipated
outcomes of therapy

 Phase 2: the professional
sets the short-term goals
that will lead to the
desired long-term goals

 Phase 3: the professional
sets session-level goals
for a client that are written
in measurable and
observable terms

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-20

Intervention Models

 Pull-out/direct service
 Co-teaching/parallel instruction
 Intervention consultation

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-21

WHAT ARE SOME COMMON APPROACHES
TO INTERVENTION FOR COMMUNICATION
DISORDERS?



Behaviorist Approaches



Linguistic-Cognitive Approaches



Social-Interactionist Approaches



Family-Centered Intervention

s

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-22

Behaviorist Approaches
 Based on classic learning theory, which emphasizes

the importance of the environment for shaping
behavior and, in particular, the influence of
consequences on behavioral change.

 Terminal Behaviors
 Clinicians are responsible for

 Identifying observable and measurable goals
 Specifying the level of mastery at each goal
 Controlling each intervention session
 Collecting data in each session

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-23

Linguistic-Cognitive
Approaches
 Based on theories of developmental psychology and

cognitive science, which emphasize the
developmental sequences and underlying rule-
governed organization of communicative behavior

 Parameters
 Goals of communication acquisition: when, how, and why
 Helping the individual lean the rules that underlie successful

communication
 The learner is engaged fully in the intervention process

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-24

Social-Interactionist
Approaches
 Based on theories of developmental psychology that

emphasize the importance of social interactions
among individuals as a critical means for
development and learning

 Vygotsky’s influence
 Terms

 Social plane
 Psychological plane
 Zone of proximal development
 Scaffolding

Communication Sciences and Disorders: A
Clinical Evidence-Based Approach, 3e
Justice and Redle

6-25

Family-Centered Intervention
 Built upon the concept of family systems

theory, which emphasizes that “the family as
a whole is greater than the sum of its parts”.

 Treatment goals emphasize an individual’s
participation within and access to family
activities and contexts, and may incorporate
family members’ perspectives regarding
viable treatment approaches.

Chapter 6 Communication Assessment and Intervention: Evidence-Based Practices

Focus Questions

Introduction

What Is Evidence-based Practice?

What Is Assessment?

Purposes and Processes of Assessment

Screening and Referral

Designing and Administering the Assessment Protocol
Formal Testing: Norm-Referenced and Criterion-Referenced Tests

Norm-Referenced Tests

Standard Normal Distribution

Criterion-Referenced Tests

Dynamic Assessment

Interpreting Assessment Findings

Developing an Intervention Plan
Monitoring Progress and Outcomes

What Is Intervention?

Purposes of Intervention

Intervention Planning

Intervention Models

WHAT ARE SOME COMMON APPROACHES TO INTERVENTION FOR COMMUNICATION DISORDERS?

Behaviorist Approaches

Linguistic-Cognitive Approaches

Social-Interactionist Approaches

Family-Centered Intervention

M3: Interactive Activity

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Communication Sciences and Disorders: A Clinical Evidence-Based Approach, 3e
Laura M. Justice and Erin E. Redle
© 2014, 2010, 2006 Pearson Education, Inc.
All rights reserved.

Chapter 6

Communication Assessment and Intervention: Evidence-Based Practices

Communication Sciences and Disorders: A Clinical Evidence-Based Approach, 3e
Justice and Redle
© 2014, 2010, 2006 Pearson Education, Inc.
All Rights Reserved.
6-*

Focus Questions
What is evidence-based practice?
What is assessment?
What is intervention?
What are some common approaches to intervention for communication disorders?

Communication Sciences and Disorders: A Clinical Evidence-Based Approach, 3e
Justice and Redle
© 2014, 2010, 2006 Pearson Education, Inc.
All Rights Reserved.
6-*

Introduction

People in the field of communication sciences and disorders fill a variety of roles.

Key responsibilities include assessment and intervention, or diagnosis and treatment.

Communication Sciences and Disorders: A Clinical Evidence-Based Approach, 3e
Justice and Redle
© 2014, 2010, 2006 Pearson Education, Inc.
All Rights Reserved.
6-*

What Is Evidence-based Practice?

Integrate knowledge from several perspectives scientific evidence

Clinical expertise

Client perspective

Definition

Process by which the clinician integrates these three areas to arrive at the best plan of action for a particular client

Communication Sciences and Disorders: A Clinical Evidence-Based Approach, 3e
Justice and Redle
© 2014, 2010, 2006 Pearson Education, Inc.
All Rights Reserved.
6-*

What Is Assessment?

Assessment

the systematic process of gathering information about an individual’s background, history, skills, knowledge, perceptions, and feelings.

Involves may disciplines with diverse knowledge, skills, and experiences.

A test is merely part of a complete assessment.

Communication Sciences and Disorders: A Clinical Evidence-Based Approach, 3e
Justice and Redle
© 2014, 2010, 2006 Pearson Education, Inc.
All Rights Reserved.
6-*

Purposes and Processes of Assessment

To identify skills that a person has, and those the person does not have in a particular area of communication.

To guide the design of intervention for enhancing a person’s skills in a particular area of communication.

To monitor a person’s communicative growth and performance over time.

To qualify a person for special services.

Communication Sciences and Disorders: A Clinical Evidence-Based Approach, 3e
Justice and Redle
© 2014, 2010, 2006 Pearson Education, Inc.
All Rights Reserved.
6-*

Screening and Referral

This tasks are completed to identify those who may require a more comprehensive assessment.

Screening: test or task to conduct a quick check of performance.

Referral: when a professional’s help is formally requested.

Communication Sciences and Disorders: A Clinical Evidence-Based Approach, 3e
Justice and Redle
© 2014, 2010, 2006 Pearson Education, Inc.
All Rights Reserved.
6-*

Designing and Administering the Assessment Protocol

Chart review

Interviews

Systematic observation

Questionnaire/survey

Formal test

Instrumentation

Communication Sciences and Disorders: A Clinical Evidence-Based Approach, 3e
Justice and Redle
© 2014, 2010, 2006 Pearson Education, Inc.
All Rights Reserved.
6-*

Formal Testing: Norm-Referenced and Criterion-Referenced Tests

Norm-Referenced Test

Used to compare performance with that of a same-age peer

Criterion-Referenced Test

Used to determine level of achievement in a particular area

Communication Sciences and Disorders: A Clinical Evidence-Based Approach, 3e
Justice and Redle
© 2014, 2010, 2006 Pearson Education, Inc.
All Rights Reserved.
6-*

Norm-Referenced Tests
Standardization

Test must be given in a uniform and scripted manner so that it is given in exactly the same way to everyone who takes it

Normative sample

A group of individuals who were given the test to identify standards of performance at specific age levels

Standard scores

The index that identifies how a person’s test performance compares to that of their normative peers.

Diagnostic accuracy

The ability of a test to correctly describe a condition

Communication Sciences and Disorders: A Clinical Evidence-Based Approach, 3e
Justice and Redle
© 2014, 2010, 2006 Pearson Education, Inc.
All Rights Reserved.
6-*

Standard Normal Distribution

Derived from mathematical models of probability regarding how scores will range from a skill or aptitude that is assumed to be normally distributed within the population

Terminology

Raw Score

Normal Curve

Mean

Standard deviation

Percentile Rank

Communication Sciences and Disorders: A Clinical Evidence-Based Approach, 3e
Justice and Redle
© 2014, 2010, 2006 Pearson Education, Inc.
All Rights Reserved.
6-*

Criterion-Referenced Tests

Criterion-referenced assessment

to determine an individual’s level of achievement or skill in a particular area of communication

Instruments

Require establishment of a clear standard of performance

Require design of specific tasks

Must provide clear guidelines for interpretation

Communication Sciences and Disorders: A Clinical Evidence-Based Approach, 3e
Justice and Redle
© 2014, 2010, 2006 Pearson Education, Inc.
All Rights Reserved.
6-*

Dynamic Assessment

Analyzes how much and what types of support or assistance are needed to bring an individual’s communicative performance to a higher level

Leo Vygotsky’s influence

Interpreting Assessment Findings

Steps to interpret assessment findings

Diagnosis

Differential Diagnosis

Determine the severity of the disorder

Very mild, mild, moderate, severe, and very severe

Characterizing the client’s prognosis

Developing an Intervention Plan

Components of an intervention plan:

Identifying treatment goals

Describing the possible length and frequency of treatment

Describing treatment contexts and activities

Monitoring Progress and Outcomes

Not a one-shot deal that stops when the diagnosis is made

An ongoing process that monitors progress and outcomes for the client

Purposes

Monitor a client’s progress during treatment

Modify the treatment plan as progress is made

Determine when a client should be discharged from treatment

What Is Intervention?

Definition

Refers to the implementation of a plan of action to improve one or more aspects of an individual’s communicative abilities.

Qualities

Effectiveness

Efficient

Feasible

Purposes of Intervention

Prevention

Remediation

Compensatory

Intervention Planning

Goal

Targeted communication achievement of an individual

Procedure

The clinician’s plan of action

Goal characteristics

Functional

Measurable

Attainable

Phases

Phase 1: the professional sets long-term for a client, the anticipated outcomes of therapy

Phase 2: the professional sets the short-term goals that will lead to the desired long-term goals

Phase 3: the professional sets session-level goals for a client that are written in measurable and observable terms

Intervention Models

Pull-out/direct service

Co-teaching/parallel instruction

Intervention consultation

WHAT ARE SOME COMMON APPROACHES TO INTERVENTION FOR COMMUNICATION DISORDERS?

Behaviorist Approaches

Linguistic-Cognitive Approaches

Social-Interactionist Approaches

Family-Centered Interventions

Behaviorist Approaches

Based on classic learning theory, which emphasizes the importance of the environment for shaping behavior and, in particular, the influence of consequences on behavioral change.

Terminal Behaviors

Clinicians are responsible for

Identifying observable and measurable goals

Specifying the level of mastery at each goal

Controlling each intervention session

Collecting data in each session

Linguistic-Cognitive Approaches

Based on theories of developmental psychology and cognitive science, which emphasize the developmental sequences and underlying rule-governed organization of communicative behavior

Parameters

Goals of communication acquisition: when, how, and why

Helping the individual lean the rules that underlie successful communication

The learner is engaged fully in the intervention process

Social-Interactionist Approaches

Based on theories of developmental psychology that emphasize the importance of social interactions among individuals as a critical means for development and learning

Vygotsky’s influence

Terms

Social plane

Psychological plane

Zone of proximal development

Scaffolding

Family-Centered Intervention

Built upon the concept of family systems theory, which emphasizes that “the family as a whole is greater than the sum of its parts”.

Treatment goals emphasize an individual’s participation within and access to family activities and contexts, and may incorporate family members’ perspectives regarding viable treatment approaches.

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