Topic 5

WORKING WITH CLIENTS

Skills to be learned
 scheduling clients
 evaluating communicative and swallowing
disorders
 developing and implementing treatment
plans
 writing reports
 maintaining records
 working with families
 coordinating services with other
professionals
SCHEDULING

 Factors
◦ Student clinician schedule
◦ Supervisor’s schedule
◦ Student’s experience academic level
◦ Type, frequency and duration of service
◦ Population served
◦ Clients’ cultures
◦ Clinical site
◦ Financial resources
Scheduling - University Clinics
 Initial contact (procedure varies at each
university, but common sense information
such as introducing yourself, asking about
availability, providing directions, may also
start case history).
Hospital Schedules
 Frequency and duration (usually 5 to 6
days/week)
 Optimum schedule for patient
 Coordinate with nursing staff
 Coordinate with other rehab personnel
 Allow time for meetings and conferences
 Coordinate with family visit
 Adhere to schedule
 Be punctual
 Time for indirect services (reports, consultation,
etc.)
 Verify appointments with assistants
School Schedules
 Type of schedule: block or intermittent
 Delivery models
 Frequency of services
 Individual or group
 School class schedule
 Time for consultation, testing, report
writing, and meetings
In general (all sites)

 Schedule sessions to optimize

effectiveness
 Coordinate with other services
 Follow the schedule
 Allow time for indirect services
ASSESSMENT

 Plan and discuss with supervisor

 Obtain case history
 Interview (Problems: establishing rapport,
too many yes/no questions, redundant
questions, ignoring important information,
stereotypic notions).
 Perform Oral Mechanism exam
◦ Sample Oral Mechanism Exam
ASSESSMENT
 Screen hearing
◦ Sample Hearing Screening
 Obtain speech/language samples
◦ Getting a speech/language sample
 Administer standardized tests
◦ Reliable
◦ Valid
◦ culturally non-biased
◦ Sample Standardized Test for Preschool
 Disorder specific evaluation
 Observe a variety of skills
 Discuss impressions and recommendations
 Analyze results and write reports
 WORKING WITH CLIENTS AND
FAMILIES
 Check with supervisor before discussing important
issues
 Give overview of planned services
 Repeat important information
 Give accurate information
 Inform that it’s often difficult to determine a cause for
disorders
 Discuss sequence of treatment
 Allow time for questions
 Give probabilistic information on treatment outcomes
 Encourage active participation and observation
 Review treatment progress
 Be aware of internet research (fads)
REPORT WRITING
Diagnostic (Dx)
 Identifying information
 Statement of problem
 Background information
 Behavioral observations
 Detailed information about each part of the
assessment
◦ Hearing screening
◦ Oral mech exam
◦ receptive and expressive language
◦ Articulation
◦ Voice
◦ fluency
REPORT WRITING
Diagnostic (Dx)

 Summary and impressions

 Recommendations
 Signature
Treatment (Tx) plans

 Prognostic statement
 Goals and objectives
 Type, frequency, and duration
Lesson plans

 Objectives
 Procedures and materials
◦ Example procedures and materials next slide
Progress reports
 Daily progress notes (e.g. SOAP notes)
 Periodic progress notes
 Final summaries
Other reports
 Discharge reports
 IEP (Individualized Education Program)
 IFSP (Individualized Family Service Plan)
RECORD KEEPING

 Client files
 Practicum hours
WORKING WITH OTHER
PROFESSIONALS
 Audiologist  Orthodontist
 Board Certified  Otolaryngologist
Behavior Analyst  Pediatrician
(BCBA)  Physiatrist
 Cardiologist  Prosthodontist
 Dietician  Radiologist
 Neurologist  Registered nurse
 Occupational Therapist  Social worker
 Physical Therapist  Psychologist
Educational specialists
 Adaptive Physical Education Specialist
 Educational Audiologist
 Principal
 School nurse
 School psychologist
 Special ed teacher
 Teacher
SLPAs

 Implement treatment plans

 Assist in screening
 Collect and document data
 Check and maintain equipment
SLPAs may NOT
 Administer tests
 Interpret test results
 Screen or diagnose feeding/swallowing disorders
 Participate in parent conference without
 Provide counseling
 Develop or modify treatment plans
 Assist with treatment without supervision or without
plan
 Sign any formal documents
 Select, refer, or discharge clients
 Disclose confidential information
 Demonstrate swallowing strategies or precautions
Future Direction
 Internet
 Telepractice (telehealth, telemedicine)