Diagnostics is one of the most difficult clinical tasks that requires

Specialized training

Ability to synthesize the field of study

Knowledge of norms and testing techniques

Advanced observation skills

Ability to be empathetic

Use of human intuition

Diagnostics is one of the most difficult clinical tasks that must

Assess all aspects of behavior in question

Assess individuals with varying styles and influences within a dynamic environment

Rely on testing tools that are imprecise

Engage in testing that is incomplete and ambiguous

Participate in activities that are often frustrating

What is diagnostics?

Continues and open ended process that results in answers or partial answers that are open to revision with added information

Scope of Practice

Prevention

Screening

Consultations

Assessment

Diagnosis

Treatment

Intervention

Management

Counseling

Follow-up services

Audiologists Scope of Practice

Professionals engaged in autonomous practice to promote healthy hearing, communication, competency, and quality of life for persons of all ages through prevention, identification, assessment, and rehabilitation of hearing, auditory function, balance, and other related systems

Principle of Ethics I

Individuals shall provide all services competently

Principle of Ethics IF

Individuals shall fully inform the persons they serve of the nature and possible effects of services rendered and products dispensed, and they shall inform participants in research about the possible effects of their participation in research conducted

Principle of Ethics

Individuals not reveal, without authorization, any professional or personal information about identified persons served professionally or identified participants involved in research about scholarly activities unless required by law to do so, or unless doing so is necessary to protect the welfare of the person or of the community or otherwise required by law

Diagnosis (Greek meaning)

Dia- apart

Gnosis- to know

Diagnosis

The clinician must know the client thoroughly and must know how that person responds while performing varying tasks

It is not just a process of labeling, but a process of thoroughly understanding the problem

Evaluation/assessment

The process of arriving at a diagnosis

The comprehensive investigation of a client’s disorder while utilizing multiple measures

Evaluation activities may continue until there is sufficient information that leads to effective treatment

The diagnostic process is an ongoing aspect of the total clinical management process

Screening

Activities of test that quickly identify individuals who merit further evaluation

Only demonstrates the need for further testing

Formal/informal

Purpose of Assessment

To describe the individuals communication development and status

Arrive at good understanding of problem-diagnose

Determine whether the individual’s communication skills sufficiently deviate from normal expectations to warrant concern or intervention

Therapy may need to begin before a firm diagnosis is made and is justified with the understanding that:

Any initial treatment approach is experimental to some degree

Most treatment goals are based on educated guesses

The goal of understanding the nature and extent of the problem may require more time and varied efforts

Obtain as much info. As you can during diagnostics but continue during treatment

Purpose of Assessment

Identify factors that relate to the presence or maintenance of a communication disorder

Make prognostic judgments about change with and without intervention

Monitor changes in communication abilities and performance across time

Appraisal-collection of data

Diagnosis-end result of studying an interpreting the collected data

Impairment

Basic biological and psychological systems that are necessary for communication

Disability

Functions that are disrupted by the impairment

Handicap

Limitations in the fulfillment of social and cultural functions that result from impairments and disabilities

Goal of the clinical diagnostic process

Understanding the client’s communication disorder

Function of diagnosis is to determine whether the presenting communication pattern constitution a handicap

What constitutes a communication disorder?

Difference-Is there a difference? When and in what context?

Disturbance-Is there a breakdown in communication during transmission?

Disorder-How might difference & disturbance produce a handicapping condition?

Cultural Norms

Idea that there are behaviors that society considers acceptable and unacceptable within the cultural group

Individual Norms

Idea that each individual possesses experiences and physical limitations

Judgments regarding normalcy of persons behavior must take into account variables such as age, intelligence and experience

What is a communication disorder?

Functional within their community

Demonstrates competence with current and future audiences

Likelihood individuals will face difficulties communicating with others

Community norms regarding communication

Diagnostics is a disciplined process

Formal and informal measures provide comprehensive descriptor of behavior

Clinicians must use most reliable and updated assessment tools

Standardized tools facilitate performance with typically developing populations

Closer look at diagnostics

Clinicians integrates testing results with clinical history to develop diagnostic impressions

Clinicians develops hypotheses about diagnoses through testing

Hypotheses are rationally tested throughout assessment process

Setting Dependents

Healthcare-patients

Freestanding clinics-clients

School-student/children

Some settings- consumers

Medical Model

Emphasis is placed upon classification of symptoms into disease categories that have specific etiologies

Goal is to classify and explain

It is assumed that problem is internal

Behavioral Model

Utilizing other resources in order to understand the problem

Include family and cultural context in diagnostic process to learn dynamics of communication problem

Observe client in his/her natural setting

Determine settings promote better communication or impede communication success

Diagnosis is more than labeling

Classification systems are used, though insufficient as primary means of diagnosing

Must follow orderly system of identifying characteristics

Clinician must be willing to label it

Labeling disorder without rationale or characteristics –bad

Determining etiology

Cautions:

Predisposition- genetic factors (stuttering)

Precipitation- causal factors (ear infection)

Perpetuation- current factors (habit)

Professional hazards

Science

Deficate model

Art

Clinical Problem Solving Steps

At the conclusion of an assessment

Determination of the complaint

Observe, describe, measure, analyze

Factors that impact diagnostics

Diagnosis vs eligibility

Impact on Diagnosis

Clinician

Characteristics of a good diagnostician

Diagnostic Questions

Diagnostic Questions

Interviews

Written Questionnaires