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Sherlock

Holmes
Diagnos2c Agency


Background
Informa/on
Formulate an
ini2al small set
of hypotheses
(Referral le<er,
Previous Tes2ng
Language or
other areas)

Obtain addi2onal
informa2on as directed
by ini2al hypotheses
(Case History,
Standardized Tes2ng,
etc. )
1. Problem or no
problem ?
2. What is the problem ?
3. What is the nature of
the problem ?
4. Dieren=al Diagnosis ?


Deduc2ve v. Induc2ve
Use a reasoning strategy
(deduc2ve v. induc2ve) to process
the informa2on in the clinical
context of the case
Deduc&ve Reasoning: develop
hypotheses to explain a case
problem and apply collected
informa=on to test the
hypotheses; if - then - but
therefore
Induc&ve - starts with informa=on
from observa=ons matched to an
established paGern to come to a
hypothesis; yields discoveries that
are probable.
???Eligibility??? Alterna2ve Assessment
Approaches ??????
Gathering Clues- Formula2ng
Gathered Clues Sucient Plan

What is the nature of the
Problem or no problem problem
What is the problem Dieren=al Diagnosis
Interven=on Formula=on
Authen=c Assessment , Client-
Specic, Criterion Referenced,
Dynamic, PorQolio, Dieren=al
Diagnosis, Baseline Informa=on


Integra2ng and Interpre2ng
Assessment Data

Diagnosis, Prognosis and
Recommenda=on

Severity Statement
Prognos=c Statement
Recommenda=ons
Establishing Baseline
Func=on
EBP Process
Test the nal diagnosis.
Consider other possible
diagnoses
Evaluate the process.
(Stop, Think, Act,
Review)
Communicate the
diagnosis.

Interven2on
Therapy
Assessment
Objec=ves: Target
Behaviors
Baseline of target
Behaviors
Therapeu=c
Environment
Treatment program

References
Eva KW. What every teacher needs to know
about clinical reasoning. Med Educ.
2005;39(1):98-106.
Kassirer JP. Teaching clinical reasoning: case-
based and coached. Acad Med. 2010;
85:1118-1124.
Jerry: Eligibility
MLU 1.68
PLS_recep=ve 68
PLS_expressive 64
PLS-total 62
GFTA 75
Eligibility: TOLD
Target Selec=on: Norma=ve data and/or
the client-specic approach (Paul, 2013)

Select behaviors that make the most immediate and socially signicant
dierence in your childs communica=on and reading skills: func/onal
targets.
Select targets that are the most useful and can be readily produced and
reinforced in his or her natural environment : will assist with carryover
and maintenance of behavior.
Select targets that can be expanded and modied. For example, rst
work on isola=ng the syllables in words"snowman" becomes "sno"
and "man" (a task of analysis) and then move to the more dicult task
of isola=ng the individual sounds in a word. Or, begin with combining
the two words of snow and man into one word and then move to a
three syllable word (a task of synthesis).
Select words, language structures, and pragma=c targets that relate to
your child's environment and culture.
Target Selec=on
your childs diagnosis, current levels of
performance, communica=ve and learning
needs, the environment, andpar=cularly
important for the older clienthis or her wishes.
Remember, treatment that is matched to your
childs needs and interests and incorporates her
strengths will be most benecial for her and fun
and rewarding for everyone!

Target Selec=on: Play Based
Required targets: select targets to teach then iden=fy a way to require those
targets during play.
Start with the lesson, not with the toy or game!
You may think in terms of how to give access to something the child wants
following skill demonstra=on. This
Youll also have suggested targets that are encouraged but not required. This is
because requiring target demonstra=on at too high a frequency quickly turns
the play session into drill-based work and begins to peel away the benets of
playful learning.
Memorable episode: The more episodic and story-like your play-based session is,
the beGer.
Associated events scaold memories.
Memorable targets: In addi=on to the play episode being memorable, its perhaps
even more important that the targets be memorable.
Ive used Sleepy Sue with a ve-year-old who called me out the next session
because I accidentally called Sue, Sam.And that was great! But a lot of kids
wouldnt remember that target, just like they wont likely remember many of
the target words in a series of ashcards. So Ive also had Sleepy Sue do a
cooking episode.
Target Selec=on: Play Based
Play-based learning can be done with children of any age.
What would play-based learning look like for a rh grader?
Start by considering how rh graders play with one another (for example,
talking about their favorite TV show), and design from there.




Meredith Poore Harold, PhD, CCC-SLP,
Phonology: Target Selec=on
Authen=c Assessment
Observa2on
Pragma=cs: interrupted teacher, ?
Play: ?
AGen=on: easily distracted, ?
Speech Intelligibility: poor
Intelligibility
The intelligibility of Jerrys speech in this language
sample is 93%, which is 0.55 Standard Devia=ons
below the mean (94.94.) for a child of his age (Paul,
308.)
Goal: Revision ????