And Answers Graded A+
Assessment CORRECT ANSWERS The Rule: Break the rules (don't have to read the
directions as they are written in the manual) Not like IQ tests; make their performance
better
People involved: physicians, physiatrist (rehab medicine), nursing, SLP, OT, PT,
Psychology, Recreational Therapy, Social Worker/Case Manager, Discharge Manager
-Tricky because patients change so frequently after a stroke and they are always
moving
-"Prognosis is generally good based on residual health status, family involvement, and
personal motivation"
Assessment CORRECT ANSWERS Goals:
-Diagnose communication impairment
-Differentially diagnose type of impairment (e.g., aphasia, dementia, RHD, dysarthria,
apraxia, swallowing)
-Determine severity level (mild: natural speaker, just not efficient; severe:
mute/perseverative responses)
-Determine prognosis for recovery (1. severity 2. length of time from onset 3. overall
health status 4. age 5. family involvement 6. personal motivation 7. pain/fatigue
-Identify deficits and strengths
-Plan treatment
-Monitor improvements (spontaneous and therapy-related, but we don't care; realistic
goals)
Case History CORRECT ANSWERS (case manager-need a medical referral)
-A full case history of medical and social aspects of the patient is crucial to an accurate
diagnosis
-Information from medical chart, patient and family members is essentail prior to
beginning testing
(working/retired, hobbies, groups/social activities, family members/location,
friends/locations, R or L handed)
Types of Testing CORRECT ANSWERS -Standardized vs non-standardized (few
normed tests-only WAB)
-Formal vs informal
-Screening tests vs full test batteries
Regulations: certain time period (24 hrs) to get first SOAP written including a diagnosis
(may say "preliminary evaluation indicates expressive aphasia")
Testing Considerations CORRECT ANSWERS (include in report)
General state of health: physical condition
-Alertness
, -Fatigue (guaranteed)
-Pain (after effects are painful; hemiparesis: weakkness/pain/achin in leg and arm (more
often)
-Emotional/mental health (aware of what happened to them-possible depression-still
motivated to work on speech/lang. tasks)
-Sensory less (writing/gesturing, facial sensory-droop)
-Associated deficits/hemiparesis (no change in hearing-"hearing appears adequate for
speech or managing conversational speech")
-Medication (may affect cognitive alterness)
Communication Skills to Assess CORRECT ANSWERS -Language
-Cognition
-Speech
-Swallowing
-Hearing
-Communication interaction
Settings of Assessment CORRECT ANSWERS -Acute care
-Acute rehabilitation center
-Outpatient rehabilitation
-Long-term care facilities
Functional Independent Measure Score (FIM) CORRECT ANSWERS -Has to be
reported within 72 hrs of admission
-The FIM score ranges from 1-7
(Refer to notes for more information)
Areas of FIM Assessment CORRECT ANSWERS -Eating (SLP may help with
swallowing)
-Grooming
-Bathing
-Dressing (upper/lower body)
-Toileting
-Bladder management
-Bowel management
-Transferring (to go from one place to another) in a bed, chair, and/or wheelchair
-Transferring on and off a toilet
-Transferring into and out of a shower
-Locomotion (moving) for walking or in a wheelchair
-Locomotion going up and down stairs
-Comprehension (SLP)
-Expression, social interaction (SLP)
-Problem solving (SLP)
-Memory (SLP)