Diagnostics

WHO MODEL

• International Classification of Functioning, Disability, and Heath (ICF) based on the World Health Organization (WHO model)

  • “Health” is defined as “the complete physical, mental, and social functioning of a person and not merely the absence of disease” by WHO.

  • ICF is a classification framework of health and health-related conditions

  • Used as a component of health

  • Can be used in inter-professional collaborative practice or with a person-centered care approach

  • For children and adults

  • Components/Classifications:

    • Functioning & Disability:

      • Body Functions and Structures including Anatomy, Physiology and Psychology

      • Activity and participation of a person's functional status

      • Communication, interpersonal interactions, mobility, self care

    • Contextual Factors

      • Environmental factors that are out of the individuals control

      • Family, occupation, laws, cultural beliefs

      • Personal Factors

      • Age, race, gender, education level

https://www.asha.org/slp/icf/

Prognostic Factors

**Variables that assist in predicting recovery**

Inclusive Practice Considerations Working with Various Age Groups

Inclusive Considerations Working with Various Populations

II. Considerations for working with the Transgender Community

• Use of pronouns, tools and respectful language while working with individuals

• Gearing treatment plan towards addressing things like voice, pitch, intonation and fluency as it is consistent with gender identity

(ASHA, Voice and communication services for transgender and gender diverse populations 2021)

• Financial resources and access to insurance and care that matches a person’s gender identity

• Cultural, medical, physical and emotional factors

• Inclusive intake, insurance forms and office space

(ASHA, Voice and communication services for transgender and gender diverse populations 2021)

*Service provision will vary depending on stage and type of transition (Adler, 2007)

Inclusive Practice Considerations

Working with Individuals from Various Cultural and Linguistic Backgrounds

I. Considerations for working with various cultural and linguistic groups

• The awareness and role that clinician’s intersectionality will play in service delivery (Moxely et al., Cultural Competence in Healthcare 2004)

• An individual’s access to finances and transportation to attend treatment.

• Not all tools and assessments will be applicable or effective to all cultural groups

• Differences in dialect, primary language and fluency (ASHA, Cultural competence 2021)

  • • • • Latino English (The Spanish vowel system consist of fewer vowels than of English)

        • AAE (African American English and Standard American English though similiar should not be considered against each other)

        • Asian American Dialects

www.asha.org/practice-portal/templates/

• Obtaining feedback and additional tools where necessary to meet the needs of a person’s culture or background

• Ensuring that service delivery does not interfere with client’s values, beliefs, religion or spirituality (ASHA, Cultural competence 2021)

• Specific cultures are prone to various conditions which may impact swallowing, communication and speech disorders. (ASHA, Cultural competence 2021)

II. Dialectic Variations and Considerations

• ASHA asserts that no dialect can be considered a disorder

• Clinicians must use testing procedures which are not discriminatory

• Symptoms of a language disorder are not attributable to dialect

• There exists a wide range of language variation within each dialect

• African American English, Standard English and Appalachian English are all examples of English dialects in the United States.

• Standardized testing presents with limitations and testing bias for different dialects

(ASHA, American English dialects 1970)

Qualifying For Services VS Identifying A Disability

Qualify for services, IDEA and standard deviation

• Per New York under the IDEA regulations, the presence of a disability or delay qualifies for services when it impacts the individual in one or more developmental domain:

·This criteria includes a delay of more than 12 months in one area

·A 33% delay in one domain or 25% delay in two domains or

·It can also result in the use of standardized testing to determine if the individual falls below 2.0 standard deviations below the mean. If no standard tests are available, the delay is determined by qualitative measurement and observation.

• With specific regard to Speech and Language, a severe delay is determined when no word development is indicated by 18 months of age.

(ETCAcenter.org 2014)

Federal Laws and Regulations for the SLP

Laws Affecting Speech Language Pathology

Licensure and Scope of Practice

Healthcare and Insurance Issues

Education Legislation and Regulations

IDEA

FERPA

HIPAA

Rehabilitation Act 504

ADA