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Family centered Ax (Crais et al (2006) ten most freq occuring practices…
Family centered Ax
Crais et al (2006) ten most freq occuring practices that promote fam centered Ax
Time spent finding out fam's most impt concerns
All Ax results explained to fam
Time spent identifying next steps for fam, professionals
Conclusions summarised after sharing Ax results w fam
Fam asked if behaviours observed in Ax were typical of child
Fam given choice to be present for all Ax
Fam asked about child's strengths
During Ax, professionals made +ve comments about child
Fam asked to describe child's daily routine
Fam given choice to sit beside child in Ax
Least freq occuring practices
Fam asked whether they agreed w diagnosis
Fam given choice of Ax location
Fam asked to identify strategies to use in Ax
Fam asked to write down observations of cihld before, during Ax, if completed, asked to describe
Fam given choice to complete Ax checklist, if completed, asked to talk about what they noticed
Fam asked what activities/techniques in previous Ax were most/least successful
Fam met whole professional team before Ax
How to set up room, rationale
Pin child to corner
Toys (pizza, puzzle, ball game) laid on floor for child to play
Toys laid on top of cupboard (see if child asks parent for help)
Give chair for parents to sit but see if they get on the floor
Visual schedule
Need to tell them 'It's fine for you and your child to play with any of the toys in the room". "Is this how you normally play? How do you think that went?"
Hebbler, Rooney (2009) best practice principles
Ax should include fam as full partners
Ax should be based on multiple sources
Ax should provide info about child's fning w/i everyday settings, situations
Ax should provide info to guide Tx
Qns probe child's expressive, receptive lang skills
Receptive baby
How does your baby respond to your smile? calling his name? saying 'no', 'come here', 'give to me'
Does your baby look at fam members/familiar objects when you ask for them/name them
How does your baby ask for things? Point?
How does your baby show you things? Does he draw your attention by pointing?
Expressive baby
Do you have concerns that your baby is too quiet?
Any concerns about the way your baby comm. with you? Makes sounds? Responds to you?
What sounds does your baby make? Spontaneously or in response to talking
Does your baby say other clear words apart from mama, dada?
Receptive 1;0-5;0
Does child recognise common words by looking/pointing
Point to body parts when asked?
Follow 2 keyword instructions
Identify objects for functional use eg. which one do we eat with?
Does child follow instructions w 'in' or 'on', 'under', 'behind',
2 step directions?
Unds 2/more tasks in succession
Expressive 1;0-5;0
When your child wants something, how does he ask for it?
Does child repeat back what has been said to him?
Does your child use 'I', 'mine', 'what', 'why' qns?
Tell you sth that has already happened
Does he offer explanations?
Routines
What does child like to talk about?
Use of technology?
what does he draw?
What SLP observes during play-based interaction
Is child communicating using
joint visual attention
age appropriate eye contact
facial expression
gestures eg. pointing, showing, taking adult by hand
sounds, what type CV structure?
gestures w sounds, words
single words, word combinations?
type of words? nouns, verbs, empty lang?
Why is child communicating?
Primitive speech acts, pragmatics
Other dev observations
Play pattern
Attachment, parent-child interaction
Posture
Diaper
signs of frustration
using dummy
Speech intelligibility
Voice quality
Child-caregiver interaction
Does she sit f2f w child, eye level, get down on floor?
Does caregiver allow child to choose activity? Follow child's lead?
Does caregiver wait to let the child take a turn?
Does the caregiver join in the play?
Is the interaction balanced?
How is the caregiver communicating? Non-specific lang, one-step, two-step instruction, using rising intonation, yes/no qns, facial expressions, giving time for child to respond, parenting styles, amt of praise
Stein Rubin, Fabus (2012) 3 rationales for SLP case history interviews
Obtain child's full dev history
Determine parent's concerns, perception of problem
Determine parent invl, attitude, motivation