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Times New Roman1.$Times New Roman1.Times New Roman1h8zCambria1,8zCalibri18zCalibri18zCalibri1zCalibri1zCalibri1<zCalibri1>zCalibri1?zCalibri14zCalibri14zCalibri1 zCalibri1 zCalibri1zCalibri1zCalibri1 zCalibri1zCalibri"$"#,##0_);\("$"#,##0\)!"$"#,##0_);[Red]\("$"#,##0\)""$"#,##0.00_);\("$"#,##0.00\)'""$"#,##0.00_);[Red]\("$"#,##0.00\)7*2_("$"* #,##0_);_("$"* \(#,##0\);_("$"* "-"_);_(@_).))_(* #,##0_);_(* \(#,##0\);_(* "-"_);_(@_)?,:_("$"* #,##0.00_);_("$"* \(#,##0.00\);_("$"* "-"??_);_(@_)6+1_(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_)"Yes";"Yes";"No""True";"True";"False""On";"On";"Off"],[$ -2]\ #,##0.00_);[Red]\([$ -2]\ #,##0.00\)                (  (  (  (  (  (  (  (  (  (  (  (  '  '  '  '  '  '  '  '  '  '  '  '    !   # ff + ) , * %     P  P        " `           & a> $   & & &       & 8 @  8@@ &  H  hP @  #  (@  #8 @  (@@   h@@   H   h@  h@  (@@   ( @  "8@ @  "8Q@ @   (@@  (P @  (P  (@@   (@ "@ @ "Q@ @  (P   h@@    h@   h@   hP @    hP @   h@   hP @   "8@ @  "8Q@ @  "8@ @  "@ @  (Q@@  (Q@  #8Q@  "8Q@ @  "8QQ@ @ "@ "P @  "Q@ @   8@ @  &8@ 8@@  &8P @     "8@@    8Q@ @   8Q@ @  (@@  (@  (Q@@  (Q@    8UQ@ @ 8PQ @ 8P @  @ @  @ @  @ @    U@  U@  U@ @  "8QU@ @ "8Q@ @  " 00_)[$## }-}? 00_) 20% - Accent1M 20% - Accent1 ef % 20% - Accent2M" 20% - Accent2 ef % 20% - Accent3M& 20% - Accent3 ef % 20% - Accent4M* 20% - Accent4 ef % 20% - Accent5M. 20% - Accent5 ef % 20% - Accent6M2 20% - Accent6  ef % 40% - Accent1M 40% - Accent1 L % 40% - Accent2M# 40% - Accent2 L湸 % 40% - Accent3M' 40% - Accent3 L % 40% - Accent4M+ 40% - Accent4 L % 40% - Accent5M/ 40% - Accent5 L % 40% - Accent6M3 40% - Accent6  Lմ % 60% - Accent1M 60% - Accent1 23 % 60% - Accent2M$ 60% - Accent2 23ٗ % 60% - Accent3M( 60% - Accent3 23֚ % 60% - Accent4M, 60% - Accent4 23 % 60% - Accent5M0 60% - Accent5 23 %! 60% - Accent6M4 60% - Accent6  23 % "Accent1AAccent1 O % #Accent2A!Accent2 PM % $Accent3A%Accent3 Y % %Accent4A)Accent4 d % &Accent5A-Accent5 K % 'Accent6A1Accent6  F %(Bad9Bad  %) Calculation Calculation  }% * Check Cell Check Cell  %????????? ???+ Comma,( Comma [0]-&Currency.. Currency [0]/Explanatory TextG5Explanatory Text %0 : Followed Hyperlink 1Good;Good  a%2 Heading 1G Heading 1 I}%O3 Heading 2G Heading 2 I}%?4 Heading 3G Heading 3 I}%235 Heading 49 Heading 4 I}%6( Hyperlink 7InputuInput ̙ ??v% 8 Linked CellK Linked Cell }% 9NeutralANeutral  e%"Normal :Noteb Note   ;OutputwOutput  ???%????????? ???<$Percent =Title1Title I}% >TotalMTotal %OO? Warning Text? Warning Text %XTableStyleMedium9PivotStyleLight16` Pages 1-5Page 6  ; fffP0@bZ  3  @@   EAlabama A&M University"Communicative Sciences & DisordersSpeech & Hearing ClinicPracticum EvaluationClient Disorder / Difference%Client Cultural /Linguistic DiversityClient Age Group8The following evaluation of clinical practicum will be completed by student self-evaluation and by supervisor evaluation of student performance at beginning, midterm and the end of the semester. Knowledge or skills will be rated according to the descriptors on the Supervision Rating Scale/Supervision Continuum:  7 e5 = Consistent 4 = Adequate 3 = Present 2 = Emerging 1 = Not Evident NO = Not ObservedKNOWLEDGE / SKILLBEHAVIORAL DESCRIPTORSGOALMTFINALA.ORAL COMMUNICATION1.4Demonstrates effective speaking and listening skillsDemonstrates speaking and listening ability for effective clinical and professional interaction with clients and their relevant others.2.Demonstrates speech and language skills in English so that modeling of the target phoneme, grammatical feature, or other aspect of speech and language that characterizes the client's problem is correct.+Demonstrates effective modeling and targetsORAL COMMUNICATION TOTALB.WRITTEN COMMUNICATION ORGANIZATION/Follows appropriate format for type of document4Presents information in organized and concise manner;Uses a logical order and appropriate transition statements.7Follows standard format as stated in clinic procedures. CONTENT/STYLE3.GWrites thorough, objective reports that synthesize various data sources,Includes supporting data and relevant information in diagnostic reports, initial tx plans, lesson plans, SOAP notes, summary reports, professional correspondence, or other assigned reports; information is integrated and synthesized for appropriate analysis of information and support for conclusions.4.$Includes appropriate recommendationsyIncludes specific ideas for tx, including measurable goals, procedures, cues, reinforcement, and materials, as indicated.5.Writes clearly and concisely^Excludes insignificant or irrelevant information, does not include new information in summary.6.(Writes appropriate behavioral objectivesPlans/writes behavioral objectives and goals that consider functional needs of clients and are prioritized, measurable, achievable.7.*Uses professional language and terminology8.&Edits and proofreads all documentationSCarefully edits and proofreads written documentation and reports before submission.WRITTEN COMMUNICATION TOTALC./INTERACTION AND PERSONAL/PROFESSIONAL QUALITIESPROFESSIONAL RESPONSIBILITY@Is punctual for meetings with supervisor and for client sessionsArrives before session to set up clinic room, begins work promptly at scheduled diagnostic/therapy time, is on time for meetings.Attends all scheduled meetings/classes/seminars. If unable to attend meeting, informs supervisor well in advance. Reschedules therapy sessions when absent (following supervisor approval).=Submits work on time and as specified according to proceduresSSubmits written reports/lesson plans by due dates; work is complete when submitted.%Demonstrates organization/preparationIs prepared for sessions, has practiced test administration and techniques, session is well sequenced and organized; brings appropriate or required materials/documents to sessions and meetings.Demonstrates initiative in clinical management_Demonstrates knowledge of clinic safety, confidentiality, ethical procedures, clinic proceduresDemonstrates adherence to universal/standard precautions/infection control procedures, emergency and safety procedures, ASHA Code of Ethics, confidentiality procedures. Follows checkout procedures for materials, tests, and client files; does not remove client records from the clinic.+Keeps compete, accurate, and timely recordsnAccurately completes practicum hours, places and secures all information appropriately in client file, following clinic procedures. Completes all sections of client folder in a timely manner and submits for processing. Sends reports as indicated to client, caregivers, physicians, etc. ensures appropriate release of information and fee payment contract are in file.#Maintains a professional appearancetDresses appropriately for clinic assignments, following dress code guidelines; conducts self in professional manner.PROFESSIONAL INTERACTIONS9.Is approachable and responsive to clients, parents, and other professionals. Demonstrates poise and maturity in professional interactions10.,Is approachable and responsive to supervisorlConsults with the supervisor in appropriate setting and manner, respects supervisory relationship, seeks information and or clarifies information in an open, non-defensive manner. Seeks input; accepts supervisors comments/suggestions, integrates supervisor's suggestions. Responds to and incorporates supervisor's feedback on written documentation, as appropriate.11.Displays acceptance of the client's disability and differences; treats all clients with positive regard. Respects cultural differences)Adapts to client's age, cognitive level, language level, and cultural/ethic differences with appropriate communication strategies and modifications to the therapy setting. Demonstrates acceptance and tolerance for cultural differences; varies interaction style as needed for clinical interactions.12.%Collaborates with other professionalstConsults with other professionals as appropriate for case management; secures consent and maintains confidentiality.PROFESSIONAL ATTITUDE13. Demonstrates pride in professionShows enthusiasm in professional interactions about speech-language pathology as a profession and career choice; is a positive role model for others as a clinician.14.3Displays emotional control, stability, and maturityvMaintains a neutral emotional display when appropriate or needed. Demonstrates emotional maturity and self-confidence.15./Demonstrates interest and involvement in clinic16.9Demonstrates ability to self-evaluate professional growthComes prepared to conferences for discussing clinical performance; sets goals for own clinical and professional development. Provides constructive feedback to the supervisor regarding the supervisory process and developmental needs.D. PREVENTION&Demonstrates ability to screen hearing7Demonstrates ability to screen for middle ear pathologyDDemonstrates ability to screen speech-language and swallowing skillsParticipates in prevention activities that eliminate, inhibit, or delay the onset and development of a communication or swallowing disorder by minimizing susceptibility or reducing exposure%INTERACTION/PROFESSIONAL SKILLS TOTALPREVENTION TOTALE. ASSESSMENTPLANNINGFDemonstrates understanding of referral questions and diagnostic issuesThoroughly reviews client history/reason for referral, and plans appropriately; secures necessary information from client/caregiver, if indicated.tDemonstrates ability to integrate knowledge from academic courses and research to formulate a diagnostic hypothesis.7Selects and administers appropriate evaluation measuresEXECUTION: DIAGNOSTIC/SCREENING%Conducts appropriate client interviewZTalks to client, caregivers, spouse, as appropriate and generates investigative questions.Manages client behavior0Administers formal and informal tests accuratelyOrganizes/manages sessionOrganizes session appropriately, manages materials and modifies environment as needed, uses time efficiently. Modifies procedures to meet client's needs, uses appropriate language for client's level.DATA COLLECTION AND SCORINGRecords responses accuratelyScores accurately,Scores formal and informal tests accurately.ANALYSIS AND INTERPRETATION]Accurately analyzes, interprets, and integrates data; applies academic and clinical knowledgeAnalyzes and interprets data accurately; integrates results from case history, observation, formal testing and informal procedures to make accurate impressions and assessment/diagnosis. Integrates knowledge form academ< ic courses into assessment interpretation.Makes accurate recommendations for intervention or referrals to other professionals or services, as needed. Is aware when full evaluation is needed after screenings.ASSESSMENT TOTALF. INTERVENTION=Investigates client file for pertinent background informationIdentify client's needs, case management issues, relevant factors, previous treatment, outcomes and recommendations; makes contacts as appropriate to secure necessary information.VDevelops an individualized intervention plan that considers client and caregiver needsdEstablishes treatment plans with objectives and goals that meet the individual client's needs. Collaborates with clients and relevant others in the planning process; plans projected progress considering length of planned therapy. Sequences and organizes short-term objectives and long-term goals appropriately considers future planning and carryover needs.^Plans specific, effective and appropriate therapy procedures, including cues and reinforcementUses procedures appropriate for client's needs, strengths, developmental level, learning style, cultural and linguistic factors. Plans for modifications needed in the physical environment to meet the client's needs. Follows hierarchies to transition clients to next level.aApplies theory, research, and knowledge from academic courses in formulating an intervention planlDemonstrates ability to integrate knowledge from academic courses and best practices into clinical practice.1Develops/plans treatment to ensure generalization]Follows intervention plans; modifies strategies, materials, or instrumentation as appropriateFollows plan and modifies as appropriate to meet client needs. Uses branching strategies. Involves clients and relevant other in the intervention process.KSelects or develops a variety of materials, strategies, and instrumentation|Uses a variety of strategies to gain client cooperation. Considers functional needs of client. Demonstrates ability to facilitate attention, concentration, cooperation, and learning in clients of all ages; uses age-appropriate strategies for client management. Deals with problem behaviors appropriately. Identifies and reacts appropriately to client's verbal/nonverbal responses.Uses session time efficiently8Measures and evaluates client's performance and progressSCollects data accurately and efficiently without interrupting the flow of therapy. (CSD 321, 406, 516) L1, L2, L3pProvides appropriate and effective verbal directions and reinforcement; monitors verbal and nonverbal behaviors.*Monitors verbal and nonverbal interactions(Communicates effectively with the clientGives information clearly, concisely, and at a language level that is meaningful to the client. Gives clear and consistent instructions, modifies instructions when the client is not understanding. Communicates rational for therapy techniques, as appropriate for age and cognitive level."Provides home program instructionsTrains client and caregivers in home program, ensures that client/caregiver understands instructions. Provides home program materials, as appropriate, and documents training in client file.#Demonstrates problem-solving skills REPORTING4Accurately records and evaluates clients performanceDAccurately completes required documentation of intervention results.VProvides organized presentation of information to client, caregivers, supervisor, etc.qIs prepared, practiced, well-sequenced, and well-organized with material and presentation that is free of jargon.8Provides feedback to client and/or caregiver effectivelyINTERVENTION TOTAL#PRACTICUM EVALUATION RATING SUMMARYGOAL SETTING CONFERENCEMIDTERM RATING FINAL RATINGAreaStudent Area Total RatingTotal Score For Each Area%OralWrittenInteraction/Professional Prevention Assessment InterventionTotalGRADE Clinical Supervisor(s) SignatureDateBClinical Supervisor(s) Signature DateStudent SignatureIStudent Signature DaterADDITIONAL COMMENTS ON PERFORMANCE, STUDENT CLINICAL/PROFESSIONAL GOALS, DATE (attach additional sheet, if needed)_ Student is recommended to continue in clinic practicum in the ϲ Clinic/ϲ sites.} Student is recommended to continue in clinic practicum in off-campus placements (requires a minimum rating of 4.0).x Student needs continued development of skill or competency areas. A Competency Remediation Plan may be needed.c Student does not demonstrate required skills to continue placement in clinical practicum.GradeLetterABCDF3Records client's responses during test administration and informal observations; observes performance of the client with insight; collects a communication sample. Ensures backup data retrieval system available (i.e., audio and/or videotape, second tape recorder). Accurately discriminates sound productions.RGrading Scale: 90 - 100 = A; 80 - 89 = B; 70 - 79 = C; 60 - 69 = D; below 60 = FUses formal, professional, objective language that is grammatically correct. Explains jargon and terminology as appropriate. Avoids emotional language. Uses approved abbreviations in daily documentation. No abbreviations not on approved list.4Attends scheduled meetings, classes, client sessionsAttends to case management issues and seeks information and resources; recognizes case management needs; provides client with optimal level of service.Appropriately interacts with clients and caregivers in the clinical setting: demonstrates active listening skills and appropriate nonverbal communication. Addresses client's concerns in a positive and confident manner, is receptive to clients and caregiver's questions, utilizes effective counseling techniques. Provides organized information during conferences that are appropriate for educational level of client or caregiver.Views each clinical assignment as a learning opportunity, recognizes personal needs for clinical and professional growth and experiences, displays a positive attitude about all cases and assignments. Demonstrates effort and enthusiasm for the clinical assignments.}Performs puretone air conduction hearing screening accurately. Correctly interprets findings and makes appropriate referrals.Performs screening tympanometry accurately under supervision of audiologist. Correctly interprets findings and makes appropriate referrals.}Performs speech-language and swallowing screenings accurately. Correctly interprets findings and makes appropriate referrals.Participates in identification of target groups at risk for communication disorders and prevention activities to identify and eliminate risk factors for the onset, development, or maintenance of a communication disorder; or to improve ability to cope with communication disorders (such as clinic and community screenings, health fairs, inservices, parent/client education, support groups, etc.).dApplies theory, research, and knowledge from academic courses in formulating a diagnostic hypothesisInvestigates validity and reliability data and chooses appropriate diagnostic tools. Selects appropriate behavioral observations, non-standardized/standardized tests, and instrumental procedures. Demonstrates understanding of cultural factors.XUses appropriate techniques to manage client behavior that facilitates best performance.Demonstrates preparation and appropriate amount of practice; administers test efficiently according to standardized procedures; shows ability to correctly establish basal and ceiling.9Makes recommendations based on integration of informationDevelops objectives and strategies to address generalization needs. Collects data on generalization skills and plans accordingly.Paces session well, obtains an optimal number of client responses. Conducts efficient and effective transitions between tasks. Avoids unnecessary delays, dialogue, and interruptions.3Uses resources from the clinic, class, supervision, library, journals, Internet, etc. to effectively address clini<Tcal needs and concerns; does not depend on supervisor for problem identification, evaluation, and generation of solution. Conducts self-evaluation of the session to improve own clinical skills.WDiscusses treatment plans and gives therapy feedback in a clear and practical manner, ensuring confidentiality. Summarizes session objectives and results at the conclusion of the session. Communicates effectively, recognizing the needs, values, preferred mode of communication, and cultural/linguistic background of the client, and caregivers.iAdapted from: Clinical Evaluation Form, The University of Texas, Speech and Hearing Center, Austin, Texas&ZAdapted from: CF 405 (Revised 07-09-02) Practicum Evaluation UGA Speech and Hearing ClinicLanguageAfrican AmericanTottlerPragmatic Language/AutismAnglo-AmericanChildSpeech and Language ScreeningsVarietyNAQ1. Student will learn how to adequately administer the Rosetti test with 90% acc.>Esther J. Embden, MA, CCC-SLP/L 06/15/099Esther J. Embden, MA, CCC-SLP/L 06/01/09>Esther J. 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