Trying to evaluate communication during the COVID-19 pandemic is a challenge. Like me, you’re probably minimizing what you carry into homes (or rooms). But we still need to provide a good assessment of communication skills.
Free DIRECT downloads: Caterpillar Passage and Grandfather Passage – assessment. (Email subscribers get free access to all the resources in the Free Subscription Library.)
Outline:
- Making single-use communication evaluation folders.
- Tips for using single-use evaluation folders.
- Contents of a single-use communication evaluation folder (All but Cookie Theft/Picnic are free).
- Agency forms.
- Neuro-QoL Scales for communication and speech difficulties.
- Aphasia Impact Questionnaire – single visual rating scale.
- Image to elicit a narrative – Cookie Theft or The Picnic.
- A reading passage – Caterpillar or Grandfather.
- Your preferred subtests of standardized batteries.
- Tactus Therapy’s 100 examples of functional long-term goals.
- Which communication evaluation tools would you add?
- Related Eat, Speak, & Think posts.
- Reference.
Making single-use communication evaluation folders
Since we don’t yet know if we can contract the virus after contact with contaminated paper or plastic, everyone is operating under an abundance of caution. Which means that we should think very carefully about using testing materials with our patients.
Your employer’s policies and procedures are the final word, but for reference, here is what I’m doing. I’m limiting what I carry into all houses. If someone is under investigation or confirmed to have the virus, I won’t take anything into the home that can’t be thrown away.
And this precaution is causing me to change how I assess communication skills. In the past, I relied heavily on full assessment batteries, such as the BDAE-3 and the WAB-R, as well as using a microphone and software on my laptop for voice.
Luckily, we have plenty of options for assessment measures, even if they don’t quite reach the level of psychometric soundness that we would prefer. So now, I’ve made up a batch of single-use communication evaluation folders which I store in my car.
I use manila file folders*, but you could simply staple or paperclip the stack of papers together.
If I think I’ll be bringing in additional materials, I’m more likely to use a folder with pockets*, especially if there are executive function difficulties.
*This is an Amazon affiliate link. As an Amazon associate, I may earn a small commission on qualifying purchases. There is no extra charge to you, and it will help keep Eat, Speak, & Think sustainable.
Tips for using single-use evaluation folders
Start off with what you think you’d use most often. I tried to pick single-page items that would give me useful information.
Individualize the contents of the folder if you gain insightful information during your chart review or phone call to schedule the evaluation.
Tips for how to capture data during the assessment:
- Record the scores or other information on your computer.
- If you don’t have your computer, write down the information on paper you keep in your pocket.
- Alternatively, you can snap a picture of the form (without identifying information).
- Or you can create a voice or text memo on your phone (which can be kept in a zip-lock bag).
Contents of a single-use communication evaluation folder
I’ll list what I’m currently carrying in my communication evaluation folders, and then write more about each one.
- The forms my agency requires.
- Neuro-QoL Scales:
- Aphasia Impact Questionnaire – single visual rating scale.
- Image to elicit a narrative.
- Cookie Theft picture from the BDAE-3.
- Picnic Scene from the WAB-R.
- A reading passage.
- Your preferred subtests of standardized batteries
- Tactus Therapy’s 100 examples of functional long-term goals.
Neuro-QOL Scales
The National Institutes of Health funds HealthMeasures, which offers a number of free tools of interest to speech-language pathologists. These are quick self-assessment questionnaires with T-scores.
The Neuro-QoL Scale for Communication has scoring instructions, but currently the link for the T-score table is not working. I found this particular scale as I was writing this post, so I don’t have the table either. According to the scoring manual, this is how to calculate the score:
The score is obtained by adding up the values of the response to each question, then subtracting 5 from the total sum, multiplying by 100 and dividing by 20, or (Summed score – 5) X100/20.
Neuro-QoL: Quality of Life in Neurological Disorders Scoring Manual. Version 2.0. March 2015
On the other hand, the Neuro-QoL Scale for Speech Difficulties does have scoring and interpretation available.
Aphasia Impact Questionnaire – single visual rating scale
The Aphasia Impact Questionnaire is a “pictorial, self-report questionnaire.” It’s free to download, with a request to consider a donation.
Since the AIQ is multi-page, I don’t take it with me during evaluation. If I take it during a later session, I’d simply print out a copy and leave it there.
But I do like to have the visual response scale handy to support communication. It’s a sequence of five images, ranging from quite unhappy to quite happy. There are a eight separate scales available, to reflect different ethnicity and genders.
I print out a male and female version of the ethnicity reported in the chart, then slip them into a plastic page protector. Usually, I include a sheet of cardboard* in the middle to make it more durable.
*This is an Amazon affiliate link. As an Amazon associate, I may earn a small commission on qualifying purchases. There is no extra charge to you, and it will help keep Eat, Speak, & Think sustainable.
Image to elicit a narrative
The Cookie Theft picture and The Picnic Scene are each line drawings of a complex scene. Each is from a published, standardized assessment battery.
Picture description is a common way to elicit information about a person’s speech, language, and cognitive communication abilities. I’m planning on writing about how to use a speech sample to assess some aspects of voice, motor speech, language, and cognitive-communication skills.
A reading passage
I’ve typically used the Grandfather passage, and sometimes the Rainbow passage, for assessment. However, while writing this post, I came across an article comparing the Caterpillar passage to the Grandfather passage. I’m going to try out the Caterpillar passage, which is about a roller coaster.
The Caterpillar passage
The Caterpillar passage was designed to improve upon The Grandfather passage. It has the following properties (see the article for more):
- Updated language.
- Contains all English phonemes.
- 197 words and 261 syllables.
- Average of 12.1 words per sentence.
- 64% of words are “high frequency”.
- Flesh-Kincaid Reading grade level 5.0.
- Word pairs of increasing length.
- Repetition of words: Caterpillar x7, tick x3, memorable x2.
Grandfather passage
The Grandfather passage was originally introduced by Charles Van Riper in 1963, who closely based it on a passage from Sir Arthur Conan Doyle’s last Sherlock Holmes novel. It was later updated by Darley, Aronson, & Brown (1975).
According to Patel, et al (2013), it has the following properties:
- Contains almost all phonemes of English.
- 133 words and 177 syllables.
- Average of 16.5 words per sentence.
- 54% of words are “high frequency”.
- Flesh-Kincaid Reading grade level: 5.2.
- Does not include word pairs of increasing length.
- Only includes one word that is repeated: Grandfather x2.
Your preferred subtests of standardized batteries
Take a look at your standardized test batteries and see if you can identify subtests that you can administer with minimal to no materials.
There are multiple options to enable you to administer these subtests, always keeping in mind your agency’s policies. You could:
- Laminate the relevant page(s).
- Slip them into a page protector (maybe tape the top?).
- Throw the paper away if it comes in contact with anything.
- Keep the paper in your pocket or clean hand.
- Take a photo and store on your phone, which can be kept in a plastic zip-lock bag.
Tactus Therapy’s 100 examples of functional long-term goals
Tactus Therapy’s Setting Goals in Aphasia Therapy has a great two-page list of 100 examples of functional long-term goals.
If I can’t identify at least one concrete functional goal during the assessment, I leave this list with my patient. I ask them and their family to mark the top five to 10 things they’d love to achieve during therapy.
Then when I return, we review the list and determine which one or two we should address first. Sometimes we base the choice on importance, but sometimes we need a “quick win” to bolster confidence and motivation.
Which communication evaluation tools would you add?
I’d be really interested in hearing how you’re handling communication evaluations during the COVID-19 pandemic. Which items do you carry with you?
Related Eat, Speak, & Think posts
- Single-use swallow evaluation folders.
- Single-use cognitive evaluation folders.
- How to assess pragmatic skills in adults with brain injury.
- Easy discourse measures to demonstrate improvement.
- Tips for dynamic speech assessment.
References
- Patel, R., Connaghan, K., Franco, D., Edsall, E., Forgit, D., Olsen, L., Ramage, L., Tyler, E., & Russell, S. (2013). “The caterpillar”: a novel reading passage for assessment of motor speech disorders. American journal of speech-language pathology, 22(1), 1–9. https://doi.org/10.1044/1058-0360(2012/11-0134)
Free DIRECT downloads: Caterpillar Passage and Grandfather Passage – assessment. (Email subscribers get free access to all the resources in the Free Subscription Library.)
Featured image by stux–12364 from pixabay, found on Canva.com.
Lisa earned her M.A. in Speech-Language Pathology from the University of Maryland, College Park and her M.A. in Linguistics from the University of California, San Diego.
She participated in research studies with the National Institute on Deafness and other Communication Disorders (NIDCD) and the University of Maryland in the areas of aphasia, Parkinson’s Disease, epilepsy, and fluency disorders.
Lisa has been working as a medical speech-language pathologist since 2008. She has a strong passion for evidence-based assessment and therapy, having earned five ASHA Awards for Professional Participation in Continuing Education.
She launched EatSpeakThink.com in June 2018 to help other clinicians be more successful working in home health, as well as to provide strategies and resources to people living with problems eating, speaking, or thinking.
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