The Clinical Procedures
Identification of General Clinical Professional
The clinical framework is a listing of
procedures that are common across the disciplines of audiology
and speech-language pathology. Cultural and linguistic
differences can influence any and all of these
Referral. How the client hears about the intervention services
available. This includes self, family/friend, or
professional (e.g., doctor, case worker, teacher).
Several factors can influence the scheduling of
clients. Consider communication of the schedule,
concepts of time and value of punctuality, and holidays,
observances, and Sabbaths.
Initial Information Gathering (Assessment and
The initial information gathering is the time
when background information is collected to determine the
nature of the client's complaint as well to identify factors in
the client's background that could change the way assessment
and/or therapy is conducted. The initial information gathering
includes several factors worthy of consideration:
- The medium used to gain the information
(e.g., telephone, hospital/clinic interview, home interview,
forms sent via mail).
- The content of the interview, including names
(pronunciation, use of monikers, etc.), and types of
questions (e.g., closed/open ended, invasive/noninvasive,
- Differences between the client and clinician
(e.g., gender, age, education, race/ethnicity).
- Paralinguistic factors (e.g., body positions,
speech rate, eye contact, use of gestures, vocal volume,
- Dress (e.g., use of uniforms/lab coats, use
of street clothes, how much skin is revealed).
"Assessment" refers to the time when the
client's complaint is being investigated to determine if a
disorder exists, and if so, what action is necessary to
address the disorder. The following factors fall under
- Setting (e.g., home, clinic,
- Participants (parents, spouse, children,
teacher, peers, etc.).
- Methods (e.g., prepackaged assessments,
standardized, norm/criterion-referenced assessments,
language sampling, other nonstandardized, non-normed
- Language/dialect of assessment (includes
audiological speech reception word lists).
This area concerns the time when the
assessment results or treatment methods are communicated to
the client and may involve procedures that the client or
client's family is to perform on a daily basis. This
can include the diagnosis of a "disorder," "difference," or a
"handicap." This also may involve the determination of
what needs treatment and what doesn't (this can differ
significantly between cultural groups). The above
considerations under "Initial Information Gathering" also
pertain to this area.
"Treatment" refers to the time when the
client receives some kind of intervention based on the
results of a preceding assessment to address any concerns,
complaints, or deficiencies. Treatment involves the
- Implications of receiving treatment for the
- Cultural/religious objections to receiving
- Ability to attend/participate in treatment
sessions (e.g., cost, scheduling, transportation).
- Social interaction/pragmatics with
- Creation of goals.
- Use of reinforcements/punishments.
- Materials used.
- Communication of progress.
- Language/dialect used during
"Discharge" involves the process that occurs
when the client-clinician relationship is ending. The
discharge usually involves many of the factors included in
"Initial Information Gathering" and
"Recommendation/Counseling/Client Education" (See above);
however, discharge also includes-
- determination of "goal mastery,"
- determination of a plateau in
- functional maintenance recommendations,
- report writing.