The Clinical Procedures

Identification of General Clinical Professional Tasks

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 procedures.

Referral. How the client hears about the intervention services available. This includes self, family/friend, or professional (e.g., doctor, case worker, teacher).

Scheduling. 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 Treatment)

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, subject matter).
  • 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, intonation).
  • 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 assessment:

  • Setting (e.g., home, clinic, hospital).
  • Participants (parents, spouse, children, teacher, peers, etc.).
  • Methods (e.g., prepackaged assessments, standardized, norm/criterion-referenced assessments, language sampling, other nonstandardized, non-normed methods).
  • Language/dialect of assessment (includes audiological speech reception word lists).

Recommendations/Counseling/Client Education

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 following:

  • Implications of receiving treatment for the diagnosis.
  • Cultural/religious objections to receiving treatment.
  • Ability to attend/participate in treatment sessions (e.g., cost, scheduling, transportation).
  • Social interaction/pragmatics with client.
  • Creation of goals.
  • Use of reinforcements/punishments.
  • Materials used.
  • Communication of progress.
  • Language/dialect used during treatment.


"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 performance,
  • functional maintenance recommendations, and
  • report writing.

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