Clinical Communication & Therapy Flashcards

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CASLPO

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The College of Audiologists and Speech-Language Pathologists of Ontario (CASLPO) is the regulatory body that governs audiologists and speech-language pathologists in Ontario. Its purpose is to protect the public interest by setting standards, enforcing the Regulated Health Professions Act, 1991, and administering related regulations and by-laws. CASLPO membership is required to use protected titles like “speech-language pathologist” or “audiologist.”

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SAC

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Speech-Language and Audiology Canada (SAC) is the national professional organization supporting speech-language pathologists and audiologists across Canada. It offers membership categories, professional development, and a certification process for eligible graduates. SAC also includes membership options for communicative disorders assistants (CDAs).

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OSLA

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The Ontario Association of Speech-Language Pathologists and Audiologists (OSLA) is a provincial advocacy and professional support organization. It represents and promotes the professions in Ontario, supporting members who work with communication, swallowing, and hearing healthcare needs. OSLA collaborates with SAC for broader professional impact.

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CDAAC

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The Communicative Disorders Assistant Association of Canada (CDAAC) is an organization for communicative disorders assistants (CDAs). Members must complete an approved program and adhere to the Association’s Standards of Practice and Code of Ethics. CDAAC supports excellence in CDA practice and ongoing professional growth.

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ASHA

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The American Speech-Language-Hearing Association (ASHA) is a major professional, scientific, and credentialing association for audiologists, speech-language pathologists, and related scientists. It represents over 200,000 members and affiliates, providing standards, certification, and professional resources. ASHA supports research, clinical practice, and education in communication and hearing sciences.

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RHPA

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The Regulated Health Professions Act (RHPA), 1991, provides a common framework for regulation of health professions in Ontario. It aims to protect the public, promote high-quality care, and ensure accountability of regulated professions to the public. The RHPA makes it an offense to falsely hold oneself out as a member of a regulated health profession.

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SLP Scope

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The speech-language pathologist (SLP) scope of practice covers assessment, treatment, and prevention of speech and language dysfunctions. SLPs work to develop, maintain, rehabilitate, or augment oral-motor and communicative functions across the lifespan. Their role includes diagnostic evaluation, therapy planning, and intervention for communication disorders.

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Audiologist Scope

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The audiologist (AUD) scope of practice includes assessment and management of auditory function and auditory dysfunction. Audiologists provide treatment and prevention services to develop, maintain, rehabilitate, or augment auditory and communicative functions. Clinical activities include hearing assessment, hearing aid services, and auditory rehabilitation.

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CDA Scope

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The communicative disorders assistant (CDA) scope of practice, when supervised, includes treatment and prevention of speech, language, and auditory dysfunctions. CDAs support development, maintenance, rehabilitation, or augmentation of oral-motor, communicative, and auditory functions under SLP/AUD supervision. Their role focuses on implementing therapy plans, data collection, and supporting clinicians.

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Developmental Milestones

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Developmental milestones are observable markers of a child’s functioning and progress in key domains. They help clinicians track expected growth and identify possible delays or disorders. Milestones guide assessment, goal-setting, and early intervention planning.

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Developmental Domains

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Developmental domains are specific areas of a child’s growth and functioning, typically grouped as communication, cognitive, motor, self-adaptive, and socio-emotional. Evaluating all domains gives a comprehensive view of a child’s strengths and needs. Domain knowledge informs assessment, interdisciplinary collaboration, and therapy planning.

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Communication Domain

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The communication domain encompasses receptive and expressive language skills including verbal, nonverbal, and written modalities. It covers understanding, message formulation, use of gestures, signs, pictures, writing, and augmentative and alternative communication (AAC). Hearing, vision, touch, and movement also influence communication development.

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Receptive Language

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Receptive language refers to understanding and comprehension of verbal and nonverbal information, including gestures and written material. It depends on sensory abilities like hearing and vision as well as cognitive processing. Receptive skills are foundational for following instructions and learning language.

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Expressive Language

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Expressive language is the ability to convey meaning using verbal and nonverbal means such as words, signs, gestures, pictures, writing, or AAC. Communication begins at birth and expressive skills develop through interaction. Therapy targets help clients produce more effective and varied expressive communication.

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Cognitive Domain

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The cognitive domain covers abilities in perception, memory, attention, reasoning, and related mental processes. Specialists like psychologists and developmental pediatricians often assess cognitive functioning. Understanding cognition is essential for setting realistic goals and tailoring therapeutic approaches.

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Motor Domain

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The motor domain includes gross motor skills (large muscles and torso control) and fine motor skills (precise, smaller movements). Professionals such as physiotherapists and occupational therapists address motor development and disorders. Motor ability influences speech production, feeding, and participation in therapy tasks.

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Gross Motor

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Gross motor skills involve large muscle activities such as sitting, walking, and torso control. These skills impact mobility, posture, and the physical ability to participate in many therapy tasks. Gross motor delays often require collaboration with physiotherapists and related specialists.

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Fine Motor

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Fine motor skills involve precise movements of smaller muscles, such as hand and finger coordination used for writing, manipulating objects, and some speech-related gestures. Occupational therapists commonly address fine motor development. Fine motor abilities can affect tasks like using communication aids and producing speech sounds.

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Self-Adaptive Domain

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The self-adaptive domain involves personal independence (e.g., dressing, feeding), social responsibilities, and managing environmental demands for work and leisure. Professionals like educators, occupational therapists, and behaviour therapists support adaptive functioning. SLPs and CDAs may assist by providing visuals, feeding strategies, or supporting pragmatic skills.

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Socio-Emotional Domain

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The socio-emotional domain examines emotional expression, regulation, self-concept, and social role development. Social workers, psychiatrists, and behaviour therapists often address socio-emotional concerns. SLPs/CDAs monitor social interactions for pragmatic language difficulties and implement behaviour management strategies in therapy.

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Interprofessional Collaboration

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Interprofessional collaboration refers to working with professionals such as teachers, physiotherapists, occupational therapists, psychologists, doctors, dieticians, and caregivers. Collaboration supports holistic assessment and coordinated intervention across domains. Effective teamwork enhances outcomes for clients in diverse settings.

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Therapeutic Skills

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Therapeutic skills are clinician techniques used to facilitate positive communication change, including motivation, modelling, cueing, reinforcement, and corrective feedback. These skills also cover session management elements like seating, pacing, and data collection. Mastery of these techniques supports effective and efficient therapy.

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Motivation

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Motivation in therapy refers to factors that drive a client’s engagement and participation, including extrinsic rewards (e.g., stickers) and intrinsic factors (e.g., pride). Understanding what motivates a client helps clinicians design activities that increase response frequency and persistence. Motivation strategies should be individualized by age and client preferences.

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Communicating Expectations

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Communicating expectations means clearly stating desired behaviours and progress criteria for sessions. Being explicit helps clients understand and meet therapeutic goals, often raising their level of performance. Clear expectations also guide reinforcement and corrective feedback strategies.

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Enthusiasm and Animation

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Using enthusiasm, animation, varied pitch, and appropriate volume signals clinician confidence and engagement and helps sustain client attention. Dynamic delivery enhances attending, participation, and motivation. Clinicians adjust level of animation to suit each client’s needs and cultural preferences.

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Seating and Proximity

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Seating arrangements and proximity refer to how clinician and client are positioned to optimize interaction and goal achievement. Choices like side-by-side or across-the-table seating depend on age, goals, and procedures. Appropriate proximity (about two feet for many interactions) supports cueing and modelling while respecting cultural and personal boundaries.

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Therapeutic Touch

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Therapeutic touch involves clinician-guided tactile contact to teach or cue movements, often to the face, neck, shoulder, or upper back. Touch can be an effective teaching tool but should always be used with permission and cultural sensitivity. Clinicians must ensure touch is non-threatening and appropriate for the therapeutic objective.

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Preparation and Pacing

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Preparation includes planning materials and session flow to minimize non-productive time; pacing is the clinician’s skill in moving efficiently through stimuli and eliciting responses. Good preparation and appropriate pacing maximize therapy intensity and learning opportunities. New skills often require slower pacing and more practice trials.

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Fluency (Session)

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Fluency in therapy refers to smooth transitions and coherent sequencing of activities within a session. It reduces filler speech and downtime, keeping the client engaged and focused. Tools like lesson plans, visuals, and charts help clinicians maintain session fluency.

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Antecedents

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Antecedents are events or stimuli presented before a client response, including alerting cues, modelling, and prompts. They set up the opportunity for a target response and guide behaviour in discrete trial and other teaching formats. Effective antecedents increase the likelihood of correct responses.

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Alerting Stimuli

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Alerting stimuli are signals that notify the client a stimulus or instruction is about to be presented, such as a verbal cue like “watch my face” or a nonverbal hand raise. They prepare attention and readiness for the upcoming task. Alerting cues help optimize response accuracy and engagement.

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Cueing and Prompting

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Cueing and prompting are supports provided to promote correct client responses and can be auditory, visual, or tactile-kinesthetic. These aids are used to scaffold performance and are faded as competence increases. Effective cueing reduces errors while teaching new skills.

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Modelling

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Modelling is the clinician’s production of a target behaviour for the client to imitate, using clear prompts such as “Say…” or “Do…”. Models should be natural, grammatically correct, and appropriately varied. Modelling provides a concrete example for clients to emulate.

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Direct Teaching

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Direct teaching involves explicit instruction of new skills across multiple learning modalities through describing, demonstrating, and questioning. It includes structured techniques like error correction, prompting, and guided practice. Direct teaching is used to establish skills not yet in the client’s repertoire.

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Wait-Time

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Wait-time is the deliberate pause (commonly 3–5 seconds) after a prompt to allow the client time to respond. It demonstrates expectation and encourages independent responding. Appropriate wait-time improves response rates and reduces clinician prompting.

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Stimulus Presentation

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Stimulus presentation covers how stimuli are presented to elicit responses, considering modality, complexity, and sequencing. Effective presentation is crucial for shaping new behaviours and facilitating learning. Clinicians design stimuli to support successive approximations toward the terminal response.

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Shaping

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Shaping, or successive approximations, is a technique that reinforces small steps gradually approaching a target behaviour. Clinicians identify an initial imitable component, teach and reinforce it, then build intermediate responses toward the terminal response. Shaping is used to teach behaviours not yet in the client’s repertoire.

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Discrete Trial Training

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Discrete Trial Training (DTT) is a structured teaching method that uses clear antecedents, prompts, responses, and consequences in repeated trials. It emphasizes systematic presentation, reinforcement, corrective feedback, and data collection. DTT is useful for teaching specific skills in a controlled format.

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Reinforcement

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Reinforcement involves delivering consequences that increase the frequency or strength of a response, helping sustain newly learned behaviour. Positive reinforcers follow correct responses to encourage repetition and skill consolidation. Reinforcement must be paired with praise and gradually faded to support generalization.

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Types of Reinforcers

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Types of positive reinforcers include verbal praise, tokens (initially exchanged 1:1), tangible items (e.g., stickers), intangible reinforcers (e.g., playing a game), and primary reinforcers (e.g., edibles). Reinforcers should be meaningful to the client and paired with verbal praise before fading. Variety and personalization increase reinforcement effectiveness.

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Schedules of Reinforcement

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Schedules of reinforcement describe when reinforcers are delivered and affect acquisition and maintenance of behaviours. Continuous schedules reinforce every correct response and are good for establishing new responses; intermittent schedules reinforce only some responses and are used to maintain behaviours. Intermittent schedules can be fixed-ratio or variable-ratio to shape persistence.

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Continuous Schedule

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A continuous schedule provides reinforcement after every correct response, which accelerates acquisition of a new behaviour. This schedule is typically used at the start of teaching until the client demonstrates reliable responding. Once stabilized, clinicians transition to intermittent schedules for maintenance.

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Intermittent Schedule

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An intermittent schedule reinforces only some correct responses and helps maintain behaviour and promote resistance to extinction. It can take forms such as fixed-ratio or variable-ratio reinforcement. Intermittent schedules are introduced after behaviours are established on continuous reinforcement.

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Rule of Thumb

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The common rule of thumb in therapy is to begin with a continuous reinforcement schedule to establish new responses, then shift to intermittent reinforcement once spontaneous responding increases substantially from baseline. This approach supports acquisition first and then maintenance and generalization. Clinicians monitor baseline performance to guide schedule changes.

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Corrective Feedback

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Corrective feedback informs clients what was incorrect and how to improve, using specific, immediate, and positive corrections. It combines techniques like modelling, cueing, prompting, and requests for self-correction to enhance learning. The goal is to improve accuracy without undermining communicative confidence.

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Feedback Strategies

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Key corrective feedback strategies include providing immediate correction, explicit correction showing the correct response, self-correction modelling, recasts, and clarification requests. Feedback should be specific, actionable, and balanced with praise and reinforcement. Checking for understanding ensures the client knows how to improve.

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Self-Correction Modelling

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Self-correction modelling is when the clinician deliberately makes and then corrects an error to demonstrate the repair process, or prompts the client to self-correct. This approach helps clients learn error monitoring and repair strategies. It is often paired with requests for the client to attempt correction independently.

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Recasts

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A recast is a corrective strategy where the clinician repeats the client’s utterance back correctly without requiring the client to repeat it. Recasts provide a model of correct form while maintaining communication flow and reducing pressure. They are particularly useful for language interventions and preserving communicative confidence.

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Clarification Request

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A clarification request is a feedback method asking the client to clarify or repeat an unclear or incorrect utterance, prompting reanalysis and correction. It encourages the client to notice and repair communication breakdowns. Clarification requests are used to promote self-monitoring and conversational repair skills.

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Tips for Success

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Effective feedback should always be positive, balanced with praise and reinforcers, and followed by checks for understanding. Clinicians should emphasize what was done correctly and provide clear, actionable guidance for errors. Combining encouragement with specific instruction preserves motivation and facilitates learning.