Biomedical Engineering Reference
In-Depth Information
adult world, making the most of their own real potential, would seem closely linked to a
cultural change (perhaps only just begun) that, through a knowledge of the way in which
these disorders function and the consequent use of the appropriate tools, will render study
more fulfilling for most young people.
14.2 Case Evaluation in a Multidisciplinary Team
or as a Professional Consultant
The following is a case study documented by Hill (2006) that exemplifies following the
EBP steps and uses performance and outcomes measurement to monitor gains toward
achieving short- and long-term goals of intervention. A multidisciplinary team approach
was involved in the assessment process. As a client-centered principle, the client managed
the team that consisted of the SLP clinical supervisor, graduate students in SLP train-
ing, an AT consultant, a rehabilitation engineer, a rehabilitation counselor, a university
advisor, and a parent. The goals and objectives of intervention reflect the ICF model. The
client self-identified the need to re-evaluate his use of AT because he was failing his first
semester at the university. His goal was to receive a four-year degree, become gainfully
employed, and live independently.
14.2.1 Characterizing the Client
The case involves a 22-year-old college student with cerebral palsy. He was referred to the
AT center of a university by the university's office for students with disabilities. The refer-
ral indicated the need to identify strategies to improve communication and academic per-
formance. The student had a high school diploma and an associate degree in accounting
from another college. He transferred at the start of the semester into a four-year degree
program. High school and college transcripts, medical records, and other educational test-
ing records were reviewed. Standardized screening indicated no hearing or visual acuity
problems. Spoken and written language samples confirmed linguistic and communication
competence. Other standardized instruments indicated that auditory comprehension and
vocabulary skills were within normal adult ranges. Performance data on current use of an
AAC system and computer were collected and reviewed. Interviewing was used to collect
personal evidence about the client's values and needs for spoken and written communica-
tion and participation in other daily living activities. The ICF was used to support the activ-
ities and level of participation expected by the client. His expressed values were consistent
with the desire to be a “faster, more efficient” communicator with comments that he did not
appreciate having his messages “guessed” by other people. He valued being able to use his
own words rather than having pre-stored messages. In addition, he valued that all of his AT
could be integrated and upgraded to work as efficiently and effectively as possible.
14.2.2 Step 1: Asking Meaningful eBP Questions
The team discussed the PICO format of asking questions to seek the evidence that mattered
for this client. The patient was an adult with cerebral palsy enrolled in college; his current
AT was used as the intervention; the comparison was an alternative language represen-
tation method; and the outcome was increased communication rate and communication
