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Clinical Utility

Theoretical Basis

  • Used in individuals with moderate to severe dementia
  • Used to:
  • Determine functional communication strengths
  • Set treatment goals
  • Compare the examinee to other patients with dementia
  • Develop Functional Management Plans
  • Develop discharge summaries
  • Reports help determine dementia severity, identify preserved skills and vulnerable functions
  • Evolved from over a decade of research on AD and communicative function
  • 1/2 of the items came from a research battery used in a 5 year longitudinal study (N = 91)
  • The other 1/2 items developed to account for disease effects on functional communication

Administration

(www.proedinc.com)

Test administration takes 30 minutes and can be split into more than one session

FLCI

(Bayles & Tomoeda, 1994)

Scoring

Domains Assessed

- Greeting and naming

- Answering questions

- Writing

- Sign comprehension

- Object-to-picture matching

- Word reading and comprehension

- Reminiscing

- Following commands

- Pantomime

- Gesture

- Conversation

  • Mark yes or no (1/0)
  • Make judgments based on acceptable responses
  • Make judgments based on conversation skills
  • Patterns of responses can be used to determine individual strengths and weaknesses

(Chapey, 2008 p. 996)

(Bayles and Tomoeda, 1994)

WHO ICF Application:

  • Activities domain: basic functional needs in everyday contexts
  • Ex: recognition of environmental signage (stop, enter, exit)
  • Participation domain: aspects that enhance quality of life
  • Ex: answering open-ended questions (regarding holiday, favourite foods)
  • Attempting to determine the impact of dementia on Participation in Society and Contextual Factor levels of the ICF model

Psychometric Properties

Functional Linguistic Communication Inventory (FLCI)

(WHO ICF, 2001)

  • Established Validity and Reliability
  • Ecological validity
  • Criterion validity
  • High test-retest reliability

Sarah Crouse, Felicity Lof, Ainsley MacDougall

What is Functional Communication?

"the ability to receive or convey a message, regardless of the mode, to communicate effectively and independently in a given environment”

(Chapey, 2008 p.996)

(Bayles & Tomoeda, 2007)

4 Domains specific to clients with dementia:

  • social communication
  • communication of basic needs
  • reading, writing, and number concepts
  • daily planning

(Tomoeda, 2001 p. 68)

Purpose

(ASHA, 1991)

(Carvalho & Mansur, 2010)

  • To quantify functional linguistic communication skills of people with moderate to severe dementia
  • Determine a client's baseline level of function, the severity of the patient's dementia, and the client's preserved functional skills

Currently the sole commercially available test of functional communication for this population

(Papathanasiou & Coppes, 2016 p. 465)

Overall Strengths & Weaknesses

References

Other Tests

American Speech-Language-Hearing Association. (1990). Report of the advisory panel to ASHA’s functional communication

measures project. Rockville, MD.

Bayles, K., & Tomoeda, C. (2007). Cognitive-communication disorders of dementia. San Diego, CA: Plural Publishing.

Carvalho, I., & Mansur, L. (2010). Functional communication: What happens along alzheimer’s disease? Alzheimer’s & Dementia 6(4): S321

Chapey, R. (Ed 5). (2008). Language intervention strategies in aphasia and related neurogenic communication disorders. Baltimore, Maryland: Lippincott Williams & Wilkins.

Jackson, S. (2008). The functional linguistic communication inventory [PDF Document]. Retrieved from American Speech-Language-Hearing Association Website: http://search.asha.org/default.aspx?q=FLCI

Papathanasiou, I., & Coppens, P. (Ed 2). (2016). Aphasia and Related Neurogenic Communication Disorders. Burlington, MA: Jones and Bartlett Learning.

Pro-ed Incorporated. Functional communication linguistic inventory: FLCI. Retreived from http://www.proedinc.com/customer/productView.aspx?ID=1932.

Toemeda, C. (2001) Comprehensive assessment for dementia: A necessity for differential diagnosis and management. Seminars in Speech and Language. 22(4): 275-290

World Health Organization. (2001). ICF: International classification of function, disability and health. Geneva: World Health Organization.

  • The Arizona Battery for Communication Disorders (ABCD) should be used for mild dementia patients to avoid a ceiling effect
  • Other functional assessment tests:
  • Bristol Activities of Daily Living (BADL)
  • Barthel Index
  • Functional Independence Measure
  • Instrumental Activities of Daily Living
  • Informant Questionnaire on Cognitive Decline in the Elderly

Bayles & Tomoeda, 1994

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