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Directions For this assignment: Review the Session Planning Template and Melanie’s Acute Care Case History You will use the information to envision and complete an evaluation session plan for Melanie Robins. Review the sections of the session plan and fill in the missing information by answering questions 1-8. Make sure that the Daily Objectives, Activities, and Rationales relate to each other. Session Planning Template: Image transcription text SESSION PLAN Client’s Initials Date Clinician Time Room # Daily Objectives: Must be measurable and yield Activity/Strategy: Include materials to … Show more Case History: Name: Melanie Robins Date of Birth: 2/12/78 Age: 44 Date of Evaluation: 5/5/22 ICD-10 Code: Q28.2 History: Melanie Robins is a 44-year-old female who was evaluated on 5/5/22. Her spouse, Richard, was present for this evaluation. Mrs. Robins was admitted to the hospital due to worsening and uncontrolled grand mal seizures in March 2022. Workup revealed a left frontoparietal arteriovenous malformation. Per neurology, her previously undiagnosed AVM was likely the cause of her recent 6-month history of grand mal seizure activity. Her neurologist recommended surgical intervention and she is now status-post left frontoparietal temporal craniotomy with electricorticography and mapping. Her hospital course was complicated by cognitive deficits, right hemiplegia, pneumonia, and iliofemoral deep vein thrombosis. She presents with residual cognitive impairment (especially memory) and is dependent for mobility and basic activities of daily living. Other than Mrs. Robins’ recent 6-month onset of grand mal seizures, past medical history is unremarkable. Seizures are reportedly now well-controlled with medication. The following personal history was collected from both Mrs. Robins and her spouse during the initial patient interview. Mrs. Robins’ highest level of education completed is an MBA. She wears glasses to read and hearing is reportedly within functional limits. She works as the office manager for her family’s bakery and completes many complex tasks such as pricing and maintaining stock as well as managing contracts with local restaurants. The patient stated that her primary goal was to, “get back to her family, and to her bakery!” Her spouse sought private counsel with this clinician following the interview and stated that his spouse had been very tearful and worried about her ability to return to her functional baseline given her residual cognitive deficits. QUIZ: Question 1 Refer to the following section of Melanie’s session plan. What would this Daily Objective be? Daily Objectives _______________________________________________________. Activity/Strategy: Plan: follow up questions from patient interview, learn patient goals; screen other Big 9 areas (social language, voice, speech, fluency) Materials: prepared questionnaire Time: 5 minutes Rationale: Follow up: office manager in bakery – what are your daily duties? Will help plan tx goals. Hobbies/interests will shape tx goals. Would she like to involve anyone in her therapy? Duchan, J. F., Kovarsky, D. (2011, October/December). Rapport and relationships in clinical interactions. Topics in Language Disorders, 31(4) 297-299. Chapey, R., Duchan, J. F., Elman, R. J., Garcia, L. J., Kagan, A., Lyon, J. G., & Simmons-Mackie, N. (2000, February). Life participation approach to aphasia: A statement of values for the future. The ASHA Leader, 5(3), 4-6. https://doi.org/10.1044/leader.FTR.05032000.4 Option A: Water break Option B: Oral mechanism exam Option C: Build rapport Question 2 Refer to the following section of Melanie’s session plan. What would the appropriate Activity/Strategy be? Daily Objectives: Oral Mechanism Exam & CN Exam Activity/Strategy: _______________________________________ Rationale: Rule out motor speech impairment, hemiparesis. Option A Plan: screen swallowing Materials: water, provide snack options (granola bar, cookies, or grapes) Time: 5 minutes Option B Plan: Assess orofacial musculature strength, sensation, symmetry, and range of motion; Screen other Big 9 areas (voice, speech, fluency) Materials: penlight, tongue depressor Time: 10 minutes Option C Plan: initial eval Materials: penlight, tongue depressor, water, cups, straw, crackers, grapes, WAB-R, paper, pencil, Time: 90 minutes Question 3 Refer to the following section of Melanie’s session plan. What would this Daily Objective be? Daily Objectives: __________________________ Activity/Strategy Plan: Screen hearing Materials: audiometer, screening protocol, pen Time: 5 minutes Rationale: To rule out hearing loss as contributing factor to language deficits Bennett, R. J., Conway, N., Fletcher, S., & Barr, C. (2020). The role of the general practitioner in managing age-related hearing loss: A scoping review. American Journal of Audiology, 29(2), 265-289. https://doi.org/10.1044/2020_AJA-19-00090 Option A Build rapport Option B Hearing screening Option C WAB-R Question 4 Refer to the following section of Melanie’s session plan. What is the appropriate Rationale for this objective? Daily Objectives: Oral Mechanism Exam & CN Exam Activity/Strategy: Plan: Assess orofacial musculature strength, sensation, symmetry, and range of motion; Screen other Big 9 areas (voice, speech, fluency) Materials: penlight, tongue depressor Time: 10 minutes Rationale: __________________________ Option A Rule out motor speech impairment, hemiparesis Option B Evaluate patient risk of aspiration Option C Need for additional SLP order to eval/treat swallowing and/or voice? Question 5 Refer to the following section of Melanie’s session plan. What would this Daily Objective be? Daily Objectives: ______________________________ Activity/Strategy: Plan: screen swallowing Materials: water, provide snack options (granola bar, cookies, or grapes) Time: 5 minutes Rationale: Evaluate patient risk of aspiration Kawashima, K., Motohashi, Y., & Fujishima, I. (2004). Prevalence of dysphagia among community-dwelling elderly individuals as estimated using a questionnaire for dysphagia screening. Dysphagia, 19(4), 266-271. https://doi.org/10.1007/s00455-004-0013-6 Option A Clinical swallow evaluation Option B WAB-4 Option C Oral mech and cranial nerve Exam Question 6 Refer to the following section of Melanie’s session plan. What would the Activity/Strategy be? Daily Objectives: Hearing Screening Activity/Strategy: _________________________________ Rationale: To rule out hearing loss as contributing factor to language deficits Bennett, R. J., Conway, N., Fletcher, S., & Barr, C. (2020). The role of the general practitioner in managing age-related hearing loss: A scoping review. American Journal of Audiology, 29(2), 265-289. https://doi.org/10.1044/2020_AJA-19-00090 Option A Plan: follow up questions from patient interview, learn patient goals; screen other Big 9 areas (social language, voice, speech, fluency) Materials: prepared questionnaire Time: 5 minutes Option B Plan: Screen hearing Materials: audiometer, screening protocol, pen Time: 5 minutes Option C Plan: Assess expressive/receptive language, reading/writing (modalities), social language; rule out acquired apraxia; Screen: voice, fluency, cognition Materials: audiometer, screening protocol, pen Time: 55 minutes Question 7 Refer to the following section of Melanie’s session plan. Which of these would be an additional Rationale? Daily Objectives: WAB-R Activity/Strategy: Plan: Assess expressive/receptive language, reading/writing (modalities), social language; rule out acquired apraxia; Screen: voice, fluency, cognition Materials: audiometer, screening protocol, pen Time: 55 minutes **Rationale: Diagnose aphasia type; consider visual field deficits, presence of fatigue __________________________________________________________________________ Determine current level of function Benghanem, S., Rosso, C., Arbizu, C., Moulton, E., Dormont, D., Leger, A., Pires, C., & Samson, Y. (2019). Aphasia outcome: The interactions between initial severity, lesion size and location. Journal of Neurology, 266(6), 1303-1309. https://doi.org/10.1007/s00415-019-09259-3 Benninger, M. S., Holy, C. E., Bryson, P. C., & Milstein, C. F. (2017). Prevalence and occupation of patients presenting with dysphonia in the United States. Journal of Voice, 31(5), 594-600. https://doi.org/10.1016/j.jvoice.2017.01.011 Option A Assess stimulability Option B Evaluate patient risk of aspiration Option C Rule out motor speech impairment, hemiparesis Question 8 Refer to the following section of Melanie’s session plan. Which of these would be an additional Rationale? Daily Objectives: Wrap up Activity/Strategy: Plan: Explain therapy plan and schedule next session; what questions do you have for me? Materials: computer Time: 5 minutes Rationale: ___________________________________ Need for additional SLP order to eval/treat swallowing and/or voice? Boyle, M. (2004). Semantic feature analysis treatment for anomia in two fluent aphasia syndromes. American Journal of Speech-Language Pathology, 13(3), 236-249. https://doi.org/10.1044/1058-0360(2004/025) Option A Would the patient like to involve anyone in her therapy? Option B Discuss additional referrals, e.g., ENT, PT, OT, cognitive testing, psych, etc. Option C Diagnose aphasia type; consider visual field deficits, presence of fatigue

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