You want to use a person-centered care approach — working on meaningful goals and activities with the person you are treating — but it’s just SO. HARD. to know how to do that when all you have is a standardized score from the CLQT (see also: MOCA, WAB, RIPA, WJ-III, TEA, and on and on).

You’re not alone! It’s really hard to figure out a functional need when you’ve been focused on just getting those standardized scores. So what can we do about it? (*Practically. Realistically. We’re ALL on a time schedule here.)

This is the Discovering Functional Needs Series. I’m blogging about real, practical tools so that you can feel at ease and prepared to treat with a person-centered approach from the get-go.

In case you missed it: Check out Setting-Specific Checklists, Person-Centered Outcomes, Observing Real Life Activities, and Motivational Interviewing.

And this week we’re talking about: Standardized Tests

Sigh of relief: We’re finally talking about something back in our comfort zones: Standardized testing. The earlier topics in this series emphasized non-standardized portions of assessment (So we understand activity / participation needs, context / environment, communication partners, quality of life, etc). Because of this new focus, standardized testing won’t be emphasized as the end-all-be-all in a person-centered approach.

Are you saying to scrap the standardized tests? No WAY. These tests ARE indeed helpful – but just 1 slice of a big pie. The tests give you insight and information about why someone’s activity may be affected, and what strategies may be helpful. Certainly knowing the impairment – and the severity – is important as we choose appropriate interventions. For example, you might choose to use Goal-Plan-Do-Review with someone who has mild attention challenges (but not if they have severe challenges).

The point is that we can’t focus only on the impairment because it leaves a lot of the picture blank in terms of what someone actually needs to do. I address this by prioritizing the other parts of my evaluation (See previous posts in series) and then I select a standardized test to administer that will finish coloring in the picture I have of someone’s performance.

If someone has no interest in reading, or reports no changes in reading, I am not going to be giving a standardized reading test because their NEEDS are what I am focused on first. If someone expresses difficulties like forgetting to turn off the oven, misplacing keys, forgetting to order dinner – then I complete standardized testing for memory and attention and understand the severity of level of these impairments so that I can pick the right interventions.

With the movement in our field towards a person-centered approach that accounts for someone’s activity and participation levels, I’m really happy to see that many newer tests that are coming out are more integrative or have tasks that are in-context instead of decontextualized. These are my favorite standardized tests because:

• The patient can clearly see why it matters if they don’t do so well on the test (No more asking “What does this have to do with anything?”
• It naturally opens up the conversation for the SLP and the patient to discuss home needs and points to areas that may need attention.
• The tests naturally help point toward a personalized plan of care.

I’ve slowly been compiling a list of the tests that include a focus that is more activity-based or has someone perform tasks in-context. I’d love to share my summary and description here:

What about you? What are the ways that standardized testing SUPPORTS your treatment approach? Are there any tests you would add to the list?