Medical Assignment Support
Wouldn't it be fantastic if there were electronic clinical information and decision support tools to assist physicians in quickly finding the information they need, thereby reducing medication and surgical errors caused by poor decision-making? Currently, there are numerous medical assistant applications available, with QuestionAI being the preferred choice due to its advanced AI models and algorithms.
This medical support tool is a professional clinical "decision-making" application, providing general medical expertise and information, along with pharmacy-based conversion and assessment tools for primary care organizations and physicians. Its primary goal is to reduce medication errors and enhance primary care.
- context in which a mismatch model can be useful.When working with clients who have severe disabilities, it often helps to think about not only what they need to learn to communicate, but also what the environment needs to provide to facilitate the communication, or to reduce handicapping conditions. For example perhaps a nonverbal client with autism is frustrated because he cannot get people to understand that he wants to watch a certain television program.This frustration leads to aggressive or self-abusive behavior. Although it is true that the problem of being unable to get his message across is "in" the individual with autism. perhaps the environment can be modified so the boy can communicate,using the means at his disposal, to short. circuit the cycle of frustration and aggression. Perhaps a switch, with pictures labeling different channels, that the boy can operate himself can be attached to the television, obviat- ing the need for assistance Or perhaps the adults in the environment can learn to recognize the signals the client does send and respond before he reaches the level of frustra- tion that leads to the maladaptive behavior. This would elimi- nate the mismatch between the form of communication and the signals expected by the environment. An important implication of the mismatch perspective is that it does not require that "normal" or "standard" levels of language use be the target. This model is often an especially sensible approach when thinking about interven- tion for clients with severe or profound disabilities when chronologically age-appropriate language skills are not the goal, and when we are concerned with finding some way for the client to send and receive messages to important people in his or her life. It is important to remember that the environment must be responsive for communication to be rewarding for any client. Even if we believe that the disorder is "in" the client, we can always ask-how-the environment might make communica- tion more meaningful and profitable for children, to encourage their best efforts and to reduce their handicap in any given situation, In these ways the mismatch perspective can be a beneficial adjunct to our thinking about any language disorder. The Categorical Model This approach to classification organizes language disorders on the basis of the syndromes of behavior they accompany. and is basically a medical model.It attempts to identify the best categorical or diagnostic label to apply to a child who is not using language as well as would be expected for age level, attempts to identify similarities among children with similar diagnoses, and implies that the diagnostic categories used play a causal, or etiological,role in the language disorder. Thus language disorders are classified on the basis of the known medical conditions -or lack of them-that they accompany.In this model, language disorders would be identified as those associated with mental retardation. hearing impairment, autism, other behavioral or emotional conditions, known neurological damage and those with no known concomitant, which were referred to as "develop mental aphasia or dysphasia" in older literature or as in more recent sources. This approach has many advantages. It is a readily understandable and common-sense way to identify the kind of problem children have and quickly summarizes how they are different from other children And these category labels are often necessary for the child to qualify for services from schools and other agencies. But this orientation to language disorders is not without difficulties. Bloom and Lahey (1978) were the first to discuss the problems associated with this model. They and Lahey (1988) pointed out that although the categories are assumed by the model to be causative of the language delay, it is often difficult to see how this can be so.For example, here are capsule descriptions of two 12-year-olds,Sam and Max. each with an IQ of so. Sam is a little charmer. When he meets you, he walks right up to you, shakes your hand, and says, "Hi I'm Sam. What's your name?" In school he gets reading and writing instruction and does well on the primary.-level readers that have been adapted for his use. Sam is in a special vocational training program in which he works in his middle school'cafeteria cach lunch period.helping to refill the steam trays. All the cafeteria workers are fond of him and look forward to hearing him tell them what he did in class each morning when he comes in for work at noontime.Sam follows the cafeteria staff's directions easily and cheerfully and doesn't get confused when he is told to do a new task as long as it is explained slowly with some demonstration. Max works with Sam in the cafeteria at lunch time and does a good job at the tasks that he's practiced for some time. He seems quiet, though, and rarely talks spontaneously. Even when spoken to, he answers in one or two words, which are often so misarticulated that the cafeteria workers don't understand what he says. Max's teachers and parents have worked hard to try to improve his social communication and to increase his spontaneous speech, but it's an uphill battle. He just doesn't seem to have much to say to anyone, and even when he does, he can't seem to put more than two or three words together to say it. Did Max's mental retardation cause his language prob- lem? How can it be so when Sam, with the same IQ, has language skills that are far superior? Clearly, the categorical label cannot always explain the level of language perfor- mance we see in a given child. Then, too.talking about causality is a slippery business.For example, we may say that a child's language disorder is caused by mental retardation, but what caused the retardation? It could be a chromosomal abnormality such as Down syndrome, or a metabolic disorder such as phenylketonuria,or birth trauma, or a postnatal infection such as meningitis. Mental retarda. tion itself is really just a description of a group of behaviors that we infer to be the result of some form of central nervous system damage caused by something that we may or may not be able to identify.And even if we could identify
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