Return to Page 3

Call for Papers Form
Page 4 of 4


To Programs Page
This form was designed to be printed using your browser menu print command.   Mail or fax the completed form to the address listed on page 1.  The location of this page is: http://www.michiganspeechhearing.org/call4papersform4.html

2009 MSHA Annual Conference Proposal Rating Form

Name of First Author: ______________________________________________________________________

Title: _____________________________________________________________________________________

Session Type:

/  /  Short Course (3 hours)                                         
/  /  Double Mini-Seminar (2 hours)
/  /  Minute Mini-Seminar (1 hour)                        
/  /  Poster Session (1 hour)
/  /  Grand Rounds or Panel Discussion (1 hour):

Content Area:  

Audiology & Hearing Impairment

Medical Speech-Language Pathology

Professional Issues

Public School Speech- Language Pathology

__ Vestibular Assessment/Rehab
__ Aural Rehab
__ Amplification
__ Medical Audiology
__ Educational Audiology
__ Hearing Conservation
__ Pediatric Audiology

__Cochlear Implants

__Auditory-Verbal Therapy

__Hearing Imp Curricula (language and reading)
 

__ Voice Disorders & Alaryngeal Speech
__ Dysphagia
__ Child Lang Disorders
__ Neurogenic SLP & Cognition Disorders
__ Pediatric Service
__ Geriatric Services
__ Dysfluency 

__ Ethics
__ Outcomes
__ Public Policy
__ Training Issues
__ Regulatory Issues
__ Diversity Issues
__ Supervision

__Counseling Role __Evidence-Based Practice

__ Voice Disorders
__ Dysphagia
__ Child Language Disorders
__ Aug & Alternative Communication
__ Physical or Hearing Imp/ or SXI
__ Aural Rehabilitation

__ Assistive Technology
 __Law, Monitoring  __RTI

__ASD

 __Fluency

 __Autism

 __Learning Disabilities

All information above this line to be completed by author.
______________________________________________________________________________________  
 All information below this line to be completed by reviewer.

Review Rating Scale
Select the number that represents your opinion of this proposal for the program:
0      1      2      3      4      5
Low                              High

Indicate reason(s) for rating (check all that apply):
/  / Incomplete abstract/summary/narrative
/  / Insufficient data
/  / Previously published/presented information
/  / Weak content/organization
/  / Poor/weak/inappropriate research design
/  / Marginal interest

Comments: (Must comment if rating 3 or below)