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Law J, Levickis P, Rodríguez-Ortiz IR, Matić A, Lyons R, Messarra C, Kouba Hreich E, Stankova M. Working with the parents and families of children with developmental language disorders: An international perspective. JOURNAL OF COMMUNICATION DISORDERS 2019; 82:105922. [PMID: 31425855 DOI: 10.1016/j.jcomdis.2019.105922] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 07/04/2019] [Accepted: 07/14/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The relationship between parental input and child language development has had a complex history. It has become clear that indirect parent training for the parents of children with delayed language development is an important feature of interventions offered by speech and language therapists in the anglophone countries. Yet we know less about how this type of approach is realised in other countries. METHODS In this paper we report the results of a survey of practice undertaken as part of the work of COST Action IS1406, a European Union (EU) funded research network. The focus of this paper is specifically on parent-related questions and responses referring to children under the age of twelve. The survey was devised by members of the Action and circulated electronically during the summer of 2017. In all, 4024 practitioners responded from 60 countries, the majority of whom came from EU member countries. FINDINGS Respondents to the survey indicated that indirect therapy is commonly carried out via the parent in the early years and via teachers later. A range of professional groups, in addition to speech and language therapists, is likely to adopt this approach; including teachers, pedagogues and psychologists. A variety of interventions is reported, some of which have a reasonable evidence-base underpinning them. It is interesting to see the widespread involvement of fathers and other family members in interventions. Finally, the fact that practitioner characteristics (age, experience, location of practice etc.) are not related to the use of indirect techniques points to the universal recognition of the value of these approaches. CONCLUSIONS Despite the very different traditions in the practice of intervention across countries, there is clearly a widespread recognition of the importance of indirect approaches to intervention and specifically those focusing on parents. The mixture of family members being involved in interventions is a very promising indication of the role sharing commonly associated with the contemporary family. Yet the number of specific intervention approaches identified is relatively small given the number of respondents. There is a need for a better understanding of what exactly practitioners are doing when they involve parents in intervention or carry out parent-child interaction interventions and how well these interventions work in routine practice. This also has implications for the application of evidence-based practice and the precise nature of the interventions concerned (advice to parents, video interaction training etc.).
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Affiliation(s)
- James Law
- School of Education, Communication & Language Sciences, Newcastle University, Newcastle upon Tyne, UK.
| | - Penny Levickis
- School of Education, Communication & Language Sciences, Newcastle University, Newcastle upon Tyne, UK; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
| | | | - Ana Matić
- Department of Speech and Language Pathology, University of Zagreb, Croatia.
| | - Rena Lyons
- Discipline of Speech and Language Therapy, National University of Galway, Ireland.
| | - Camille Messarra
- Institut Supérieur d'Orthophonie, Université Saint Joseph Beyrouth, Lebanon.
| | - Edith Kouba Hreich
- Institut Supérieur d'Orthophonie, Université Saint Joseph Beyrouth, Lebanon.
| | - Margarita Stankova
- Department of Health and Social Work, New Bulgarian University, Bulgaria.
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Nelson T, Mok Z, Ttofari Eecen K. Use of Transcription when Assessing Children’s Speech: Australian Speech-Language Pathologists’ Practices, Challenges, and Facilitators. Folia Phoniatr Logop 2019; 72:131-142. [DOI: 10.1159/000503131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 09/03/2019] [Indexed: 11/19/2022] Open
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Brosseau-Lapré F, Roepke E. Speech Errors and Phonological Awareness in Children Ages 4 and 5 Years With and Without Speech Sound Disorder. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:3276-3289. [PMID: 31433730 DOI: 10.1044/2019_jslhr-s-17-0461] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose The aim of this study was to examine the relationship between types of speech errors produced by children with speech sound disorders (SSD) and children with typical speech and language development (TD) and phonological awareness (PA) skills. Method Participants were 40 children, half with SSD and half with TD, ages 4 and 5 years. They completed standard speech, language, and PA tests as well as produced single words varying in length from 1 to 5 syllables. Production of each consonant was classified as either correct production, omission, substitution, and distortion; errors were also classified as typical or atypical. Results The children with SSD produced similar proportions of each type of speech errors in mono-, di-, and multisyllabic words. In contrast, the children with TD produced much lower, but not significantly different, proportions of omissions, substitutions, distortions, and typical speech errors at each word length. They produced no atypical errors in monosyllabic words and were significantly more likely to produce them in multisyllabic words. Proportions of omissions and atypical speech errors were significantly correlated with PA performance. Variance in PA skills was predicted partly by vocabulary, language skills, and age; omissions accounted for an additional 5% of variance in PA. Other types of speech errors did not account for additional significant variance in PA performance. Conclusions Poorer PA skills were found to be associated with omissions and atypical speech errors. Research is required to investigate the potential of omission and atypical error use in predicting which children are likely to receive diagnoses of SSD and later literacy difficulties.
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Affiliation(s)
| | - Elizabeth Roepke
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN
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Alsaad M, McCabe P, Purcell A. The application of the maximal opposition therapy approach to an Arabic-speaking child. JOURNAL OF COMMUNICATION DISORDERS 2019; 81:105913. [PMID: 31279082 DOI: 10.1016/j.jcomdis.2019.105913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 05/03/2019] [Accepted: 05/30/2019] [Indexed: 06/09/2023]
Abstract
The aim of this study is to examine the efficacy and applicability of the maximal opposition approach to treatment of an Arabic-speaking child with a phonological disorder. A 4:2 year old Jordanian boy, born and raised in Kuwait, received phonological therapy using a maximal opposition approach with major-class distinctions, using a single-case experimental design. The child's speech production accuracy improved. Success with this one child suggests phonological contrast therapy-specifically a maximal opposition approach-could be used to treat other Arabic-speaking children who present with phonological disorders. More research is required before the most appropriate technique and treatment frequency for Arabic speaking children can be determined.
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55
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Sugden E, Lloyd S, Lam J, Cleland J. Systematic review of ultrasound visual biofeedback in intervention for speech sound disorders. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2019; 54:705-728. [PMID: 31179581 DOI: 10.1111/1460-6984.12478] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 04/17/2019] [Accepted: 05/12/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND As cost and access barriers to ultrasound technology have decreased, interest in using ultrasound visual biofeedback (U-VBF) as a tool for remediating speech sound disorders (SSD) has increased. A growing body of research has investigated U-VBF in intervention for developmental SSD; however, diversity in study design, participant characteristics, clinical methods and outcomes complicate the interpretation of this literature. Thus, there is a need for a synthesis and review of the evidence base for using U-VBF in intervention for SSD. AIMS To synthesise and evaluate the research evidence for U-VBF in intervention for developmental SSD. METHODS A systematic review was conducted. Eight electronic databases were searched for peer-reviewed articles published before 2018. Details about study design, participants, intervention procedures, service delivery, intervention intensity and outcomes were extracted from each study that met the inclusion criteria. The included studies were rated using both a critical appraisal tool and for their reporting of intervention detail. MAIN CONTRIBUTIONS Twenty-eight papers, comprising 29 studies, met the inclusion criteria. The most common research design was single-case experimental design (44.8% of studies). The studies included between one and 13 participants (mean = 4.1) who had a mean age of approximately 11 years (range = 4;0-27 years). Within the research evidence, U-VBF intervention was typically provided as part of, or as an adjunct to, other articulatory-based therapy approaches. A range of lingual sounds were targeted in intervention, with 80.6% of participants across all reviewed studies receiving intervention targeting rhotics. Outcomes following therapy were generally positive with the majority of studies reporting that U-VBF facilitated acquisition of targets, with effect sizes ranging from no effect to a large effect. Difficulties with generalisation were observed for some participants. Most studies (79.3%) were categorised as efficacy rather than effectiveness studies and represented lower levels of evidence. Overall, the reviewed studies scored more highly on measures of external validity than internal validity. CONCLUSIONS The evidence base for U-VBF is developing; however, most studies used small sample sizes and lower strength designs. Current evidence indicates that U-VBF may be an effective adjunct to intervention for some individuals whose speech errors persist despite previous intervention. The results of this systematic review underscore the need for more high-quality and large-scale research exploring the use of this intervention in both controlled and community contexts.
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Affiliation(s)
- Eleanor Sugden
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Susan Lloyd
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
- Clinical Audiology, Speech & Language Research Centre, Queen Margaret University, Musselburgh, UK
| | - Jenny Lam
- Paediatric Speech and Language Therapy, NHS Lothian, Edinburgh, UK
| | - Joanne Cleland
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
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Combiths PN, Barlow JA, Sanchez E. Quantifying phonological knowledge in children with phonological disorder. CLINICAL LINGUISTICS & PHONETICS 2019; 33:885-898. [PMID: 31379215 PMCID: PMC6756935 DOI: 10.1080/02699206.2019.1584247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 02/11/2019] [Accepted: 02/14/2019] [Indexed: 05/26/2023]
Abstract
Generative phonologists use contrastive minimal pairs to determine functional phonological units in a language. This technique has been extended for clinical purposes to derive phonemic inventories for children with phonological disorder, providing a qualitative analysis of a given child's phonological system that is useful for assessment, treatment, and progress monitoring. In this study, we examine the single-word productions of 275 children with phonological disorder from the Learnability Project (Gierut, 2015b) to confirm the relationship between phonemic inventory - a measure of phonological knowledge - and consonant accuracy - a quantitative, relational measure that directly compares a child's phonological productions to the target (i.e. adult-like) form. Further, we identify potential percentage accuracy cutoff scores that reliably classify sounds as in or out of a child's phonemic inventory in speech-sound probes of varying length. Our findings indicate that the phonemic function of up to 90% of English consonants can be identified from percentage accuracy for preschool-age children with phonological disorder when a sufficiently large and thorough speech sample is used.
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Affiliation(s)
- Philip N Combiths
- Language and Communicative Disorders, San Diego State University, University of California , San Diego , CA , USA
| | - Jessica A Barlow
- Speech, Language, and Hearing Sciences, San Diego State University , CA , USA
| | - Emilie Sanchez
- San Diego Unified School District , San Diego , CA , USA
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57
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Barrett C, McCabe P, Masso S, Preston J. Protocol for the Connected Speech Transcription of Children with Speech Disorders: An Example from Childhood Apraxia of Speech. Folia Phoniatr Logop 2019; 72:152-166. [PMID: 31269497 PMCID: PMC6940559 DOI: 10.1159/000500664] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 04/26/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE While it is known that connected speech has different features to single-word speech, there are currently few recommendations regarding connected speech transcription. This research therefore aimed to develop a clinically feasible protocol for connected speech transcription. The protocol was then used to assist with description of the connected speech of children with childhood apraxia of speech (CAS), as little is known about their connected speech characteristics. PARTICIPANTS AND METHODS Following a literature review, the Connected Speech Transcription Protocol (CoST-P) was iteratively developed and trialled. The CoST-P was then used to transcribe 50 connected utterances produced by 12 children (aged 6-13 years) with CAS. The characteristics of participants' connected speech were analysed to capture independent and relational analyses. RESULTS The CoST-P was developed, trialled, and determined to have adequate reliability and fidelity. The frequency of inter-word segregation (mean = 29) was higher than intra-word segregation (mean = 4). Juncture accuracy was correlated with intelligibility metrics such as percentage of consonants correct. CONCLUSION Connected speech transcription is challenging. The CoST-P may be a useful resource for speech-language pathologists and clinical researchers. Use of the CoST-P assisted in displaying CAS speech characteristics unique to connected speech (e.g., inter-word segregation and juncture).
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Affiliation(s)
- Catherine Barrett
- Speech Pathology, The University of Sydney, Sydney, New South Wales, Australia
| | - Patricia McCabe
- Speech Pathology, The University of Sydney, Sydney, New South Wales, Australia,
| | - Sarah Masso
- Speech Pathology, The University of Sydney, Sydney, New South Wales, Australia
| | - Jonathan Preston
- Department of Communication Sciences and Disorders, Syracuse University, Syracuse, New York, USA
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Cunningham BJ, Daub OM, Cardy JO. Barriers to implementing evidence-based assessment procedures: Perspectives from the front lines in pediatric speech-language pathology. JOURNAL OF COMMUNICATION DISORDERS 2019; 80:66-80. [PMID: 31085404 DOI: 10.1016/j.jcomdis.2019.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 04/29/2019] [Accepted: 05/06/2019] [Indexed: 06/09/2023]
Abstract
PURPOSE This practice-based research study was a collaborative effort between researchers and speech-language pathologists (SLPs). The purpose of the study was to assess SLPs' perceptions of barriers for two new evidence-based assessment procedures to be implemented in practice. Procedures were for (1) program-level outcome monitoring and (2) individual vulnerability testing for children who are deaf or hard of hearing. These procedures were summarized for clinicians in an online learning module. METHOD After finishing the online learning module, SLPs completed electronic surveys to identify perceived barriers to implementation. Fifty-four SLPs completed an online survey specific to the program-level outcome monitoring procedures. Twenty-five also completed an online survey specific to individual vulnerability testing. Surveys were structured using the Ottawa Model of Research Use, which assesses barriers within three components: (1) the practice environment; (2) clinicians' knowledge, skills, and beliefs; and (3) the evidence-based innovation (development and content of the online learning module). RESULTS Most items specific to program-level outcome monitoring were rated positively. Some barriers were identified within the practice environment and evidence-based innovation, but clinicians' skills, knowledge, and beliefs were not barriers to implementation. For individual vulnerability testing, barriers were noted across all components of the Ottawa Model of Research Use. CONCLUSIONS This work demonstrates the value of including front-line clinicians in the development of evidence-based assessment procedures. Through practice-based research, we identified SLPs' perceived barriers to implementation, allowing for modifications to be made to the online learning module prior to wider-scale implementation. The barriers identified and methods used in our work may be useful to other researchers and programs involved in developing materials and methods for the implementation of evidence-based assessment procedures.
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Affiliation(s)
- Barbara Jane Cunningham
- School of Communication Sciences and Disorders, Western University, Elborn College, Room 2516, 1201 Western Road, London, ON N6G 1H1, Canada.
| | - Olivia May Daub
- School of Communication Sciences and Disorders, Western University, Elborn College, Room 2516, 1201 Western Road, London, ON N6G 1H1, Canada
| | - Janis Oram Cardy
- School of Communication Sciences and Disorders, Western University, Elborn College, Room 2516, 1201 Western Road, London, ON N6G 1H1, Canada
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Gomez M, McCabe P, Purcell A. Clinical management of childhood apraxia of speech: A survey of speech-language pathologists in Australia and New Zealand. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 21:295-304. [PMID: 31122069 DOI: 10.1080/17549507.2019.1608301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 03/14/2019] [Accepted: 04/11/2019] [Indexed: 06/09/2023]
Abstract
Purpose: A number of studies have been published that have investigated the practices of speech-language pathologists in relation to speech sound disorder intervention; however, specific research about the treatment of childhood apraxia of speech is not available. This study aimed to describe the treatment approaches being used by speech-language pathologists, explore their perspectives of evidence-based practice and identify perceived barriers to implementing empirical research recommendations. Method: An online survey was distributed to speech-language pathologists in Australia and New Zealand. In total, 109 valid surveys were completed by participants who answered a series of multiple choice, yes/no, short answer and Likert-scaled questions. Result: Speech-language pathologists demonstrated a strong preference for eclectic interventions to treat childhood apraxia of speech. When asked to identify the primary treatment approach they used (whether as a stand-alone; or as the primary approach within an eclectic intervention), the most frequently used intervention was the Nuffield Dyspraxia Programme. Many speech-language pathologists reported valuing empirical research evidence, despite identifying a range of barriers that impact their ability to implement evidence-based practice in childhood apraxia of speech treatment. Conclusion: Although many speech-language pathologists use the Nuffield Dyspraxia Programme as their primary intervention, most clinicians use it as part of an eclectic/hybrid intervention. The effectiveness of eclectic interventions for childhood apraxia of speech has not been empirically evaluated.
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Affiliation(s)
- Maryane Gomez
- a Faculty of Health Sciences , University of Sydney, Lidcombe, NSW , Australia
| | - Patricia McCabe
- a Faculty of Health Sciences , University of Sydney, Lidcombe, NSW , Australia
| | - Alison Purcell
- a Faculty of Health Sciences , University of Sydney, Lidcombe, NSW , Australia
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Masso S, McLeod S, Baker E. Tutorial: Assessment and Analysis of Polysyllables in Young Children. Lang Speech Hear Serv Sch 2019; 49:42-58. [PMID: 29282474 DOI: 10.1044/2017_lshss-16-0047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 09/18/2017] [Indexed: 11/09/2022] Open
Abstract
Purpose Polysyllables, words of 3 or more syllables, represent almost 30% of words used in American English. The purpose of this tutorial is to support speech-language pathologists' (SLPs') assessment and analysis of polysyllables, extending the focus of published assessment tools that focus on sampling and analyzing children's segmental accuracy and/or the presence of phonological error patterns. Method This tutorial will guide SLPs through a review of 53 research papers that have explored the use of polysyllables in assessment, including the sampling and analysis procedures used in different research studies. The tutorial will also introduce two new tools to analyze and interpret polysyllable speech samples: the Word-Level Analysis of Polysyllables (WAP; Masso, 2016b) and the Framework of Polysyllable Maturity (Framework; Masso, 2016a). Results Connected speech and single-word sampling tasks were used across the 53 studies to elicit polysyllables, and a number of analysis methods were reported, including measures of segmental accuracy and measures of structural and suprasegmental accuracy. The WAP and the Framework extend SLPs' depth of analysis of polysyllables. Conclusion SLPs need a range of clinical tools to support the assessment and analysis of polysyllables. A case study comparing different speech analysis methods demonstrates the clinical value in utilizing the WAP and the Framework to interpret children's polysyllable productions in addition to traditional methods of speech sampling and analysis.
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Affiliation(s)
- Sarah Masso
- Charles Sturt University, Bathurst, Australia
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Jesus LM, Santos J, Martinez J. The Table to Tablet (T2T) Speech and Language Therapy Software Development Roadmap. JMIR Res Protoc 2019; 8:e11596. [PMID: 30698534 PMCID: PMC6372937 DOI: 10.2196/11596] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/01/2018] [Accepted: 09/02/2018] [Indexed: 11/22/2022] Open
Abstract
Background Few studies have analyzed gains in using computers in speech and language therapy interventions for children with speech and/or language disorders when compared to a control group, but virtual tutors and computer-based visual feedback have been gaining interest in the literature. Previous systematic reviews mainly focused on development technological details of computer-based speech training systems or the potential of integrating mobile technology into education and rehabilitation, but recent systematic reviews have also evaluated the efficacy of computer-based speech and language therapy for children and how digital technology can support different activities, at school or elsewhere. Objective This study aimed to analyze a continuous communication and joint team approach to develop solutions focused on the real needs of end users, which digitally emulate reliable and validated physical intervention materials for children with speech sound disorders (SSD). Methods The Table to Tablet (T2T) software was developed using a design-based research methodology, which included four phases: activities development; ethnographic pretesting with a sample from the target population; software development; and beta-testing. The technology used to develop the software, the method used to ensure satisfaction and replay ability of the intervention materials, and results from the ethnographic and beta-testing phases are presented. Results Nineteen activities were developed during the first phase, which were then tested, with 7 service users, using a physical prototype. The beta-test approach included extensive testing and reformulation, supported by direct, nonparticipant observation and data collection using a questionnaire designed for children. Feedback was used to improve the software and interaction with users. Conclusions The use of T2T-based intervention programmes by speech and language therapists (SLTs) will allow these professionals to make a better and more effective communication intervention, based on proven methodologies, that coexists in a structured physical and a digital version. These versions provide a full, 6-week intervention program, with minimal effort in preparing the session by the SLTs while delivering a very consistent intervention, with high replay value. A continuous communication and joint team approach was beneficial to the project and to the development of a solution focused on the real needs of SLTs and children with SSD. All problems were approached as a team with different skills and expertise, which minimized errors (eg, the developer making choices that would save him from spending time doing something that would not be used) and time spent. To add to this, the importance of integrating the end users as testers and collecting their opinions and actions per session allowed the production of better-targeted activities. Trial Registration ClinicalTrials.gov NCT02490826; https://clinicaltrials.gov/ct2/show/NCT02490826
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McLeod S, Masso S. Screening Children's Speech: The Impact of Imitated Elicitation and Word Position. Lang Speech Hear Serv Sch 2019; 50:71-82. [DOI: 10.1044/2018_lshss-17-0141] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose
Diagnostic decision making is influenced by the attributes of assessments. In order to propose time-efficient protocols for screening children's speech, this study aimed to determine whether eliciting imitated responses and analyzing productions in different word positions resulted in different levels of consonant accuracy.
Method
Participants were 267 English-speaking preschool-age children in the Sound Start Study whose parents were concerned about their speech. They were assessed using the International Speech Screener: Research Version (ISS;
McLeod, 2013
) using either imitated or spontaneous elicitation. Productions were compared with an established diagnostic assessment of speech accuracy (Diagnostic Evaluation of Articulation and Phonology;
Dodd, Hua, Crosbie, Holm, & Ozanne, 2002
).
Results
Participants' performance on the ISS was significantly correlated with performance on the Diagnostic Evaluation of Articulation and Phonology. Eliciting imitated productions on the ISS (
M
= 2:18 min,
SD
= 0:59 min) took significantly less time than spontaneous productions (
M
= 6:32 min,
SD
= 2:34 min). There was no significant difference in accuracy of imitated versus spontaneous productions in word-initial position; however, consonants were significantly less accurate in spontaneous than imitated productions in other word positions. Overall, participants had significantly lower consonant accuracy in word-initial position than within-word or word-final positions. Examination of the influence of word position on test discrimination, using receiver operating characteristic analyses, revealed acceptable test discrimination for percentage of consonants correct across word positions.
Conclusion
This research supports using imitated elicitation and analysis of percentage of consonants correct in word-initial position as a time-efficient procedure when screening the speech of English-speaking preschool children.
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Affiliation(s)
- Sharynne McLeod
- School of Teacher Education, Charles Sturt University, Sydney, New South Wales, Australia
| | - Sarah Masso
- School of Teacher Education, Charles Sturt University, Sydney, New South Wales, Australia
- Faculty of Health Sciences, The University of Sydney, New South Wales, Australia
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Rojas Contreras DP, Fernández Gallardo MA, Peñaloza Castillo CI, Torres Morales FH, Pino Castillo JD, Bustos Rubilar MA, Castro Abarca PB, Fuentes-López EA. Acquisition age of lateral and rhotic phonemes: the opinion of Speech and Language Therapists from Santiago, Chile. REVISTA CEFAC 2019. [DOI: 10.1590/1982-0216/201921111318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Purpose: to describe at which age do speech and language therapists consider the / l /, / ɾ /, / r / phonemes should be acquired; to describe the criteria used by speech and language therapists to consider a phoneme as acquired; and to investigate the diagnostic criteria used by these professionals. Methods: this is an analytical cross-sectional study in which an online questionnaire was completed by 151 speech and language therapists from the Metropolitan region of Chile. The questionnaire included questions regarding the aims of this study. Results: around a 30% of respondents considered the /l/ phoneme to be acquired between 3,6-4,6 years, a 72% agreed on the /ɾ/ phoneme to be acquired from 4,0 to 4,11 and a 40% declared the acquisition of the /r/ phoneme between 5,6-5,11. When determining a phoneme as acquired, a 46.3% of interviewees referred to do it only when it was produced always and a 30% declared to consider as such when produced more than 50% of the times. When exposed to a real case, respondents provided three different diagnostic options. Conclusion: results showed a wide age range in which speech and language therapists consider the lateral and rhotic phonemes to be acquired, showing no consensus. There are diverse criteria to determine when each phoneme is acquired. Similarly, different opinions were evidenced regarding when a disorder would be defined as phonologic or articulatory.
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Thomas DC, McCabe P, Ballard KJ. Combined clinician-parent delivery of rapid syllable transition (ReST) treatment for childhood apraxia of speech. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 20:683-698. [PMID: 28443686 DOI: 10.1080/17549507.2017.1316423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 03/17/2017] [Accepted: 03/31/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE Although speech-language pathologists use parent-delivered home-practice, little is known about the quality of this practice and its relation to treatment efficacy. This study reports both treatment outcomes and fidelity following combined clinician-parent delivery of Rapid Syllable Transition (ReST) treatment. METHOD Five children aged 5:1-11:7 with childhood apraxia of speech received 12 treatment sessions; six clinic-based and six at home, using multiple baselines across participants design. We investigated the children's acquisition of treated pseudo words, generalisation to untreated pseudo and real words, and maintenance of gains. We also assessed parent and clinician treatment fidelity and reliability of perceptual judgements. RESULT Two children improved on all treated behaviours; two showed treatment effect on one of their two treated behaviours, and one child had no treatment effect. Only two children generalised to the majority of untreated items. Variable treatment fidelity was found across parents and aspects of treatment. Child outcome was likely influenced by multiple factors, including treatment fidelity, reliability of perceptual judgements and child factors. CONCLUSION Combined clinician-parent delivery of ReST was less efficacious than previously reported clinician-only delivered ReST. Further investigation of the factors affecting outcome is recommended prior to clinical application of the combined model of service delivery.
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Affiliation(s)
- Donna C Thomas
- a Faculty of Health Sciences , The University of Sydney , Lidcombe , Australia
| | - Patricia McCabe
- a Faculty of Health Sciences , The University of Sydney , Lidcombe , Australia
| | - Kirrie J Ballard
- a Faculty of Health Sciences , The University of Sydney , Lidcombe , Australia
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Sugden E, Baker E, Munro N, Williams AL, Trivette CM. An Australian survey of parent involvement in intervention for childhood speech sound disorders. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 20:766-778. [PMID: 28816080 DOI: 10.1080/17549507.2017.1356936] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 07/13/2017] [Accepted: 07/13/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE To investigate how speech-language pathologists (SLPs) report involving parents in intervention for phonology-based speech sound disorders (SSDs), and to describe the home practice that they recommend. Further aims were to describe the training SLPs report providing to parents, to explore SLPs' beliefs and motivations for involving parents in intervention, and to determine whether SLPs' characteristics are associated with their self-reported practice. METHOD An online survey of 288 SLPs working with SSD in Australia was conducted. RESULT The majority of SLPs (96.4%) reported involving parents in intervention, most commonly in providing home practice. On average, these tasks were recommended to be completed five times per week for 10 min. SLPs reported training parents using a range of training methods, most commonly providing opportunities for parents to observe the SLP conduct the intervention. SLPs' place of work and years of experience were associated with how they involved and trained parents in intervention. Most (95.8%) SLPs agreed or strongly agreed that family involvement is essential for intervention to be effective. CONCLUSION Parent involvement and home practice appear to be intricately linked within intervention for phonology-based SSDs in Australia. More high-quality research is needed to understand how to best involve parents within clinical practice.
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Affiliation(s)
- Eleanor Sugden
- a Discipline of Speech Pathology, Faculty of Health Sciences , The University of Sydney , Lidcombe , Australia
| | - Elise Baker
- a Discipline of Speech Pathology, Faculty of Health Sciences , The University of Sydney , Lidcombe , Australia
| | - Natalie Munro
- a Discipline of Speech Pathology, Faculty of Health Sciences , The University of Sydney , Lidcombe , Australia
| | - A Lynn Williams
- b College of Clinical and Rehabilitative Health Sciences , East Tennessee State University , Johnson City , TN , USA and
| | - Carol M Trivette
- c Department of Early Childhood Education , East Tennessee State University , Johnson City , TN , USA
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McKechnie J, Ahmed B, Gutierrez-Osuna R, Monroe P, McCabe P, Ballard KJ. Automated speech analysis tools for children's speech production: A systematic literature review. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 20:583-598. [PMID: 29996691 DOI: 10.1080/17549507.2018.1477991] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 05/14/2018] [Accepted: 05/14/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE A systematic search and review of published studies was conducted on the use of automated speech analysis (ASA) tools for analysing and modifying speech of typically-developing children learning a foreign language and children with speech sound disorders to determine (i) types, attributes, and purposes of ASA tools being used; (ii) accuracy against human judgment; and (iii) performance as therapeutic tools. METHOD Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were applied. Across nine databases, 32 articles published between January 2007 and December 2016 met inclusion criteria: (i) focussed on children's speech; (ii) tools used for speech analysis or modification; and (iii) reporting quantitative data on accuracy. RESULT Eighteen ASA tools were identified. These met the clinical threshold of 80% agreement with human judgment when used as predictors of intelligibility, impairment severity, or error category. Tool accuracy was typically <80% accuracy for words containing mispronunciations. ASA tools have been used effectively to improve to children's foreign language pronunciation. CONCLUSION ASA tools show promise for automated analysis and modification of children's speech production within assessment and therapeutic applications. Further work is needed to train automated systems with larger samples of speech to increase accuracy for assessment and therapeutic feedback.
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Affiliation(s)
- J McKechnie
- a Faculty of Health Sciences , University of Sydney , Lidcombe , NSW , Australia
| | - B Ahmed
- b Department of Electrical and Computer Engineering , Texas A&M University , Doha , Qatar , and
| | - R Gutierrez-Osuna
- c Department of Computer Science and Engineering , Texas A&M University , College Station , TX , USA
| | - P Monroe
- a Faculty of Health Sciences , University of Sydney , Lidcombe , NSW , Australia
| | - P McCabe
- a Faculty of Health Sciences , University of Sydney , Lidcombe , NSW , Australia
| | - K J Ballard
- a Faculty of Health Sciences , University of Sydney , Lidcombe , NSW , Australia
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Furlong L, Serry T, Erickson S, Morris ME. Processes and challenges in clinical decision-making for children with speech-sound disorders. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2018; 53:1124-1138. [PMID: 30216607 DOI: 10.1111/1460-6984.12426] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 08/05/2018] [Accepted: 08/12/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Children with speech-sound disorders (SSD) constitute a significant proportion of speech-language pathologists' (SLPs) caseloads. Previous research has investigated the clinical practice of SLPs intervening with children with SSD; however, little is known about the clinical decision-making underpinning their practice. AIMS The clinical decision-making of SLPs working with children with SSD was explored to understand how their clinical decisions were influenced by: (1) beliefs about what works in therapy; (2) prior clinical experience; and (3) client and service-related variables. METHODS & PROCEDURES Semi-structured, individual, in-depth interviews were conducted with 11 SLPs. Inductive thematic analysis was used to identify and explore key ideas and themes. OUTCOMES & RESULTS Four themes emerged: (1) clinical decision-making procedures were highly individualized; (2) parental involvement was viewed as central to the success and progression of therapy; (3) therapy procedures were influenced by practice-setting constraints; and (4) engaging in evidence-based practice within clinical settings was perceived as challenging. CONCLUSIONS & IMPLICATIONS In clinical settings, a range of factors influence decision-making and therapy provided by SLPs to children with SSD. These SLPs had a high regard for clients' values and preferences. Prior clinical experiences also shaped clinical practice. Clinical decision-making was influenced by practice-setting constraints. SLPs are under pressure in their workplaces and are struggling to manage the competing demands on their time. Large clinical caseloads, heavy workloads, current service-delivery models and changing family structures are all impacting on the provision of therapy to children with SSD and therapy outcomes. As a profession, there is a need to consider these barriers and identify ways to overcome them in order to assist SLPs to routinely adopt the highest standards of clinical practice for children with SSD.
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Affiliation(s)
- Lisa Furlong
- Discipline of Speech Pathology, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, Melbourne, VIC, Australia
| | - Tanya Serry
- Discipline of Speech Pathology, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, Melbourne, VIC, Australia
| | - Shane Erickson
- Discipline of Speech Pathology, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, Melbourne, VIC, Australia
| | - Meg E Morris
- Discipline of Speech Pathology, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, Melbourne, VIC, Australia
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Hegarty N, Titterington J, McLeod S, Taggart L. Intervention for children with phonological impairment: Knowledge, practices and intervention intensity in the UK. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2018; 53:995-1006. [PMID: 30047190 DOI: 10.1111/1460-6984.12416] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 06/18/2018] [Accepted: 06/29/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Across the world, research has shown that intervention for children with phonological impairment can be both effective and efficient. However, it has also raised concerns about the translation of this evidence to practice, highlighting questions around clinician knowledge and the understanding of approaches, and the intensity of intervention provided within real-life clinical contexts. AIMS To investigate the clinical management of phonological impairment by speech and language therapists (SLTs) in the United Kingdom (UK). METHODS & PROCEDURES An anonymous, UK-wide, online survey was developed using Qualtrics. The target audience were UK-based SLTs who worked with children with phonological impairment. The following topics were explored: (1) SLTs' understanding of intervention approaches; (2) SLTs' use of intervention approaches to treat phonological impairment; and (3) SLTs' provision of intervention intensity for children with phonological impairment. OUTCOMES & RESULTS A total of 166 responses were analyzed. To remediate phonological impairment, SLTs most commonly used speech discrimination (79.5%), conventional minimal pairs (77.3%), phonological awareness therapy (75.6%) and traditional articulation therapy (48.4%). Participants least frequently used the complexity approaches targeting the empty set (82.9%) and two- to three-element clusters (75%) as well as the cycles approach (75.6%). Results also showed that some SLTs were uncertain of what the empty set and two- to three-element clusters approaches entailed. In terms of intervention intensity, participants predominantly provided intervention once per week (69%) for a total of 9-12 sessions (ranging from five to 30 sessions, 71.5%) and elicited targets 10-30 times in single words per session (59.4%) in sessions lasting 21-30 min (41.4%). CONCLUSIONS & IMPLICATIONS The most commonly used intervention approaches identified in the current survey (i.e., speech discrimination, conventional minimal pairs and phonological awareness therapy) may be used eclectically by SLTs, which could impact upon the effectiveness and efficiency of treatment for phonological impairment. The current study also highlighted that almost half the participants always/often used traditional articulation therapy to remediate phonological impairment, even though this approach has been found to be less effective for this difficulty. Additionally, it appears that the currently provided intervention intensity for phonological impairment in the UK is significantly lower than what is indicated in the literature. Therefore, a research-practice gap exists for SLTs in the UK working with children with phonological impairment.
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Affiliation(s)
- Natalie Hegarty
- Institute of Nursing and Health Research, Ulster University, Magee, Derry-Londonderry, UK
| | - Jill Titterington
- Institute of Nursing and Health Research, Speech and Language Therapy Department, Ulster University, Jordanstown, Newtownabbey, UK
| | - Sharynne McLeod
- School of Teacher Education, Charles Sturt University, Bathurst, NSW, Australia
| | - Laurence Taggart
- Institute of Nursing and Health Research, Ulster University, Jordanstown, Newtownabbey, UK
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Baker E, Williams AL, McLeod S, McCauley R. Elements of Phonological Interventions for Children With Speech Sound Disorders: The Development of a Taxonomy. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 27:906-935. [PMID: 29801043 DOI: 10.1044/2018_ajslp-17-0127] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 01/29/2018] [Indexed: 05/13/2023]
Abstract
PURPOSE Our aim was to develop a taxonomy of elements comprising phonological interventions for children with speech sound disorders. METHOD We conducted a content analysis of 15 empirically supported phonological interventions to identify and describe intervention elements. Measures of element concentration, flexibility, and distinctiveness were used to compare and contrast interventions. RESULTS Seventy-two intervention elements were identified using a content analysis of intervention descriptions then arranged to form the Phonological Intervention Taxonomy: a hierarchical framework comprising 4 domains, 15 categories, and 9 subcategories. Across interventions, mean element concentration (number of required or optional elements) was 45, with a range of 27 to 59 elements. Mean flexibility of interventions (percentage of elements considered optional out of all elements included in the intervention) was 44%, with a range of 29% to 62%. Distinctiveness of interventions (percentage of an intervention's rare elements and omitted common elements out of all elements included in the intervention [both optional and required]) ranged from 0% to 30%. CONCLUSIONS An understanding of the elements that comprise interventions and a taxonomy that describes their structural relationships can provide insight into similarities and differences between interventions, help in the identification of elements that drive treatment effects, and facilitate faithful implementation or intervention modification. Research is needed to distil active elements and identify strategies that best facilitate replication and implementation.
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Affiliation(s)
- Elise Baker
- Discipline of Speech Pathology, Faculty of Health Sciences, The University of Sydney, New South Wales, Australia
| | | | - Sharynne McLeod
- Charles Sturt University, Bathurst, New South Wales, Australia
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Gomez M, McCabe P, Jakielski K, Purcell A. Treating Childhood Apraxia of Speech With the Kaufman Speech to Language Protocol: A Phase I Pilot Study. Lang Speech Hear Serv Sch 2018; 49:524-536. [DOI: 10.1044/2018_lshss-17-0100] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 12/18/2017] [Indexed: 11/09/2022] Open
Abstract
Purpose
A Phase I pilot study was designed to collect preliminary evidence on the use of the Kaufman Speech to Language Protocol (K-SLP; Kaufman, 2014) to treat children with childhood apraxia of speech. We hypothesized that the K-SLP approach would result in more accurate speech production in targeted words, whereas untrained (control) words and speech sounds would remain unchanged.
Method
A single-case multiple-baseline across behaviors experimental design was used to see if experimental feasibility could be demonstrated. Two children each received a total of 12 1-hr treatment sessions over 3 weeks. The children's response to treatment and experimental control was measured by administering baseline, treatment, and posttreatment probes.
Results
Both children showed some response to treatment, as measured by percent phonemes correct; however, the response to treatment varied. In general, for the treated words that improved with therapy, accuracy was maintained above baseline level during the maintenance phase. Minimal generalization was observed for this study, with only 1 participant generalizing treatment gains to 2 sets of untrained (similar) words.
Conclusion
This Phase I pilot study provides limited preliminary evidence for the effectiveness of the K-SLP approach in treating childhood apraxia of speech in some children under the conditions specified in this study. Replication of these results in well-controlled studies is needed before this structured and operationalized version of the K-SLP approach can be recommended for clinical use.
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Sugden E, Baker E, Munro N, Williams AL, Trivette CM. Service delivery and intervention intensity for phonology-based speech sound disorders. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2018; 53:718-734. [PMID: 29900638 DOI: 10.1111/1460-6984.12399] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 03/16/2018] [Accepted: 04/27/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND When planning evidence-based intervention services for children with phonology-based speech sound disorders (SSD), speech and language therapists (SLTs) need to integrate research evidence regarding service delivery and intervention intensity within their clinical practice. However, relatively little is known about the optimal intensity of phonological interventions and whether SLTs' services align with the research evidence. AIMS The aims are twofold. First, to review external evidence (i.e., empirical research evidence external to day-to-day clinical practice) regarding service delivery and intervention intensity for phonological interventions. Second, to investigate SLTs' clinical practice with children with phonology-based SSD in Australia, focusing on service delivery and intensity. By considering these complementary sources of evidence, SLTs and researchers will be better placed to understand the state of the external evidence regarding the delivery of phonological interventions and appreciate the challenges facing SLTs in providing evidence-based services. METHODS & PROCEDURES Two studies are presented. The first is a review of phonological intervention research published between 1979 and 2016. Details regarding service delivery and intervention intensity were extracted from the 199 papers that met inclusion criteria identified through a systematic search. The second study was an online survey of 288 SLTs working in Australia, focused on the service delivery and intensity of intervention provided in clinical practice. MAIN CONTRIBUTIONS There is a gap between the external evidence regarding service delivery and intervention intensity and the internal evidence from clinical practice. Most published intervention research has reported to provide intervention two to three times per week in individual sessions delivered by an SLT in a university clinic, in sessions lasting 30-60 min comprising 100 production trials. SLTs reported providing services at intensities below that found in the literature. Further, they reported workplace, client and clinician factors that influenced the intensity of intervention they were able to provide to children with phonology-based SSD. CONCLUSIONS & IMPLICATIONS Insufficient detail in the reporting of intervention intensity within published research coupled with service delivery constraints may affect the implementation of empirical evidence into everyday clinical practice. Research investigating innovative solutions to service delivery challenges is needed to provide SLTs with evidence that is relevant and feasible for clinical practice.
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Affiliation(s)
- Eleanor Sugden
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
- Discipline of Speech Pathology, University of Sydney, Sydney, NSW, Australia
| | - Elise Baker
- Discipline of Speech Pathology, University of Sydney, Sydney, NSW, Australia
| | - Natalie Munro
- Discipline of Speech Pathology, University of Sydney, Sydney, NSW, Australia
| | - A Lynn Williams
- Department of Audiology and Speech-Language Pathology, East Tennessee State University, Johnson City, TN, USA
| | - Carol M Trivette
- Department of Early Childhood Education, East Tennessee State University, Johnson City, TN, USA
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McCabe PJ. Elizabeth Usher Memorial Lecture: How do we change our profession? Using the lens of behavioural economics to improve evidence-based practice in speech-language pathology. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 20:300-309. [PMID: 29724145 DOI: 10.1080/17549507.2018.1460526] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 02/25/2018] [Indexed: 06/08/2023]
Abstract
Evidence-based practice (EBP) is a well-accepted theoretical framework around which speech-language pathologists strive to build their clinical decisions. The profession's conceptualisation of EBP has been evolving over the last 20 years with the practice of EBP now needing to balance research evidence, clinical data and informed patient choices. However, although EBP is not a new concept, as a profession, we seem to be no closer to closing the gap between research evidence and practice than we were at the start of the movement toward EBP in the late 1990s. This paper examines why speech-language pathologists find it difficult to change our own practice when we are experts in changing the behaviour of others. Using the lens of behavioural economics to examine the heuristics and cognitive processes which facilitate and inhibit change, the paper explores research showing how inconsistency of belief and action, or cognitive dissonance, is inevitable unless we act reflectively instead of automatically. The paper argues that heuristics that prevent us changing our practice toward EBP include the sunk cost fallacy, loss aversion, social desirability bias, choice overload and inertia. These automatic cognitive processes work to inhibit change and may partially account for the slow translation of research into practice. Fortunately, understanding and using other heuristics such as the framing effect, reciprocity, social proof, consistency and commitment may help us to understand our own behaviour as speech-language pathologists and help the profession, and those we work with, move towards EBP.
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Affiliation(s)
- Patricia J McCabe
- a Discipline of Speech Pathology, Faculty of Health Sciences , The University of Sydney , Sydney , Australia
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Rumbach AF, Rose TA, Cheah M. Exploring Australian speech-language pathologists' use and perceptions ofnon-speech oral motor exercises. Disabil Rehabil 2018; 41:1463-1474. [PMID: 29376445 DOI: 10.1080/09638288.2018.1431694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To explore Australian speech-language pathologists' use of non-speech oral motor exercises, and rationales for using/not using non-speech oral motor exercises in clinical practice. METHODS A total of 124 speech-language pathologists practising in Australia, working with paediatric and/or adult clients with speech sound difficulties, completed an online survey. RESULTS The majority of speech-language pathologists reported that they did not use non-speech oral motor exercises when working with paediatric or adult clients with speech sound difficulties. However, more than half of the speech-language pathologists working with adult clients who have dysarthria reported using non-speech oral motor exercises with this population. The most frequently reported rationale for using non-speech oral motor exercises in speech sound difficulty management was to improve awareness/placement of articulators. The majority of speech-language pathologists agreed there is no clear clinical or research evidence base to support non-speech oral motor exercise use with clients who have speech sound difficulties. CONCLUSIONS This study provides an overview of Australian speech-language pathologists' reported use and perceptions of non-speech oral motor exercises' applicability and efficacy in treating paediatric and adult clients who have speech sound difficulties. The research findings provide speech-language pathologists with insight into how and why non-speech oral motor exercises are currently used, and adds to the knowledge base regarding Australian speech-language pathology practice of non-speech oral motor exercises in the treatment of speech sound difficulties. Implications for Rehabilitation Non-speech oral motor exercises refer to oral motor activities which do not involve speech, but involve the manipulation or stimulation of oral structures including the lips, tongue, jaw, and soft palate. Non-speech oral motor exercises are intended to improve the function (e.g., movement, strength) of oral structures. The majority of speech-language pathologists agreed there is no clear clinical or research evidence base to support non-speech oral motor exercise use with clients who have speech sound disorders. Non-speech oral motor exercise use was most frequently reported in the treatment of dysarthria. Non-speech oral motor exercise use when targeting speech sound disorders is not widely endorsed in the literature.
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Affiliation(s)
- Anna F Rumbach
- a School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , Australia
| | - Tanya A Rose
- a School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , Australia
| | - Mynn Cheah
- a School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , Australia
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Hearnshaw S, Baker E, Munro N. The speech perception skills of children with and without speech sound disorder. JOURNAL OF COMMUNICATION DISORDERS 2018; 71:61-71. [PMID: 29306068 DOI: 10.1016/j.jcomdis.2017.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 11/20/2017] [Accepted: 12/03/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE To investigate whether Australian-English speaking children with and without speech sound disorder (SSD) differ in their overall speech perception accuracy. Additionally, to investigate differences in the perception of specific phonemes and the association between speech perception and speech production skills. METHOD Twenty-five Australian-English speaking children aged 48-60 months participated in this study. The SSD group included 12 children and the typically developing (TD) group included 13 children. Children completed routine speech and language assessments in addition to an experimental Australian-English lexical and phonetic judgement task based on Rvachew's Speech Assessment and Interactive Learning System (SAILS) program (Rvachew, 2009). This task included eight words across four word-initial phonemes-/k, ɹ, ʃ, s/. RESULTS Children with SSD showed significantly poorer perceptual accuracy on the lexical and phonetic judgement task compared with TD peers. The phonemes /ɹ/ and /s/ were most frequently perceived in error across both groups. Additionally, the phoneme /ɹ/ was most commonly produced in error. There was also a positive correlation between overall speech perception and speech production scores. CONCLUSIONS Children with SSD perceived speech less accurately than their typically developing peers. The findings suggest that an Australian-English variation of a lexical and phonetic judgement task similar to the SAILS program is promising and worthy of a larger scale study.
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Affiliation(s)
| | - Elise Baker
- The University of Sydney, 75 East Street, Lidcombe, NSW, 2141, Australia.
| | - Natalie Munro
- The University of Sydney, 75 East Street, Lidcombe, NSW, 2141, Australia.
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Macrae T. Stimulus Characteristics of Single-Word Tests of Children's Speech Sound Production. Lang Speech Hear Serv Sch 2017; 48:219-233. [DOI: 10.1044/2017_lshss-16-0050] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 06/01/2017] [Indexed: 11/09/2022] Open
Abstract
Purpose
This clinical focus article provides readers with a description of the stimulus characteristics of 12 popular tests of speech sound production.
Method
Using significance testing and descriptive analyses, stimulus items were compared in terms of the number of opportunities for production of all consonant singletons, clusters, and rhotic and nonrhotic vowels of Standard American English; phonetic/phonological and structural complexity; and the presence of bound morphemes.
Results
The tests varied widely in terms of the number of opportunities for production of consonant singletons, clusters, and rhotic and nonrhotic vowels. Most of the tests included only 1 opportunity, scored or unscored, to produce a majority of the consonant singletons in each word position. Only 3 of the tests included stimulus items with 3-element clusters. The majority contained limited opportunities to produce 3- or 4-syllable stimulus items. The tests provided sufficient opportunities for production of most vowels, although most did not score vowels. The tests differed significantly in the complexity of their stimulus items. Most, however, contained a negligible number of items that, with the addition of a bound morpheme, resulted in a word-final cluster.
Conclusion
Most of the tests elicit an inadequate sample with which to conduct a comprehensive phonological analysis.
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Affiliation(s)
- Toby Macrae
- School of Communication Science and Disorders, Florida State University, Tallahassee
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Titterington J, Bates S. Practice makes perfect? The pedagogic value of online independent phonetic transcription practice for speech and language therapy students. CLINICAL LINGUISTICS & PHONETICS 2017; 32:249-266. [PMID: 28857633 DOI: 10.1080/02699206.2017.1350882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Accuracy of phonetic transcription is a core skill for speech and language therapists (SLTs) worldwide (Howard & Heselwood, 2002). The current study investigates the value of weekly independent online phonetic transcription tasks to support development of this skill in year one SLT students. Using a mixed methods observational design, students enrolled in a year one phonetics module completed 10 weekly homework activities in phonetic transcription on a stand-alone tutorial site (WebFon (Bates, Matthews & Eagles, 2010)) and 5 weekly online quizzes (the 'Ulster Set' (Titterington, unpublished)). Student engagement with WebFon was measured in terms of the number of responses made to 'sparks' on the University's Virtual Learning Environment Discussion Board. Measures of phonetic transcription accuracy were obtained for the 'Ulster Set' and for a stand-alone piece of coursework at the end of the module. Qualitative feedback about experience with the online learning was gathered via questionnaire. A positive significant association was found between student engagement with WebFon and performance in the 'Ulster Set', and between performance in the 'Ulster Set' and final coursework. Students valued both online independent learning resources as each supported different learning needs. However, student compliance with WebFon was significantly lower than with the 'Ulster Set'. Motivators and inhibitors to engagement with the online resources were investigated identifying what best maximised engagement. These results indicate that while 'independent' online learning can support development of phonetic transcription skills, the activities must be carefully managed and constructively aligned to assessment providing the level of valance necessary to ensure effective engagement.
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Affiliation(s)
- Jill Titterington
- a Department of Speech and Language Therapy, Ulster University , Jordanstown , Northern Ireland
| | - Sally Bates
- b Department of English and Language Sciences, Plymouth Marjon University , Plymouth , England
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Broome K, McCabe P, Docking K, Doble M. A Systematic Review of Speech Assessments for Children With Autism Spectrum Disorder: Recommendations for Best Practice. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 26:1011-1029. [PMID: 28772287 DOI: 10.1044/2017_ajslp-16-0014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 03/07/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE The purpose of this systematic review was to provide a summary and evaluation of speech assessments used with children with autism spectrum disorders (ASD). A subsequent narrative review was completed to ascertain the core components of an evidence-based pediatric speech assessment, which, together with the results of the systematic review, provide clinical and research guidelines for best practice. METHOD A systematic search of eight databases was used to find peer-reviewed research articles published between 1990 and 2014 assessing the speech of children with ASD. Eligible articles were categorized according to the assessment methods used and the speech characteristics described. RESULTS The review identified 21 articles that met the inclusion criteria, search criteria, and confidence in ASD diagnosis. The speech of prelinguistic participants was assessed in seven articles. Speech assessments with verbal participants were completed in 15 articles with segmental and suprasegmental aspects of speech analyzed. Assessment methods included connected speech samples, single-word naming tasks, speech imitation tasks, and analysis of the production of words and sentences. CONCLUSIONS Clinical and research guidelines for speech assessment of children with ASD are outlined. Future comparisons will be facilitated by the use of consistent reporting methods in research focusing on children with ASD.
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Affiliation(s)
- Kate Broome
- Discipline of Speech Pathology, The University of Sydney, Australia
- The Sydney Children's Hospital Network, Sydney, Australia
| | - Patricia McCabe
- Discipline of Speech Pathology, The University of Sydney, Australia
| | | | - Maree Doble
- Discipline of Speech Pathology, The University of Sydney, Australia
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McLeod S, Baker E, McCormack J, Wren Y, Roulstone S, Crowe K, Masso S, White P, Howland C. Cluster-Randomized Controlled Trial Evaluating the Effectiveness of Computer-Assisted Intervention Delivered by Educators for Children With Speech Sound Disorders. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:1891-1910. [PMID: 28672376 DOI: 10.1044/2017_jslhr-s-16-0385] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 02/20/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE The aim was to evaluate the effectiveness of computer-assisted input-based intervention for children with speech sound disorders (SSD). METHOD The Sound Start Study was a cluster-randomized controlled trial. Seventy-nine early childhood centers were invited to participate, 45 were recruited, and 1,205 parents and educators of 4- and 5-year-old children returned questionnaires. Children whose parents and educators had concerns about speech were assessed (n = 275); 132 children who were identified with phonological pattern-based errors underwent additional assessment. Children with SSD and no difficulties with receptive language or hearing, typical nonverbal intelligence, and English as their primary language were eligible; 123 were randomized into two groups (intervention n = 65; control n = 58), and 3 withdrew. The intervention group involved Phoneme Factory Sound Sorter software (Wren & Roulstone, 2013) administered by educators over 9 weeks; the control group involved typical classroom practices. Participants were reassessed twice by a speech-language pathologist who was unaware of the initial assessment and intervention conditions. RESULTS For the primary outcome variable (percentage of consonants correct), the significant mean change from pre- to postintervention for the intervention group (mean change = +6.15, p < .001) was comparable in magnitude to the significant change for the control group (mean change = +5.43, p < .001) with a small between-groups effect size for change (Cohen's d = 0.08). Similar results occurred for measures of emergent literacy, phonological processing, participation, and well-being. CONCLUSION Computer-assisted input-based intervention administered by educators did not result in greater improvement than typical classroom practices.
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Affiliation(s)
| | | | | | - Yvonne Wren
- Bristol Speech and Language Therapy Research Unit, United KingdomUniversity of Bristol, United Kingdom
| | - Sue Roulstone
- Bristol Speech and Language Therapy Research Unit, United KingdomUniversity of the West of England, Bristol, United Kingdom
| | | | | | - Paul White
- University of the West of England, Bristol, United Kingdom
| | - Charlotte Howland
- The University of Sydney, AustraliaCharles Sturt University, Sydney, Australia
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McCormack J, Baker E, Masso S, Crowe K, McLeod S, Wren Y, Roulstone S. Implementation fidelity of a computer-assisted intervention for children with speech sound disorders. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 19:265-276. [PMID: 28351159 DOI: 10.1080/17549507.2017.1293160] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 02/04/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Implementation fidelity refers to the degree to which an intervention or programme adheres to its original design. This paper examines implementation fidelity in the Sound Start Study, a clustered randomised controlled trial of computer-assisted support for children with speech sound disorders (SSD). METHOD Sixty-three children with SSD in 19 early childhood centres received computer-assisted support (Phoneme Factory Sound Sorter [PFSS] - Australian version). Educators facilitated the delivery of PFSS targeting phonological error patterns identified by a speech-language pathologist. Implementation data were gathered via (1) the computer software, which recorded when and how much intervention was completed over 9 weeks; (2) educators' records of practice sessions; and (3) scoring of fidelity (intervention procedure, competence and quality of delivery) from videos of intervention sessions. RESULT Less than one-third of children received the prescribed number of days of intervention, while approximately one-half participated in the prescribed number of intervention plays. Computer data differed from educators' data for total number of days and plays in which children participated; the degree of match was lower as data became more specific. Fidelity to intervention procedures, competency and quality of delivery was high. CONCLUSION Implementation fidelity may impact intervention outcomes and so needs to be measured in intervention research; however, the way in which it is measured may impact on data.
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Affiliation(s)
- Jane McCormack
- a The University of Sheffield , Sheffield , UK
- b Charles Sturt University , Bathurst , Australia
| | - Elise Baker
- c The University of Sydney , Sydney , Australia
| | - Sarah Masso
- b Charles Sturt University , Bathurst , Australia
| | | | | | - Yvonne Wren
- d University of Bristol , Bristol , UK , and
| | - Sue Roulstone
- e The University of the West of England , Bristol , UK
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Masso S, McLeod S, Wang C, Baker E, McCormack J. Longitudinal changes in polysyllable maturity of preschool children with phonologically-based speech sound disorders. CLINICAL LINGUISTICS & PHONETICS 2017; 31:424-439. [PMID: 28409664 DOI: 10.1080/02699206.2017.1305450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Children's polysyllables were investigated for changes in (1) consonant and vowel accuracy, (2) error frequency and (3) polysyllable maturity over time. Participants were 80 children (4;0-5;4) with phonologically-based speech sound disorders who participated in the Sound Start Study and completed the Polysyllable Preschool Test (Baker, 2013) three times. Polysyllable errors were categorised using the Word-level Analysis of Polysyllables (WAP, Masso, 2016a) and the Framework of Polysyllable Maturity (Framework, Masso, 2016b), which represents five maturity levels (Levels A-E). Participants demonstrated increased polysyllable accuracy over time as measured by consonant and vowel accuracy, and error frequency. Children in Level A, the lowest level of maturity, had frequent deletion errors, alterations of phonotactics and alterations of timing. Participants in Level B were 8.62 times more likely to improve than children in Level A at Time 1. Children who present with frequent deletion errors may be less likely to improve their polysyllable accuracy.
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Affiliation(s)
- Sarah Masso
- a School of Teacher Education, Charles Sturt University , Bathurst , Australia
| | - Sharynne McLeod
- a School of Teacher Education, Charles Sturt University , Bathurst , Australia
| | - Cen Wang
- a School of Teacher Education, Charles Sturt University , Bathurst , Australia
| | - Elise Baker
- b The Faculty of Health Sciences, The University of Sydney , Sydney , Australia
| | - Jane McCormack
- c The Department of Human Communication Sciences , The University of Sheffield , Sheffield , UK
- d School of Community Health, Charles Sturt University , Albury , Australia
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Rosado IM, Donicht G, Simoni SND, Pagliarin KC, Keske-Soares M. Percepção da inteligibilidade e gravidade do desvio fonológico por fonoaudiólogos e leigos. REVISTA CEFAC 2017. [DOI: 10.1590/1982-0216201719215916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: comparar o julgamento perceptual por fonoaudiólogos(as) e leigos(as) quanto à inteligibilidade da fala de crianças com desvio fonológico, e verificar a concordância deste julgamento com a gravidade do desvio fonológico. Métodos: a pesquisa foi composta por duas amostras: julgada e julgadora. A amostra julgada foi constituída por 30 crianças do banco de dados da clínica fonoaudiológica da instituição, com diagnóstico de desvio fonológico, na faixa etária de 4 anos e 1 mês a 7 anos e 11 meses (20 do gênero masculino e 10 do feminino). A amostra julgadora, foi composta por seis leigos, que não possuíam qualquer contato com crianças, sendo três do gênero masculino e três do feminino; e seis fonoaudiólogos, sendo três do gênero masculino e três do feminino. Resultados: o julgamento da inteligibilidade por leigos(as) é mais prejudicado do que a inteligibilidade por fonoaudiólogos(as), pois estes possuem formação técnica para entender a fala do outro, julgando melhor a fala da criança. Leigos e leigas concordam de forma semelhante em relação à gravidade do desvio fonológico, diferentemente do grupo de fonoaudiólogos x fonoaudiólogas, onde as fonoaudiólogas julgam e concordam melhor quanto à inteligibilidade e a gravidade do desvio fonológico. Conclusão: profissionais fonoaudiólogos(as) julgam de forma mais adequada a inteligibilidade da fala de crianças com desvio fonológico; as fonoaudiólogas possuem melhor percepção para julgar a gravidade do desvio quando comparadas aos grupos de leigos e leigas, demonstrando haver necessidade de informações a este último sobre o tema.
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Sugden E, Baker E, Munro N, Williams AL. Involvement of parents in intervention for childhood speech sound disorders: a review of the evidence. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2016; 51:597-625. [PMID: 27017993 DOI: 10.1111/1460-6984.12247] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 12/15/2015] [Accepted: 01/06/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Internationally, speech and language therapists (SLTs) are involving parents and providing home tasks in intervention for phonology-based speech sound disorder (SSD). To ensure that SLTs' involvement of parents is guided by empirical research, a review of peer-reviewed published evidence is needed. AIMS To provide SLTs and researchers with a comprehensive appraisal and analysis of peer-reviewed published intervention research reporting parent involvement and the provision of home tasks in intervention studies for children with phonology-based SSD. METHODS & PROCEDURES A systematic search and review was conducted. Academic databases were searched for peer-reviewed research papers published between 1979 and 2013 reporting on phonological intervention for SSD. Of the 176 papers that met the criteria, 61 were identified that reported on the involvement of parents and/or home tasks within the intervention. These papers were analysed using a quality appraisal tool. Details regarding the involvement of parents and home tasks were extracted and analysed to provide a summary of these practices within the evidence base. MAIN CONTRIBUTION Parents have been involved in intervention research for phonology-based SSD. However, most of the peer-reviewed published papers reporting this research have provided limited details regarding what this involved. This paucity of information presents challenges for SLTs wishing to integrate external evidence into their clinical services and clinical decision-making. It also raises issues regarding treatment fidelity for researchers wishing to replicate published intervention research. CONCLUSIONS & IMPLICATIONS The range of tasks in which parents were involved, and the limited details reported in the literature, present challenges for SLTs wanting to involve parents in intervention. Further high-quality research reporting more detail regarding the involvement of parents and home tasks in intervention for SSD is needed.
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Affiliation(s)
| | - Elise Baker
- The University of Sydney, Sydney, NSW, Australia
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83
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Masso S, McLeod S, Baker E, McCormack J. Polysyllable productions in preschool children with speech sound disorders: Error categories and the Framework of Polysyllable Maturity. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2016; 18:272-287. [PMID: 27111638 DOI: 10.3109/17549507.2016.1168483] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 02/24/2016] [Accepted: 03/16/2016] [Indexed: 06/05/2023]
Abstract
PURPOSE Children with speech sound disorders (SSD) find polysyllables difficult; however, routine sampling and measurement of speech accuracy are insufficient to describe polysyllable accuracy and maturity. This study had two aims: (1) compare two speech production tasks and (2) describe polysyllable errors within the Framework of Polysyllable Maturity. METHOD Ninety-three preschool children with SSD from the Sound Start Study (4;0-5;5 years) completed the Polysyllable Preschool Test (POP) and the Diagnostic Evaluation of Articulation and Phonology (DEAP-Phonology). RESULT Vowel accuracy was significantly different between the POP and the DEAP-Phonology. Polysyllables were analysed using the seven Word-level Analysis of Polysyllables (WAP) error categories: (1) substitution of consonants or vowels (97.8% of children demonstrated common use), (2) deletion of syllables, consonants or vowels (65.6%), (3) distortion of consonants or vowels (0.0%), (4) addition of consonants or vowels (0.0%), (5) alteration of phonotactics (77.4%), (6) alteration of timing (63.4%) and (7) assimilation or alteration of sequence (0.0%). The Framework of Polysyllable Maturity described five levels of maturity based on children's errors. CONCLUSIONS Polysyllable productions of preschool children with SSD can be analysed and categorised using the WAP and interpreted using the Framework of Polysyllable Maturity.
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Affiliation(s)
- Sarah Masso
- a Charles Sturt University , Bathurst , Australia
| | | | - Elise Baker
- b The University of Sydney , Australia , and
| | - Jane McCormack
- c Charles Sturt University , Albury , Australia and The University of Sheffield, UK
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84
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Yoder PJ, Camarata S, Woynaroski T. Treating Speech Comprehensibility in Students With Down Syndrome. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2016; 59:446-59. [PMID: 27300156 PMCID: PMC4972011 DOI: 10.1044/2015_jslhr-s-15-0148] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 11/09/2015] [Accepted: 11/10/2015] [Indexed: 05/13/2023]
Abstract
PURPOSE This study examined whether a particular type of therapy (Broad Target Speech Recasts, BTSR) was superior to a contrast treatment in facilitating speech comprehensibility in conversations of students with Down syndrome who began treatment with initially high verbal imitation. METHOD We randomly assigned 51 5- to 12-year-old students to either BTSR or a contrast treatment. Therapy occurred in hour-long 1-to-1 sessions in students' schools twice per week for 6 months. RESULTS For students who entered treatment just above the sample average in verbal-imitation skill, BTSR was superior to the contrast treatment in facilitating the growth of speech comprehensibility in conversational samples. The number of speech recasts mediated or explained the BTSR treatment effect on speech comprehensibility. CONCLUSION Speech comprehensibility is malleable in school-age students with Down syndrome. BTSR facilitates comprehensibility in students with just above the sample average level of verbal imitation prior to treatment. Speech recasts in BTSR are largely responsible for this effect.
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Abstract
This paper describes a comprehensive speech sound assessment for preschool children suspected of having a speech sound disorder (SSD). Recommended components include standardized single-word testing, additional single-word testing, connected speech sampling, phonological analyses, stimulability testing, and inconsistency testing. While data collection and some cursory analyses take place during the evaluation session, allowing the speech-language pathologist (SLP) to share key information with the parents/caregivers, much of the in-depth analysis takes place later. Since most preschool children's SSDs are phonological in nature, a phonological approach to analysis, target selection, and treatment is required. Two examples of phonological analyses, a place-voice-manner (PVM) analysis and an error pattern analysis, are discussed. Both allow the SLP to identify patterns of difficulty in the child's speech with regards to the place, voicing, and/or manner characteristics of target consonants. Phonological analyses can be performed using the child's single-word and connected speech samples. This information, along with the results from the stimulability and inconsistency testing, will allow the SLP to gain a complete picture of the child's speech sound abilities and difficulties, determine prognosis for change, and identify treatment targets.
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Affiliation(s)
- Toby Macrae
- School of Communication Science and Disorders, Florida State University
Tallahassee, FL
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86
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Verdon S, McLeod S, Wong S. Supporting culturally and linguistically diverse children with speech, language and communication needs: Overarching principles, individual approaches. JOURNAL OF COMMUNICATION DISORDERS 2015; 58:74-90. [PMID: 26513218 DOI: 10.1016/j.jcomdis.2015.10.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 09/04/2015] [Accepted: 10/07/2015] [Indexed: 06/05/2023]
Abstract
Speech-language pathologists (SLPs) are working with an increasing number of families from culturally and linguistically diverse backgrounds as the world's population continues to become more internationally mobile. The heterogeneity of these diverse populations makes it impossible to identify and document a one size fits all strategy for working with culturally and linguistically diverse families. This paper explores approaches to practice by SLPs identified as specialising in multilingual and multicultural practice in culturally and linguistically diverse contexts from around the world. Data were obtained from ethnographic observation of 14 sites in 5 countries on 4 continents. The sites included hospital settings, university clinics, school-based settings, private practices and Indigenous community-based services. There were 652 individual artefacts collected from the sites which included interview transcripts, photographs, videos, narrative reflections, informal and formal field notes. The data were analysed using Cultural-Historical Activity Theory (Engeström, 1987). From the analysis six overarching Principles of Culturally Competent Practice (PCCP) were identified. These were: (1) identification of culturally appropriate and mutually motivating therapy goals, (2) knowledge of languages and culture, (3) use of culturally appropriate resources, (4) consideration of the cultural, social and political context, (5) consultation with families and communities, and (6) collaboration between professionals. These overarching principles align with the six position statements developed by the International Expert Panel on Multilingual Children's Speech (2012) which aim to enhance the cultural competence of speech pathologists and their practice. The international examples provided in the current study demonstrate the individualised ways that these overarching principles are enacted in a range of different organisational, social, cultural and political contexts. Tensions experienced in enacting the principles are also discussed. This paper emphasises the potential for individual SLPs to enhance their practice by adopting these overarching principles to support the individual children and families in diverse contexts around the world.
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Affiliation(s)
| | | | - Sandie Wong
- Charles Sturt University, Bathurst, Australia
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87
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Preston JL, Irwin JR, Turcios J. Perception of Speech Sounds in School-Aged Children with Speech Sound Disorders. Semin Speech Lang 2015; 36:224-33. [PMID: 26458198 DOI: 10.1055/s-0035-1562906] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Children with speech sound disorders may perceive speech differently than children with typical speech development. The nature of these speech differences is reviewed with an emphasis on assessing phoneme-specific perception for speech sounds that are produced in error. Category goodness judgment, or the ability to judge accurate and inaccurate tokens of speech sounds, plays an important role in phonological development. The software Speech Assessment and Interactive Learning System, which has been effectively used to assess preschoolers' ability to perform goodness judgments, is explored for school-aged children with residual speech errors (RSEs). However, data suggest that this particular task may not be sensitive to perceptual differences in school-aged children. The need for the development of clinical tools for assessment of speech perception in school-aged children with RSE is highlighted, and clinical suggestions are provided.
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Affiliation(s)
- Jonathan L Preston
- Department of Communication Sciences and Disorders and Haskins Laboratories, Syracuse University, New York, New York
| | - Julia R Irwin
- Haskins Laboratories and Department of Psychology, Southern Connecticut State University, New Haven, Connecticut
| | - Jacqueline Turcios
- Haskins Laboratories and Department of Psychology, Southern Connecticut State University, New Haven, Connecticut
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88
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Lee AS, Gibbon FE. Non-speech oral motor treatment for children with developmental speech sound disorders. Cochrane Database Syst Rev 2015; 2015:CD009383. [PMID: 25805060 PMCID: PMC6743085 DOI: 10.1002/14651858.cd009383.pub2] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Children with developmental speech sound disorders have difficulties in producing the speech sounds of their native language. These speech difficulties could be due to structural, sensory or neurophysiological causes (e.g. hearing impairment), but more often the cause of the problem is unknown. One treatment approach used by speech-language therapists/pathologists is non-speech oral motor treatment (NSOMT). NSOMTs are non-speech activities that aim to stimulate or improve speech production and treat specific speech errors. For example, using exercises such as smiling, pursing, blowing into horns, blowing bubbles, and lip massage to target lip mobility for the production of speech sounds involving the lips, such as /p/, /b/, and /m/. The efficacy of this treatment approach is controversial, and evidence regarding the efficacy of NSOMTs needs to be examined. OBJECTIVES To assess the efficacy of non-speech oral motor treatment (NSOMT) in treating children with developmental speech sound disorders who have speech errors. SEARCH METHODS In April 2014 we searched the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE (R) and Ovid MEDLINE In-Process & Other Non-Indexed Citations, EMBASE, Education Resources Information Center (ERIC), PsycINFO and 11 other databases. We also searched five trial and research registers, checked the reference lists of relevant titles identified by the search and contacted researchers to identify other possible published and unpublished studies. SELECTION CRITERIA Randomised and quasi-randomised controlled trials that compared (1) NSOMT versus placebo or control; and (2) NSOMT as adjunctive treatment or speech intervention versus speech intervention alone, for children aged three to 16 years with developmental speech sound disorders, as judged by a speech and language therapist. Individuals with an intellectual disability (e.g. Down syndrome) or a physical disability were not excluded. DATA COLLECTION AND ANALYSIS The Trials Search Co-ordinator of the Cochrane Developmental, Psychosocial and Learning Problems Group and one review author ran the searches. Two review authors independently screened titles and abstracts to eliminate irrelevant studies, extracted data from the included studies and assessed risk of bias in each of these studies. In cases of ambiguity or information missing from the paper, we contacted trial authors. MAIN RESULTS This review identified three studies (from four reports) involving a total of 22 children that investigated the efficacy of NSOMT as adjunctive treatment to conventional speech intervention versus conventional speech intervention for children with speech sound disorders. One study, a randomised controlled trial (RCT), included four boys aged seven years one month to nine years six months - all had speech sound disorders, and two had additional conditions (one was diagnosed as "communication impaired" and the other as "multiply disabled"). Of the two quasi-randomised controlled trials, one included 10 children (six boys and four girls), aged five years eight months to six years nine months, with speech sound disorders as a result of tongue thrust, and the other study included eight children (four boys and four girls), aged three to six years, with moderate to severe articulation disorder only. Two studies did not find NSOMT as adjunctive treatment to be more effective than conventional speech intervention alone, as both intervention and control groups made similar improvements in articulation after receiving treatments. One study reported a change in postintervention articulation test results but used an inappropriate statistical test and did not report the results clearly. None of the included studies examined the effects of NSOMTs on any other primary outcomes, such as speech intelligibility, speech physiology and adverse effects, or on any of the secondary outcomes such as listener acceptability.The RCT was judged at low risk for selection bias. The two quasi-randomised trials used randomisation but did not report the method for generating the random sequence and were judged as having unclear risk of selection bias. The three included studies were deemed to have high risk of performance bias as, given the nature of the intervention, blinding of participants was not possible. Only one study implemented blinding of outcome assessment and was at low risk for detection bias. One study showed high risk of other bias as the baseline characteristics of participants seemed to be unequal. The sample size of each of the included studies was very small, which means it is highly likely that participants in these studies were not representative of its target population. In the light of these serious limitations in methodology, the overall quality of the evidence provided by the included trials is judged to be low. Therefore, further research is very likely to have an important impact on our confidence in the estimate of treatment effect and is likely to change the estimate. AUTHORS' CONCLUSIONS The three included studies were small in scale and had a number of serious methodological limitations. In addition, they covered limited types of NSOMTs for treating children with speech sound disorders of unknown origin with the sounds /s/ and /z/. Hence, we judged the overall applicability of the evidence as limited and incomplete. Results of this review are consistent with those of previous reviews: Currently no strong evidence suggests that NSOMTs are an effective treatment or an effective adjunctive treatment for children with developmental speech sound disorders. Lack of strong evidence regarding the treatment efficacy of NSOMTs has implications for clinicians when they make decisions in relation to treatment plans. Well-designed research is needed to carefully investigate NSOMT as a type of treatment for children with speech sound disorders.
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Affiliation(s)
- Alice S‐Y Lee
- University College CorkDepartment of Speech and Hearing SciencesBrookfield Health Sciences ComplexCollege RoadCorkIreland
| | - Fiona E Gibbon
- University College CorkDepartment of Speech and Hearing SciencesBrookfield Health Sciences ComplexCollege RoadCorkIreland
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McLeod S, Verdon S. A review of 30 speech assessments in 19 languages other than English. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2014; 23:708-723. [PMID: 24700105 DOI: 10.1044/2014_ajslp-13-0066] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 03/22/2014] [Indexed: 06/03/2023]
Abstract
PURPOSE In this study, the authors aimed to evaluate instruments designed to assess children's speech production in languages other than English. METHOD Ninety-eight speech assessments in languages other than English were identified: 62 were commercially published, 17 published within journal articles, and 19 informal assessments. A review was undertaken of 30 commercially published assessments that could be obtained. RESULTS The 30 instruments assessed 19 languages: Cantonese, Danish, Finnish, German, Greek, Japanese, Korean, Maltese-English, Norwegian, Pakistani-heritage languages (Mirpuri, Punjabi, Urdu), Portuguese, Putonghua (Mandarin), Romanian, Slovenian, Spanish, Swedish, and Turkish. The majority (70.0%) assessed speech sound production in monolingual speakers, 20.0% assessed one language of bilingual speakers, and 10.0% assessed both languages of bilingual speakers. All used single-word picture elicitation. Approximately half (53.3%) were norm-referenced, and the number of children in the normative samples ranged between 145 and 2,568. The remaining assessments were criterion-referenced (50.0%) (one fitted both categories). The assessments with English manuals met many of the psychometric criteria for operationalization; however, only 2 provided sensitivity and specificity data. CONCLUSIONS Despite the varying countries of origin, there were many similarities between speech assessments in languages other than English. Few were designed for use with multilingual children, so validation is required for use in English-speaking contexts.
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