Qualitative research: implications for description and assessment

Online Aphasia Groups: Navigating Issues of Voice and Identity

PURPOSE

Participation in aphasia groups is associated with increased communication, reduced feelings of social isolation, and increased quality of life. Despite the growing popularity of online aphasia groups, little is known about how to manage conversation in this format. We examined online aphasia book club sessions to examine how the facilitator supported group members' participation in conversation.

METHOD

Interactional sociolinguistic discourse analysis was used to analyze the behaviors and actions of the facilitator and group members. Qualitative data for this study were drawn from four recorded online aphasia book club sessions held through a university's free aphasia clinic on the Zoom web-conferencing platform.

RESULTS

Sociolinguistic discourse analysis revealed strategic facilitator behaviors that served to (a) give members with varying levels of verbal language abilities voice, (b) foreground or background aspects of voice, and (c) minimize her own voice to promote interactional symmetry between herself and group members.

CONCLUSIONS

Identity formed the backdrop for facilitators' actions when leading online groups, guiding decisions about who got to talk, when, for how long, through what modality, and about what topics. A better understanding of the interactions that occur online, such as how to develop and protect the identities of group members, could equip facilitators with the tools necessary for facilitating positive, engaging aphasia therapy groups online.

New perspectives, theory, method, and practice: Qualitative research and innovation in speech-language pathology

Purpose: Research in speech-language pathology has been dominated by experimental, empirical, and scientific approaches, which build on hypothesis testing and logical, deductive reasoning. Qualitative approaches stem from a different paradigm or world view which imply different questions and methodologies which, for example, emphasise codesign, reciprocity, individual experience and context. This article explores the relationship between qualitative inquiry in the field of speech-language pathology and innovation. It aims to show how the aspirations of the profession can be supported, and how innovation can be achieved, through research which sheds light on the lived experiences and perceptions of clients and families and builds an understanding of how they function in their everyday contexts.Method: We summarise qualitative approaches in speech-language pathology, explain the notion of innovation, and review qualitative research as a source of theoretical, methodological, and practice innovation in speech-language pathology.Result: Not only has qualitative inquiry underpinned examples of theoretical, methodological and practice innovations in speech-language pathology, but it can also play a part in enhancing translation and implementation of research innovations.Conclusion: An explicit consideration of what we mean by innovation is useful for speech-language pathologists. Qualitative research complements other forms of research in the field and has prompted new theoretical understandings, new methodologies and methods of research, and new ways to deliver our services in ways that are responsive to our clients and communities.

The Impact of Racism, Power, Privilege, and Positionality on Communication Sciences and Disorders Research: Time to Reconceptualize and Seek a Pathway to Equity

Purpose The purpose of this article is to explore how racism, privilege, power, and positionality negatively impact clinical research conducted in the discipline of communication sciences and disorders. Conclusions Evidence suggests solutions will not emerge from a minor revision or adjustment of current research approaches. Instead, to make deep and necessary changes, a complete restructuring of the research process is needed. This restructuring calls for a reconceptualization of how research questions and hypotheses are formed, how methods are selected, how data are analyzed and interpreted, and who is at the table throughout this process of knowledge generation. Such an overhaul of current research approaches will offer the field a solution-oriented roadmap for scientific investigation that facilitates greater equity in the research enterprise that translates into improved clinical outcomes for all clients served.

School-Based Speech-Language Pathologists' Perspectives on Diagnostic Decision Making

PURPOSE

This study used a structured open interview approach to elicit information from school-based speech-language pathologists (SLPs) regarding their assessment practices for children with suspected language impairment.

METHOD

Phone interviews were conducted with 39 school-based SLPs who were employed across the United States. The interviews explored assessment topics related to assessment tool selection and rationale and the integration of assessment data to determine treatment eligibility.

RESULTS

The results of this study suggest that SLPs use both standardized testing and informal testing for their diagnostic procedures. Standardized testing appears to be the tool that drives diagnostic decisions regarding eligibility and severity. Informal measures, such as parent/teacher interviews and language sampling, were used by school-based SLPs to gather information regarding naturalistic language use; however, they seem less important in the diagnostic decision-making process. Also, SLPs reported completing language sample transcription and analysis in real time while interacting with a child.

CONCLUSIONS

School-based SLPs appear to rely on the results from standardized testing when determining treatment eligibility for children with language impairment. The reliance on standardized testing appears to be driven by institutional policies. We discuss the potential impact of federal/state/district guidelines on diagnostic decisions and consider the research-to-practice gap.

Services for children with central auditory processing disorder in the Republic of Ireland: current and future service provision

PURPOSE

An interdisciplinary research group was established to investigate current and future service provision for children with central auditory processing disorder ([C]APD) in the Republic of Ireland. The aim of Phase 1 was to identify current awareness and knowledge of (C)APD among the relevant professionals in Ireland, including level of service provision, if any, available for children with (C)APD. The aim of Phase 2 was to explore the initial steps required to develop an integrated service for children presenting with (C)APD.

METHOD

A quantitative design was used in Phase 1, and 520 surveys were distributed to speech and language therapists, audiologic scientists, and educational psychologists. A qualitative participative design was used in Phase 2.

RESULTS

There was a 53% response rate to the survey. The main findings from Phase 1 were that all professional groups considered themselves to be inadequately informed and lacking in skills for (C)APD assessment or intervention. In Phase 2, 98 participants with backgrounds in speech and language therapy, audiologic science, educational psychology, and occupational therapy engaged in interdisciplinary discussions to identify the first steps required to develop a (C)APD service.

CONCLUSION

All professional groups considered that they were inadequately informed about (C)APD, and the first steps required to develop services in Ireland include the promotion and development of interdisciplinary teamwork and education, a need for additional resources, a clearer understanding of the definition of (C)APD, and evidence-based assessment and management of this condition.

Current Training and Continuing Education Needs of Preschool and School-Based Speech-Language Pathologists Regarding Children With Cleft Lip/Palate

Purpose

The purpose of this study was to obtain information regarding the education and experience of preschool and school-based speech-language pathologists (SLPs) regarding the assessment and treatment of children born with cleft lip and/or palate and to determine their continuing education needs in this area.

Method

A 16-item mixed-methods survey to collect quantitative and qualitative data was distributed via postal mail to a geographically diverse random sample of 565 preschool and school SLPs.

Results

The response rate was 59%. With an average of 15.93 years in practice, respondents reported that they infrequently saw children with cleft lip/palate. When treating these children, respondents wanted communication with the cleft–craniofacial team, accessible continuing education through Web sites and conferences, and clinically practical information relevant to the school setting.

Conclusion

When assessing and treating a low-incidence population such as children with cleft-related communication disorders, school-based SLPs need accessible, accurate continuing education resources and collaboration with specialists in the field.

Assessing quality of life in stuttering treatment outcomes research

Stuttering can affect many aspects of a person's life. People who stutter report that they experience negative reactions to stuttering, difficulty communicating in key situations, diminished satisfaction with life, and a reduced ability to achieve their goals in life. Unfortunately, most treatment outcomes studies have focused on changes in the observable characteristics of stuttering, with significantly fewer studies examining the broader consequences of stuttering. This paper proposes that evaluation of stuttering treatment outcomes can be enhanced through assessment of impact of stuttering on a speaker's quality of life. A means of assessing quality of life is described, based on the Overall Assessment of the Speaker's Experience of Stuttering (OASES; Yaruss & Quesal, 2006, 2008). The OASES is a multi-dimensional assessment instrument built upon the World Health Organization's International Classification of Functioning, Disability, and Health (ICF; WHO, 2001; see also Yaruss & Quesal, 2004). One section of the OASES is designed to assess specific aspects of quality of life in individuals who stutter. Preliminary data from two ongoing studies involving the OASES are briefly summarized in order to demonstrate: (a) that individuals who stutter do report an adverse impact on their quality of life as a result of stuttering and (b) that quality of life can improve following treatment for stuttering. It is recommended that future stuttering treatment outcomes studies directly examine the broader consequence of stuttering by focusing, in part, on quality of life.

EDUCATIONAL OBJECTIVES

After reading this article, the participant will be able to: (1) describe some of the adverse consequences of stuttering reported by individuals who stutter; (2) define quality of life as it relates to the study of the stuttering disorder; (3) explain the value of assessing quality of life in stuttering treatment outcomes research.

An examination of how speech and language therapists assess and diagnose children with specific language impairment in Ireland

Three criteria for diagnosing specific language impairment (SLI) are defined in the literature: exclusionary definitions, inclusionary definitions, and qualitative markers. However, the assessment and diagnosis of this complex impairment in clinical practice can be challenging. The aims of this research were twofold: (1) to make explicit the current assessment procedures which speech and language therapists (SLTs) use when they diagnose children with SLI in Ireland, and (2) to explore SLT's perceptions and experiences of the process of diagnosing children with SLI. Both quantitative and qualitative methods were used in this study. A survey of 199 SLTs in Ireland was carried out to address aim one and a focus group was conducted to address the second aim. The findings were that SLTs use exclusionary and inclusionary definitions of SLI, and qualitative markers when assessing children who they suspect may have SLI. SLTs in Ireland consider a diagnosis of SLI when children present with a verbal-performance discrepancy, a positive family history, word finding difficulties and lack of progress in therapy. The results of the qualitative strand indicated that assessment and diagnosis of children with SLI is a complex, time-consuming process involving other professionals. What emerged was a complex picture with tensions between therapists' professional judgements, policy, evidence-based practice and resources.

Communication in young children with fragile X syndrome: a qualitative study of mothers' perspectives

PURPOSE

To provide descriptive and qualitative information about communication in young children with fragile X syndrome (FXS) and about how families react to and accommodate communication differences in their children.

METHOD

In-depth interviews were conducted with 55 mothers of young children with FXS. Interviewers asked mothers to describe their children's communication, strategies they used to help promote their children's communication, communication-related frustrations, their expectations for their children, and the roles that they perceive for themselves.

RESULTS

Over half the children were nonverbal and learning to communicate with augmentative and alternative communication. Mothers reported using strategies that were developmentally appropriate and recommended by early childhood experts, such as reading and talking to their children. Many mothers identified challenges faced in helping their child to communicate, and some cited difficulty obtaining speech-language services as a challenge. Mothers identified their roles as caregiver, teacher, therapist, and advocate.

CONCLUSIONS

The perspectives offered by mothers are valuable because they indicate how children with FXS communicate in natural contexts. Information about mothers' expectations and roles may help clinicians to be sensitive to variables that will affect working with young children and their families.

Communicative ability conceptions among children who stutter and their fluent peers: a qualitative exploration

Meta issues in stuttering were examined by analyzing verbal-descriptive data drawn from structured interviews with 23 male children who stutter (CWS) and their 23 fluent male peers. Participants described others' "good" and "bad" talk behaviors and provided their self-appraisals as talkers. Analysis of interview transcripts suggested that CWS favored unidimensional criteria for describing others' talk behaviors, where others' speech-language forms, particularly allusions to stuttering behaviors, were noted most commonly in the descriptions. In contrast, children who did not stutter used multidimensional criteria to describe others' talk behaviors, where others' speech-language forms and pragmatic behaviors were weighted evenly, particularly for positive descriptions. Additionally, many CWS expressed reservations in describing themselves as "good talkers," whereas their fluent peers provided mainly positive appraisals of their own talking abilities. Outcomes provide evidence that early conceptions of communicative abilities among CWS are influenced by their stuttering experiences and diverge from early communicative ability conceptions among their fluent peers.

EDUCATIONAL OBJECTIVES

The reader will learn about and be able to; (1) recognize the relevance of examining communicative ability conceptions among children who stutter within the context of educational research on ability conceptions in children; (2) identify qualitative methods used to analyze interviews with participants; and (3) appreciate the role of personal experiences in shaping communicative ability conceptions among children who stutter.

Contributions of qualitative research to the knowledge base of normal communication

As clinical speech-language pathology moves toward a progressive use of qualitative research methodologies and applications for clinical purposes, it is helpful to know how the qualitative paradigm has influenced our field. This article reviews a number of studies from the social sciences and their impact on our knowledge of the properties of communication and the investigation of cognitive and language acquisition. This review indicates that qualitative research currently has a significant impact on our knowledge bases in clinical speech-language pathology.

Qualitative research and speech-language pathology: a tutorial for the clinical realm

As an analytic paradigm, qualitative research offers much to clinical speech-language pathology. This paradigm has a long history of use in the social sciences, and it is well suited to address the complex issues of speech, language, and communication. As an introduction to this forum on qualitative research, this article provides an operational definition of qualitative research, discusses the primary distinguishing traits of this research paradigm, and describes six viable traditions of inquiry for our application. Additionally, numerous qualitative studies within our field are considered, and five potential reasons for the increased use of qualitative research studies in our discipline are discussed.