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Kotsis K, Boukouvala M, Tzotzi A, Koullourou I, Mitropoulou A, Serdari A, Siafaka V, Hyphantis T. Health-Related Quality of Life and Behavioral Difficulties in Greek Preschool Children with Developmental Language Disorder. Healthcare (Basel) 2024; 12:470. [PMID: 38391845 PMCID: PMC10888439 DOI: 10.3390/healthcare12040470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 02/24/2024] Open
Abstract
Developmental language disorder (DLD) has a great impact on language skills as well as on a wide range of functioning areas, such as social and school functioning. In the present study, we aim to explore the Health-Related Quality of Life (HRQoL) of preschool children with DLD, compared to children with no language difficulties, using a self and proxy report method. A total of 230 parents of preschool children with DLD and 146 parents of children without language difficulties completed the Pediatric Quality of Life Inventory (PedsQLTM) 4.0 Generic Core Module and the Strengths and Difficulties Questionnaire (SDQ). Additionally, 71 children with DLD and 55 peers without DLD completed the self-reported PedsQLTM module. The parents of kindergarten children (5-6 years old) with DLD reported that their kids experience worse social and school functioning compared to the control group. In addition, the children with DLD self-reported lower physical and social functioning. The parents of children with DLD reported that their children experience higher hyperactivity/inattention problems than the parents of the control group. Kindergarten children with DLD have a poorer HRQoL compared to their peers, as perceived by themselves and their parents. Moreover, children with DLD present with higher hyperactivity and inattention symptoms. Health professionals working with children who have DLD need to consider not only the language difficulties but also the children's wellbeing and symptoms of hyperactivity and inattention.
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Affiliation(s)
- Konstantinos Kotsis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45 110 Ioannina, Greece
| | - Maria Boukouvala
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45 110 Ioannina, Greece
| | - Alexandra Tzotzi
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45 110 Ioannina, Greece
| | - Iouliani Koullourou
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45 110 Ioannina, Greece
| | - Andromachi Mitropoulou
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45 110 Ioannina, Greece
| | - Aspasia Serdari
- Department of Child and Adolescent Psychiatry, Medical School, Democritus University of Thrace, 68 100 Alexandroupolis, Greece
| | - Vassiliki Siafaka
- Department of Speech & Language Therapy, School of Health Sciences, University of Ioannina, 45 500 Ioannina, Greece
| | - Thomas Hyphantis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45 110 Ioannina, Greece
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Sherman V, Glista D, Cunningham BJ. Engaging clinical end users in the development of an outcome measurement protocol for paediatric communicative health systems. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:821-829. [PMID: 36444943 DOI: 10.1080/17549507.2022.2148741] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE To develop a conceptual framework of the factors likely to influence clinicians' use of a new participation-focused outcome measurement protocol in a large paediatric speech-language pathology program. METHOD A convenience sample of 27 end users (clinicians, managers) were recruited from Ontario, Canada's Preschool Speech and Language Program. Participants engaged in one virtual concept mapping session in groups of five to six during which they learned about the new protocol, and generated statements in response to a prompt asking them to identify factors that would influence their use of the protocol. Following all sessions, participants asynchronously sorted and rated all statements, and data were analysed using multidimensional scaling and hierarchical cluster analyses. RESULT Six themes were identified: (1) response from families; (2) use of resources; (3) feasibility and clinical utility; (4) relevance and value-added for clinicians; (5) streamlining policies and guidelines; and (6) delivery, administration, and modification of tool. Response from families, feasibility and clinical utility, and use of resources received the highest importance ratings. CONCLUSION Concept mapping methodology was used to engage clinicians and managers to identify the barriers to a new implementation protocol for outcome measurement. Results will support future research and implementation efforts.
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Affiliation(s)
- Victoria Sherman
- School of Communication Sciences and Disorders, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Danielle Glista
- School of Communication Sciences and Disorders, Faculty of Health Sciences, Western University, London, Ontario, Canada
- The National Centre for Audiology, Western University, London, Ontario, Canada
| | - Barbara J Cunningham
- School of Communication Sciences and Disorders, Faculty of Health Sciences, Western University, London, Ontario, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
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Singer I, de Wit E, Gorter JW, Luinge M, Gerrits E. A systematic scoping review on contextual factors associated with communicative participation among children with developmental language disorder. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:482-515. [PMID: 36239148 DOI: 10.1111/1460-6984.12787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/12/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Variations in communicative participation of children with developmental language disorder (DLD) cannot be wholly explained by their language difficulties alone and may be influenced by contextual factors. Contextual factors may support or hinder communicative participation in children, which makes their identification clinically relevant. AIMS To investigate which contextual (environmental and personal) factors in early childhood are protective, risk or neutral factors for communicative participation among school-aged children with DLD, and to identify possible gaps in knowledge about this subject. METHODS & PROCEDURES A scoping review was conducted based on a systematic search of studies published from January 2007 to March 2022 in Pubmed, Embase (without MEDLINE), CINAHL and PsycINFO. In total, 8802 studies were reviewed using predefined eligibility criteria, of which 32 studies were included for data extraction and critically appraised using the Critical Appraisal Skills Programme (2021) tools. MAIN CONTRIBUTION The methodological quality of included studies was adequate to strong. Personal protective factors identified are being a preschool girl, reaching school age and being prosocial, while personal risk factors are becoming a teenager or adolescent, having low socio-cognitive skills and experiencing comorbid mobility impairment or behavioural problems. Gender after the preschool years and non-verbal abilities were not found to be of influence, and the role of socio-emotional skills is inconclusive. Receiving therapy is an environmental protective factor, while the association between socio-economical family characteristics with communicative participation is inconclusive. CONCLUSIONS & IMPLICATIONS Limited research has been conducted on which risk and protective factors present in early childhood are associated with later communicative participation of children with DLD. The influence of co-occurring health conditions, social background variables, individual psychological assets, interpersonal relationships and attitudes of other people represent knowledge gaps. In addition, knowledge about the comparative effectiveness of different types of interventions and service delivery models, and the impact of administrative control, organizational mechanisms and standards established by governments on children's communicative participation is lacking. More longitudinal research is needed focusing on the identification of relevant personal and environmental factors and the interactions between them in relation to communicative participation outcomes. WHAT THIS PAPER ADDS What is already known on this subject Children with DLD experience varying degrees of communicative participation restrictions. Insight into contextual factors that influence communicative participation can help to identify children at risk and inform family and child-centred therapy. Systematic research on contextual factors that facilitate or hinder communicative participation in children with DLD is currently lacking. What this paper adds to existing knowledge Knowledge of protective factors can guide the development of interventions for children and young people with DLD that boost resilience and facilitate communicative participation, while insight into the risk factors can help professionals identify the most vulnerable children and develop interventions that can lift or neutralize barriers present in the life of these children. Specific groups potentially at risk are young boys, children with co-morbid mobility impairment, children with conduct problems, and children reaching adolescence. In contrast, potentially protective factors are reaching school age and being prosocial. In addition, the development of socio-cognitive skills may be beneficial for the communicative participation of children with DLD. What are the potential or actual clinical implications of this work? To support communicative participation, it is important that professionals who work with children with DLD understand which groups are at risk for communicative participation restrictions, and which factors can foster resilience. In the absence of evidence-based instruments for the systematic assessment of personal and environmental factors, consulting parents and children on the contextual factors that they perceive as important remains critical.
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Affiliation(s)
- Ingrid Singer
- Research group Speech and Language Therapy, HU University of Applied Sciences Utrecht, the Netherlands
- Utrecht University, Utrecht, the Netherlands
| | - Ellen de Wit
- Hanze University of Applied Sciences Groningen, Groningen, the Netherlands
| | | | - Margreet Luinge
- Hanze University of Applied Sciences Groningen, Groningen, the Netherlands
| | - Ellen Gerrits
- Research group Speech and Language Therapy, HU University of Applied Sciences Utrecht, the Netherlands
- Utrecht University, Utrecht, the Netherlands
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Cunningham BJ, Cermak C, Head J, Oram Cardy J. Clinical feasibility, utility, and usability of the Profile of Preschool Communication: A pilot test in community settings. JOURNAL OF COMMUNICATION DISORDERS 2022; 98:106232. [PMID: 35689872 DOI: 10.1016/j.jcomdis.2022.106232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 04/20/2022] [Accepted: 06/03/2022] [Indexed: 06/15/2023]
Abstract
AIM . This study aimed to pilot test, assess usability and utility of, and identify barriers to implementation for the Profile of Preschool Communication (PPC) - a new data collection tool designed to support outcome monitoring in preschool speech-language programs and practice-based research. METHODS . This pilot study was conducted with three sites in the Ontario Preschool Speech and Language (PSL) program. Twenty-three speech-language pathologists used the PPC for all outcome monitoring assessments for 2-3-months and provided feedback about their experience using it in practice. Then, 18 of the 23 speech-language pathologists completed online surveys to rate usability and utility, and report their perceived implementation barriers and facilitators. RESULTS . Speech-language pathologists reported difficulties completing some sections of the PPC, most notably obtaining data related to maternal education and family history of mental health concerns. Usability and utility were generally rated favorably with some items rated as neutral. Barriers to implementation included the paper format, completion time, requirement to ask personal questions, and the perception by some that data were useful for outcome monitoring but not practice. Facilitators included ease of use, an improvement over the existing tool, and the collection of data to support service planning. CONCLUSIONS . The PPC shows potential as an outcome monitoring data collection tool in preschool speech-language pathology programs. Findings will be of interest to researchers engaged in practice-based research and those interested in engaging end users to develop clinically meaningful tools.
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Affiliation(s)
- Barbara Jane Cunningham
- School of Communication Sciences and Disorders, Western University, Elborn College, 1201 Western Road, London, ON, N6G 1H1, Canada; CanChild Centre for Childhood Disability Research, McMaster University, Hamilton ON, L8S1C7, Canada.
| | - Carly Cermak
- School of Communication Sciences and Disorders, Western University, Elborn College, 1201 Western Road, London, ON, N6G 1H1, Canada
| | - Julianna Head
- School of Health Studies, Western University, 1151 Richmond Street, London, ON, N6A 3K7, Canada
| | - Janis Oram Cardy
- School of Communication Sciences and Disorders, Western University, Elborn College, 1201 Western Road, London, ON, N6G 1H1, Canada
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Kwok EY, Moodie ST, Cunningham BJ, Oram Cardy J. Barriers and Facilitators to Implementation of a Preschool Outcome Measure: An Interview Study with Speech-Language Pathologists. JOURNAL OF COMMUNICATION DISORDERS 2022; 95:106166. [PMID: 34875453 DOI: 10.1016/j.jcomdis.2021.106166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 09/24/2021] [Accepted: 11/03/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION The Preschool Speech and Language Program in Ontario, Canada implemented the Focus on the Outcomes of Communication Under Six (FOCUS), an outcome measure, in 2012. This study aimed to investigate commonly experienced facilitators of and barriers to implementing the FOCUS in clinical practice from the perspectives of speech-language pathologists (SLPs). METHODS Thirty-seven SLPs participated in semi-structured interviews to share their experiences adopting the FOCUS in clinical practice. A deductive content analysis of interview transcripts was conducted using the Theoretical Domains Framework (TDF), followed by an inductive analysis to identify sub-themes within each domain. RESULTS SLPs frequently encountered barriers within three TDF domains: Environmental Context and Resources (e.g., difficulties integrating the FOCUS into assessment sessions and intervention schedules), Beliefs about Consequences (e.g., beliefs that data collected using the FOCUS lack relevance to clinical practice), and Social Influences (e.g., administration of the FOCUS harmed rapport with families). Commonly reported facilitators were found in the Behavioural Regulation (e.g., reminder system) and Environmental Context and Resources (e.g., availability of administrative personnel and technology support) domains. CONCLUSIONS SLPs identified barriers and facilitators to implementing an evidence-based outcome measure into practice. Insights drawn from SLPs' perspectives will support the design of new methods to improve the implementation of functional outcome measurement tools within programs.
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Affiliation(s)
- Elaine Yl Kwok
- Department of Pediatrics, McMaster University; CanChild Centre for Childhood Disability Research, McMaster University.
| | - Sheila Tf Moodie
- National Centre for Audiology, Faculty of Health Sciences, Western University
| | - Barbara Jane Cunningham
- CanChild Centre for Childhood Disability Research, McMaster University; School of Communication Sciences and Disorders, Western University
| | - Janis Oram Cardy
- National Centre for Audiology, Faculty of Health Sciences, Western University; School of Communication Sciences and Disorders, Western University
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Cunningham BJ, Oram Cardy J. Reliability of Speech-Language Pathologists' Categorizations of Preschoolers' Communication Impairments in Practice. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:734-739. [PMID: 33524271 DOI: 10.1044/2020_ajslp-20-00239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose An efficient and reliable way to categorize children's communication impairments based on routine clinical assessments is needed to inform research and clinical decisions. This preliminary study assessed interrater reliability of speech-language pathologists' categorization of preschoolers' speech, language, and communication impairments using a clinical consensus document. Method Six speech-language pathologists at three community sites worked in pairs to assess 38 children aged 1-5 years, then used the clinical consensus document to categorize children's communication impairments broadly. Identified language and speech sound impairments were further subcategorized. Results Speech-language pathologists had substantial to almost perfect agreement for three broadly focused impairment categories. Agreement for whether language difficulties/disorders were developmental or associated with a biomedical condition was almost perfect, but moderate for whether difficulties impacted receptive or expressive language, or social communication skills. Agreement was fair for rule-based speech delays/disorders, but low for motor-based and mixed speech impairments. Conclusions Results support use of the clinical consensus document to collect data for reliable categories. Additional work is needed to confirm reliability for some broadly focused impairment categories and for subcategorization of speech impairments.
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Affiliation(s)
- Barbara Jane Cunningham
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Janis Oram Cardy
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
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Cunningham BJ, Thomas-Stonell N, Rosenbaum P. Assessing communicative participation in preschool children with the Focus on the Outcomes of Communication Under Six: a scoping review. Dev Med Child Neurol 2021; 63:47-53. [PMID: 32909263 DOI: 10.1111/dmcn.14665] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/30/2020] [Indexed: 12/12/2022]
Abstract
AIM To describe uses of the Focus on the Outcomes of Communication Under Six (FOCUS) in research with children with and without various communication disorders since its publication in 2010. METHOD Six databases were searched for the term 'Focus on the Outcomes of Communication Under Six'. With additional searches we ascertained 70 articles, of which 25 met inclusion criteria for full review and data extraction. RESULTS The FOCUS has been used in research across multiple countries, purposes, populations, contexts, and versions. Evaluative studies have described: the development of children's communicative participation skills and factors that impact the development of communicative participation; the impact of specific interventions on communicative participation; how FOCUS captures change relative to measures of impairment; and how FOCUS performs when used at different intervals. Adaptations have included: use of the FOCUS as a descriptive or discriminative tool; use with children outside the validated age range; use of select items; and use with typically developing children. INTERPRETATION The FOCUS is used worldwide in research and practice, and much has been learned about children's communicative participation. Future research is needed to explore the relationship between children's impairments and their communicative participation, develop a FOCUS App, and develop and validate a FOCUS for school-age children.
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Affiliation(s)
- Barbara Jane Cunningham
- School of Communication Sciences and Disorders, Western University, Elborn College, London, Ontario, Canada.,CanChild, McMaster University, Hamilton, Ontario, Canada
| | | | - Peter Rosenbaum
- CanChild, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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Kwok EYL, Moodie STF, Cunningham BJ, Oram Cardy JE. Selecting and tailoring implementation interventions: a concept mapping approach. BMC Health Serv Res 2020; 20:385. [PMID: 32375752 PMCID: PMC7203846 DOI: 10.1186/s12913-020-05270-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 04/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To improve the uptake of research into practice, knowledge translation frameworks recommend tailoring implementation strategies to address practice barriers. This study reports our experience pairing the Theoretical Domains Framework with information from multiple stakeholder groups to co-develop practice-informed strategies for improving the implementation of an evidence-based outcome measurement tool across a large community health system for preschoolers with communication impairments. METHODS Concept mapping was used to identify strategies for improving implementation of the Focus on the Outcomes of Communication Under Six (FOCUS) in Ontario Canada's Preschool Speech and Language Program. This work was done in five stages. First, we interviewed 37 speech-language pathologists (clinicians) who identified 90 unique strategies to resolve practice barriers to FOCUS implementation. Second, clinicians (n = 34), policy-makers (n = 3), and members of the FOCUS research team (n = 6) sorted and rated the strategies by importance and feasibility. Third, stakeholders' sorting data were analyzed to generate a two-dimensional concept map. Based on the rating data from stakeholders, we prioritized a list of strategies that were rated as highly important and highly feasible, and summarized the practice barriers addressed by each of the prioritized strategies. Fourth, we validated these findings with stakeholders via an online survey. Fifth, the mechanisms of action of the prioritized list of strategies were considered based on available evidence from the Theoretical Domains Framework and associated behavior change literature. RESULTS Stakeholders categorized the 90 unique implementation strategies into a six-cluster concept map. Based on stakeholders' ratings, a list of 14 implementation strategies were prioritized. These implementation strategies were reported to resolve barriers within the environmental context and resources and beliefs about consequences domains of the Theoretical Domains Framework. All but one of the prioritized strategies have a demonstrated link in resolving existing barriers according to the behavioral change literature. CONCLUSIONS Our study contributes to a growing literature that demonstrates the process of tailoring implementation strategies to specific barriers. Practical drawbacks and benefits of using concept mapping as a way to engage stakeholders in implementation research are discussed.
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Affiliation(s)
- Elaine Yuen Ling Kwok
- School of Communication Sciences and Disorders, University of Western Ontario, Elborn College, 1201 Western Road, London, Ontario N6G 1H1 Canada
| | - Sheila T. F. Moodie
- School of Communication Sciences and Disorders, Western University and The National Centre for Audiology, Western University, Elborn College, RM 2262K, 1201 Western Road, London, Ontario N6G 1H1 Canada
| | - Barbara Jane Cunningham
- School of Communication Sciences and Disorders, University of Western Ontario, Elborn College, 1201 Western Road, London, Ontario N6G 1H1 Canada
| | - Janis E. Oram Cardy
- School of Communication Sciences and Disorders, University of Western Ontario, Elborn College, 1201 Western Road, London, Ontario N6G 1H1 Canada
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Piazzalunga S, Salerni N, Limarzi S, Ticozzell B, Schindler A. Assessment of children's communicative participation: a preliminary study on the validity and reliability of the Italian Focus on the Outcomes of Communication Under Six (FOCUS-I) in preschool age. SPEECH LANGUAGE AND HEARING 2020. [DOI: 10.1080/2050571x.2020.1738037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Silvia Piazzalunga
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
- Department of Psychology, University of Milan-Bicocca, Milan, Italy
| | | | - Sofia Limarzi
- Scientific Institute IRCCS “E. Medea”, Bosisio Parini, Italy
| | - Benedetta Ticozzell
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
| | - Antonio Schindler
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
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Cunningham BJ, Kwok E, Turkstra L, Oram Cardy J. Establishing consensus among community clinicians on how to categorize and define preschoolers' speech and language impairments at assessment. JOURNAL OF COMMUNICATION DISORDERS 2019; 82:105925. [PMID: 31434024 DOI: 10.1016/j.jcomdis.2019.105925] [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: 12/11/2018] [Revised: 07/30/2019] [Accepted: 07/31/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE To achieve consensus amongst speech-language pathologists (SLPs) on the categories and definitions of preschoolers' communication impairments. METHODS In Phase 1, impairments were identified, categorized, and defined based on an evidence review. In Phase 2, a four-round Modified Delphi study was completed with SLPs (N = 38). SLPs reviewed three documents that categorized and defined preschoolers': (1) broadly focused impairments, (2) language disorder sub-categories, and (3) speech sound disorder sub-categories; rated whether categories captured all preschoolers with communication impairments and definitions were clear (consensus = 90% agreement across all documents); and made suggestions for improvement. Documents were revised between rounds based on SLPs' responses, literature review, and consultation with experts. RESULTS In Round 1, 90% agreement was reached only for the language disorder sub-categories document. In Round 2, no consensus was reached for the Speech Sound Disorder sub-categories document. In Round 3, consensus was reached for all three documents, but a fourth round was run to incorporate newly updated terminology. In Round 4, consensus was reached for updated terminology presented in the language disorders document. CONCLUSIONS Clinical and research expertise are integrated throughout the final documents, resulting in consensus terminology for preschoolers' communication impairments. Findings can support consistent terminology for preschoolers with communication impairments amongst SLPs. In research, documents will be used in a developing data collection tool that will undergo reliability testing prior to use in large scale studies related to children's communication. This study demonstrates the value of engaging in practice-based research.
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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.
| | - Elaine- Kwok
- School of Communication Sciences and Disorders, Western University, Elborn College, Room 2516, 1201 Western Road, London, ON, N6G 1H1, Canada
| | - Lyn Turkstra
- School of Rebabilitation Sciences, McMaster University, Institute of Applied Health Sciences Building, Room 403, 1400 Main Street West, Hamilton, ON, L8S 1C7, 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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