TBI knowledge and pragmatic assessment among Connecticut school speech-language pathologists

Traumatic brain injury in the acute care setting: assessment and management practices of speech-language pathologists

PRIMARY OBJECTIVE

To characterize current knowledge, beliefs, confidence, and practice patterns of acute care speech-language pathologists (SLPs) in assessing and managing cognitive-communication disorders following traumatic brain injury (TBI).

RESEARCH DESIGN

We developed an online survey to learn more about current TBI knowledge and practice patterns of acute care SLPs, with the goal of establishing a baseline upon which changes in SLP training and practice standards may be measured.

METHODS AND PROCEDURES

We distributed the survey to 1800 SLPs in 18 states via postal mail, in addition to posting it to relevant online groups. One hundred and eighty-two practicing acute care SLPs responded to the survey.

MAIN OUTCOMES AND RESULTS

Respondents were highly variable in their training and knowledge about TBI, their beliefs about cognitive-communication rehabilitation, and their practice patterns in assessing, managing, and communicating about TBI during the acute stage of injury.

CONCLUSIONS

These results highlight the need for more consistent training about cognitive-communication deficits during and after graduate school, as well as the development of sensitive, specific, and standardized assessment tools, education protocols, and shared language for describing patients with TBI along the continuum of care.

Stuttering Practice Self-Assessment by School Speech-Language Practitioners

Purpose The purpose of this study was to survey school speech-language practitioners' self-perceptions of their confidence, knowledge, and need for support for working with school-age students who stutter (SWS). Method A total of 120 school-based speech-language practitioners from 27 Nashville, Tennessee, area counties completed an online, 35-item survey examining caseloads, coursework, continuing education, experience, and perceived levels of skill and confidence in service provision to SWS. They also rated their need for consultation from speech-language pathologists who specialize in stuttering to improve their skills with SWS. Results Respondents were least confident in and needed most support for providing intervention to SWS. Those who needed most support for intervention rated themselves as less knowledgeable about stuttering theory, assessment, and intervention and were less confident about working with students who only stutter and with SWS who have concomitant communication concerns. Greater practitioner confidence in stuttering intervention skills was positively correlated with the number of SWS on caseloads; continuing education credits in stuttering; and knowledge of stuttering theory, assessment, and intervention. Respondents who completed a graduate course on stuttering had greater confidence in stuttering intervention and were less likely to identify a need for support from specialists. Conclusions School speech-language practitioners continue to report needing additional education, practice opportunities, and support, especially with intervention, and desiring specialized guidance to serve SWS. Those with more experience, education, and knowledge about stuttering are more confident and skillful, reflecting the potential positive impact of increased opportunities to learn about and work with SWS. These needs may be addressed through increased availability of specialists in stuttering to consult with school practitioners; opportunities for school-based practitioners to become peer mentors; and provision of readily available, intervention-focused continuing education experiences and resources.

Factors Influencing Choices of Contextualized Versus Traditional Practices With Children and Adolescents Who Have Traumatic Brain Injury

PURPOSE

This preliminary investigation examined speech-language pathologists' (SLPs') use of contextualized practices (i.e., functional, personally relevant, nonhierarchical, and collaborative) compared with traditional practices (i.e., clinical, generic, hierarchical, and expert driven) with school-age children and adolescents with traumatic brain injury (TBI).

METHODS

An electronic survey asked SLPs about their use of clinical activities described as more or less contextualized. Research questions focused on frequency of using contextualized practices and factors associated with their use or nonuse.

RESULTS

Seventy responses met criteria for analysis; 98% of these participants reported using at least 1 contextualized practice. Higher use of contextualized practices was associated with working in schools compared to health care settings, access to experts, and greater experience with TBI. Most frequently cited reasons for not using contextualized practices included not fitting the student and scheduling issues.

CONCLUSIONS

Factors associated with using contextualized practices suggest that access to experts and experience with TBI are critical components for facilitating contextualized practice recommendations. Reasons for not using certain contextualized practices highlight the need to address scheduling issues and to increase education about practices that may best meet the unique needs of students with TBI.

Voice Disorder Management Competencies: A Survey of School-Based Speech-Language Pathologists in Nebraska

Purpose

The purpose of this survey was to determine the self-perceived competence levels in voice disorders of practicing school-based speech-language pathologists (SLPs) and identify correlated variables.

Method

Participants were 153 master's level, school-based SLPs with a Nebraska teaching certificate and/or licensure who completed a survey, including demographic information and a 25-item voice disorders competency checklist.

Results

Findings indicated school-based SLPs did not feel particularly competent in their ability to assess and treat students with voice disorders. Only 1 response mean was higher than a “moderately competent” level. All other item means were at or below this level. Four correlations indicated positive associations with SLPs' overall self-perceived competence levels: number of continuing education activities related to voice disorders, number of clients with voice disorders in the last 3 months, percentage of time spent with clients who have voice disorders, and feelings of preparation in the area of voice disorders immediately after academic program completion. Informal comparisons to medically based SLP respondents ( n = 22) were included.

Conclusion

School-based SLPs' competence perceptions with voice disorders are consistent with the minimal levels of competence reported for other underserved or low-incidence populations. Pursuing continuing education in voice disorders is recommended at the same time as access to the population becomes available.

Assessment practices of speech-language pathologists for cognitive communication disorders following traumatic brain injury in adults: an international survey

PRIMARY OBJECTIVE

This study's objective was to examine the current assessment practices of SLPs working with adults with acquired cognitive communication impairments following a TBI.

METHODS AND PROCEDURES

Two hundred and sixty-five SLPs from the UK, the US, Canada, Australia and New Zealand responded to the online survey stating the areas of communication frequently assessed and the assessment tools they use.

MAIN OUTCOMES AND RESULTS

SLPs reported that they routinely assessed functional communication (78.8%), whereas domains such as discourse were routinely assessed by less than half of the group (44.3%). Clinicians used aphasia and cognitive communication/high level language tools and tools assessing functional performance, discourse, pragmatic skills or informal assessments were used by less than 10% of the group. The country and setting of service delivery influenced choice of assessment tools used in clinical practice.

CONCLUSIONS

These findings have implications for training of SLPs in a more diverse range of assessment tools for this clinical group. The findings raise questions regarding the statistical validity and reliability of assessments currently used in clinical practice. It highlights the need for further research into how SLPs can be supported in translating current evidence about the use of assessment tools into clinical practice.