Purpose Childhood apraxia of speech (CAS), a motor-based speech disorder, has been well studied in English contexts. However, there is a limited understanding of the applicability of its features to ...other languages. Thus, this study sought to determine the applicability of the features identified in the English CAS literature to Cantonese CAS. Method A two-round modified Delphi survey of experts was used to identify the clinical features of CAS in Cantonese speakers. Ten Cantonese-speaking qualified speech therapists were recruited as experts. In Round 1, the experts were asked an open-ended question about the clinical features of Cantonese CAS. In Round 2, the experts were asked to rate the importance of the proposed clinical features for making differential diagnoses of Cantonese CAS on a 5-point Likert scale ranging from 1 (
) to 5 (
). Results In Round 1, the expert panel identified 79 clinical features in nine domains. Sixty-two features (78.5%) were consistent with English CAS. Three English features were not identified in this study, while three features specifically related to Cantonese phonology were identified. In Round 2, 29 clinical features across six domains were found to meet the statistical criteria and were therefore regarded as important for making differential diagnoses of CAS among Cantonese speakers. Conclusions The results suggest that the clinical features identified in the English CAS literature are applicable to Cantonese CAS. The consistency of the findings implies that core and possible co-occurring features are shared between English and Cantonese CAS. The six features that were not common in both languages were discussed. Further investigation of CAS in and between different languages is recommended. This study is not the end point. Future studies can empirically examine the lexical tones or pitch variations to develop a possible objective measure for CAS.
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DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
ObjectivesTo describe the rehabilitation services available for communication disorders in Sri Lanka and to estimate the adequacy of the services in provinces and districts of the country.SettingThe ...study considered government and private institutions, which provide rehabilitation services for communication disorders in Sri Lanka.ParticipantsInstitutions providing services of speech–language pathologists, audiologists and audiology technicians in Sri Lanka.Primary and secondary outcome measuresWe investigated the number of government hospitals and private institutions, which provide speech–language pathology and audiology services in Sri Lanka as the primary outcome measure. A number of speech–language pathologists, audiologists and audiology technicians working in the institutions were obtained from records and institution-based inquiries to identify the adequacy of the services in the country as the secondary outcome measure.ResultsOf the 647 government hospitals that provide free healthcare services in the country, 45 and 33 hospitals had speech and language therapy and audiology units, respectively. Government hospitals do not have audiologists but only have audiology technicians. The number of speech and language therapists and audiology technicians in the government sector per 100 000 population in the country was 0.44 and 0.18, respectively. There were wide variations in specialist to population ratio between districts. 77 private centres provide speech therapy services in 15 out of the 25 districts; 36 private centres provide audiological evaluations in 9 districts.ConclusionsThe number of specialist speech and language therapists and audiologists is not sufficient to provide adequate rehabilitation services for communications disorder for the Sri Lankan population. Not recruiting audiologists to the government sector affects the management of hearing impairment in the affected.
The aim of this study was to better understand current grammatical intervention approaches. Despite grammatical language being a common weakness among children with language impairment, relatively ...little is known about current grammatical intervention practices of speech-language pathologists (SLPs). Such information is needed to guide the development and evaluation of grammatical interventions and to identify areas in which the current practice is not empirically supported.
Participants included 338 SLPs working primarily with children. Participants completed an online survey regarding their implementation of nine different grammatical intervention components, including goals, procedures, dosage, agents, contexts, goal attack strategies, service delivery models, activities, and outcome measurements. Participants also indicated how they would alter the intervention setting and dosage if resources were unlimited.
We grouped participants based on the ages of children that represent the largest percentage of their caseload resulting in an early education group (n = 114) and an elementary group (n = 224). We aggregated responses from each question to gain an estimate of current implementation practices associated with each intervention component queried.
This study provides general guidelines of current clinical practices to help guide research on grammatical interventions for children and to promote successful translation and implementations of evidence-based treatment approaches. Results may also help clinicians and researchers better understand misalignments between empirically supported intervention approaches and current approaches for treating grammatical weaknesses.
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DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
The purpose of this pilot study was to determine the impact of including peers with typically developing language (TDL) in language intervention sessions for preschool children with diagnosed ...developmental language disorder (DLD).
To measure peer effects, participants received 8 weeks of group language intervention in their neighborhood head start. Twenty children with DLD were randomly assigned to one of two conditions. Children in the experimental condition received language intervention with a peer with TDL; children in the control condition received language intervention with another peer with DLD. Pre- and posttest measures of language (semantics, syntax, morphology, and narrative) were collected. Teachers, speech-language pathologists, and assessors were blind to study condition.
All children in the study showed gains from pre- to posttest; there were no statistically significant differences between conditions. However, effect size estimates (Cohen's
) indicated that the children in the experimental condition showed an advantage over the control condition in syntax, morphology, and narrative.
This study provides preliminary evidence that children with DLD show increased gains in language when paired with peers with TDL. This finding supports previous research in educational literature, suggesting that children's development is influenced by the skills of their peers. Additional research is warranted to further explore and understand the role of peers for children with DLD.
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DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Purpose: In this clinical focus article, we discuss the nature of critical thinking, its importance for adolescents, and its interaction with later language development. We also introduce a language ...arts program, "Philosophy for Adolescents." The program aims to support critical thinking, narrative and expository discourse, and the use of complex syntax and literate vocabulary. Method: In designing "Philosophy for Adolescents," we examined research from education, psychology, philosophy, and speech-language pathology in the areas of critical thinking and narrative discourse. The resulting program encourages students to think independently, listen to others, offer reasons and evidence to support their views, and express themselves with accuracy, clarity, and efficiency. Implementation is illustrated with a case study of a 12-year-old girl. Results: Although critical thinking improves during adolescence, many students struggle in this area, particularly in the ability to offer reasons and evidence to support their views. This suggests that these adolescents could benefit from instruction in critical thinking. Research also indicates that competence in critical thinking is associated with narrative and expository discourse, and with the use of complex syntax and literate words such as metacognitive verbs. Instruction using "Philosophy for Adolescents" may be carried out in small groups or individually by a speech-language pathologist working collaboratively with a teacher, teaching assistant, or other professional. Designed for flexible application, the program may be used with adolescents who have language disorders and those who have typical language development. Conclusion: Research is necessary to evaluate the program with students from diverse backgrounds, having differing levels of language competence and academic achievement.
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DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
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.
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.
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.
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.
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DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
A user-centered design approach for eHealth interventions improves their effectiveness in stroke rehabilitation. Nevertheless, insight into requirements of end-users (patients/informal caregivers ...and/or health professionals) for eRehabilitation is lacking. The aim of this study was to identify end-user requirements for a comprehensive eHealth program in stroke rehabilitation.
Eight focus groups were conducted to identify user requirements; six with patients/informal caregivers and two with health professionals involved in stroke rehabilitation (rehabilitation physicians, physiotherapists, occupational therapists, psychologists, team coordinators, speech therapist). The focus groups were audiotaped and transcribed in full. Direct content analysis was used to identify the end-user requirements for stroke eHealth interventions concerning three categories: accessibility, usability and content.
In total, 45 requirements for the accessibility, usability and content of a stroke eRehabilitation program emerged from the focus groups. Most requirements concerned content (27 requirements), followed by usability (12 requirements) and accessibility (6 requirements). Patients/informal caregivers and health professionals each identified 37 requirements, respectively, with 29 of them overlapping.
Requirements between stroke patients/informal caregivers and health professionals differed on several aspects. Therefore, involving the perspectives of all end users in the design process of stroke eRehabilitation programs is needed to achieve a user-centered design.
The study was approved by the Medical Ethical Review Board of the Leiden University Medical Center P15.281.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Dialectal variations are present in all languages, originating from cultural, geographic and socioeconomic diversity. This study investigates speech-language pathologists' (SLPs) linguistic bias ...towards non-standard language forms and dialects, and factors that may impact on these attitudes. Language attitude studies reveal that negative attitudes towards variation can lead to bias against speakers of non-standard dialects. If SLPs hold linguistic bias towards speakers of non-standard dialects, this has the potential to impact upon their clinical judgement of difference vs. disorder and lead to inequality of service provision. A total of 129 Australian SLPs completed an online survey, which involved ranking 28 attitudinal statements regarding language variation on a 5-point scale from strongly disagree to strongly agree. The survey data were analysed using a factor analysis in SPSS to identify latent factors that identified attitudes towards non-standard dialects followed by inferential analyses to investigate how attitudes were related to the demographic data of participants. Results identified five key factors from the survey, these were (1) Use of non-standard English, (2) Language impurity, (3) Diversity in form, (4) Social acceptability, and (5) Prescriptive language rules. SLPs held generally positive attitudes towards the use of non-standard forms and the socially determined acceptability of language. SLPs were more neutral in their attitudes towards diversity in form and the need for prescriptive rules and generally held negative views towards language purity (e.g., the use of "youse" as a plural form of you). A significantly positive association was found between professional development (PD) on cultural and linguistic diversity and positive attitudes towards Factors 1 and 3. Years of practice were significantly related to Factor 2, with less experienced SLPs holding more negative views relating to language purity. While many SLPs identify the value of language variation and its reflection of a person's cultural and linguistic diversity, negative attitudes towards non-standard forms and variation in school and occupational settings have the potential to negatively impact differential diagnosis, goal setting and the delivery of culturally responsive speech-language pathology services to speakers of non-standard dialects.
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IJS, NUK, OILJ, UL, UM, UPUK, VSZLJ
Transcutaneous electrical stimulation (TES) was introduced as a modality for dysphagia rehabilitation more than a decade ago. The underlying premise of this modality is improving the structural ...movements and enhancing neural activation based on stimulation-induced muscle contractions. However, divisive evidence exists regarding the effectiveness of this treatment modality. This manuscript reviews current evidence regarding the effects of transcutaneous electrical stimulation (TES) on clinical and physiological aspects of swallowing function. Furthermore, this narrative review delineates the knowledge gap in this area and recommends future research roadmap. This review gives a comprehensive picture regarding current knowledge of TES to practicing speech and language pathologists and interested researchers. It highlights the need for more robust studies in this area. It also encourages researchers to focus more on the physiologic studies to understand the physiologic underpinning behind this treatment modality.
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FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UL, UM, UPUK
Purpose
The Viking Speech Scale is used to classify speech performance in children with cerebral palsy (CP). A Dutch‐language version (VSS‐NL) has recently become available. This study aimed to ...determine the reliability and validity of the VSS‐NL and the association with motor type of CP, Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS) and Communication Function Classification System (CFCS).
Methods
A total of 90 children with CP, recruited throughout the Netherlands, took part in the study. VSS‐NL classifications by speech and language therapists unfamiliar (SLT1) and familiar (SLT2) with the child, parents and physicians were compared. Convergent and discriminant validity were determined with the Intelligibility in Context Scale‐Dutch (ICS‐NL) and the Computer Based Instrument for Low Motor Language Testing (C‐BiLLT). Inter‐ and intrarater reliability were determined by weighted Kappa (ƙw). Validity and associations between VSS‐NL and GMFCS, MACS and CFCS were determined with Spearman's coefficient. Association between VSS‐NL and motor type of CP was determined with Fisher's exact test.
Results
Interrater reliability was excellent between SLT1‐SLT2 (ƙw = 0.93, 95% confidence interval CI 0.87–0.99), good between SLT1‐parent (ƙw = 0.71, 95% CI 0.60–0.83), SLT1‐physician (ƙw = 0.70, 95% CI 0.58–0.81), SLT2‐parent (ƙw = 0.71, 95% CI 0.57–0.84), SLT2‐physician (ƙw = 0.73, 95% CI 0.62–0.85) and parent‐physician (ƙ = 0.72, 95% CI 0.60–0.85). Intrarater reliability was excellent for SLTs familiar and unfamiliar to the child (ƙw = 1.00, 95% CI 1.00–1.00), and very good for physicians (ƙw = 0.89, 95% CI 0.75–1.00) and parents (ƙw = 0.72, 95% CI 0.62–1.00).
Convergent validity was very strong (r = −0.81, p < 0.001) and discriminant validity moderate (r = −0.56, p < 0.001). Association with motor type of CP was significant (χ2 = 27.558, p < 0.001) and strong with GMFCS (r = 0.62, p < 0.001), MACS (r = 0.63, p < 0.01) and CFCS (r = 0.69, p < 0.001).
Conclusion
The VSS‐NL is a reliable and valid system to classify speech performance in children with cerebral palsy. Classifications can be performed by SLTs, parents and physicians.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
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