International Journal of Speech-Language Pathology最新文献

Purpose: The quantity and quality of maternal interactive behaviours during shared reading were compared for mothers from China and mothers from the US.

Method: Ten Chinese mothers from Fuzhou City in Fujian Province, China and 10 mothers from four US states video-recorded themselves reading two storybooks, one selected by the families and one by investigators, to their typically developing 4-year-olds. Videotapes were transcribed in Mandarin and English, respectively, and analysed using investigator-developed codes.

Result: Chinese mothers had a higher percentage of extra-textual talk than US mothers and attention to print (i.e. English letters or Chinese characters) was uncommon among mothers in both groups. Chinese mothers had more frequent use of question prompts, acknowledgements, extensions, and explanations compared to US mothers. Only Chinese mothers elaborated on the moral of the story.

Conclusion: Chinese mothers' frequent use of a question-give-answer pattern was consistent with Chinese culture which prioritises assertiveness and education. Generalisation would require an investigation of within-culture variation as well as an increased sample size. Understanding shared reading as a culturally valid context can support emerging speech-language services in China.

Purpose: Virtual reality offers a wide range of possible healthcare applications thanks to the realistic simulation of any environment. Employing a user-centered design, this study evaluates a prototype application that is intended to help bridge the gap between the settings of voice therapy and vocally stressful everyday situations. The study aims to evaluate the applicability and benefits of a fully immersive virtual reality application in voice therapy from a user perspective and to identify future development directions.

Method: Semi-structured interviews were conducted in which seven voice speech-language pathologists (therapists) and 13 voice patients shared their experiences with the virtual reality application during a practical trial phase. The qualitative data were evaluated using content analysis to gain a comprehensive understanding of user experiences and views.

Result: Three main potentials for the use of the application in voice therapy were identified: a) Implementation and consolidation of voice-relevant behaviours in a controlled and realistic environment, b) identification of individual treatment goals by observing patients in realistic situations, and c) simplified possibility of using biofeedback to support therapy.

Conclusion: Important development needs were identified for the application prototype used. Overall, the results indicate that fully immersive virtual reality systems are a promising tool in voice therapy.

Purpose: Evidence suggests that people with minor stroke can experience multiple post-stroke impairments. This study explored the communication skills of people with minor stroke one week and three months post-stroke.

Method: A longitudinal cohort mixed method design was used. Participants completed the Western Aphasia Battery-Revised, Boston Naming Test, La Trobe Communication Questionnaire-Self, Montreal Cognitive Assessment, and the Hospital and Anxiety Depression Scale, along with semi-structured interviews and conversation samples 1 week and 3 months post-stroke.

Result: Fourteen participants were recruited. Five experienced aphasia according to Western Aphasia Battery-Revised scores at one week. Boston Naming Test scores improved significantly between one week and three months (p = .020). There were no significant changes in Western Aphasia Battery-Revised, La Trobe Communication Questionnaire-Self, Montreal Cognitive Assessment, or Hospital and Anxiety Depression Scale scores between one week and three months (all p > .05). Word finding difficulties were noted in most participants' conversation samples, but rarely led to conversation breakdowns. Qualitative content analysis revealed eight categories, including communication changes and their impact, the impact of other post-stroke impairments, strategies used, and services received.

Conclusion: This study provides further evidence that a subset of people with minor stroke experience post-stroke communication changes. Future research should explore the optimal speech-language pathology support for this potentially under-serviced patient cohort.

Purpose: Functional dysphagia is complex, affecting physical health as well as wellbeing. In this expert opinion paper with associated exemplar case series, we propose a framework for understanding functional dysphagia.

Method: A literature review of approaches to understanding and treating functional dysphagia are presented, moving beyond the predominant medical model to encompass psychosocial aspects of the condition. An exemplar case series of six clients is then given. Learnings from fields of laryngology and cognitive and applied behavioural psychology are discussed; and a biopsychosocial framework for assessment and therapy are proposed.

Result: Client presentations can be vastly different yet, for many, relatively quick return to normal eating can be achieved with targeted therapy. Using a biopsychosocial framework allows comprehensive assessment and targeted interventions.

Conclusion: We should consider a broader biopsychosocial framework in dysphagia practice so that those with functional dysphagia no longer go through a process of diagnosis through exclusion. While large scale randomised efficacy trials do not exist-and may not be feasible or useful-clinicians can learn from associated fields of laryngology and psychology, and confidently develop therapy programmes for their clients. The biopsychosocial framework developed in this paper provides guidance to clinicians working in this field.

Purpose: The recovery model underlying mental health services emphasises the importance of the voice of the adolescent client in identifying needs, goals, and negotiating intervention. This study aimed to characterise speech-language pathologists' (SLPs) knowledge, attitude, and practice in relation to communication assessment of adolescents, focusing on adolescents with mental health concerns and the use of discourse sampling and analysis.

Method: An online survey using a Knowledge, Attitude, Practice framework gathered data from 43 English-speaking SLPs. SLPs responded, using a five-point Likert scale, to closed statements regarding perceived knowledge, attitude, and practice in approaches to communication assessment. Survey items relating to discourse sampling and analysis were aggregated into subscales and six statements related to assessment of adolescents with mental health concerns. A final, open-ended question invited comments on changing clinical practice.

Result: A strong positive correlation was found between knowledge and practice; with a weak, positive correlation between knowledge and attitude.

Conclusion: SLPs are aware of the benefits of a comprehensive communication assessment. However, greater knowledge and experience is needed to incorporate more formalised approaches into clinical practice, especially as it relates to social and emotional outcomes. Participants' comments suggest that professional learning communities may be helpful in delivering this outcome.

Purpose: The impact of known barriers and facilitators to culturally responsive practice in paediatric speech-language pathology services across different social, linguistic, and educational contexts is not well understood. An innovative data visualisation method was used to determine which barriers and facilitators most impacted different professional activities as reported by speech-language pathologists practising in Australia and Hong Kong.

Method: A total of 111 speech-language pathologists in Australia and 76 in Hong Kong completed a survey with questions related to barriers and facilitators when working with families from diverse multilingual backgrounds. Descriptive statistics and correspondence analysis were used to explore relationships between professional activities and the barriers and facilitators in both contexts.

Result: Correspondence analysis revealed that barriers impacted the two contexts more distinctively than the facilitators. Two activities most strongly impacted by barriers in both contexts included engagement in management and communication. Regarding facilitators, speech-language pathologists in both contexts indicated that cultural awareness most facilitated the development of rapport and knowledge of language most facilitated diagnosis.

Conclusion: The impact of barriers was more varied between contexts which may be due to the different health and educational contexts that speech-language pathologists work in. In contrast, facilitative factors may be more robust and stable across these two cultural contexts.

Purpose: Interpretive description is a constructivist, flexible, qualitative research approach used to generate knowledge to inform practice in applied disciplines. Despite potential value for the speech-language pathology profession, there has been limited discussion of interpretive description in our field to date. The purpose of this scoping review was to describe how interpretive description has been used in speech-language pathology research. We asked: a) How and to what extent has interpretive description been used as a methodological framework for primary research in the field of SLP and b) what features of interpretive description are most salient in the speech-language pathology studies that have used interpretive description to date?

Method: Arksey and O'Malley's (2005) methodological framework for scoping reviews was used. In May 2023, we searched five databases for peer-reviewed, primary research publications that reported using ID, were specific to speech-language pathology, and were written in English. Two researchers independently reviewed articles for inclusion. A third researcher provided input when consensus could not be reached.

Result: Nineteen articles met criteria. Data were extracted regarding article characteristics including use of theory, types of findings, clinical applicability, and description of disciplinary epistemology.

Conclusion: Interpretive description is an emerging methodological framework in speech-language pathology research. Advantages and challenges of interpretive description for speech-language pathology are discussed.

Purpose: Although up to 89% of autistic children experience feeding difficulties, little is known about the impact of these difficulties on mealtime participation. The aim of this study was to explore the impact of feeding difficulties on the mealtime participation of autistic children and their families based on caregiver experiences.

Method: Participants were 78 caregivers who completed online surveys for 80 children (5-12 years) with a formal diagnosis of Autism Spectrum Disorder (ASD). The online survey contained eight open-ended questions exploring how children participated in mealtimes at home, in the community, at celebrations, on holidays, and at school; as well as exploring cultural influences on mealtimes.

Result: Using thematic analysis, three themes were identified: 1) Participation at home, emphasised the individualised nature of experiences and impacts for children and families, while 2) participation in the community, highlighted the range of contexts in which children and families experience challenges. 3) Influence and experience, accounted for cultural and social factors that mediated the child and family's impacts and experience, including a lack of understanding in the community.

Conclusion: The findings highlight that autistic children with feeding difficulties and their families may experience a range of mealtime participation challenges. Caregivers also reported feelings of failure, stress, and judgement; some of which stemmed from interactions with extended family, friends, school, and society which increased their difficulties when navigating mealtime participation. Addressing the challenges requires a strengths-based approach including creating inclusive and accessible community environments that accommodate diverse feeding preferences and support the well-being of neurodivergent children and their families.

Purpose: Increasingly, videofluoroscopic swallow studies are being conducted without a radiologist. This study explored current assessment of structural dysphagia in adults during videofluoroscopic swallow studies, both internationally and within the Australian context.

Method: A document analysis of available international videofluoroscopic swallow studies guidance regarding the use of videofluoroscopic swallow studies for structural dysphagia was performed, followed by an online survey of Australian speech-language pathologists seeking information regarding roles, practices, training, and self-perceived competence specific to interpreting structural abnormalities.

Result: Eleven international guidelines agreed that: a) identification of structural abnormalities is one purpose of videofluoroscopic swallow studies, b) radiologists are responsible for diagnostics, however, c) 55% conceded videofluoroscopic swallow studies takes place without a radiologist if unavailable. Of 139 Australian speech-language pathologists surveyed, only 11% reported constant radiologist presence with 84% requesting radiologists' input to review images. Fifty eight percent had received training to identify structural abnormalities. Self-perceived competence in identifying structural dysphagia was positively correlated with videofluoroscopic swallow studies experience (r = 0.43, p < 0.05).

Conclusion: International guidance varies in its advocacy for speech-language pathologist led videofluoroscopic swallow studies. Speech-langauge pathologists in Australia are often conducting videofluoroscopic swallow studies without a radiologist present and may need to determine when to request radiologist review of potential structural abnormalities. Speech-language pathology training and multidisciplinary clinical pathways are needed to mitigate the risk of missed structural diagnoses.

Purpose: This study compared the effects of Lee Silverman Voice Treatment and Expiratory Muscle Strength Training on swallow, cough, and voice function in individuals with Parkinson's disease.

Method: Fifty-eight individuals with mild-moderate Parkinson's disease (male = 45, M = 69 years, SD = 8) were enrolled in a two-treatment clinical trial and completed four consecutive weeks of either Lee Silverman Voice Therapy or Expiratory Muscle Strength Training. All participants completed standard protocol videofluoroscopic swallow study, spirometry-cough tests, acoustic-voice assessment, and self-rated questionnaires pre- and post-therapy. Data were analysed by masked clinicians using specialised software. Mixed-model repeated measures and t-tests were performed.

Result: Lee Silverman Voice Treatment resulted in greater effects in acoustic aerodynamic voice measures (loudness, pitch-range, and aerodynamic-efficiency; p < .05) compared to the Expiratory Muscle Strength Training group. There were significant effects on pharyngoesophageal segment maximum opening (p =.01) following Lee Silverman Voice Treatment. Expiratory Muscle Strength Training resulted in significantly greater change in maximum hyoid displacement (Hmax; p = .04) and decreased Hmax duration (p < .01) compared to Lee Silverman Voice Therapy group. No cough measures and self-reported questionnaires significantly differed between groups with both groups improving post-treatment.

Conclusion: Both Lee Silverman Voice Therapy and Expiratory Muscle Strength Training improved specific swallow efficiency and airway defence capacity despite differences in task and therapeutic dose. Only Lee Silverman Voice Thearpy improved vocal intensity. Both treatments are feasible options for individuals with mild-moderate Parkinson's disease.