International Journal of Speech-Language Pathology最新文献

Purpose: Discharge decisions pose a challenge in speech-language pathology practice. Although professional guidance exists, there is little research on what factors influence discharge decisions in practice. This study aimed to explore the discharge decisions of speech-language pathologists in the context of children with Developmental Language Disorder, in particular to identify influential factors.

Method: This is a qualitative knowledge-elicitation study using individual interviews and a focus group to explore the knowledge of 19 Croatian speech-language pathologists with more than two years experience of working with children with Developmental Language Disorder.

Result: Speech-language pathologists described a complex process that was influenced by four overarching case-related factors: A child reaching a plateau, the child's achievements, support, and motivation. Much of this knowledge was challenging for clinicians to define and measure. Speech-language pathologists also reported the influence of resource pressures.

Conclusion: The process described by speech-language pathologists broadly follows published professional guidance. Clinicians descriptions of the interpretation of those factors to child, family, and situational contexts showed the individualisation and weighing up of the relative importance of factors. These detailed judgements were challenging. Therefore, support and monitoring particularly for novice speech-language pathologists is recommended. Discussion between clinicians will also support the emergence of consensus and build confidence in discharge decision-making. Further explication of the influential factors and development of ways to measure and evaluate levels of support and children's functional performance is needed.

Purpose: To develop a grounded theory related to the experiences of individuals with mild, moderate, and severe traumatic brain injuries within healthcare contexts.

Method: This investigation examined the open-ended responses of the mCARE-TBI survey, which was distributed throughout the US and Canada. There were 64 responses that met criteria for analyses. Participants self-reported as ≥18 years old, ≥1 year post onset, and indicated they had no unrelated neurological diagnoses prior to their traumatic brain injury, nor prior diagnosed psychiatric conditions. Grounded theory was employed to generate a theoretical model regarding the lived experiences of individuals with traumatic brain injury in healthcare contexts.

Result: Qualitative analyses identified three overarching themes: Positive characteristics (collaboration, empathy and attitudes, strong communication skills, and being knowledgeable), neutral (having knowledge and providing adequate care), and negative characteristics of providers (poor communication and limited knowledge, being unprofessional and lacking empathy, and being dismissive and neglectful). This informed a model for effective or 'present' providers versus ineffective or 'absent' providers.

Conclusion: There has been limited productive movement regarding development of adaptive strategies in the recovery phases of traumatic brain injury. Our model identifies specific suggestions for providers, primarily derived from subthemes, which could be used to develop provider training.

Purpose: This pragmatic clinical trial examined the functional impact of a modified speech-language pathology intervention delivery model (including telepractice, reduced therapy frequency, and emphasised home programmes with parent training) on child outcomes.

Method: A convenience sample of 40 children from speech-language pathology clinics at one institution was randomly assigned to 8 weekly or 8 fortnightly hour-long speech-language pathology intervention sessions. Pre-treatment and post-treatment standardised tests were administered and compared. All participants received parent training, a prescription for home programmes, and chose their preferred mode of treatment (telepractice and/or in-office). ANOVA and t-tests explored outcomes. Significance level was 0.05.

Result: Performance improved post-intervention in both groups; score improvements were not significantly different between weekly vs. fortnightly groups or delivery modes. This may indicate that varied modes and frequencies of therapy produce similar outcomes. Home programme completion did not result in significant outcome differences. Some findings may be attributed to the small sample size.

Conclusion: Children's functional speech-language performance outcomes may not differ based on frequency (weekly vs. fortnightly) and/or modality of intervention (telepractice vs. in-office). More research in larger populations is needed to explore if such interventions are efficacious while reducing burden to families' schedules, finances, and travel.

Purpose: This study explores the impact of digital health care literacy of individuals with communication disorders on speech-language pathologists' intention to use telehealth.

Method: A convergent mixed methodology design was employed. Quantitative data were collected from 183 speech-language pathologists representing clinical, educational, and medical settings across the USA, while qualitative insights were obtained through semi-structured interviews with 25 participants.

Result: Quantitative analyses revealed significant group differences in perceived digital health care literacy among telehealth users (F = 6.23, p < .01). However, digital health care literacy was not a statistically significant predictor of the speech-language pathologists' intention to use telehealth. (β = 0.01, t= .12, p > .05). Qualitative findings illuminated four interrelated themes, among these, organisational support and client characteristics emerged as particularly prominent factors influencing telehealth success.

Conclusion: This study demonstrates that while speech-language pathologists recognise the value of telehealth, its effective implementation is constrained by digital health care literacy and technological readiness of clients.

Purpose: This study examined knowledge of the role of the speech-language pathologist amongst patient-facing staff within an acute mental health ward in a tertiary Australian hospital. Annually, over 260,000 Australians experience serious mental illness requiring inpatient care. Serious mental illness is commonly associated with swallowing and/or communication disorders, yet speech-language pathologists are under-represented in acute serious mental health treatment teams.

Method: This study utilised a convergent parallel mixed-method design, comprising an online survey and follow-up interviews with patient-facing staff in an Australian mental health inpatient unit. Quantitative data were analysed descriptively and qualitative data were analysed using deductive content analysis and adapted reflexive thematic analysis.

Result: Twenty-nine participants completed the survey and three completed interviews. Most staff (75%) identified the speech-language pathologist role in swallowing management. Fewer than half (48%) were aware of the speech-language pathologist role in communication management, despite most (73%) reporting communication breakdowns with patients. Ambiguous referral pathways limited access to speech-language pathologists who were primarily contacted for swallowing or as a "last-resort" in communication management.

Conclusion: Limited and ambiguous referral pathways restrict access to speech-language pathologists, perpetuating limited opportunities for interdisciplinary collaboration. Greater advocacy and education efforts are needed to enhance understanding of the role of speech-language pathology in acute care for serious mental illness.

Purpose: Language sample analysis is an ecologically valid method for assessing the language of multilingual children. It is frequently used in research to obtain developmental data and in practice as an adjunct to language assessment.

Method: A systematic review was done according to the PRISMA-P guidelines to identify and synthesise current naturalistic language sample analysis practices used by speech-language pathologists to assess the language of multilingual children. Four databases were searched, including ERIC, Linguistics Database, Scopus, and PubMed. The methodological quality of the included studies was assessed using the Mixed Methods Appraisal Tool.

Result: The search yielded 602 articles. After abstract-level screening, 57 articles were screened at full-text level. Fourteen articles were included in the review. Findings indicate wide variability in language sample analysis practices related to elicitation, transcription, and coding and analysis practices; which may hinder the consistent application of language sample analysis across contexts and highlight the need for further investigation.

Conclusion: The review identified and synthesised several practices used with multilingual children to elicit, transcribe, code, and analyse language samples. Directions for further research and clinical implications are discussed.

Purpose: This pilot research explored the use of Minecraft^™ as an accessible game-based program for facilitating social skills development and collaboration in 10-12-year-old pre-adolescent autistic children.

Method: Underpinned by inclusive research principles, the study was co-designed with consumers with lived experience and used a mixed-method design to explore intervention effects across different intensities (high vs. low) and modalities (in-person vs. online).

Result: A total of 11 children participated, divided into four groups of 2-3 players each. The findings showed that both low- and high-intensity groups showed non-significant social skills improvements, with highest perceived gains in low-intensity online and high-intensity in-person groups. Parent and child reports of social competence with peers were mixed. Online friendships were limited across groups, with none reported amongst the in-person group participants. Qualitative analysis highlighted three interconnected dimensions of engagement, including relational, structural, and contextual; shaping experiences of collaboration, social competence, and accessibility.

Conclusion: Despite limitations that warrant cautious interpretation, the study demonstrates the value of co-design with families and people with lived experience; which should remain central to future research.

Purpose: Teaching evidence-based intervention method is essential for developing student clinicians' knowledge, perceived clinical competence, and professional fulfilment. To optimise learning outcomes, accommodating the learning tendencies of Generation Z, who currently make up the undergraduate cohort, is considered of particular importance. This study evaluated the effectiveness of three instructional methods for teaching dialogic reading to undergraduate speech-language pathology students.

Method: Sixty-four undergraduate speech-language pathology students participated in a role-play simulating a book reading session with a child, during which their use of dialogic reading strategy was video-recorded. Participants were then randomly assigned to one of three groups: (a) Lecture with self-reflection, (b) lecture with peer feedback, or (c) lecture with expert feedback. Dialogic reading strategy use was reassessed in a second recorded session.

Result: Analyses revealed significant improvements in dialogic reading strategy use across all instructional methods. Both peer and expert feedback groups outperformed the self-reflection group. High inter-rater reliability and treatment fidelity supported these findings.

Conclusion: Instructional approaches combining real-world scenarios with practice-oriented feedback enhance the acquisition of evidence-based intervention strategies. Receiving feedback-whether from peers or experts-positively influences learning outcomes. Given the learning tendencies of Generation Z, feedback-based approaches may represent an effective instructional strategy in undergraduate speech-language pathology education.

Purpose: To explore how speech-language pathologists perceive their professional identity and practices in gender affirming care and to explore how these perceptions are related to supporting gender diverse clients' psychological wellbeing and their experience of identity.

Method: In this exploratory, qualitative study, we facilitated three focus group discussions. Reflexive thematic analysis was used to construct themes in a data-driven, iterative manner.

Result: Fourteen speech-language pathologists shared their perspectives on their professional identity and practices in gender affirming care. We constructed five themes: Identifying as a voice modification expert, the client's confidante, an equal collaborator, a self-compassionate clinician, and a unique clinician. Speech-language pathologists felt most comfortable assisting clients with their voice but were somewhat uncertain about supporting client psychological wellbeing directly and systematically. They experienced gender affirming care as rewarding, demanding, and appreciably different to other areas of speech-language pathology.

Conclusion: Speech-language pathologists who provide gender affirming care need support to expand their professional identity to feel comfortable and responsible addressing clients' various needs, including client psychological wellbeing and their experience of identity. Speech-language pathologists need further support to manage the demanding aspects of their work, maintain their own psychological wellbeing, and provide continuous care for gender diverse people.

Purpose: There is limited research into the current practices and factors that may influence speech-language pathologists in the prescription and utilisation of assistive technology to support return to work goals for people with cognitive communication disorder post traumatic brain injury.

Method: An exploratory cross-sectional survey of speech-language pathologists in Australia and the UK who work with adults with traumatic brain injury was completed. Mixed method analysis identified the types of assistive technology used by clinicians, and highlighted barriers and facilitators to prescribing assistive technology. Descriptive statistics, reflexive thematic analysis, and content analysis were employed to analyse survey responses.

Result: Sixteen speech-language pathologists reported employing a range of assistive technology devices and applications to support communication and memory difficulties. Reflexive thematic analysis resulted in a central organising concept of 'a nuanced approach' with five themes. Content analysis highlighted barriers to assistive technology use that were consistent with previous research related to their design and function, service provision, and awareness and information.

Conclusion: Surveyed clinicians primarily prescribed familiar devices and inbuilt or downloadable applications. The prescription and use of assistive technology by surveyed clinicians is multifaceted, involving considerations of the individual and workplace barriers and facilitators to determine its utility.