International Journal of Speech-Language Pathology最新文献

Purpose: Little is known about how community-based speech-language pathologists experience continuity of care when working with children with cleft palate. This study explored how continuity of care is promoted, the barriers and facilitators encountered, and the nature of collaboration with cleft team clinicians and families.

Method: Twelve community-based speech-language pathologists from Australia and New Zealand participated in semi-structured interviews. Participants worked across private practices, schools, hospitals, and community health. Reflexive thematic analysis was used to interpret the data.

Result: Three global themes were developed: (1) Navigating roles and relationships, (2) communication and collaboration, and (3) I need help - and I have some ideas. Participants valued collaborative care, but described variable communication, and limited access to cleft team support. Trusting relationships and clear, timely information were key facilitators in continuity of care.

Conclusion: Community speech-language pathologists play a central role in cleft care and demonstrate a strong commitment to engage in collaborative care yet face barriers to inclusion and collaboration. Findings point to the need for clearer communication pathways, shared planning, and inclusive, team-based models that better facilitate collaboration between community clinicians, cleft team clinicians, and parents.

Purpose: Oropharyngeal dysphagia (eating, drinking, and swallowing difficulties) in children with neurodisability impacts their whole life. Speech-language pathologists optimise safe, efficient, and enjoyable mealtimes by providing interventions that require carers to adapt their mealtime assistance behaviours. This systematic review identifies and evaluates peer-reviewed mealtime interventions evidence, including content, child, and carer outcomes targeted and effectiveness.

Method: Eleven database and manual searches were completed (January 2024). Eligible studies reported on school-aged children with neurodisability and oropharyngeal dysphagia carer mealtime interventions in any setting against any comparator. Data extraction and quality assessment were completed leading to narrative synthesis.

Result: From 9627 reports, 29 studies (34 reports) were included in this review. Studies had variable designs, only one randomised controlled trial. There were 941 child and 457 carer participants, variably described. Multiple mealtime interventions by varied healthcare professionals targeted different carer behaviours. Twenty-four studies met quality criteria for synthesis with data too heterogeneous for meta-analysis. Studies demonstrated positive outcomes for child and carer mealtime safety, efficiency, and enjoyment using multiple measures.

Conclusion: Mealtime interventions appear better than none. Study evidence is low quality and heterogeneous, with no optimum approach evident. Good quality studies using consistent participant descriptions and core outcome set are required.

Purpose: This preliminary study sought to explore speech-language pathology students' perspectives of a novel placement experience embedding traditional and non-traditional placement and supervisory model-elements in a hospital setting.

Method: A mixed-method sequential explanatory design was used, incorporating an online survey comprising of 26 questions and a focus group. Descriptive statistics were obtained and a reflexive thematic approach was used to analyse the transcripts.

Result: Six final-year speech-language pathology students on their entry-level 32-day adult placement participated. This novel placement model was perceived as highly successful, fostering competence, confidence, and professional identity. Contextual factors were viewed as critical to its success and related to both the hybrid placement and supervision model components. The importance of diverse and practical learning experiences, a supportive learning environment, and the supervision style of the primary clinical educator were viewed as important for learning success.

Conclusion: It appears that a hybrid placement experience embedding traditional and student-led clinic elements and combining supervision models, can optimise the development of occupational and professional competence in undergraduate speech-language pathologists. Clinical educators who allow increased opportunities for 'learning from mistakes', and a positive learning culture that fosters connectedness, are important to facilitate undergraduate speech-language pathologists' independent decision making and improved confidence.

Purpose: This study aims to explore the current practices and challenges faced by speech-language pathologists in three Southeast Asian countries (Malaysia, Indonesia, and Vietnam) in assessing and treating multilingual children with developmental language disorder.

Method: A survey was designed and administered to 110 speech-language pathologists across Malaysia, Indonesia, and Vietnam. The survey contained 60 questions on current practices and knowledge of existing resources for assessing and treating multilingual children with developmental language disorder. Data were analysed to identify relationships between practices and demographic variables including country of origin, years of service, and speech-language pathologists' multilingual status.

Result: Current practices reveal little knowledge and/or use of standardised tests for developmental language disorder across countries, but relatively high self-perceived competence when working with multilingual clients for Indonesia and Malaysia. However, several challenges were perceived across the board in practice with multilingual children, including socioeconomic challenges (i.e. costs involved for families and social status), insufficient training on the relevant topics, and limited access to appropriate tools and resources in their current practice.

Conclusion: Findings suggest the need for training and appropriate assessment tools to ensure the adoption of evidence-based service delivery for multilingual caseloads, minimising misclassification of developmental language disorder and boosting confidence levels in speech-language pathologists in Southeast Asia.

Purpose: Speech-language pathology students require mental health skills to support their well-being during tertiary education and prepare them to work with individuals at elevated risk of mental health challenges. Mental health first aid equips individuals with the skills to recognise and respond to mental health concerns. Although mental health first aid has been integrated into some allied health programs, no studies have explored the perspectives of speech-language pathology students on its relevance to academic and professional contexts.

Method: A qualitative descriptive design was employed to explore the experiences of Australian speech-language pathology students with mental health first aid. Seven students participated: Six in two focus groups and one via written responses. Data were analysed using qualitative content analysis.

Result: Four themes were developed: (a) Mental health first aid has a place in speech-language pathology education and practice, (b) building the knowledge and skills for mental health support, (c) adapting mental health first aid to fit the needs of people supported by speech-language pathologists, and (d) considerations for educators.

Conclusion: Mental health first aid may enhance speech-language pathology students' confidence and mental health literacy, however, students may experience a mismatch between increased awareness and perceived clinical readiness. Mental health first aid alone may not equip students with the skills required to support their clients, indicating a need for further training and adaptation.

Purpose: The purpose of this review was to map speech intelligibility measures used for assessing d/Deaf and hard-of-hearing children onto the International Classification of Functioning, Disability and Health.

Method: This review considered perceptual speech intelligibility measures (Articulation functions b320) used to assess deaf and hard-of-hearing children aged 12 years and younger. The following electronic databases were searched: CINAHL; ERIC (ProQuest); Linguistic, Language, and Behaviour Abstracts; Scopus; Medline via PubMed; CENTRAL via Ovid; Cochrane via Ovid; and Joanna Briggs via Ovid. Data were extracted describing the article, participant, listener, study, speech intelligibility, and psychometric characteristics from the 245 included studies.

Result: Speech intelligibility was measured as articulation functions (b320) through speaking (d330) in all studies. Other Body Functions frequently measured were speech discrimination (b2304; 28%) and mental functions of language (b167; 27%). Activities and Participation factors other than speaking d330 were generally not considered. Speech intelligibility was most often measured in the context of health services (e5800; 66%).

Conclusion: Previous research on the speech intelligibility of deaf and hard-of-hearing children has largely lacked a broader perspective of functioning. Clinicians and educators of deaf and hard-of-hearing children should consider Activities and Participation, Environmental, and Personal Factors when assessing speech intelligibility.

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: Pharyngeal residue rating scales are often used to rate pharyngeal residue observed during flexible endoscopic evaluation of swallowing. Despite the widespread use of pharyngeal residue rating scales, there is no data that has systematically explored user experience. The aim of this scoping review was to investigate specific reporting of user experience, user centred design principles, and normative data in the development of pharyngeal residue rating scales.

Method: A scoping review was conducted across four electronic databases inclusive of all dates until June 2024. Grey literature searching occurred in March-April 2023 and was repeated in June 2024. This review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) protocol. Titles/abstracts, full texts, and data extraction were reviewed by two independent reviewers.

Result: A total of 22 sources were included, with 18 unique pharyngeal residue rating scales identified. Two studies referred to user experience, seven included at least one user centred design principle, and four studies reported on normative data.

Conclusion: The findings of this review highlight few pharyngeal residue rating scales include the experience of the intended user and establish normative data in the initial development phase. User experience, user centred design principles, and normative data may be useful considerations to optimise functionality.

Purpose: The parents of children who are deaf or hard-of-hearing may require a spoken language interpreter to access early-intervention services. This research sought to describe speech-language pathologists' perspectives regarding collaboration with interpreters in this space.

Method: Twenty-seven speech-language pathologists working in Australia completed a cross-sectional mixed-method online survey. Participants responded to questions about knowledge they thought was important for interpreters to know before collaborating in early-intervention and their best and worst experiences when collaborating with interpreters. Quantitative and qualitative analyses of participants' responses were undertaken.

Result: Less than half of the 27 speech-language pathologists reported that a qualified interpreter was always used in appointments. Speech-language pathologists stated that the most important information for interpreters to know before an appointment included key terminology in both languages and the purpose of the appointment for which they were interpreting. Major themes relating to before, during, and after the session were identified. Subthemes relating to briefing, procedural skills and prior knowledge, and environmental factors were identified.

Conclusion: Speech-language pathologists identified significant barriers to effective collaboration with interpreters in early-intervention settings. Future research should seek the perspectives of interpreters, educators, caregivers, and deaf or hard-of-hearing children collaborating in the early-intervention space.

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.