International Journal of Speech-Language Pathology最新文献

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.

Purpose: Few resources are available to support speech-language pathologists (SLPs') dynamic assessment of vocabulary with school-aged children. We developed the Word Learning Dynamic Assessment Protocol (currently undergoing pilot testing). Framed by implementation science, in the current study we worked with speech-language pathologists to explore their perspectives on the acceptability of the Word Learning Dynamic Assessment Protocol.

Method: Eight speech-language pathologists who work with school-aged children watched a video demonstration of the Word Learning Dynamic Assessment Protocol being administered with a 6-year-old child and were then interviewed to share their thoughts on the Word Learning Dynamic Assessment Protocol's acceptability.

Result: Six themes were generated using reflexive thematic analysis: 1) Structure, scripting, and resourcing builds confidence in speech-language pathologists, 2) gaining important insight into the learning process, 3) flexible assessment supports child engagement and diversity, 4) family buy-in is created with clear communication, 5) a worthwhile investment of time?, and 6) building a more tailored assessment.

Conclusion: The speech-language pathologists who took part in this study valued the structure and resourcing of the Word Learning Dynamic Assessment Protocol as a way of supporting their ability to evaluate a child's strengths and challenges in vocabulary development in an engaging and individually tailored manner. Suggestions for further development will guide task refinement to meet the needs of speech-language pathologists.

Purpose: Urdu is the lingua franca and national language of Pakistan, and is the 10th most-spoken language worldwide with over 230 million speakers. The Urdu phonological system has been examined over the past decades. However, the system has been evolving. This paper aimed to review the available studies investigating various aspects of the Urdu phonological system and to reveal the variations noted among these studies.

Method: Twenty-one studies examining the phonological system of Urdu were located. The studies were reviewed in terms of consonants, geminates, consonant clusters, vowels, diphthongs, syllable structure, phonotactic constraints, and stress.

Result: The findings indicated that 38 consonants, 23 vowels, and 15 diphthongs are used in contemporary Urdu. Most consonants exist as geminates word medially. There are six syllable structures. The consonant clusters are constrained to the coda position only, and short vowels cannot exist in the word-final position. Like other syllable-timed languages, stress is not prominent in Urdu.

Conclusion: Based on this review, a contemporary Urdu phonemic and syllable structure inventory has been proposed. This will serve as a reference for use in further acquisition research and clinical practice.

Purpose: The purpose of this study was to explore the perspectives of qualified and student speech-language pathologists (SLPs) on the clinical utility of informant report and observation tools following a 1-day workshop using a decision tree.

Method: Each participant group (qualified [n = 4] or student SLP [n = 8]) attended a 1-day workshop where they engaged with informant report and structured observation tools using video case studies. Each workshop concluded in a focus group conducted by an independent researcher. NVivo 12 software supported inductive coding and subsequent thematic analysis of transcribed data.

Result: Thematic analysis revealed that participants' perceptions of tools' clinical utility could be conceptualised as three themes (a) tool characteristics, (b) external clinical work demands, and (c) clinician preparedness.

Conclusion: Participants' views on the utility of informant report and structured observation were influenced by tensions between their desires, the realities of clinical practice, and their own capabilities. This has implications for workforce development in the field in providing clinician guidance, training, and support.

Purpose: This study reported the experiences of New Zealand caregivers of children with language and literacy difficulties in having their child's needs identified.

Method: The participants were 14 mothers of children with idiopathic language and literacy difficulties, recruited through social media language and literacy difficulties support groups. Two mothers identified as Māori and 12 New Zealand European. Data were collected through semi-structured interviews. A phenomenological approach using reflexive thematic analysis was used.

Result: These mothers had learned about language, literacy, and the education system to advocate for their child and perceived a lack of knowledge on the part of schools. Nearly all had sought a diagnosis, with understanding and access to support reported as positive consequences and stigma as a negative. Some preferred labels emphasising difference rather than disorder, consistent with traditional Māori and neurodiversity views. The mothers described their experience as a fight, due to their concerns being ignored, the need to pay for private diagnostic assessments and difficulty accessing services. They appreciated assessors who gave useful, comprehensible information and supported school liaison.

Conclusion: These mothers wanted improved teacher training and publicly funded diagnostic assessment services to improve access to best practice language and literacy instruction for their children.