International Journal of Speech-Language Pathology最新文献

Purpose: The spread of airborne diseases, including coronaviruses, remains a widespread public health concern. Published studies outline the use of protective barriers to limit the spread of pathogenic particles and droplets resulting from coughing, sneezing, and talking. The findings suggest a role for these barriers during aerosol-generating procedures, such as flexible endoscopic evaluation of swallowing (FEES). However, the question remains of whether doffing a protective barrier will create a concentrated cloud of particles that will increase health professionals' exposure.

Method: We simulated four clinical scenarios of coughing and sneezing, talking, eating and drinking, and delivering supplemental oxygen to test whether doffing the FEES Box protective barrier would result in a particle cloud.

Result: For all scenarios simulated, doffing the FEES Box did not result in a significant increase in mean particle count. Further, the manner of FEES Box removal did not significantly influence mean particle counts on a consistent basis.

Conclusion: These results suggest that doffing the FEES Box does not increase exposure to airborne particles. Although more research is needed to confirm these findings, FEES Box usage should be considered during aerosol-generating procedures, to protect and reassure healthcare professionals who work with patients with COVID-19 or other airborne diseases.

Purpose: Facial nerve palsy (FNP) affects physical and social function, including speech. There exists discrepancy between professional and patient perception of appearance following FNP; however, speech differences remain unknown. We aimed to compare ratings of speech intelligibility by different listeners.

Method: Patients were identified through the Sydney Facial Nerve Service. FNP related scoring was obtained using the Sunnybrook Facial Grading System, Sydney Facial Grading Score, Facial Disability Index, and Speech Handicap Index. Intelligibility was scored by a speech-language pathologist, member of the public, and patient using a standardised passage. FNP scoring and intelligibility were compared using interclass coefficients (ICC).

Result: Forty patients were recruited (females = 20). There was no difference in FNP scoring, nor between the frequency or types of phonemic errors. Observers' rating of intelligibility had an ICC of 0.807, compared with 0.266 and 0.344 for patients compared to the member of the public and speech-language pathologist respectively. Observers rated males and females intelligibility similar (p > 0.05), but females rated their intelligibility lower than males (74.5 ± 12.8 vs. 82.5 ± 8.4, p = 0.025).

Conclusion: Patients, particularly females, perceive their speech to be less intelligible than observers. Clinicians should be aware of this discrepancy, which does not correlate with physical function.

Purpose: To present the sensitivity and specificity and establish cutoff points (receiver operating characteristic [ROC] curve) for the PraxiFala Battery.

Method: The sample included 308 Brazilian-speaking children aged 3;0-7;11. Twenty-one children had motor speech disorders (MSD), 58 children had phonological disorder (PD), and 229 had typical speech (TS) development. Participants were administered the PraxiFala Battery, which contains verbal (word and sentence production), nonverbal (orofacial praxis), and diadochokinetic tasks. The sensitivity and specificity of items in each task were then calculated using ROC curves.

Result: Total scores on the verbal (word production), nonverbal (orofacial praxis), and diadochokinetic tasks had good sensitivity and specificity. The only scores with poor sensitivity and specificity in differentiating between TS, PD, and MSD were consistency and prosody in the verbal tasks (sentence production), and item /ta/ in the diadochokinetic task. Area under the ROC curve (AUC) values were greater than 0.7 for most items in the comparison between TS vs. MSD and PD vs. MSD. AUC values were poor or fair among children with TS and PD, suggesting that this instrument may not be accurate in identifying these groups.

Conclusion: The verbal, nonverbal, and diadochokinetic tasks in the PraxiFala Battery had good sensitivity and specificity.

Purpose: The rapid adoption of telepractice services by health professionals was necessary to maintain service continuity for children with paediatric feeding disorders during the COVID-19 pandemic, during periods where in-person therapy was restricted. The aim of this study was to explore clinical perspectives and reflections on the use of telepractice for managing paediatric feeding disorders during the pandemic.

Method: A post-positivist qualitative approach using thematic analysis was adopted. This study seeks to understand participants' experiences and thoughts from allied health professionals from speech-language pathology, occupational therapy, and dietetics working with paediatric feeding in Western Australia. All participants delivered at least 10 telepractice sessions to children from birth to 12 years with a paediatric feeding disorder. Braun and Clarke's six-step thematic analysis process was used to analyse the data inductively.

Result: Eleven allied health professionals representing eight clinical settings in Western Australia, including speech-language pathology, occupational therapy, and dietetics, working with paediatric feeding were recruited. The results revealed four themes: families becoming the catalyst of change, clinician comfort over confidence, insights into authentic mealtimes, and the paradox of choice.

Conclusion: This study highlighted the need to build clinicians' confidence and competence, and the provision of service guidelines and training. Although many clinicians had positive experiences with telepractice, most returned to in-person delivery once COVID-19 restrictions were lifted, emphasising the importance of comfort in service delivery selection. We recognise that the findings of this study are constrained by the fact that it was conducted in a single geographical region and utilised a small qualitative sample. While telepractice was successful in managing paediatric feeding disorders, further development and implementation of telepractice guidelines are needed for telepractice to be a viable service delivery option for families and children with feeding disorders.

Purpose: There is little consensus on evidence-based practice guidelines for the selection of criterion-referenced assessments. Having confidence in scores from criterion-referenced assessments requires evidence that items align with their intended constructs. The purposes of these studies were to demonstrate evidence of content validity for the revised item set of a developing social communication assessment and to provide clinicians with a model of content validity evaluations that can be generalised to the review of other assessments.

Method: In Study 1, 10 experts rated 25 newly-developed items for how well they represented the intended construct. In Study 2, seven participants ages 14-20 were administered the Three Step Test Interview to assess their cognitive processes for responding to new items. Examinee responses were coded for construct-relevant and construct-irrelevant factors.

Result: Twenty-three of the 25 newly-developed items were deemed representative of the intended construct by experts and elicited construct-relevant response processes from examinees.

Conclusion: The integration of expert review and examinee cognitive interviewing provides a more complete evaluation of the alignment of the items to their intended construct. Transparent reports of the methods and findings of content validity studies strengthen the ability of clinicians to select criterion-referenced assessments that support valid decisions.

Purpose: Non-invasive ventilation (NIV) provides respiratory support without invasive endotracheal intubation but can hinder patients' ability to communicate effectively. The current study presents preliminary results using a novel in-mask ventilator microphone to enhance talker intelligibility while receiving NIV.Method: A proof-of-concept study assessed sentence intelligibility of five healthy adult talkers using a prototype model of the microphone under continuous positive airway pressure (CPAP; 5/5 cm H₂O) and bilevel positive airway pressure (BiPAP; 8/4 cm H₂O) ventilator conditions. A pilot study then assessed intelligibility, subjective comprehensibility and naturalness, and patient- and conversation partner-reported communication outcomes for eight patients undergoing therapeutic NIV while being treated in an intensive care unit (ICU).Result: Intelligibility increased significantly with the microphone on in the BiPAP condition for healthy volunteers. For patients undergoing NIV in an ICU, intelligibility, comprehensibility, and patient and conversation partner ratings of conversation satisfaction significantly improved with the microphone on. Patients with lower baselines without the microphone in certain measures (intelligibility, comprehensibility) generally showed a greater microphone benefit than patients with higher baselines.Conclusion: Use of a novel microphone integrated into NIV improved intelligibility during ventilation for both healthy volunteers and patients undergoing therapeutic NIV. Additional clinical studies will define precise benefits and implications of such improved intelligibility.

Purpose: To discuss whether stuttering causality matters to clinicians during clinical practice, and how and why it might matter. Additionally, to provide early-career clinicians and students with entry-level assistance with this complex topic.

Method: The issue was discussed by two academics and two experienced speech-language pathologists in private practice. Written conversational turns in an exchange were limited to 100 words each. When that written dialogue was concluded, the moderator summarised the discussion.

Result: All participants agreed that the cause of stuttering does matter to speech-language pathologists during clinical practice.

Conclusion: The following three key points emerged from the conversation. Firstly, no-one referred to a formally stated theory or model when explaining cause to clients. Instead, all in the conversation stayed on the solid ground of current facts about the cause of stuttering. Secondly, explaining the cause of stuttering can benefit clients and parents. It can support them and give them confidence and empowerment during clinical management and increase the credibility of a management plan. Finally, in essence, this topic relates to evidence-based practice, for which there are no fixed rules. Different clinicians may make different judgments about what is and what is not true, useful, and important.

Purpose: Children who utilise augmentative and alternative communication (AAC) have difficulty participating in interactions with peers and speech-language pathologists (SLPs) lack training in the development of activities to specifically target participation. The purpose of the current study was to explore a pilot online training program designed to provide information about the development of collaborative learning (CL) activities to support participation.

Method: A single-subject, multiple baseline across six participants in an initial group and a replication group was completed to assess the number of CL elements included in probe responses during baseline, intervention, and maintenance phases.

Result: SLPs were highly accurate in their ability to answer multiple choice questions about CL elements (80%-90%); however, the overall effect of the intervention was weak with a Tau-U of 0.48 for the initial group and 0.53 for the replication group.

Conclusion: SLPs can begin to develop skills in designing CL activities for children who utilise AAC as a means to support participation and foster social interaction. Future research is necessary to design efficient and effective online training for SLPs.

Purpose: There has been concern that a shift in disability funding to the National Disability Insurance Scheme (NDIS) in Australia may have influenced paediatric speech and language intervention to involve parents less in service delivery. This study aimed to describe paediatric speech-language pathologists' (SLPs) practices and perceptions of parent involvement in NDIS-funded speech and/or language intervention.Method: Seventy-two paediatric SLPs currently practicing in Australia with NDIS-funded speech and/or language clients completed an online survey. The survey assessed SLPs' self-reported practices supporting parent involvement through Likert scale responses and included open-text questions about perceived barriers and facilitators in NDIS-funded intervention services. Results from the survey were analysed using descriptive statistics, significance testing, and thematic analysis.Result: The majority of SLPs indicated commitment to involving parents in intervention. Experienced SLPs used more family-centred practices and Department of Education (DE)-based SLPs used fewer. Barriers arose from SLP, parent, and workplace characteristics. Facilitators included communication and rapport building, utilising a family-centred model of service delivery, and parent characteristics.Conclusion: This self-selected sample of Australian SLPs utilised many techniques to facilitate parent involvement within NDIS-funded paediatric speech and language intervention. Results indicate NDIS-funded SLP services for families are family focused.