International Journal of Speech-Language Pathology最新文献

Purpose: To examine the characteristics of speech-language pathology (SLP) consumers prior to and during the COVID-19 pandemic, with respect to the mode of service delivery within a local health district in New South Wales, Australia, to inform future health service planning.

Method: Observational study examining SLP occasions of service data pre-COVID-19 (2019-2019; n = 6413) and during the COVID-19 pandemic (2020-2021; n = 6908). Spatial mapping and multilevel models were used to examine associations between sociodemographic characteristics, telehealth utilisation, and videoconferencing.

Result: During COVID-19, SLP occasions of service increased by 7.7% compared to pre-COVID-19. Model 1 found odds of adopting telehealth (telephone or videoconference) during COVID-19 were significantly higher for those aged 0-4 and 5-17 years compared to older age groups. Consumers in inner regional areas were significantly less likely to adopt telehealth than in major city areas, whereas females were significantly more likely to adopt telehealth. Those living in areas experiencing higher relative disadvantage were less likely to use telehealth. Model 2 found odds of adopting videoconferencing only were also significantly higher for the younger age groups (0-4 and 5-17 years) and females.

Conclusion: A rapid transition to a virtual model of care was critical to the successful delivery of SLP services during COVID-19. Immediate prioritisation and integration of targeted models of care, where suitability is high and benefits most likely to be experienced, is feasible.

Purpose: Translation of research is requisite for speech-language pathologists; however, barriers have been reported. This review aimed to identify the extant literature published on communication for autistic children, and examine the replicability and translatability of communication interventions for speech-language pathologists providing services to children with autism.

Method: A scoping review was conducted using a six-stage protocol. Following initial database searching and screening, data were extracted from included studies for demographic characteristics and Template for Intervention Description and Replication (TIDieR) checklist elements. Stakeholder consultation interviews with 13 speech-language pathologists who work with autistic children were also undertaken.

Result: The database search revealed 4719 studies on the topic of communication in autistic children, of which 762 were communication intervention studies. Of these included intervention studies, 30% were considered replicable according to the TIDieR checklist. Stakeholder consultation revealed that poorly described intervention studies hindered translation efforts.

Conclusion: The vast amount of autism communication intervention literature and the variable quality of intervention description reporting are barriers to accessing high quality literature for translation to practice. Improved reporting of intervention descriptions in autism communication intervention studies would support research translation into clinical settings.

Purpose: The purpose of this systematic review and meta-analysis was to synthesise the evidence from randomised controlled trials for caregiver training on child and family outcomes for children with paediatric feeding disorder.

Method: A systematic review was conducted in accordance with PRISMA guidelines. Searches of Medline, CINAHL, PsychInfo, and EMBASE were conducted using the key concepts of paediatrics, feeding disorders, parents/caregivers, and training. Eligible studies included randomised controlled trials published in peer-reviewed articles, testing the impact of caregiver training on outcomes for children with paediatric feeding disorder.

Result: Eight articles met the inclusion criteria, involving 575 participants from three countries. Seven articles were included in the meta-analyses, providing high certainty evidence that caregiver training improves child feeding behaviours and reduces unhelpful caregiver mealtime strategies compared with no intervention. Uncertainty remains in regard to impact on caregiver stress and intervention intensity.

Conclusion: Caregiver training is an effective strategy for improving outcomes in children with paediatric feeding disorder. Further research is required to determine the most effective methods of caregiver training, including the intensity of treatment required to attain clinically important benefits for families with different levels of need.

Purpose: Children and families choose eating and drinking with acknowledged risk, often while receiving support from professionals, such as paediatricians and speech-language pathologists. These decisions may fall inside the zone of parental discretion, where decisions are deemed to be 'good enough' for a child and may not prioritise physical health but would not cause significant harm. Often a contentious space, health professionals may feel uncertain of their ethical or legal obligations when supporting these families and children. Further complicated when children attend education and are fed by school staff, school-based speech-language pathologists may feel unsure how to support these children and families. Much of the literature surrounding paediatric feeding disorders comes from the US; however, these studies do not consider the legal context of New Zealand.

Result: This article attempts to outline laws, legal principles, and ethical principles applicable to this topic, in the hopes of highlighting health professionals' obligations and options when supporting these families.

Purpose: Late radiation-associated dysphagia is a rare side effect of radiation treatment for head and neck cancer. Arising over five years after treatment, it may profoundly impact survivors' health and quality of life. This study sought to gain insight into the lived experience of late radiation associated dysphagia.

Method: This qualitative study utilised semi-structured phone interviews. Research assistants completed transcription using a consensus process with the first author for unclear speech segments. A patient partner was consulted at all study stages. Participants were purposively sampled from a single Canadian province, and an inductive thematic analysis was employed.

Result: Twelve participants were enrolled between 9-33 years post cancer diagnosis. Four main themes were identified: a) Glad to be alive, but…, b) eating isn't the same, c) it changes everything, and d) a lot of gaps.

Conclusion: We identified impacts beyond physiological changes. Social connection, daily logistics and eating related quality of life challenges were prevalent. Results highlight gaps in person-centred decision making and access to health care professionals who understand and recognise this complex condition. We recommend improved patient education, provider awareness, as well as monitoring and treatment for late effects.

Purpose: This feasibility study explored literacy instruction for children with autism in an area of socioeconomic disadvantage during the COVID-19 pandemic.

Method: Fifty-nine autistic children (5-12 years) participated in a baseline assessment before being assigned to one of two instruction conditions or a control group. The first instruction group participants received a total of 13 weeks of literacy instruction using ABRACADABRA (a free online web application), delivered by a speech-language pathologist. The second instruction condition also received a total 13 weeks of ABRACADABRA literacy instruction, supplemented with shared book reading. The control group continued their business-as-usual school and other activities over the 13 weeks.

Result: Children who participated in instruction made statistically significant gains in their nonword reading skills from pre- to post-instruction with a large effect size. There were no other statistically significant results at the conservative alpha level utilised. However, effect sizes for all reading outcome measures were similar to previous research using ABRACADABRA with autistic children (with medium to large effect sizes observed across various reading accuracy and reading comprehension skills).

Conclusion: Further research on literacy instruction delivered via via in person sessions and telepractice for children with autism is greatly needed. These findings contribute to the scarce knowledge base of literacy instruction for children with autism and the impact of the COVID-19 pandemic on this group.

Purpose: Prior reviews have identified that US speech-language pathologists receive minimal university training in augmentative and alternative communication. This scoping review sought to identify and synthesise current research on training experiences, needs, and outcomes of clinicians in augmentative and alternative communication, globally.

Method: A scoping review was conducted identifying literature within four databases in addition to citation chaining. Two authors reviewed 30% of abstracts with the final 70% reviewed by the first author. Review of full texts followed the same method. Data were extracted and analysed according to participant profile, training experiences, needs, and outcomes.

Result: Thirty-one studies were included. Clinicians reported limited university training in augmentative and alternative communication; many reported accessing post-graduate training. Training needs varied, however, the need for training in augmentative and alternative communication was commonly reported (options, high-tech, assessment, and intervention).

Conclusion: We found there is substantial variability in how augmentative and alternative communication training is provided at university level both within and between countries. Clinicians reported accessing post-qualification training and indicated training needs in a range content areas. The outcomes of training in augmentative and alternative communication appears positive for student-clinicians. Further research focussed on qualified-clinicians is required using comprehensive evaluation procedures.

Purpose: Many mealtime interventions have been developed over the past ten years. The effective implementation of such interventions into clinical practice is crucial to improve the swallowing safety and/or mealtime-related quality of life for people living with dysphagia or at risk of malnutrition. This systematic review summarises and critically appraises the literature on implementation of mealtime interventions in inpatient and aged care settings.

Method: A systematic database search was conducted using CINAHL, Embase, and MEDLINE. In total, 4475 records were identified and 25 studies met the inclusion criteria. Data were extracted relating to country, healthcare setting and characteristics, number of participants, target population, research method and designi intervention implemented, framework used, implementation strategies, facilitators and barriers to implementation, intervention outcomes, and implementation outcomes.

Result: Findings highlighted gaps in the literature regarding implementation of evidence-based mealtime interventions and their associated outcomes. Staff training and engaging key stakeholders were the most used implementation strategies. Inconsistencies in the reporting of implementation processes and outcomes were identified.

Conclusion: Further research is required to evaluate the most effective strategies for implementing mealtime interventions and the successful integration of evidence-based practices, thus enhancing the quality of care and the well-being of individuals experiencing dysphagia.

Purpose: This study compared performance of multilingual and monolingual children on the OZI-Short Form (a parent-report checklist for early communication from 12-30 months) with reference to receptive and expressive vocabulary, gestures, and communicative games/routines. Scores for three semantic subcategories (animals, clothing, food and drink) were compared between cohorts to assess for any evidence of cultural bias.

Method: Parents of children (n = 552) aged 10.5 to 31.5 months completed the OZI-SF. Total concept scores were calculated. Regression analyses were performed to compare performance between cohorts.

Result: No differences between cohorts for three summary scores: Receptive vocabulary, gestures, and games/routines. Differences were found in expressive vocabulary, with multilingual children scoring lower than monolingual children. For semantic categories, there were differences receptively for 'food and drink', and expressively for 'food and drink' and 'clothing', with multilingual children scoring lower. No differences were found for 'animals'.

Conclusion: The use of total concept scores on the OZI-SF revealed consistent performance between cohorts on receptive and non-verbal scores suggesting clinical confidence in these aspects of the OZI-SF. Differences in performance on expressive measures encourage clinical caution. Further research is needed on the clinical utility of vocabulary screening tools acknowledging the cultural sensitivity of semantic categories.

Purpose: As part of a collaborative academic-based service-learning experience, graduate students collaborated with individuals with aphasia to develop an educational training for community members. This study aimed to examine the impact of a collaborative academic-based service-learning experience on application of course content through community, academic, and interpersonal engagement.

Method: Participants included 36 graduate students in an aphasia course. In groups, they met twice and presented the training to the selected community members with the person with aphasia. After each meeting and the presentation, students wrote a reflective essay. Following the presentation, students completed the Three Aspects of Engagement Survey.

Result: Survey responses revealed increased community, academic, and interpersonal engagement. Thematic analysis of reflective essays (108 total) revealed five main themes: a) Evolving perceptions of aphasia, b) diverse characteristics of aphasia, c) communication strategies, d) collaboration, and e) outcomes of academic-based service-learning experience.

Conclusion: Findings revealed that students applied course content and gained insight into the impact of aphasia on life participation. They felt empathy for individuals with aphasia and plan to implement holistic, individualised care as well as spread awareness in the community. This collaborative academic-based service-learning experience is linked to the framework for teaching the life participation approach to aphasia.