International Journal of Speech-Language Pathology最新文献

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: To evaluate the impact of a speech-language pathology (SLP) pathway on recovery following oesophagectomy.

Method: An audit was conducted at a single metropolitan public hospital in Sydney, Australia. Patients between 2014-2021 undergoing a three-stage oesophagectomy (n = 41) were included in the study. The sample was divided into two groups, those who received usual care (2014-2019) and those who received perioperative SLP assessment and intervention (2020-2021), with data collected across swallowing and health outcomes. Patient demographics and outcomes between the two groups were compared.

Result: Patients who received perioperative SLP intervention commenced oral intake faster postoperatively (SLP intervention group Mdn = 6.50 days, IQR = 6.00-7.00; usual care group Mdn = 9.00 days, IQR = 7.00-13.25; p = 0.001). There was no statistically significant difference between groups in rates of aspiration on the postoperative leak test (p = 0.32). No statistically significant differences were found between the two groups in length of hospital stay or number of swallowing-related medical images completed during their admission.

Conclusion: Perioperative SLP intervention has a positive impact on commencing oral intake following a three-stage oesophagectomy, however, it does not have a significant impact on rates of aspiration postoperatively. This pathway may contribute to enhanced recovery after oesophagectomy.

Purpose: The purpose of this study was to assess the long-term stability of objective and subjective psychosocial improvements and fluency more than 10 years after participation in an intensive stuttering therapy camp.

Method: Ten former participants in intensive stuttering therapy (IST; mean age at time of intervention 14; 2 years) participated in this study. Outcomes of the IST at that time were assessed with the Stuttering Severity Instrument (SSI-3; Riley, 1994) and a questionnaire to measure the psychosocial impact of stuttering. A semi-structured video call and a general questionnaire for the long-term evaluation were used to gauge the participants' perceptions of the IST. These follow-up data were compared to the therapy outcomes reported by Cook (2011, 2013).

Result: Therapy effects on the severity of stuttering and psychosocial impact were stable over the follow-up period of more than 10 years. Moreover, scores for psychosocial impact and severity of stuttering further decreased from the end of the IST to the long-term evaluation. The intensive time and the periodically offered follow-up treatments were described as particularly positive by the participants.

Conclusion: Intensive stuttering therapy in childhood or adolescence can have a long-term positive effect on both internal and external stuttering symptoms.

Purpose: Children with developmental language disorder (DLD) are at heightened risk for reading difficulty. We investigated the home literacy environments of kindergarten children with DLD and typically developing (TD) peers during the COVID-19 pandemic.

Method: We analysed scores from standardised assessments of oral language, nonverbal intelligence, and word reading in conjunction with home literacy questionnaire data at three time points.

Result: Frequency of engagement in home literacy activities did not differ by group during school closures or when schools reopened. Caregivers from both groups reported increased home literacy engagement during closures. Engagement returned to pre-pandemic levels when schools reopened. For the DLD group, the child's word reading ability and interest in literacy were positively associated with the home literacy environment. Family history of language and/or literacy difficulty was negatively associated with the home literacy environment. For the TD group, only the child's interest in literacy was positively associated with the home literacy environment.

Conclusion: These findings elucidate the need for further research related to home literacy and families of children with DLD, with a focus on identifying potential strengths and vulnerabilities related to child and caregiver factors.

Purpose: To evaluate a parent-delivered expressive vocabulary intervention using focused stimulation for young children with cerebral palsy (CP).

Method: A single case A-B design was used. Use of expressive target words was evaluated during the baseline (A) and intervention (B) phases. Untrained expressive words were used as control behaviour. Four 2- to 3-year-old boys with CP and their parents participated. All participants had an expressive vocabulary of less than 50 words at study intake. Following training, parents delivered the intervention daily at home for 5 weeks. Generalisation of the intervention was measured with a parent-rated vocabulary checklist.

Result: Two participants showed clear gains and one participant showed a smaller gain in target words. Two of these three participants did not improve on control words, but one participant increased his use of both target and control words. One participant did not increase his use of either control or target words. All participants improved on parent-reported expressive vocabulary, and for two children, improvements were large.

Conclusion: Parent-delivered focused stimulation may lead to gains in expressive vocabulary in children with CP and speech and language difficulties. The intervention would be suitable for larger single-case studies with more experimental control.

Purpose: To discuss whether early intervention can stop stuttering development. To inform junior clinicians and students of speech-language pathology about contemporary views on this issue.

Method: The issue was discussed by two university researchers and two speech-language pathologists who provide public clinical services. Written conversational turns in an exchange were limited to 100 words each. When that written dialogue was concluded, each participant provided 200 words of final reflection about the issue.

Result: Most differences that emerged centred on the clinical evidence base for early intervention, which emphasises stuttering reduction, and how it should be interpreted.

Conclusion: The evidence base for early intervention has limitations and it should be interpreted cautiously. One interpretation is that reducing stuttering severity is a justifiable core of early management. Another interpretation focuses on ease of communication, anticipation of stuttering, and covert stuttering.

Purpose: Many children who are deaf and hard of hearing (DHH) show poorer auditory word-learning skills than children with typical hearing (TH). The goal of this study was to test the effect of retrieval practice on word learning in children who are hard of hearing (HH).

Method: Twenty-six TH children and 16 children who are HH completed a speech perception and a vocabulary test, and a rapid word-learning game to learn new words under no retrieval, immediate retrieval, and spaced retrieval conditions.

Result: Linear mixed-effect models revealed that learning condition and time predicted 48% of the variance in word recognition, and age predicted 15% of word recall variance. We observed no differences in word recognition and recall between TH children and children who are HH. Children learned and remembered more words in the immediate and spaced retrieval practice conditions than in the no retrieval condition.

Conclusion: Retrieval practice is more effective for word learning and retention than passive exposure (no retrieval). Clinical and educational practices for children who are DHH could combine explicit instruction using targeted exposures and retrieval of new words with naturalistic approaches. Future studies should assess retrieval practice in real-life interventions to inform clinical and educational practices.

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: Speech-language pathologists (SLPs) are often the first point of contact for families of children with autism. Despite this, little is known about SLPs' understanding of autism and its early indicators. This study sought to investigate what Australian SLPs know about autism, the early indicators, and the actions they take when they identify these characteristics.

Method: A 34 question cross-sectional online survey was distributed through professional networks, social media channels, and industry contacts to Australian SLPs. Quantitative and qualitative data were analysed.

Result: The 70 participants worked in various contexts around the country. The majority of participants demonstrated sound knowledge of the main characteristics of autism, and some early indicators. Quantitative analysis identified a significant correlation between participant age and confidence talking to parents about possible autism. Overarching themes were identified: (a) caution may delay or prevent SLPs from taking action, (b) some factors may influence SLPs' action, and (c) SLPs take action.

Conclusion: Australian SLPs working with children have the knowledge and understanding of the main characteristics of autism and some early indicators. However, they demonstrate a cautious approach around the subject of autism, and this caution may cause delays for children requiring diagnostic services.