Sofiana Mootassim-Billah, Gwen Van Nuffelen, Jean Schoentgen, Marc De Bodt, Hichem Slama, Mathilde Le Tensorer, Dirk Van Gestel
<div> <section> <h3> Background</h3> <p>Coughing and throat clearing are different airway protective manoeuvres elicited in the framework of dysphagia. However, coughing and throat clearing may be auditorily confused during a clinical swallowing evaluation. In addition, literature reporting comparisons between coughing and throat clearing via gold standard airflow metrics is lacking.</p> </section> <section> <h3> Aims</h3> <p>To report quantitative airflow data for voluntary throat clearing, and to examine in a healthy population the aerodynamical differences between voluntary throat clearing, voluntary cough and induced reflexive cough.</p> </section> <section> <h3> Methods and Procedures</h3> <p>Forty healthy participants were included in the study. Airflow measurements were obtained from single voluntary throat clearings, single voluntary coughs and the first two induced reflexive coughs of the reflexive cough epoch. The measurements included the peak expiratory flow rate in litres/s and the cough expired volume in litres of each single manoeuvre.</p> </section> <section> <h3> Outcomes and Results</h3> <p>Results showed that voluntary throat clearing displayed lower airflow feature values compared to voluntary cough and induced reflexive cough (<i>p</i> < 0.001).</p> </section> <section> <h3> Conclusions and Implications</h3> <p>Voluntary throat clearings were aerodynamically significantly different from voluntary and reflexive coughs. Future studies should determine whether these differences reflect distinct impacts on airway protection. In dysphagic populations, instrumental assessment of throat clearing may enhance clinical swallowing evaluations.</p> </section> <section> <h3> WHAT THIS PAPER ADDS</h3> <div><i>What is already known on this subject</i> <ul> <li>A large body of literature has emphasized airflow differences between voluntary coughs and induced reflexive coughs, supporting physiological differences between both types of manoeuvres and complementary roles with regard to airway protection. Throat clearing is another airway protective manoeuvre anecdotally considered during a clinical swallowing evaluation and in literature. In addition, throat clearing is confused with coughing, and little is known regarding its ability to protect the airways.</li>
{"title":"Airflow Features Obtained From Voluntary Throat Clearing Compared to Voluntary Cough and Induced Reflexive Cough in a Healthy Population","authors":"Sofiana Mootassim-Billah, Gwen Van Nuffelen, Jean Schoentgen, Marc De Bodt, Hichem Slama, Mathilde Le Tensorer, Dirk Van Gestel","doi":"10.1111/1460-6984.70160","DOIUrl":"10.1111/1460-6984.70160","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Coughing and throat clearing are different airway protective manoeuvres elicited in the framework of dysphagia. However, coughing and throat clearing may be auditorily confused during a clinical swallowing evaluation. In addition, literature reporting comparisons between coughing and throat clearing via gold standard airflow metrics is lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To report quantitative airflow data for voluntary throat clearing, and to examine in a healthy population the aerodynamical differences between voluntary throat clearing, voluntary cough and induced reflexive cough.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Procedures</h3>\u0000 \u0000 <p>Forty healthy participants were included in the study. Airflow measurements were obtained from single voluntary throat clearings, single voluntary coughs and the first two induced reflexive coughs of the reflexive cough epoch. The measurements included the peak expiratory flow rate in litres/s and the cough expired volume in litres of each single manoeuvre.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Outcomes and Results</h3>\u0000 \u0000 <p>Results showed that voluntary throat clearing displayed lower airflow feature values compared to voluntary cough and induced reflexive cough (<i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Implications</h3>\u0000 \u0000 <p>Voluntary throat clearings were aerodynamically significantly different from voluntary and reflexive coughs. Future studies should determine whether these differences reflect distinct impacts on airway protection. In dysphagic populations, instrumental assessment of throat clearing may enhance clinical swallowing evaluations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> WHAT THIS PAPER ADDS</h3>\u0000 \u0000 <div><i>What is already known on this subject</i>\u0000 \u0000 <ul>\u0000 \u0000 <li>A large body of literature has emphasized airflow differences between voluntary coughs and induced reflexive coughs, supporting physiological differences between both types of manoeuvres and complementary roles with regard to airway protection. Throat clearing is another airway protective manoeuvre anecdotally considered during a clinical swallowing evaluation and in literature. In addition, throat clearing is confused with coughing, and little is known regarding its ability to protect the airways.</li>\u0000 ","PeriodicalId":49182,"journal":{"name":"International Journal of Language & Communication Disorders","volume":"60 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12621289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Previous studies have reported a moderate influence of environmental factors in the aetiology of stuttering. However, psychological and socio-environmental factors in stuttering are often studied independently without exploring their relationships. This makes it difficult to know which factors are most important, especially among adults who stutter (AWS), as much research has focused on the child and adolescents population. The aim of this study was to address these gaps.
Methods
After reviewing the literature, a new stuttering scale (PCS-3) was developed to capture the severity of stuttering as experienced by AWS. One hundred and three participants were recruited across five continents from online English-speaking stuttering forums. Participants were between the ages of 18–72. Seventy percent of the sample population were under 30 years old, and 66% were male. Participants with ongoing medical conditions or treatment were excluded. Backward elimination regression was used to identify the most important factors among the tested variables, followed by structural equation modelling to explore their relationship and effects on PCS-3.
Findings
The findings suggest that a history of neglect, anxiety, younger adult age and avoidant attachment are risk factors of stuttering severity in this adult sample. However, their effect on stuttering was indirect via a latent self-regulatory capacity (C) construct. Only age had a direct and indirect (via C) small to moderate effect on stuttering. C consistently had a negative moderate to large effect on stuttering across all tested models as measured by the PCS-3. Both age and C accounted for 37% of the variance of stuttering. Implications for research, interventions and limitations are discussed.
WHAT THIS PAPER ADDS
What is already known on this subject
Previous findings on stuttering have indicated moderate environmental contributions to its aetiology, but little remains known of the specific environmental influences, especially in adulthood. Most psychological research has studied different variables independently without much consideration of their underlying relationships.
What this paper adds to existing knowledge
Psychosocial variables were found to have an indirect effect on self-reported stuttering in adulthood through the latent con
{"title":"Not Anxiety but Self-Regulatory Capacity and Age Predicts Self-Reported Stuttering Severity in Adults Who Stutter (AWS)","authors":"Victor Penda","doi":"10.1111/1460-6984.70156","DOIUrl":"10.1111/1460-6984.70156","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous studies have reported a moderate influence of environmental factors in the aetiology of stuttering. However, psychological and socio-environmental factors in stuttering are often studied independently without exploring their relationships. This makes it difficult to know which factors are most important, especially among adults who stutter (AWS), as much research has focused on the child and adolescents population. The aim of this study was to address these gaps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>After reviewing the literature, a new stuttering scale (PCS-3) was developed to capture the severity of stuttering as experienced by AWS. One hundred and three participants were recruited across five continents from online English-speaking stuttering forums. Participants were between the ages of 18–72. Seventy percent of the sample population were under 30 years old, and 66% were male. Participants with ongoing medical conditions or treatment were excluded. Backward elimination regression was used to identify the most important factors among the tested variables, followed by structural equation modelling to explore their relationship and effects on PCS-3.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The findings suggest that a history of neglect, anxiety, younger adult age and avoidant attachment are risk factors of stuttering severity in this adult sample. However, their effect on stuttering was indirect via a latent self-regulatory capacity (C) construct. Only age had a direct and indirect (via C) small to moderate effect on stuttering. C consistently had a negative moderate to large effect on stuttering across all tested models as measured by the PCS-3. Both age and C accounted for 37% of the variance of stuttering. Implications for research, interventions and limitations are discussed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> WHAT THIS PAPER ADDS</h3>\u0000 \u0000 <div><i>What is already known on this subject</i>\u0000 \u0000 <ul>\u0000 \u0000 <li>Previous findings on stuttering have indicated moderate environmental contributions to its aetiology, but little remains known of the specific environmental influences, especially in adulthood. Most psychological research has studied different variables independently without much consideration of their underlying relationships.</li>\u0000 </ul>\u0000 <i>What this paper adds to existing knowledge</i>\u0000 \u0000 <ul>\u0000 \u0000 <li>Psychosocial variables were found to have an indirect effect on self-reported stuttering in adulthood through the latent con","PeriodicalId":49182,"journal":{"name":"International Journal of Language & Communication Disorders","volume":"60 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah J. Wallace, Zheng Yen Ng, Bridget Burton, Megan Isaacs, Ryan Deslandes, Gopal Sinh, Kim Barron, Phill Jamieson, Kirstine A. Shrubsole, David A. Copland, Janet Wiles, Victoria J. Palmer, Pippa Evans, Kyla Hudson, Anthony J. Angwin, Annie J. Hill, Barbra H. B. Timmer, Matthew J. Gullo, Jessica H. Campbell, Peter Worthy
<div> <section> <h3> Background</h3> <p>Speech and language therapy for post-stroke aphasia (language/communication impairment) improves language and communication in the short-term; however, access to therapy is limited, and effects are not always maintained. Mobile Health (mHealth) applications may support long-term therapy access and maintenance of gains. We present a protocol for the co-design and evaluation of a novel mHealth application for self-managed aphasia therapy.</p> </section> <section> <h3> Methods</h3> <p>An mHealth application will be developed using Experience-Based Co-Design and Human-Centred Design with people with aphasia (PWA), significant others (SO) and health professionals (HPs). Focus groups will explore self-management experiences and establish co-design priorities using the nominal group technique (<i>n</i> = 10–15 each group). The prototype will be co-designed in eight workshops (<i>n</i> = 4 each group) and evaluated via adapted user-experience (UX) testing. UX testing will use pluralistic walk-throughs, think-aloud evaluations and measures of satisfaction (SUS) and acceptance/intended use (UTAUT-2) (PWA <i>n</i> = 10, SO <i>n</i> = 5, HP <i>n</i> = 10). Feasibility and preliminary efficacy (primary outcomes of treatment adherence and goal attainment) will be assessed through a 4-week field test, followed by focus groups (PWA and SO, <i>n</i> = 20 each). A process evaluation will assess factors influencing (1) the process and outcomes of research involvement, and (2) the functioning and acceptability of the prototype application.</p> </section> <section> <h3> Discussion</h3> <p>Outcomes will include a prototype co-designed mHealth application for self-management of post-stroke aphasia and evidence of acceptability, usability and preliminary efficacy. The process evaluation will increase understanding of the adjustments required to support meaningful participation of PWA in co-design, and future directions for application development and scale-up.</p> </section> <section> <h3> WHAT THIS PAPER ADDS</h3> <div><i>What is already known on this subject</i> <ul> <li>mHealth apps can assist self-management through personalised goals, interactive support and in-the-moment feedback.</li> </ul> </div> <div><i>What this paper adds to existing knowledge</i> <ul> <li>This paper describes the protocol for the co-design and evaluation of a novel mHealth application for self-managed post-stroke aphasia treatment (AphasiaFit).</li>
背景：脑卒中后失语症（语言/沟通障碍）的言语和语言治疗在短期内改善了语言和沟通；然而，获得治疗的机会是有限的，而且效果并不总是保持不变。移动医疗（mHealth）应用程序可支持获得长期治疗并维持治疗成果。我们提出了一项协议，共同设计和评估一种新的移动健康应用程序，用于自我管理失语症治疗。方法：将与失语症患者（PWA）、重要他人（SO）和卫生专业人员（hp）一起使用基于体验的协同设计和以人为本的设计开发移动健康应用程序。焦点小组将探索自我管理经验，并使用名义小组技术建立共同设计优先级（每组n = 10-15）。原型将在8个工作坊中共同设计（每组n = 4），并通过适应性用户体验（UX）测试进行评估。用户体验测试将使用多元的走行、思考式评估和满意度测量（SUS）以及接受度/预期使用（UTAUT-2） （PWA n = 10, SO n = 5, HP n = 10）。可行性和初步疗效（治疗依从性和目标实现的主要结局）将通过为期4周的现场测试进行评估，随后是焦点小组（PWA和SO，每个n = 20）。过程评估将评估影响(1)研究参与的过程和结果，以及(2)原型应用程序的功能和可接受性的因素。讨论：结果将包括共同设计的用于中风后失语症自我管理的移动健康应用原型，以及可接受性、可用性和初步疗效的证据。过程评估将增加对所需调整的理解，以支持PWA在协同设计中的有意义参与，以及应用程序开发和扩展的未来方向。这篇论文补充的内容：在这个问题上已经知道的是，移动健康应用程序可以通过个性化目标、互动支持和即时反馈来帮助自我管理。本文描述了一种用于中风后失语自我管理（AphasiaFit）的新型移动健康应用程序的共同设计和评估方案。这项工作的潜在或实际临床意义是什么？我们的研究结果将是一个共同设计的移动健康应用程序，用于中风后失语症的自我管理治疗。该应用的临床实施可能会增加中风恢复慢性期失语治疗的可及性和依从性。
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<div> <section> <h3> Background</h3> <p>In everyday communication, word retrieval is semantically driven. A similar processing mechanism can be assumed for category fluency tasks. In contrast, in phonemic fluency tasks or rhyme production, the retrieval process must be based on the word form. In phonemic fluency, executive and language functions have been discussed as influencing this specific retrieval mechanism. In addition, studies of adults with developmental dyslexia and non-literate individuals have shown that deficits in written language processing are associated with poorer performance in phonemic fluency; a relationship that is not evident for category fluency. In people with aphasia (PWA), there is a lack of research on the possible relationship between written language skills and word form based word retrieval performance, although PWA often have acquired dyslexia/dysgraphia. There is also a paucity of data on possible effects on rhyme production.</p> </section> <section> <h3> Aims</h3> <p>The aim of the present study was to investigate the effects of written language skills, word retrieval performance, aphasia severity and executive function on phonemic fluency, rhyme production and category fluency. It is hypothesised that phonemic fluency and rhyme production are associated with written language skills, while this is not assumed for category fluency. Word retrieval performance, aphasia severity and executive functions could have an impact on all three tasks.</p> </section> <section> <h3> Methods and Procedures</h3> <p>The study was conducted with 19 PWA (13f, 6m), showing predominantly post-semantic word retrieval disorders. The assessment included the following tasks: phonemic fluency<span>,</span> rhyme production, category fluency, reading and writing of nonwords (sub-lexical written language), reading and writing of unregular words (lexical written language), oral naming in the Boston Naming Test (word retrieval), Token Test (aphasia severity) and two visual-spatial tasks, spatial 2-back (executive function: updating) and antisaccade (executive function: inhibition). Descriptive analyses included correct responses and errors. In a second step, data were analysed by using hierarchical regression analyses.</p> </section> <section> <h3> Outcomes and Results</h3> <p>For both phonemic fluency and rhyme production, reading/writing of nonwords showed the strongest explanatory power. In contrast, for category fluency, the strongest predictor was oral naming performance in the Boston Naming Test.</p> </section> <section> <h3> Conclusion and Implications</h3>
{"title":"Phonemic Fluency and Rhyme Production in People with Aphasic Word Retrieval Disorders: Sub-Lexical Written Language Skills Matter","authors":"Anja Wunderlich","doi":"10.1111/1460-6984.70157","DOIUrl":"10.1111/1460-6984.70157","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In everyday communication, word retrieval is semantically driven. A similar processing mechanism can be assumed for category fluency tasks. In contrast, in phonemic fluency tasks or rhyme production, the retrieval process must be based on the word form. In phonemic fluency, executive and language functions have been discussed as influencing this specific retrieval mechanism. In addition, studies of adults with developmental dyslexia and non-literate individuals have shown that deficits in written language processing are associated with poorer performance in phonemic fluency; a relationship that is not evident for category fluency. In people with aphasia (PWA), there is a lack of research on the possible relationship between written language skills and word form based word retrieval performance, although PWA often have acquired dyslexia/dysgraphia. There is also a paucity of data on possible effects on rhyme production.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The aim of the present study was to investigate the effects of written language skills, word retrieval performance, aphasia severity and executive function on phonemic fluency, rhyme production and category fluency. It is hypothesised that phonemic fluency and rhyme production are associated with written language skills, while this is not assumed for category fluency. Word retrieval performance, aphasia severity and executive functions could have an impact on all three tasks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Procedures</h3>\u0000 \u0000 <p>The study was conducted with 19 PWA (13f, 6m), showing predominantly post-semantic word retrieval disorders. The assessment included the following tasks: phonemic fluency<span>,</span> rhyme production, category fluency, reading and writing of nonwords (sub-lexical written language), reading and writing of unregular words (lexical written language), oral naming in the Boston Naming Test (word retrieval), Token Test (aphasia severity) and two visual-spatial tasks, spatial 2-back (executive function: updating) and antisaccade (executive function: inhibition). Descriptive analyses included correct responses and errors. In a second step, data were analysed by using hierarchical regression analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Outcomes and Results</h3>\u0000 \u0000 <p>For both phonemic fluency and rhyme production, reading/writing of nonwords showed the strongest explanatory power. In contrast, for category fluency, the strongest predictor was oral naming performance in the Boston Naming Test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion and Implications</h3>\u0000 ","PeriodicalId":49182,"journal":{"name":"International Journal of Language & Communication Disorders","volume":"60 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Purpose</h3> <p>Previous studies conducted in Türkiye (Turkey) have revealed that the level of knowledge and awareness regarding swallowing disorders in neurogenic conditions among speech and language pathology students or graduates is relatively low. Furthermore, differences in curricula across various institutions highlight the need for standardized education in this area. This study aimed to assess changes in the knowledge and awareness levels of speech and language pathologists, as well as their opinions about the training, by organizing an educational programme focused on neurogenic communication and swallowing disorders.</p> </section> <section> <h3> Method</h3> <p>A total of 5 days (40 h) of training was carried out over three weekends, with the participation of 40 expert academicians from 20 different institutions. The training was attended by 247 participants on the first day. Before and after the training, a 40-question questionnaire was administered to measure the knowledge and awareness. One hundred and twenty-nine participants filled out both tests. After the training was completed, a 12-question evaluation questionnaire was applied to the participants.</p> </section> <section> <h3> Results</h3> <p>The number of correct answers given by the participants who completed both the pre-test and post-test increased statistically significantly, from 19.09 ± 3.81 to 21.43 ± 3.67 (<i>p</i> < 0.001). The participants stated that their knowledge and awareness levels about the topics increased after the training, with a mean self-reported score of 8.99± 1.18 out of 10.</p> </section> <section> <h3> Conclusions</h3> <p>This training event was the first of its kind in the field of speech and language pathology in Türkiye. While a statistically significant increase in knowledge and awareness was observed following the training, participants' overall knowledge levels remained relatively low. These findings underscore the need for additional and ongoing training to address existing gaps and further enhance professional competencies in this area.</p> </section> <section> <h3> WHAT THIS PAPER ADDS</h3> <div><i>What is already known on this subject</i> <ul> <li>Neurological diseases affect individuals of all age groups and may lead to communication, feeding and swallowing disorders. These problems negatively affect the quality of life of affected individuals and their caregivers. There is a deficiency in the knowledge, awareness and self-confidence levels of speech and
{"title":"Training of Speech and Language Pathologists in Neurogenic Disorders: Enhancing Expertise and Awareness in Communication and Swallowing Disorders","authors":"Mümüne Merve Parlak, Seren Düzenli-Öztürk, Cansu Yıldırım, Merve Sapmaz Atalar, Halil Tayyip Uysal, Ayşen Köse, Didem Çevik","doi":"10.1111/1460-6984.70161","DOIUrl":"10.1111/1460-6984.70161","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Previous studies conducted in Türkiye (Turkey) have revealed that the level of knowledge and awareness regarding swallowing disorders in neurogenic conditions among speech and language pathology students or graduates is relatively low. Furthermore, differences in curricula across various institutions highlight the need for standardized education in this area. This study aimed to assess changes in the knowledge and awareness levels of speech and language pathologists, as well as their opinions about the training, by organizing an educational programme focused on neurogenic communication and swallowing disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A total of 5 days (40 h) of training was carried out over three weekends, with the participation of 40 expert academicians from 20 different institutions. The training was attended by 247 participants on the first day. Before and after the training, a 40-question questionnaire was administered to measure the knowledge and awareness. One hundred and twenty-nine participants filled out both tests. After the training was completed, a 12-question evaluation questionnaire was applied to the participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The number of correct answers given by the participants who completed both the pre-test and post-test increased statistically significantly, from 19.09 ± 3.81 to 21.43 ± 3.67 (<i>p</i> < 0.001). The participants stated that their knowledge and awareness levels about the topics increased after the training, with a mean self-reported score of 8.99± 1.18 out of 10.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This training event was the first of its kind in the field of speech and language pathology in Türkiye. While a statistically significant increase in knowledge and awareness was observed following the training, participants' overall knowledge levels remained relatively low. These findings underscore the need for additional and ongoing training to address existing gaps and further enhance professional competencies in this area.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> WHAT THIS PAPER ADDS</h3>\u0000 \u0000 <div><i>What is already known on this subject</i>\u0000 \u0000 <ul>\u0000 \u0000 <li>Neurological diseases affect individuals of all age groups and may lead to communication, feeding and swallowing disorders. These problems negatively affect the quality of life of affected individuals and their caregivers. There is a deficiency in the knowledge, awareness and self-confidence levels of speech and","PeriodicalId":49182,"journal":{"name":"International Journal of Language & Communication Disorders","volume":"60 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Purpose</h3> <p>This study investigates early anatomic determinants influencing the likelihood of cleft speech characteristics (CSCs) in children with cleft palate with or without lip involvement (CP+/−L). The primary objective was to identify critical anatomic factors within the first year of life that impact the presence of CSCs at Age 3.</p> </section> <section> <h3> Methods</h3> <p>The Cleft Collective Longitudinal Cohort Study of children born with a CP+/−L was utilized. Data from 293 children were included in the analyses. Anatomic variables, including cleft type, pre-operative cleft width and fistula status, were assessed in relation to CSCs. Logistic regression analyses were adjusted for confounding variables such as age, sex and hearing status.</p> </section> <section> <h3> Results</h3> <p>At 36 months, 64.9% of children with cleft palate exhibited CSCs. Anterior CSCs were most common (36.2%), while passive CSCs were least common (16.0%). Cleft type strongly influenced CSC prevalence, with UCLP and BCLP associated with higher odds of any CSC. Wider clefts were associated with passive, non-oral and posterior CSCs. Fistula presence markedly increased the odds of CSCs, especially passive and posterior CSCs. Logistic regression analyses revealed strong associations between cleft type, cleft width, fistula and specific CSCs outcomes.</p> </section> <section> <h3> Conclusions</h3> <p>The multifactorial nature of CSC production in children with CP+/−L is underscored by distinct impacts of cleft type, pre-operative cleft width and fistula status. Early, individualized interventions are paramount, emphasizing the need for proactive measures, including effective fistula management and speech therapy. Prioritizing prevention strategies for children with anatomic risk factors may reduce the likelihood of producing CSCs, contributing to more typical speech development and optimizing long-term speech outcomes for affected children.</p> </section> <section> <h3> WHAT THIS PAPER ADDS</h3> <div><i>What is already known on this subject</i> <ul> <li>Children with cleft palate, with or without lip involvement (CP+/−L), frequently develop speech sound disorders due to anatomic variations affecting the craniofacial complex. Previous research has identified a range of speech difficulties in these children, with variability in the prevalence and types of cleft spe
{"title":"Beyond Prevalence: Understanding the Relationship Between Early Anatomic Factors and the Likelihood for Cleft Speech Characteristics","authors":"Kazlin Mason, Katelyn Kotlarek, Amy Davies, Yvonne Wren","doi":"10.1111/1460-6984.70152","DOIUrl":"10.1111/1460-6984.70152","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study investigates early anatomic determinants influencing the likelihood of cleft speech characteristics (CSCs) in children with cleft palate with or without lip involvement (CP+/−L). The primary objective was to identify critical anatomic factors within the first year of life that impact the presence of CSCs at Age 3.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Cleft Collective Longitudinal Cohort Study of children born with a CP+/−L was utilized. Data from 293 children were included in the analyses. Anatomic variables, including cleft type, pre-operative cleft width and fistula status, were assessed in relation to CSCs. Logistic regression analyses were adjusted for confounding variables such as age, sex and hearing status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At 36 months, 64.9% of children with cleft palate exhibited CSCs. Anterior CSCs were most common (36.2%), while passive CSCs were least common (16.0%). Cleft type strongly influenced CSC prevalence, with UCLP and BCLP associated with higher odds of any CSC. Wider clefts were associated with passive, non-oral and posterior CSCs. Fistula presence markedly increased the odds of CSCs, especially passive and posterior CSCs. Logistic regression analyses revealed strong associations between cleft type, cleft width, fistula and specific CSCs outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The multifactorial nature of CSC production in children with CP+/−L is underscored by distinct impacts of cleft type, pre-operative cleft width and fistula status. Early, individualized interventions are paramount, emphasizing the need for proactive measures, including effective fistula management and speech therapy. Prioritizing prevention strategies for children with anatomic risk factors may reduce the likelihood of producing CSCs, contributing to more typical speech development and optimizing long-term speech outcomes for affected children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> WHAT THIS PAPER ADDS</h3>\u0000 \u0000 <div><i>What is already known on this subject</i>\u0000 \u0000 <ul>\u0000 \u0000 <li>Children with cleft palate, with or without lip involvement (CP+/−L), frequently develop speech sound disorders due to anatomic variations affecting the craniofacial complex. Previous research has identified a range of speech difficulties in these children, with variability in the prevalence and types of cleft spe","PeriodicalId":49182,"journal":{"name":"International Journal of Language & Communication Disorders","volume":"60 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12604683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Voice disorders are a major cause of difficulties in many areas of social life, as they can disrupt communication. Voice therapy, including vocal hygiene education, has an important role in the treatment of voice disorders, especially if applied in an individualised manner.</p> </section> <section> <h3> Aim</h3> <p>The aim of this study was to develop and validate a reliable and practical self-report tool, the Vocal Health Daily Tracking Form, for use in monitoring patients’ daily compliance with vocal hygiene practices and home-based voice therapy exercises.</p> </section> <section> <h3> Methods and Procedures</h3> <p>A total of 266 volunteering participants, including 212 women and 54 men aged 18 and over who were university students from departments of speech and language therapy and audiology, participated in the research. The 12-item Vocal Health Daily Tracking Form, developed based on traditional voice therapy principles, was completed at least once by all 266 participants and twice by 60 of the participants. The validity and reliability of the form were evaluated in line with the statistical analysis of the obtained data.</p> </section> <section> <h3> Outcomes and Results</h3> <p>Statistical analyses confirmed that the Vocal Health Daily Tracking Form is a reliable and valid tool. While the Kaiser-Meyer-Olkin test value of the form was found to be very good at 0.799, the Bartlett test result was 961.473 (<i>p</i> < 0.05), confirming a strong correlation between the items of the form. The Cronbach alpha value of the study was found to be sufficient at 0.809. The total correlation values were between 0.326 and 0.651, and the amount of explained variance was sufficient at 33.28%. These findings confirmed that the scale is well constructed both conceptually and structurally and is a valid and reliable measurement tool.</p> </section> <section> <h3> Conclusions and Implications</h3> <p>In addition to vocal hygiene recommendations, the individualisation of the therapy process and the use of methods based on behavioural techniques may contribute positively to the voice rehabilitation processes of individuals with voice disorders. The Vocal Health Daily Tracking Form has high validity and reliability values, confirming that it can be considered an important tool for monitoring and improving voice therapy processes. It may also help patients experience more regular and effective therapy processes by increasing their self-regulation and motivation during voice therapy.</p> </section>
背景：声音障碍是社会生活中许多领域困难的主要原因，因为它们会破坏交流。声音治疗，包括声音卫生教育，在治疗声音障碍方面具有重要作用，特别是如果以个性化的方式应用。目的：本研究的目的是开发和验证一种可靠和实用的自我报告工具，即“语音健康每日跟踪表”，用于监测患者每天遵守语音卫生习惯和家庭语音治疗练习的情况。方法和步骤：共有266名志愿者参与了这项研究，其中包括212名女性和54名男性，年龄在18岁及以上，他们都是来自言语和语言治疗以及听力学系的大学生。这份包含12个项目的《声音健康每日追踪表》是根据传统的声音治疗原则开发的，266名参与者至少完成了一次，其中60名参与者至少完成了两次。通过对所得数据的统计分析，对表格的效度和信度进行了评价。结果和结果：统计分析证实了“声带健康每日追踪表”是一个可靠和有效的工具。表格的Kaiser-Meyer-Olkin检验值非常好，为0.799，Bartlett检验结果为961.473 (p < 0.05)，证实表格各项目之间具有很强的相关性。本研究的Cronbach alpha值为0.809是足够的。总相关值在0.326 ~ 0.651之间，解释方差量为33.28%。这些发现证实了量表在概念和结构上都是很好的构建，是一个有效和可靠的测量工具。结论和意义：除了声音卫生建议外，治疗过程的个性化和基于行为技术的方法的使用可能对声音障碍患者的声音康复过程有积极的贡献。语音健康每日跟踪表具有高效度和可靠性值，确认它可以被认为是监测和改进语音治疗过程的重要工具。它还可以通过在语音治疗过程中增加患者的自我调节和动机，帮助患者体验更有规律和有效的治疗过程。本文补充的内容：关于这个主题，我们已经知道声音障碍是主要的健康问题，它对个人的沟通能力和生活质量产生负面影响（Cohen et al., 2006）。这些疾病可能是由于器质性、神经性或功能性原因引起的，并可能导致音质、音高或强度的异常变化（Behrman, 2007）。声音治疗和各种治疗方法，包括声音卫生教育和培训，在声音障碍个体的康复过程中发挥着重要作用（Garabet et al., 2024）。在治疗过程中布置的家庭作业，包括声乐练习和卫生习惯，对提高治疗效果至关重要（Desjardins et al., 2017）。本研究旨在开发并验证一种可靠实用的自我报告工具——“语音健康每日追踪表”，以监测患者在语音康复期间对语音卫生习惯和家庭语音治疗练习的日常依从性。为了实现这一目标，开发了“声音健康每日跟踪表”，允许患者记录他们每天参与的声音卫生实践和声音练习。并对新表格的效度和信度进行了评价。本研究提出了一种语音监测表格的效度和信度分析，以提高患者对语音治疗的依从性。稳定地遵守语音卫生和规定的在家练习对治疗效果有显著影响，本研究提出的语音监测表具有较高的效度（KMO = 0.799, p < 0.001）和信度，表明它可以被认为是监测影响治疗过程结果的日常练习的重要工具。这项工作的潜在或实际临床意义是什么？该研究有望为未来的研究和临床实践提供指导，以解决患者在语音治疗过程中的依从性和行为管理问题。
{"title":"Collaboration in Voice Therapy: Development of a Vocal Health Daily Tracking Form","authors":"Rıza Korhan Sezin, Ayşe Ertürk, Şerife Nur Biçen","doi":"10.1111/1460-6984.70159","DOIUrl":"10.1111/1460-6984.70159","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Voice disorders are a major cause of difficulties in many areas of social life, as they can disrupt communication. Voice therapy, including vocal hygiene education, has an important role in the treatment of voice disorders, especially if applied in an individualised manner.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this study was to develop and validate a reliable and practical self-report tool, the Vocal Health Daily Tracking Form, for use in monitoring patients’ daily compliance with vocal hygiene practices and home-based voice therapy exercises.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Procedures</h3>\u0000 \u0000 <p>A total of 266 volunteering participants, including 212 women and 54 men aged 18 and over who were university students from departments of speech and language therapy and audiology, participated in the research. The 12-item Vocal Health Daily Tracking Form, developed based on traditional voice therapy principles, was completed at least once by all 266 participants and twice by 60 of the participants. The validity and reliability of the form were evaluated in line with the statistical analysis of the obtained data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Outcomes and Results</h3>\u0000 \u0000 <p>Statistical analyses confirmed that the Vocal Health Daily Tracking Form is a reliable and valid tool. While the Kaiser-Meyer-Olkin test value of the form was found to be very good at 0.799, the Bartlett test result was 961.473 (<i>p</i> < 0.05), confirming a strong correlation between the items of the form. The Cronbach alpha value of the study was found to be sufficient at 0.809. The total correlation values were between 0.326 and 0.651, and the amount of explained variance was sufficient at 33.28%. These findings confirmed that the scale is well constructed both conceptually and structurally and is a valid and reliable measurement tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Implications</h3>\u0000 \u0000 <p>In addition to vocal hygiene recommendations, the individualisation of the therapy process and the use of methods based on behavioural techniques may contribute positively to the voice rehabilitation processes of individuals with voice disorders. The Vocal Health Daily Tracking Form has high validity and reliability values, confirming that it can be considered an important tool for monitoring and improving voice therapy processes. It may also help patients experience more regular and effective therapy processes by increasing their self-regulation and motivation during voice therapy.</p>\u0000 </section>\u0000 \u0000 ","PeriodicalId":49182,"journal":{"name":"International Journal of Language & Communication Disorders","volume":"60 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Standardised Mandarin assessment tools for examining difficulties in language comprehension and expression at different developmental stages are limited in China. The first comprehensive standardised Mandarin assessment tool is the Diagnostic Receptive and Expressive Assessment of Mandarin-Comprehensive (DREAM-C), which is normed for children aged 2.5–8 years in Mainland China.</p> </section> <section> <h3> Aims</h3> <p>This study aimed to explore the evidence-based validity of DREAM-C in children with Developmental Language Disorder (DLD) to make it clinically useful in Hubei Province, China. To evaluate the diagnostic performance of three commonly used assessment tools in identifying DLD among Mandarin-speaking children in China, using multidisciplinary clinical diagnosis as the reference standard, with particular focus on the diagnostic accuracy and concurrent validity of the DREAM-C.</p> </section> <section> <h3> Methods and Procedures</h3> <p>The detailed medical history of children with speech, language and communication needs in child healthcare paediatric outpatient clinics was taken by clinicians and speech-language therapists and assessed using the DREAM-C, Gesell Developmental Schedules (GDS), and Wechsler Preschool and Primary Intelligence Scale (WPPSI-IV) in Tongji Hospital in Hubei Province, China, from December 2018 to January 2020. The sensitivity, specificity, percent agreement and correlation coefficient for the three assessments were compared for 320 children with DLD and 101 typical children.</p> </section> <section> <h3> Outcomes & Results</h3> <p>The mean age of participants was 3.81 years (range: 2.5–5.7) for the DLD group and 4.08 years (range: 2.5–6.0) for the TD group. Results showed that the sensitivity and specificity of DREAM-C were as high as that of the GDS (>0.80) in children with DLD, and the Verbal Comprehension Index (VCI) in WPPSI-IV had a low sensitivity (0.58) in the DLD group. The percent agreement between the DREAM-C subscales and language developmental quotient (DQ) of GDS was also high (70.63%–88.75%). The scores of each subscale of DREAM-C had a moderate and significant positive correlation with the language DQ of GDS (<i>r</i> = 0.35–0.56, <i>p</i> < 0.05). The scores of each subtest of DREAM-C had significantly low correlation with the verbal comprehension index in WPPSI-IV (<i>r</i> = 0.27–0.39, <i>p</i> < 0.05) in the DLD group.</p> </section> <section> <h3> Conclusions and Implications</h3> <p>The findings indicate that DREAM-C demonstrates good diagno
{"title":"Diagnostic Accuracy and Concurrent Validity of the Diagnostic Receptive and Expressive Assessment of Mandarin-Comprehensive (Dream-C) for Developmental Language Disorder in China","authors":"Jinzhu Zhao, Lina Tang, Jinhui Li, Tianyi He, Tingting Xiong, Lu Xu, Xuejin He, Shan Huang, Xueman Lucy Liu, Yan Hao","doi":"10.1111/1460-6984.70158","DOIUrl":"10.1111/1460-6984.70158","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Standardised Mandarin assessment tools for examining difficulties in language comprehension and expression at different developmental stages are limited in China. The first comprehensive standardised Mandarin assessment tool is the Diagnostic Receptive and Expressive Assessment of Mandarin-Comprehensive (DREAM-C), which is normed for children aged 2.5–8 years in Mainland China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to explore the evidence-based validity of DREAM-C in children with Developmental Language Disorder (DLD) to make it clinically useful in Hubei Province, China. To evaluate the diagnostic performance of three commonly used assessment tools in identifying DLD among Mandarin-speaking children in China, using multidisciplinary clinical diagnosis as the reference standard, with particular focus on the diagnostic accuracy and concurrent validity of the DREAM-C.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Procedures</h3>\u0000 \u0000 <p>The detailed medical history of children with speech, language and communication needs in child healthcare paediatric outpatient clinics was taken by clinicians and speech-language therapists and assessed using the DREAM-C, Gesell Developmental Schedules (GDS), and Wechsler Preschool and Primary Intelligence Scale (WPPSI-IV) in Tongji Hospital in Hubei Province, China, from December 2018 to January 2020. The sensitivity, specificity, percent agreement and correlation coefficient for the three assessments were compared for 320 children with DLD and 101 typical children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Outcomes & Results</h3>\u0000 \u0000 <p>The mean age of participants was 3.81 years (range: 2.5–5.7) for the DLD group and 4.08 years (range: 2.5–6.0) for the TD group. Results showed that the sensitivity and specificity of DREAM-C were as high as that of the GDS (>0.80) in children with DLD, and the Verbal Comprehension Index (VCI) in WPPSI-IV had a low sensitivity (0.58) in the DLD group. The percent agreement between the DREAM-C subscales and language developmental quotient (DQ) of GDS was also high (70.63%–88.75%). The scores of each subscale of DREAM-C had a moderate and significant positive correlation with the language DQ of GDS (<i>r</i> = 0.35–0.56, <i>p</i> < 0.05). The scores of each subtest of DREAM-C had significantly low correlation with the verbal comprehension index in WPPSI-IV (<i>r</i> = 0.27–0.39, <i>p</i> < 0.05) in the DLD group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Implications</h3>\u0000 \u0000 <p>The findings indicate that DREAM-C demonstrates good diagno","PeriodicalId":49182,"journal":{"name":"International Journal of Language & Communication Disorders","volume":"60 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Recent research indicates that bilingualism does not exacerbate the language learning difficulties commonly seen in children with down syndrome (DS). However, misconceptions persist about its potential negative impact.</p> </section> <section> <h3> Aims</h3> <p>This study aimed to investigate the attitudes, perceptions and experiences of bilingual parents or guardians raising children with DS, focusing on challenges, strategies, and professional advice received. To our knowledge, this is the first study to explore this topic specifically within this population.</p> </section> <section> <h3> Methods and Procedures</h3> <p>Fifty-seven parents participated in an online survey exploring these factors using both quantitative and qualitative responses. A significant majority of participants (87.72%) had chosen to raise their children bilingually, motivated by cultural heritage, community support and perceived cognitive benefits.</p> </section> <section> <h3> Outcomes and Results</h3> <p>Overall, parental attitudes toward bilingualism were positive. Many reported receiving supportive information yet concerns and a lack of professional support were prevalent. Challenges included a shortage of bilingual therapists, inadequate educational provisions, and insufficient tailored information on bilingualism. Professional advice varied substantially. Speech and language therapists generally provided positive advice, while social workers, health visitors, and psychologists offered mixed recommendations. Nursery and school practitioners often exhibited uncertainty about bilingualism, contributing to parental concerns. Despite this, children with DS exposed to multiple languages were observed to be acquiring both languages with expected language patterns observed. Just over half (52%) of the families had concerns about raising their child bilingually, primarily about the difficulty of learning two languages, lack of support, and concerns around confusion. Crucially, those receiving positive professional advice were more likely to continue promoting bilingualism.</p> </section> <section> <h3> Conclusions and Implications</h3> <p>This study highlights the need for consistent, evidence-based support for families raising bilingual children with DS. Improved professional training and resources are needed to ensure children with DS can receive equitable access to bilingualism and are able to thrive in bilingual environments.</p>
{"title":"Attitudes Towards Bilingualism: Insights From Parents of Children With Down Syndrome","authors":"Rebecca Ward, Eloi Puig-Mayenco","doi":"10.1111/1460-6984.70153","DOIUrl":"https://doi.org/10.1111/1460-6984.70153","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Recent research indicates that bilingualism does not exacerbate the language learning difficulties commonly seen in children with down syndrome (DS). However, misconceptions persist about its potential negative impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to investigate the attitudes, perceptions and experiences of bilingual parents or guardians raising children with DS, focusing on challenges, strategies, and professional advice received. To our knowledge, this is the first study to explore this topic specifically within this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Procedures</h3>\u0000 \u0000 <p>Fifty-seven parents participated in an online survey exploring these factors using both quantitative and qualitative responses. A significant majority of participants (87.72%) had chosen to raise their children bilingually, motivated by cultural heritage, community support and perceived cognitive benefits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Outcomes and Results</h3>\u0000 \u0000 <p>Overall, parental attitudes toward bilingualism were positive. Many reported receiving supportive information yet concerns and a lack of professional support were prevalent. Challenges included a shortage of bilingual therapists, inadequate educational provisions, and insufficient tailored information on bilingualism. Professional advice varied substantially. Speech and language therapists generally provided positive advice, while social workers, health visitors, and psychologists offered mixed recommendations. Nursery and school practitioners often exhibited uncertainty about bilingualism, contributing to parental concerns. Despite this, children with DS exposed to multiple languages were observed to be acquiring both languages with expected language patterns observed. Just over half (52%) of the families had concerns about raising their child bilingually, primarily about the difficulty of learning two languages, lack of support, and concerns around confusion. Crucially, those receiving positive professional advice were more likely to continue promoting bilingualism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Implications</h3>\u0000 \u0000 <p>This study highlights the need for consistent, evidence-based support for families raising bilingual children with DS. Improved professional training and resources are needed to ensure children with DS can receive equitable access to bilingualism and are able to thrive in bilingual environments.</p>\u0000 ","PeriodicalId":49182,"journal":{"name":"International Journal of Language & Communication Disorders","volume":"60 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1460-6984.70153","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Schwarz, Elizabeth C. Ward, Chloe Walton, Marnie Seabrook
<div> <section> <h3> Background</h3> <p>Allied Health Assistants (AHAs) have been shown to increase both workforce and service capacity. To date, there has been positive evidence reported for the safe and effective delegation of dysphagia management tasks to AHAs for key roles, including dysphagia screening, mealtime monitoring and providing patient-end support during clinical swallowing assessments conducted via telehealth. The utilisation of AHA delegation to support dysphagia rehabilitation, however, has not been previously examined within an outpatient setting.</p> </section> <section> <h3> Aims</h3> <p>To (1) identify the proportion and type of dysphagia-related tasks suitable for AHA delegation within an Australian outpatient setting, (2) evaluate the safety and acceptability of AHA delegated tasks and (3) determine implementation feasibility in an Australian outpatient context guided by the Practical Robust Implementation and Sustainability Model (PRISM) framework.</p> </section> <section> <h3> Methods and Procedures</h3> <p>A mixed method pre-implementation study design was used combining (a) a time and motion study to identify suitable dysphagia rehabilitation tasks for delegation; (b) a pilot trial of AHA delegated dysphagia rehabilitation to determine patient safety and satisfaction with the model and (c) semi-structured qualitative interviews with staff to explore the factors influencing the model's feasibility, aligned to the PRISM domains.</p> </section> <section> <h3> Outcomes and Results</h3> <p>While only 25% of the outpatient speech pathology caseload was noted to be dysphagia related, more than half (65%) of the dysphagia tasks completed in the outpatient setting were deemed suitable for AHA delegation. Patient outcomes from the pilot implementation were noted to be positive, with 78% of patients demonstrating improved swallowing. Patient satisfaction and AHA confidence were also noted to be high. However, the model's feasibility within the current context was noted to be influenced by several contextual barriers, primarily within the PRISM domains of ‘organisational characteristics’ and ‘patient characteristics’.</p> </section> <section> <h3> Conclusions and Implications</h3> <p>AHA delegation in the outpatient setting was identified to be safe and acceptable to patients within the pilot trial, though contextual barriers were reported to impact the model's feasibility. Engagement of AHAs in delegated dysphagia rehabilitation tasks has the potential to provide further opportunity to improve patient access to dysphagia services, with
{"title":"An Australian Pilot Trial of the Safety and Feasibility of Allied Health Assistant Delegation in Outpatient Dysphagia Rehabilitation","authors":"Maria Schwarz, Elizabeth C. Ward, Chloe Walton, Marnie Seabrook","doi":"10.1111/1460-6984.70154","DOIUrl":"10.1111/1460-6984.70154","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Allied Health Assistants (AHAs) have been shown to increase both workforce and service capacity. To date, there has been positive evidence reported for the safe and effective delegation of dysphagia management tasks to AHAs for key roles, including dysphagia screening, mealtime monitoring and providing patient-end support during clinical swallowing assessments conducted via telehealth. The utilisation of AHA delegation to support dysphagia rehabilitation, however, has not been previously examined within an outpatient setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To (1) identify the proportion and type of dysphagia-related tasks suitable for AHA delegation within an Australian outpatient setting, (2) evaluate the safety and acceptability of AHA delegated tasks and (3) determine implementation feasibility in an Australian outpatient context guided by the Practical Robust Implementation and Sustainability Model (PRISM) framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Procedures</h3>\u0000 \u0000 <p>A mixed method pre-implementation study design was used combining (a) a time and motion study to identify suitable dysphagia rehabilitation tasks for delegation; (b) a pilot trial of AHA delegated dysphagia rehabilitation to determine patient safety and satisfaction with the model and (c) semi-structured qualitative interviews with staff to explore the factors influencing the model's feasibility, aligned to the PRISM domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Outcomes and Results</h3>\u0000 \u0000 <p>While only 25% of the outpatient speech pathology caseload was noted to be dysphagia related, more than half (65%) of the dysphagia tasks completed in the outpatient setting were deemed suitable for AHA delegation. Patient outcomes from the pilot implementation were noted to be positive, with 78% of patients demonstrating improved swallowing. Patient satisfaction and AHA confidence were also noted to be high. However, the model's feasibility within the current context was noted to be influenced by several contextual barriers, primarily within the PRISM domains of ‘organisational characteristics’ and ‘patient characteristics’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Implications</h3>\u0000 \u0000 <p>AHA delegation in the outpatient setting was identified to be safe and acceptable to patients within the pilot trial, though contextual barriers were reported to impact the model's feasibility. Engagement of AHAs in delegated dysphagia rehabilitation tasks has the potential to provide further opportunity to improve patient access to dysphagia services, with","PeriodicalId":49182,"journal":{"name":"International Journal of Language & Communication Disorders","volume":"60 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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