American Journal of Speech-Language Pathology最新文献

Purpose: A Phase II study on collaborative referencing intervention (CRI) documented significant positive treatment effects on a traditional confrontation naming measure in four participants with aphasia (PWAs). We replicated the 2021 study and extended it by studying the treatment effect on dyadic conversations and perceptions of communication confidence.

Method: Three PWAs participated in this multiple-probe, single-case experimental study composed of (a) three preparatory sessions, (b) five baseline sessions, (c) 15 CRI sessions with five treatment probes, and (d) five maintenance sessions. The dependent variables included a collaborative confrontation naming (CCN) probe, the Communication Confidence Rating Scale for Aphasia (CCRSA; Babbitt et al., 2011), and 10-min conversations each with clinician and a communication partner. Each CRI session (i.e., independent variable) consisted of a photo-matching game with the participant and clinician taking alternative turns identifying and matching personally relevant treatment cards. CCN probes were scored using a multidimensional rating scale. Analyses of correct information units_conv (CIU_conv), trouble sources, and repairs were conducted on the conversations across the study. The CCRSA scores were also analyzed across the study.

Results: Multiple-probe analysis revealed significant positive treatment effects on (a) confrontation naming (consistent with the previous study), (b) conversations (on trouble sources and repairs with clinician only, with no significant changes in CIU_conv across partners), and (c) perceived communication confidence across participants.

Conclusions: CRI emerges as a promising intervention for individuals with aphasia with potential impacts on conversations and perceived communication confidence. Future research endeavors will further augment our understanding and evidence base regarding this treatment.

Purpose: The purpose of the study was to explore the lived experiences of Asian American speech-language pathologists (SLPs) during their graduate training.

Method: This was a qualitative phenomenological study. Participants were 26 SLPs who self-identified as Asian American. All participants graduated from accredited master's programs in speech-language pathology in the United States and currently work clinically with adult populations. Participants attended one individual semistructured interview via videoconference to share their experiences being Asian in speech-language pathology. Thematic analysis was used to identify recurring patterns and themes from the interview data.

Results: Three themes were derived from the participant interviews that reflect the Asian American SLPs' past experiences as graduate students and trainees. The first theme revealed the participants' motivations and affirmations for choosing the SLP career path. The second theme describes the expectations of mutual investment between the Asian American students' commitment to professional training and their training programs' support in their professional growth. The last theme talks about the social aspects of their trainee experiences that influenced their sense of belonging.

Conclusions: There were similarities between the Asian American SLP trainee experiences and experiences of underrepresented and minoritized students from speech-language pathology and other health professions reported in the literature. Two key aspects distinct to Asian Americans and speech-language pathology were the sense of belongingness created by the social environment and the perceived tie of speech and linguistic proficiency and clinical competence. Findings contribute to how educators, leaders, and researchers can support inclusion of Asian Americans pursing speech-language pathology.

Purpose: Infants requiring noninvasive respiratory support (NRS) are often orally fed, although data supporting the safety and efficacy of this practice are limited. This study aimed to identify the rate of this practice, the amount of support received during oral feeding, and characteristics of infants orally fed during NRS use; describe feeding expert involvement; and assess change from before and after the onset of the COVID-19 pandemic.

Method: Retrospective electronic health record data from one children's hospital were extracted and manually reviewed.

Results: Results for 201 infants who required NRS during hospitalization in 2019 (n = 100) and 2022 (n = 101) were included, of which 91 (45.3%) were orally fed during NRS use. Of these, 33 were fed on high-flow nasal cannula (HFNC) with a mean flow rate of 2.75 L per minute (SD = 2.2, Mdn = 2 [min-max: 2-14]) and mean fraction of inspired oxygen (FiO₂) of 0.47 (SD = 0.31, Mdn = 0.30 [min-max: 0.21-1.0]). Thirty-seven feeding specialist consults were placed for infants fed during NRS use. Factors increasing odds of oral feeding during NRS use included not having a dysphagia or feeding difficulty diagnosis. Infants admitted during 2022 were more likely to have a respiratory diagnosis than in 2019 and were more likely to be orally fed during HFNC (50.0% [n = 25/50] in 2022 vs. 20.5% [n = 8/39] in 2019).

Conclusion: These results suggest that feeding infants on NRS is common, that some infants are more likely to be orally fed than others, and that feeding experts are rarely consulted in this population despite limited safety and efficacy data related to this practice.

Purpose: The purpose of this clinical focus article is to describe the use of the Accountable Health Communities health-related social needs screening tool for speech-language pathologists (SLPs) while highlighting two case studies of children with traumatic brain injury.

Method: This article provides an overview of social determinants of health (SDOH) and health-related social needs with a primary focus on children with traumatic brain injury. It aims to inform and prepare clinicians to use a health-related social needs screening tool, as they can be directly addressed and mitigated with adequate community resources.

Results: SLPs are in the unique position to consider and understand their clients' SDOH, providing support or referral as needed if there are areas of social need or social risk factors.

Conclusions: SLPs could screen for health-related social needs by using the Accountable Health Communities health-related social needs screening tool subsequently advocating for patient-centered, holistic care. SLPs could individualize best care practice for their patients by engaging in interprofessional practice, making appropriate assessment and treatment modifications, and referring to related professionals.

Purpose: Dynamic Temporal and Tactile Cueing (DTTC) is an evidence-based treatment for children with childhood apraxia of speech. In clinical practice, speech-language pathologists (SLPs) frequently use an eclectic approach incorporating aspects of DTTC, for reasons that are not well understood. This research note describes a qualitative investigation of the experiences of SLPs and caregivers who participated in protocolized research DTTC for a 24-session treatment efficacy study. Specifically, we sought to understand the perspectives of these SLPs and caregivers regarding (a) DTTC treatment, as provided during the study, and (b) participating in a treatment research study.

Method: Four SLPs and three caregivers participated in semistructured interviews, via Zoom, 4 weeks after the treatment study. Questions explored perceptions of research DTTC treatment and experiences of participating in a research study. Data were analyzed with inductive thematic analysis using an iterative and reflective process.

Results: One overarching main theme was identified: "Research and clinical practice: Different priorities and processes," with five subthemes. The subthemes were (a) research DTTC is more challenging, (b) research DTTC is surprisingly effective, (c) clinical practice is preferable to research, (d) research participation leads to new learning, and (e) power differential exists between researchers and clinicians.

Conclusions: Aspects of the research DTTC were uncomfortable for SLPs and families, despite its efficacy and what they learned from participating. SLPs perceived a schism between researchers and clinicians. More needs to be done to decrease the perceived gap between researchers and clinicians to facilitate implementation of evidence-based practice in nonresearch contexts.

Supplemental material: https://doi.org/10.23641/asha.28299764.

Purpose: This study examined the quantity and complexity of speech-language pathologists' (SLPs') talk during therapy with school-aged children and explored the extent to which SLP- and session-level characteristics contribute to the variability in SLP talk quantity, grammatical complexity, and lexical complexity during therapy.

Method: We used secondary data collected from 209 business-as-usual therapy session recordings collected in the fall of the school year involving 75 SLPs and 281 kindergarten, first-, and/or second-grade students. Students were receiving services for language disorder and had therapy goals targeting various domains of language. SLP talk was coded to capture various aspects of quantity and complexity.

Results: SLPs with more years of experience tended to produce a lower quantity of talk, whereas higher levels of time pressure were associated with increased quantity of talk as well as grammatical and lexical complexity. In addition, session length, mean age of children, and children's phonological awareness scores were significantly associated with SLP talk quantity, grammatical complexity, and lexical complexity.

Conclusions: This study adds to the evidence for the variability of SLP talk. SLP talk quantity and complexity are related to SLPs' years of experience and time pressure. Session-level predictors suggest grouping strategies for therapy sessions.

Purpose: This study was motivated by goal samples from practicing speech-language pathologists (SLPs) that were submitted to a website our group maintains about treatment planning for aphasia. Upon analyzing the goals, we found that less than 3% involved any form of communication partner training (CPT). Considering this finding, we sought to understand how and to what extent aphasia clinicians in the United States use CPT with significant others.

Method: We constructed a survey that included a mixture of multiple-choice and open response questions around goal setting and CPT for significant others. The survey was posted to the same website where we had originally collected the goal samples. Responses were summarized with descriptive statistics and thematic analysis.

Results: One hundred fifty-six SLPs and 138 graduate students completed the survey. Almost all SLPs (97%) reported engaging in CPT with family members, and approximately half indicated they also wrote goals about this service at least occasionally. However, most explained that CPT was typically handled without goal setting. Graduate students reported limited experience with CPT. Thematic analysis of the open responses yielded five themes and 24 codes that collectively display a multidimensional implementation problem.

Discussion: SLPs recognize the importance of CPT and employ a range of training techniques with significant others. Nevertheless, they face barriers that lead to ambivalence about writing goals for this service. On the rationale that explicit goals ensure accountability and transparency, we address some of the barriers by providing practical resources as steps toward solution-focused collaboration.

Purpose: Ankyloglossia (tongue tie) is common, and its clinical relevance is hotly debated among multidisciplinary health care providers including pediatricians, lactation consultants, otolaryngologists, and speech-language pathologists. The literature focuses on breastfeeding symptoms; less evidence exists to clarify the spectrum of possible symptoms after infancy. We conducted a scoping review of potentially related symptoms in pediatric patients who presented for clinical evaluation of untreated ankyloglossia, with the aim of mapping symptoms that providers may want to evaluate and identifying targets for further research. Kummer (2025) has alleged "erroneous statements without evidence" about "the effect of ankyloglossia on speech," "inaccurate citations," and "errors of omission" in our scoping review (pp. 1, 2). This letter provides a rebuttal of her statements.

Results: Based on results from 20 primary studies, our review drew a provisional conclusion that ankyloglossia may be associated with speech difficulty in a subset of patients; we did not assert any causal relationship. Kummer took issue with a citation in one sentence of our review; we note that some of her concerns were inaccurate, though we appreciate her clinical expertise on speech sound production. The omissions she perceived were in fact present in our original review article.

Conclusions: Kummer's letter does not warrant an erratum to our scoping review. However, her letter prompts us to urge the multidisciplinary community of providers involved in studying and caring for patients with ankyloglossia to engage in a collaborative and open-minded discussion. We must reduce professional antagonism around this controversy and work together on patient-centered research to support children whose experiences may not fit the typical clinical picture.

Purpose: There is a great deal of misinformation among professionals about the effect (or lack thereof) of ankyloglossia on speech. Consequently, many children undergo unnecessary frenotomy procedures that do not improve their speech and may cause unnecessary complications. This letter points out several erroneous statements in Cordray et al. (2023) about the effect of ankyloglossia on speech. In addition, it identifies articles that were incorrectly cited to support these statements. This letter also reveals significant errors of omission, including the results of the systematic review from the Agency for Healthcare Research and Quality, which found that there is insufficient evidence to conclude that ankyloglossia affects speech. Another omission was the consensus statement from the American Academy of Otolaryngology-Head and Neck Surgery Consensus Report, which states that ankyloglossia does not typically affect speech. Finally, this letter details the reasons why ankyloglossia is highly unlikely to affect speech.

Conclusion: Contrary to statements made in Cordray et al. (2023), there is no evidence that ankyloglossia affects speech production, and therefore, it is highly unlikely to be the cause of a speech sound disorder. This is because even with severe restriction of tongue tip movement, a compensation (or alternative method of production) can be used to produce lingual phonemes with the same acoustic output.

Purpose: Rating the quality of conversations can assess communication skills in both people with acquired brain injury and their communication partners. This study explored the clinical feasibility and reliability of two conversation rating scales: the Adapted Measure of Participation in Conversation (MPC) and the Adapted Measure of Support in Conversation (MSC).

Method: Raters were final-year speech and language therapy students (n = 14) and qualified clinicians (n = 2). Raters attended training on the Adapted MPC and MSC, watched 5 or 10 min of videotaped conversations (n = 23), and then scored them on the MPC and MSC scales. Data were collected over four phases, which varied according to the length of the training, sample length, number of samples rated, and level of clinical expertise. Feasibility data (time taken to score conversations and ease of use) were collected. Interrater reliability was assessed using intraclass correlations (ICCs: absolute agreement, single measures).

Results: Raters took 30-45 min to score a 10-min sample, and they took 20-30 min to score a 5-min sample. Ease of use was rated highly across all phases. Overall reliability for rating 5 min of conversation (ICC = .52-.73) was better than for 10 min of conversation (ICC = .33-.68). Reliability for the MPC was moderate for both students (ICC = .69) and clinicians (ICC = .55), and for the MSC, it was moderate for both students (ICC = .73) and clinicians (ICC = .58). Reliability was better for students compared with clinicians.

Conclusions: Rating a 5-min conversation in under 30 min was feasible, with more reliable results for 5-min compared with 10-min conversations. Implications for assessing conversation in the future are discussed.