American Journal of Speech-Language Pathology最新文献

Purpose: Bilingual children of the same age may differ in narrative skills depending on their experiences in each language. This study examined the effects of Spanish and English language proficiency on the production of macrostructural elements in oral story retell tasks by Spanish-English bilingual children.

Method: Forty typically developing Spanish-English-speaking children, 5-7 years of age, participated in this study. For each language, five multiple regressions were conducted to estimate the effects of Spanish and English language proficiency on narrative macrostructure on five dependent variables: two global measures (total number of elements and number of complete episodes) and the three elements of a complete episode (initiating events, actions, and outcomes), based on Spanish and English oral narrative samples.

Results: In Spanish, language proficiency accounted for the variability in all outcome measures except initiating events and actions. In English, proficiency accounted for the variability in all outcome measures except outcomes.

Conclusion: Results suggested that Spanish and English proficiency affects children's oral narrative skills, with differential effects across outcome measures in each language.

Purpose: This randomized clinical trial investigated the short- and longer-term effects of intonation training on acoustic parameters, listener perceptions, and self-reported outcomes in transgender and gender diverse (TGD) individuals.

Method: Twenty-three TGD individuals presumed female at birth (17 nonbinary and six transmasculine) aiming for a more masculine-sounding voice were randomized into two groups. Group 1 completed 4 weeks of intonation training for developing more masculine intonation patterns. Group 2 received 4 weeks of intonation training after 4 weeks of sham training. Recordings were made pretraining, after sham training (only Group 2), after intonation training (Groups 1 and 2), and at follow-up (after 4 weeks of no intervention). Acoustic and perceptual intonation parameters, self-perception of voice, and perception of masculinity/femininity by others were examined. The outcomes were analyzed using linear mixed models.

Results: Significant and desired decreases were observed in all acoustic and perceptual intonation parameters (i.e., general and final intonation shifts, general fundamental frequency [f_o] range, and f_o variation index) across sentence types (i.e., yes/no questions, question word questions, and declarative sentences). Naive listeners perceived participants' voices as significantly more masculine after intonation training. In addition, the participants reported their voice as significantly more masculine and more aligned with their gender identity. They observed significantly more downward intonation shifts at the end of utterances, significantly less pitch variation, and significantly slower pitch changes.

Conclusion: Findings support including intonation in voice and communication training for TGD individuals seeking a more masculine-sounding voice, offering an effective intervention for gender-affirming voice modification.

Supplemental material: https://doi.org/10.23641/asha.31079494.

Purpose: Despite the inestimable importance of literacy skills for children who use augmentative and alternative communication (AAC), many AAC users do not develop even basic literacy skills. The Accessible Literacy Learning (ALL) curriculum is evidence-based; however, little research has investigated the effects of instruction using the ALL app, and no research has examined parent-implemented adapted literacy instruction.

Method: A single case study with a multiple-baseline across-participants design was used to investigate the effects of instruction using the ALL app, implemented by trained parents, on the acquisition of three phonics-based early literacy skills (i.e., sound blending, decoding, and high-frequency words), with four children who had minimal or no speech and used high-tech AAC. The ALL app was implemented by parents who were virtually trained, and progress was monitored remotely by researchers. Social validity data were also collected from parents.

Results: All four participants made intervention gains in sound blending trained words, decoding trained words, and reading high-frequency words. Three of four participants demonstrated positive gains in sound blending and decoding untrained words. All parents reported the app was easy to use, appropriate for their children, and that they would continue to use the app in the future.

Conclusions: The ALL app was an effective instructional tool to simultaneously target multiple early literacy skills for AAC users. Parents were able to provide evidence-based literacy instruction with fidelity using the app. Parent-implemented ALL app interventions have the potential to increase acquisition rates, decrease abandonment of literacy instruction, and increase instructional time, ultimately improving literacy outcomes for children who use AAC.

Supplemental material: https://doi.org/10.23641/asha.30718034.

Purpose: This study explores how speech-language pathologists (SLPs) use the American Sign Language (ASL)-English bilingual approach to support Deaf students, with a focus on how their understanding of language, collaboration, and professional roles has evolved.

Method: Using a qualitative approach, semistructured interviews were conducted with five SLPs across multiple school sites who had experience implementing the Bilingual Grammar Curriculum (BGC). Emic coding and thematic analysis were used to identify recurring concepts and shifts in thinking.

Results: This research highlights five emergent themes: collaboration, undertrained, reframing language, growth, and expectations. Findings reveal that while SLP participants lacked formal preparation in working with Deaf students, they emphasized the value of ASL as a foundational language, as well as collaboration with educators and Deaf professionals, and described the BGC as a resource that not only supported student progress but also reshaped their therapeutic approaches. They also reported increased confidence and higher expectations for students.

Conclusions: The findings showed the need for systemic change in how SLPs are prepared to work with Deaf students and point to the ASL-English bilingual programs as a meaningful resource for working with Deaf students. These insights contribute to the growing call for bilingual, culturally responsive practices in speech-language pathology and support broader efforts to align services with the linguistic and cultural needs of Deaf students.

Purpose: The aim of this study was to evaluate group- and individual-level impact of ECoLoGiC (Expanding Communication and Language Opportunities Generated in Conversation) Treatment (ECoLoGiC-Tx), an aphasia intervention aimed at improving conversational language. In addition, treatment fidelity for the speech-language pathologists (SLPs) who delivered treatment was evaluated, providing feasibility data to optimize successful future field implementation.

Method: Ten people with moderate or severe aphasia completed 10 weeks of ECoLoGiC-Tx delivered twice weekly for 1 hr. Testing occurred at pretreatment, posttreatment, and at 6 weeks maintenance. Conversation/monologue samples were collected three times per testing phase. Group results were analyzed using linear mixed models. Individual data were analyzed using effect size and minimal detectable change criteria. Treatment fidelity was analyzed using an established 23-point checklist.

Results: Robust results indicate generalization across measure types at group and individual levels. Participants improved their ability to convey meaning in conversation, the primary focus of ECoLoGiC-Tx. They demonstrated an average gain of 11.31 points on the Western Aphasia Battery-Revised (range: -1 to 21.5), and 7/10 participants shifted to a less impaired category of severity (e.g., from severe to moderate aphasia). Group-level change did not occur for reading, sentence construction in a picture task or in monologue, or Grammaticality in conversation/monologue. SLP fidelity was 97.3%.

Conclusions: Pilot study findings were replicated, with robust group and individual results. Exceptional improvements occurred for 9/10 participants. Results demonstrate generalization of skills to conversation and reduced aphasia severity for most participants. Deliverability of ECoLoGiC-Tx was evidenced by very high treatment fidelity by practicing SLPs, suggesting good potential for successful field implementation.

Supplemental material: https://doi.org/10.23641/asha.30856571.

Purpose: Early traumatic events, such as maltreatment (i.e., abuse and/or neglect) or exposure to violence, are associated with wide-ranging impacts on children's development, including their language skills. The purpose of this review was to determine the current state of knowledge in the area of children's language development in the context of childhood trauma; how the type, timing, and duration of trauma affect language outcomes; and what other individual, family, or community factors are considered in the literature.

Method: A scoping review was carried out to identify relevant literature related to language, trauma, and childhood. The initial database search yielded 5,253 articles, and 115 studies were included in the final sample.

Results: Literature in the areas of maltreatment, refugee experiences, institutionalization, adversity, homelessness and eviction, harsh punishment, and community violence were represented. Language difficulties were reported across the included trauma types; among the types of maltreatment, neglect was shown to have the greatest impact on language outcomes. In general, earlier age of onset, longer duration, and greater severity of trauma were associated with more severe language difficulties. Individual, family, and community variables reported in the literature are also discussed, and gaps in the literature are identified.

Conclusions: These findings underscore the pressing need for speech-language pathologists to consider the multifactorial nature of language development in the context of trauma and for the implementation of trauma-informed practices. Recommendations for future research are presented.

Supplemental material: https://doi.org/10.23641/asha.31014589.

Purpose: This article situates the revised Communication Bill of Rights (National Joint Committee for the Communication Needs of Persons with Severe Disabilities, 2024) within a Diversity, Equity, Inclusion, and Accessibility (DEIA) framework. With an emphasis that diversity should be inclusive of disability, this work postulates the interconnectedness of DEIA and the communication rights of individuals with severe disabilities. The full set of communication rights is presented, followed by a deeper discussion of four rights that address dignity and respect in interactions, meaningful conversations that are culturally and linguistically appropriate, services across the lifespan, and access to functioning augmentative and alternative communication and other assistive technology to support communication. A DEIA implementation framework is applied to illustrate the actualization of these rights.

Conclusions: Communication rights cannot be realized in isolation. The intersecting identities of individuals with severe disabilities must be understood and responded to in practice. The actualization of communication rights fits within the larger context of honoring DEIA.

Purpose: This study aimed to investigate the language skills of children with Alexander disease (AxD) and determine whether disease subtypes and/or age contributes to variability in language performance.

Method: Eighty-two participants with AxD, confirmed by GFAP testing, were enrolled, and the disease phenotype was determined using clinical and imaging features (56 cerebral, nine intermediate, and 17 bulbospinal). The participants' language abilities were assessed using the Preschool Language Scale-Fifth Edition (PLS-5), the Clinical Evaluation of Language Fundamentals-Fifth Edition (CELF-5), and the Peabody Picture Vocabulary Test-Fourth Edition (PPVT-4), based on the patient's age and linguistic level. The Communication Function Classification System was also used to determine functional communication abilities. Wilcoxon signed-ranks test or Kruskal-Wallis test was used to determine differences across groups.

Results: The mean PLS-5 Total Language Score (TLS) was 70.10 (SD = 17.62). Performance on the CELF-5 varied by phenotype (Core Language Score [CLS]: cerebral, M = 57.22, SD = 19.89; intermediate, M = 92.50, SD = 20.54; bulbospinal, M = 91.56, SD = 19.51). PLS-5 performance was negatively correlated with age at the first research study visit for cerebral participants (TLS: rho = -.367, p = .017). CELF-5 and PPVT-4 scores, on the other hand, were not correlated with age at first visit but with age at first neurological symptom (CLS: rho = .576, p = .003; PPVT-4: rho = .336, p = .011).

Conclusions: Cerebral patients demonstrated significant language deficits, whereas intermediate and bulbospinal subjects displayed stronger abilities, with deficits in some patients. These implications can be used to determine the functional impact of communication deficits and to provide accommodations and interventions in the treatment plans of patients with AxD.

Purpose: Childhood apraxia of speech (CAS) is a pediatric speech sound disorder with genetic and neurological underpinnings, implying its presence at birth. While early identification and intervention offer clear benefits, clinicians' perspectives on early diagnosis of CAS remain unclear. This study examined speech-language pathologists' (SLPs') knowledge, beliefs, and clinical decision making regarding CAS in children under 3 years old.

Method: A novel survey was distributed to SLPs working with children under 3 years old (N = 298). Respondents shared demographic information, CAS training and knowledge, diagnostic opinions and practices, and, in a subset, clinical decision making. Data were analyzed using z tests for proportions, logistic regression, and descriptive statistics.

Results: Forty percent of early intervention SLPs believed CAS cannot be diagnosed before the age of 3 years, and 52% would not disclose a diagnosis to caregivers of children in this age group. Continuing education on CAS was the only significant predictor of accurate early diagnostic beliefs; years of experience, setting, and general CAS knowledge were not. Among SLPs who did diagnose and treat CAS in children under 3 years old, most used caregiver coaching and play-based models. Highly structured, clinician-directed interventions were relatively underused, despite strong evidence for them.

Conclusions: Findings reveal gaps in early intervention SLPs' knowledge and practices related to CAS. Hesitation to diagnose or disclose CAS in young children may delay appropriate intervention. Results highlight the need for better alignment between research and clinical practice to support early identification and treatment of CAS.

Supplemental material: https://doi.org/10.23641/asha.30781640.

Purpose: There is a critical need to develop evidence-based and accessible interventions for Spanish speakers with aphasia (SSWA). Script training is a well-established treatment that helps people with aphasia learn sentences for daily-life situations, but its evidence comes primarily from English speakers. This study aimed to examine the acceptability, usability, and preliminary efficacy of a script training intervention delivered via open-source software using adaptive distributed practice for SSWA.

Method: Six SSWA participated in this single-subject multiple-baseline design. Acceptability was assessed using the Client Satisfaction Questionnaire-8 (CSQ-8), usability was assessed using the System Usability Scale (SUS), and preliminary efficacy was evaluated based on learning a set of 45 scripted sentences from a sentence repository developed by stakeholders using Bayesian generalized mixed-effects models. The treatment spanned 6 weeks with a combination of synchronous and asynchronous practice.

Results: The group mean in the CSQ-8 and SUS indicated that participants considered the software-based treatment acceptable and usable. Statistical models indicated robust evidence for immediate and sustained treatment effects throughout treatment. The estimated number of sentences gained for the average participant was 31, ranging from 21 to 42 (out of 45 treated sentences).

Conclusions: We adapted an evidence-based treatment for SSWA, script training, and delivered it using software-based adaptive distributed practice. We found excellent usability, acceptability, and preliminary efficacy of script training treatment using open-source software.

Supplemental material: https://doi.org/10.23641/asha.30885911.