American Journal of Speech-Language Pathology最新文献

Purpose: People with aphasia (PWA) experience lexical retrieval impairments, hindering effective communication. The semantic feature analysis (SFA) protocol, a specific semantically based lexical retrieval treatment, is widely used to improve naming abilities. This study applied SFA treatment to Korean-speaking PWA, a verb-final language, to compare the efficacy of noun-SFA and verb-SFA across various linguistic levels.

Method: A total of 10 Korean-speaking PWA participated in this study. Participants were randomly assigned to either the noun-SFA or verb-SFA group. Pre- and post-assessments were conducted before and after 20 treatment sessions to evaluate the treatment and transfer effects across various linguistic domains.

Results: Group comparisons indicated that near transfer effects to untreated items within the treated word class and nonverbal semantic association abilities were more robust in the verb-SFA group. Within-group analysis showed that both SFA treatments demonstrated significant direct treatment and near transfer effects on treated word class tests. However, near transfer effects to untreated word class tests were not significant in either group. For far transfer effects, the verb-SFA group showed greater gains in sentence-level tests. Aphasia severity improved in both groups, with more pronounced recovery in the verb-SFA group.

Conclusions: The efficacy of verb-SFA treatment for Korean-speaking PWA can be attributed to the unique verb-final structure of the Korean language, where verbs and their thematic roles are emphasized at the end of sentences. This underscores the importance of considering language-specific factors when developing and implementing semantic-based treatments for PWA, particularly in verb-final languages.

Purpose: Pseudoscientific treatments in the helping professions can harm clinicians and clients. Although some clinicians may be familiar with the warning signs of pseudoscience, little research has examined which warning signs are most difficult for clinicians to identify. This study aimed to develop and validate the Susceptibility to Pseudoscience (STOP) scale and explore participant performance on the scale.

Method: The STOP scale consists of 10 hypothetical clinical scenarios reflecting common warning signs of pseudoscience. Content validity was evaluated by three experts, while convergent and divergent validity were assessed using seven related scales completed by 82 undergraduate students in communication sciences and disorders or special education. Think-aloud protocols with five undergraduates explored construct validity. Additionally, performance on the scale was examined among undergraduates and six practicing speech-language pathologists (SLPs).

Results: Experts matched the warning signs of pseudoscience to the STOP scale scenarios for all but one item. Significant positive correlations emerged between scores on the STOP scale and scores on the Need for Cognition-Short Form, the Scientific Reasoning Scale, and the Actively Open-Minded Thinking Scale-Short Form. Conversely, significant negative correlations were found between scores on the STOP scale and scores on the Pseudoscience Endorsement Scale, the Rational-Experiential Inventory, and the Revised Paranormal Belief Scale. Think-aloud responses aligned with a three-stage model of the dual-process theory. Undergraduates and SLPs showed similarities and differences in recognizing the warning signs of pseudoscience.

Conclusions: The STOP scale is a promising tool for assessing students' and clinicians' ability to detect the warning signs of pseudoscience. Findings highlight the need for targeted education to enhance pseudoscience detection among these groups.

Purpose: Mean length of utterance (MLU) is a common measure of expressive language complexity in young children, including autistic children. However, means, by nature, obscure some information about spread and variability in data. Thus, we aimed to examine a new approach to characterizing linguistic complexity in autistic children by investigating the validity of two novel measures-range of length of utterance (RLU), standard deviation of length of utterance (SDLU)-alongside established measures: MLU and total utterances (TU).

Method: Participants were 40 autistic children (12 girls, 28 boys; M_age = 41.78 months). Children participated in 10-min, play-based language samples with their caregivers. Language samples were transcribed and measures (MLU, TU, SDLU, and RLU) were derived. To examine the criterion validity of these measures, we used regression analyses to examine how well each measure explained variance in children's expressive language, as measured by the Preschool Language Scales-Fifth Edition (PLS-5).

Results: All measures (MLU, SDLU, RLU, and TU) significantly predicted PLS expressive language (ps < .001). Effect size comparisons revealed that all four predictors had large effect sizes (R² > .6). In absolute terms, MLU had the smallest effect size (R² = .682), followed by TU (R² = .72) and RLU (R² = .781), and SDLU had the largest effect size (R² = .822).

Conclusions: Findings suggest that these novel measures (SDLU and RLU) explained significant variance in children's expressive language, as measured by the PLS-5, as did MLU and TU. SDLU had the largest explanatory power, in absolute terms, followed by RLU and TU. MLU had the smallest effect size, indicating that it had the lowest explanatory power for explaining variance in children's expressive language as compared to the other three measures. Thus, examining spread and variability in utterance length data might provide important, previously overlooked, information about the complexity of autistic children's spoken language.

Supplemental material: https://doi.org/10.23641/asha.30559880.

Purpose: Nursing-driven swallow screens are a critical component of poststroke dysphagia evaluations to prevent aspiration and pneumonia. There are multiple screening protocols but no consensus tool. This study aimed to characterize variations in nurse-administered swallow screening documentation for poststroke patients by examining templates in the electronic health record (EHR) and comparing them to established protocols.

Method: Between August 2023 and January 2024, the keywords "stroke swallow screen" were searched in the Epic Community Library, a public database of documentation templates from institutions using the Epic EHR. Adult inpatient nurse-administered swallow templates were included. Pediatric, emergency department, speech-language pathology, and nonswallow screen templates were excluded. Data including hospital location, setting (academic, community, international), and protocol details of oral trials were recorded.

Results: Of 157 included templates, nearly all (152/157, 96.8%) incorporated water during oral trials, with 3 oz/90 mL as the most common specified volume (n = 115). Fewer than half (71/157, 45.2%) aligned with established screening protocols; the most frequently identified were the Yale Swallow Protocol (35/157, 22.3%) and the Barnes-Jewish Hospital-Stroke Dysphagia Screen (23/157, 14.6%). No significant association was found between institution setting and presence of an established screening protocol (p > .05).

Conclusions: Review of nurse-administered swallow screening documentation templates for patients after acute stroke highlights substantial variability despite widespread use of water-based trials. Most templates did not align with an established protocol. These findings suggest an opportunity to standardize documentation across hospital systems to support consistent practice and reduce adverse outcomes related to dysphagia after stroke.

Purpose: The current pilot study examined whether parent report of bilingual children's English proficiency and exposure predicted children's performance on English standardized language tests of vocabulary and morphosyntax. The goal was to validate parent report when assessing language abilities in bilingual children who speak minoritized languages.

Method: Participants included 30 typically developing bilingual children, ages 3;0-5;0 (years;months), speaking English as a native or second language and one of 10 other languages. Parents reported their children's English understanding and speaking proficiencies as well as language exposure via the Language Experience and Proficiency Questionnaire. Children completed standardized tests including the Peabody Picture Vocabulary Test-Fifth Edition (PPVT-5; receptive vocabulary), Expressive Vocabulary Test-Third Edition (EVT-3; expressive vocabulary), and Structured Photographic Expressive Language Test Preschool-Second Edition (SPELT-P2; expressive morphosyntax).

Results: Parent report of English understanding proficiency predicted PPVT-5 performance. English speaking proficiency predicted both EVT-3 and SPELT-P2 performance. English exposure predicted performance across all three standardized measures.

Conclusions: Parent report of English proficiency and exposure converged with bilingual children's performance on English standardized tests of vocabulary and morphosyntax, suggesting that parent report is a valuable tool and should be incorporated when assessing bilingual children's language abilities. These findings also imply that parent report can offer a culturally responsive and linguistically sensitive approach to assessing language abilities in bilingual children who speak minoritized languages or dialects, especially when standardized bilingual language tests are not available or nonexistent.

Purpose: Flexible endoscopic evaluation of swallowing (FEES) is widely used to assess dysphagia in acute care settings; however, there are currently no broadly accepted FEES standardized procedure and interpretation protocols. We identified a need to harmonize FEES practice across one acute care hospital speech-language pathology team with goals to improve consistency, interrater reliability, and clinical decision making.

Method: The Translating Evidence Into Practice model was used as a guide for harmonization. This model includes summarizing the evidence, identifying barriers to implementation, measuring performance, and ensuring all patients receive the interventions. Through a review of the literature, we identified validated outcome measures focused on swallow safety, swallow efficiency, and secretion management. Selected outcome measures were integrated into the harmonized FEES procedures, and structured documentation tools were developed to enhance consistency and efficiency. Baseline practices and perceived barriers were assessed through unstructured interviews with SLPs. Training sessions, mentorship, and audits were conducted to support protocol adherence and interrater agreement.

Results: Throughout implementation, interrater agreement for outcome measures exceeded 80%. Following the implementation phase, audits revealed the entire procedure was followed 86% of the time, with use of the abbreviated protocol 9% of the time due to safety concerns. Documentation tools were utilized in 100% of cases. SLPs reported improved ease in comparing studies and no significant increase in assessment time. Feedback prompted minor refinements, including updates to documentation tools and a quick-reference guide.

Conclusions: Harmonizing FEES practice through a structured approach improved reliability and workflow efficiency and reduced variability. The protocol may facilitate interdisciplinary communication and treatment planning. We suspect that strong stakeholder involvement contributed to successful implementation and adherence. Future efforts could assess the feasibility of implementing this approach at additional institutions.

Supplemental material: https://doi.org/10.23641/asha.30482438.

Purpose: This study investigated the effects of teletraining on parents' use of a target strategy to support communication by young children with multiple disabilities using augmentative and alternative communication (AAC) within a shared storybook reading context using digital storybooks within visual scene display AAC systems.

Method: A single-case multiple baseline design was implemented remotely with six parent-child dyads, including parents of children with concomitant speech and motor difficulties (i.e., multiple disabilities). The independent variable was the instruction in the target strategy provided to parents via teletraining. The main dependent variable was parent accuracy implementing the target strategy. Data were also collected on the resulting effect on the total number of child communication turns during the shared storybook reading.

Results: All parents learned to implement the target strategy with > 80% accuracy, given instruction, feedback, and opportunities to role-play during two teletraining sessions (a total of 50-90 min total). Parents' use of the strategy following teletraining was associated with increased communication turns, increased use of aided AAC as a communication modality, and increased expression of unique vocabulary concepts by their children with multiple disabilities.

Conclusions: This study extended the prior communication partner training research to include parents of young children with multiple disabilities who used AAC. The study also demonstrated the effectiveness, efficiency, and appropriateness of telepractice as a format for AAC intervention for geographically dispersed individuals with significant speech challenges.

Supplemental material: https://doi.org/10.23641/asha.30676292.

Purpose: This study investigated how speech-language pathologists (SLPs) observe and address variability in stuttering assessment and treatment. Variability was examined in observable overt stuttering behaviors and beyond, encompassing the emotions, beliefs, and behaviors associated with stuttering, as well as speakers' ability to engage in daily activities and participate fully in their lives. The overarching goal of the study was to identify strategies for ensuring that variability is appropriately accounted for in clinical work related to stuttering.

Method: The study employed a mixed-methods approach, combining quantitative and qualitative data collected through an online survey from 143 U.S.-based SLPs, including generalists (n = 116) and self-reported stuttering experts (n = 27). Quantitative data were analyzed using descriptive and inferential statistics to compare observations across aspects of stuttering, while qualitative data were analyzed using thematic analysis to identify patterns in clinical practices.

Results: Both generalists and stuttering experts reported that they consistently observe variability across all aspects of stuttering. For overt behaviors, 100% of both groups noted variability. In reactions to stuttering, 96.3% of generalists and 100% of stuttering experts observed variability. Variability in daily participation was reported by 91.3% of generalists and 96% of stuttering experts. Thematic analysis revealed that stuttering variability is highly individualized, influencing overt behaviors, emotional responses, and daily participation, with SLPs emphasizing comprehensive assessments, tailored treatments, and education to address its challenges and opportunities. While both groups observed and addressed variability, generalists focused more on observable behaviors, whereas experts emphasized other aspects of the stuttering experience using a more holistic approach.

Conclusions: Effectively addressing the variability of stuttering requires comprehensive, context-sensitive strategies that address the broad experience of stuttering. By tailoring interventions to individual needs and fostering resilience related to variability, clinicians can improve outcomes for people who stutter.

Purpose: This exploratory study investigates whether social network characteristics are associated with adult cochlear implant (CI) outcomes. Specifically, it examines how both social network size and diversity, including the ages and accents of frequent communication partners, relate to word and sentence recognition, subjective communication abilities, and hearing-related quality of life (QoL) in adult CI users.

Method: Twenty-six adult CI users (M_age = 67 years) with over 1 year of CI experience participated. Social network metrics were derived from responses to a lab-developed questionnaire. Participants completed word and sentence recognition tasks in quiet and multi-talker babble (MTB) conditions and self-reported measures of communication abilities (Speech, Spatial, and Qualities of Hearing Scale [SSQ]) and QoL (Cochlear Implant Quality of Life-35 Profile questionnaire). Auditory spectro-temporal resolution was evaluated with the Spectral-Temporally Modulated Ripple Test (SMRT). Partial Spearman correlations were used to examine associations between social network characteristics and outcomes, controlling for SMRT. Exploratory subgroup analyses were also conducted based on high versus low auditory spectro-temporal resolution.

Results: Greater age diversity within participants' social networks was moderately associated with more accurate word recognition (in both quiet and MTB), sentence recognition in MTB, and higher SSQ and Cochlear Implant Quality of Life global scores. Exploratory analyses suggested stronger associations between age diversity and word recognition for participants with higher auditory spectro-temporal resolution. No consistent associations were observed for social network size or accent diversity.

Conclusions: Findings suggest that exposure to age diversity among everyday communication partners in the social network may be associated with more successful communication and QoL outcomes in adult CI users, particularly for those with better auditory spectral resolution. While causality cannot be inferred, social networks may represent a modifiable and clinically relevant factor for supporting adult CI users in real-world settings.

Purpose: The American Speech-Language-Hearing Association (ASHA) includes advocacy in a list of five professional practice areas within the scope of practice for speech-language pathologists (SLPs), yet few SLPs report self-efficacy and preparedness to advocate. The purpose of this viewpoint article is to discuss advocacy within the context of the current disability and stuttering discourse and offer a structured advocacy assignment as one method of fostering graduate students' agency and action to advocate for the stuttering community.

Method: We provide an overview of advocacy within ASHA's scope of practice, disability frameworks, and self-advocacy as they relate to stutter-affirming therapy. Then, we introduce an advocacy assignment for graduate students enrolled in a semester-long stuttering course.

Results: The advocacy assignment introduced in this viewpoint article has been incorporated into four distinct stuttering courses. Here, we explain the different types of advocacy students may pursue through the assignment and example products of each advocacy type.

Conclusions: We recommend that graduate programs, course instructors, and clinical supervisors/preceptors consider opportunities to build graduate students' confidence in advocacy, particularly advocacy completed in collaboration with the stuttering community. Future research will assess the effectiveness of a stuttering advocacy assignment in increasing students' preparedness to advocate as part of their professional practice.