American Journal of Speech-Language Pathology最新文献

Purpose: This study aimed to examine the Turkish version of the Short Behavioral Inhibition Scale (SBIS-TR) and to investigate its validity and reliability.

Method: The original Short Behavioral Inhibition Scale (SBIS) was translated into Turkish in accordance with the prescribed procedures for the cross-cultural adaptation of self-report measures. This translated version was administered to 227 children and their parents, including children who stutter (CWS) and children who do not stutter (CWNS). After 7-14 days, a random sample of 98 children completed the SBIS again. Reliability and validity were assessed using statistical analyses. Reliability was assessed using Cronbach's alpha and the test-retest method. Validity was evaluated through confirmatory factor analysis, mean score comparisons between CWS and CWNS, and correlations with the Behavioral Inhibition Questionnaire Parent Form-Turkish version (BIQ-TR) and the Communication Attitude Test for Preschool and Kindergarten Children Who Stutter-Turkish version (KiddyCAT-TR).

Results: SBIS-TR demonstrated high internal consistency, with a Cronbach's alpha of .86 and a test-retest correlation coefficient of .96. Structural validity analysis confirmed that the single-factor model fits the data well, with all fit indices meeting the accepted thresholds. SBIS-TR scores showed significant negative correlations with BIQ-TR and KiddyCAT-TR scores. No significant difference was found in SBIS-TR scores between CWS and CWNS groups (p = .235), with a median SBIS score of 15 for both groups.

Conclusion: The SBIS-TR demonstrated strong reliability and evidence of convergent validity; however, the results did not fully support its construct validity due to the absence of the predicted group differences between CWS and CWNS.

Purpose: This study aims to examine the association between communication impairments and strategies with the receipt of physiotherapy (PT) and occupational therapy (OT) in long-term care (LTC) residents with dementia.

Method: LTC residents with dementia from Ontario, Canada, who were assessed by the Resident Assessment Instrument 2.0 between 2015 and 2019 were included in a cross-sectional analysis of secondary data. Adjusted odds ratios and 95% confidence intervals were obtained from a series of multivariable logistic regressions for each individual communication variable with the PT and OT variables.

Results: We included 79,769 Ontario LTC residents with dementia, where 98% were over the age of 65 years and 70% were female. Residents with dementia were less likely (Cohen's d) to receive PT if they had impaired hearing (-0.07), had an impaired ability to make oneself understood (-0.17), or had an impaired ability to understand others (-0.21). Conversely, residents with dementia were more likely to receive PT with communication strategies in place, including using a hearing aid (0.19), other receptive communication techniques (e.g., lipreading, physical contact, LTC staff writing messages; 0.10), or other modes of expression (e.g., flash cards and electronic devices; 0.13). In contrast, residents with dementia and impaired ability to be understood (0.26), to understand others (0.40), to speak clearly (0.15), or to use speech (0.15) were more likely to receive OT.

Conclusions: Residents with dementia and communication impairments were less likely to receive PT but were more likely to receive OT. When strategies to aid communication were used, residents with dementia were more likely to receive PT. Our work highlights important communication barriers and potential facilitators that must be analyzed to ensure equitable access to rehabilitation in LTC.

Background: With the increasing reliance on big data analytics in poststroke dysphagia research (which drives related health care decisions), accurate classification of large, complex data sets is crucial. Although medical coding is commonly used to define patient cohorts, there is no administrative-level instrument for classifying poststroke dysphagia severity. Thus, we aimed to develop a novel classification framework for poststroke dysphagia severity.

Method: We used data from 445 patients diagnosed with acute ischemic stroke and dysphagia from the 2017 Medicare 5% Limited Data Set to develop our poststroke dysphagia severity classification framework. For our exploratory analysis, we used unsupervised k-means clustering to categorize patients based on dysphagia indicators constructed from International Classification of Diseases, Tenth Revision, codes. The resultant clustering solution was applied to three random 60% samples of the data set to verify the stability of the dysphagia severity clusters.

Results: Cluster analysis resulted in a three-cluster algorithm characterizing mild, moderate, and severe dysphagia severity. Inspection of the clusters revealed that dysphagia severity categories were not analogous to stroke severity categories.

Conclusions: We developed a novel framework to classify poststroke dysphagia severity using administrative data. We also found discordance between stroke severity and dysphagia severity, which has implications for classification methodologies in administrative poststroke dysphagia research. Future studies are needed to validate this classification framework.

Purpose: We sought to validate the ability of Developmental Sentence Scoring (DSS) to distinguish age and diagnostic category in a large, open-access corpus of American English-speaking adult-child language interactions at TalkBank.org. We additionally sought to identify whether subscales differed by age and diagnostic category, to explore the potential for adapting DSS to shorter language samples.

Method: We utilized data from 501 children (ages 2-6 years; 50-utterance sample criterion) and 842 children (25-utterance sample criterion) as well as the open-access DSS utility in Computerized Language Analysis to analyze growth in DSS total and subscale scores and distinguish typical- and late-talker grammatical profiles.

Results: DSS total scores were most informative at younger ages; scores of typically developing (TD) children and children with a history of late talking converged over time. The most sensitive subscale was Main Verbs (MV). Shorter samples (25 utterances) were generally as informative as longer ones. Scores derived from our analyses were generally much higher than those reported by Lee (1974).

Discussion: Shorter samples (25 utterances) are as informative as longer ones for both diagnostic and therapy planning purposes. Beyond the MV subscale, DSS may have greater utility in identifying therapy intervention targets than in diagnosing language delay. Finally, use of the original percentile scores for the DSS reported by Lee (1974) may underidentify children whose language lags significantly behind that of TD peers.

Supplemental material: https://doi.org/10.23641/asha.30907109.

Purpose: Since its inception, the National Joint Committee for the Communication Needs of Persons with Severe Disabilities (NJC) has focused specifically on advocating for individuals with significant communication support needs resulting from intellectual disability. The purpose of this review article is to describe the history of terminology used to describe this group of individuals, share the results of a recent survey completed by 102 members of our NJC Network, and discuss the implications of decisions regarding terminology in the NJC's ongoing advocacy efforts.

Method: History of terminology used to describe people with intellectual disability is documented by reviewing the literature, policies, professional organizations, and self-advocacy groups that used various terms from the early 20th century to present day. The NJC distributed a survey to the NJC Network of practitioners, researchers, augmentative and alternative communication users, and family members to gain insights on terminology that should be used moving forward.

Results: Slightly more than half of the respondents to the survey endorsed the term "extensive support needs"; however, support for this term was outweighed by the written comments of the respondents who highlighted the need to move away from descriptions that focus on an individual's needs, and explicitly identify a historically marginalized group of individuals that need a clear direction for advocacy efforts.

Conclusion: As a group, current members of the NJC continue to acknowledge the importance of the language we use to identify an often overlooked group of individuals with severe disabilities when supporting and advocating for access to supports that promote growth and development in communication and participation in society.

Purpose: Left-hemisphere stroke survivors who score above the Western Aphasia Battery-Revised (WAB-R) cutoff, but have self-reported aphasia, have been called not aphasic by WAB-R (NABW). Our prior work found letter fluency tasks to be sensitive to individual cases of very mild aphasia in the NABW group. Letter fluency tasks rely on both lexical retrieval and executive functioning (EF), which leaves open the question of which domain(s) are driving the impaired letter fluency in the NABW group.

Method: Twenty-seven NABW and 63 healthy controls completed two-letter fluency tasks, timed picture naming, and an EF task called Antelopes and Cantaloupes (A&C). A&C is a test of switching control, semantic control, and phonological control. We used two-tailed Mann-Whitney U tests to compare groups. We calculated correlations between each measure and the letter fluency tasks. Receiver operating characteristic curve analysis was used to determine if any of these measures outperformed letter fluency tasks in identifying cases of very mild aphasia in the NABW group.

Results: Six measures had group differences and were correlated with the letter fluency tasks. The measures included naming reaction times (RTs), A&C measures that required rapid lexical retrieval, and an A&C measure of switching control involving lexical retrieval without phonological or semantic conflict. None of the measures had higher sensitivity and specificity for individual cases of very mild aphasia compared to letter fluency tasks.

Conclusion: Our findings suggest that deficits in rapid lexical retrieval and switching with lexical retrieval underlie impaired letter fluency in the NABW group.

Purpose: The purpose of this study was to generate a theory, grounded in data, explaining the collaborative relationships between speech-language pathologists and families in family-centered early intervention.

Method: Using constructivist grounded theory methodology, three pairs of clinicians and families allowed participatory observations, video recording of sessions, parent interviews, clinician interviews, and documentation collection. Seven additional pairs of clinicians and families were interviewed, culminating in 20 total interviews. Data were analyzed using the constant comparative method, and a substantive theory emerged.

Results: From this data set, the substantive theory is that family-professional collaborative relationships are established and maintained by participants in family-centered early intervention via a constant process of feedback loops. These loops are cyclical social interactions, incorporating each of the participants' backgrounds and building shared knowledge with informational interactions, in which the participants establish and meet expectations and give and accept agency from each of the participants.

Conclusions: The individual relationships varied, as shown in the variation of the themes in individual experiences. The collaborative clinical relationship at the heart of family-centered early intervention, however, requires the continual process of feedback between social interactions, background, informational interactions, expectations, and agency to be considered by professionals.

Supplemental material: https://doi.org/10.23641/asha.30429991.

Purpose: Although discourse analysis has been receiving growing interest among aphasia researchers and speech-language pathologists (SLPs), several key challenges, such as limited time, insufficient training, and a lack of accessible tools, preclude its practical application in clinical settings. To address these barriers, we developed and evaluated a clinical training program for Auditory-Perceptual Rating of Connected Speech in Aphasia (APROCSA; Casilio et al., 2019), a time-efficient and psychometrically robust transcriptionless system for quantifying a range of speech-language impairment features.

Method: A collaborative working group was established, comprising five researchers with expertise in discourse analysis in aphasia and eight SLPs who actively worked with individuals with aphasia in clinical or research roles. Through this partnership, SLP members provided feedback regarding their training needs, which informed the creation of a comprehensive training program that included a manual, webinar, and hybrid training sessions. Program effectiveness was measured by comparing SLPs' interrater agreement on six discourse samples before and after the training relative to expert consensus ratings, as well as posttraining perceptions on the program. Adoption of APROCSA into SLPs' work settings at approximately 1 year posttraining was also quantified.

Results: Interrater agreement improved as a function of training and newer clinicians appeared to benefit the most from the training. Posttraining perceptions were complementary to the interrater agreement findings, with nearly all SLPs indicating that the training was very helpful. At 1 year posttraining, most SLPs reported using APROCSA, primarily for assessment purposes, highlighting its effectiveness in helping them characterize spoken discourse in clinical contexts.

Conclusions: The APROCSA training program addresses key barriers to implementation, with preliminary evidence supporting its effectiveness and adoption into clinical work settings. Results overall support APROCSA's feasibility in clinical use and emphasize the benefits of targeted training for clinical discourse assessment.

Purpose: The best liquid bolus protocol to use that accurately identifies penetration, aspiration, and residue on flexible endoscopic evaluation of swallowing (FEES) remains unclear. Recently, the use of high-coating white food dye-colored water has been recommended; however, evidence to support its use is limited. In this study, penetration/aspiration and residue as a function of high-coating white water, low-coating white water, and milk were systematically evaluated.

Method: The effects of liquid type (i.e., high-coating white water, low-coating white water, and milk) and volume (i.e., 15, 20, and 90 ml) on penetration-aspiration scale (PAS) scores (i.e., 1-2 vs. 3-8) and residue (i.e., present vs. not present) were assessed in 20 healthy adults ages 22-53 years during FEES.

Results: PAS scores, vallecular residue, and pyriform sinus residue differed significantly by liquid type (p < .001, p = .002, and p < .001, respectively). PAS scores also differed significantly by bolus volume (p = .045). In general, high-coating white water yielded a significantly greater probability of penetration events than low-coating white water and milk; however, raw PAS data revealed aspiration events (PAS 6-8) were only identified in the low-coating white water and milk conditions. Vallecular residue and pyriform sinus residue were observed in 100% of the high-coating white water swallows with markedly less residue in the low-coating white water and milk conditions.

Conclusion: High-coating white water resulted in increased observed penetration events (likely due to its coating effect) compared to low-coating white water and milk while still underidentifying aspiration seen more frequently with milk test boluses in healthy adults.

Purpose: The purpose of this study was to conduct a preliminary psychometric evaluation of the speech item of the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III.

Method: Twenty neurologists specializing in movement disorders evaluated the speech-unscripted and sentence reading-of people with Parkinson's disease (PD) on the MDS-UPDRS Part III. The concurrent validity of the speech item was evaluated by comparing the ratings to a previously collected estimate of the speakers' intelligibility during sentence reading. The reproducibility of the ratings was evaluated in terms of reliability (intra- and interrater) and agreement.

Results: MDS-UPDRS Part III speech ratings based on sentence reading were moderately and negatively correlated with previously collected estimates of intelligibility. No such relationship was found for MDS-UPDRS Part III speech ratings based on unscripted speech. Individual correlations for each rater ranged widely, with some showing weak, negligible, or positive relationships with intelligibility. Intrarater reliability was high, but interrater reliability was fair for both speech tasks. Movement disorders specialists agreed on MDS-UPDRS speech ratings, on average, less than 70% of the time.

Conclusions: A critical communication outcome-intelligibility during unscripted speech-is not captured by MDS-UPDRS Part III speech ratings, suggesting weak concurrent validity of this widely used metric of speech function. The reproducibility of MDS-UPDRS Part III speech ratings across providers is fair. These speech ratings may be insufficient to assess the speech function of people with PD and identify those in need of speech services.