American Journal of Speech-Language Pathology最新文献

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.

Purpose: The purpose of this article is to provide a brief overview of the more than six-decade historical perspective on the field of intellectual disabilities (IDs), its relationship to the development of communication services and support for children and adults with severe disabilities in the context of the National Joint Committee for the Communication Needs of Persons With Severe Disabilities (NJC).

Method: This historical overview briefly reviews the development of the ID field and how it inspired the focused growth of the communication service and support needs of children and adults with severe disabilities. It details the development of the NJC and its activities over time, including current and emerging areas of concern.

Results: This article links the broader historical foundation of ID to the later establishment, mission, and ongoing development of the NJC. It describes the emergence and evolution of communication services and supports across these decades. It highlights the advocacy activities and committee products over time.

Conclusions: The NJC's work is ever-evolving, building on past advocacy efforts. It aims to positively impact the communication future for children and adults with severe disabilities.

Purpose: The Speech Assessment of Children's Home Language(s) (SACHL) offers a new, evidence-based clinical protocol for speech-language pathologists (SLPs) to assess speech in unfamiliar languages. This study used implementation science to investigate SLPs' current multilingual speech assessment practices, determine the prospective acceptability of the SACHL, and compare current confidence to prospective confidence with the SACHL.

Method: The Consolidated Framework for Implementation Research and the Theoretical Framework of Acceptability were used to explore innovation deliverers' (SLPs and student SLPs) prospective acceptability of the innovation (SACHL). Attendees at in-person and online SACHL presentations were invited to participate. A total of 360 participants responded to an online questionnaire exploring current practices, transcription skills, confidence, and acceptability of the SACHL. Statistical tests compared attendees at different presentations, SLPs and student SLPs, and monolingual and multilingual participants.

Results: The majority of participants indicated low current confidence in assessing multilingual children. Most SLPs assessed, transcribed, and analyzed multilingual children's speech in English but rarely or never applied these practices in children's home language(s). The majority of participants rated the SACHL as being culturally responsive, well designed, and easy to understand and that it could increase diagnostic accuracy. There were concerns around the time burden in using the SACHL. Most (87.45%) indicated they would like to use the SACHL in clinical practice, and there was a statistically significant improvement between current confidence and prospective confidence.

Supplemental material: https://doi.org/10.23641/asha.30716981.

Purpose: The present study aims to report on the psychosocial outcomes of children aged 6-12 years who did or did not respond to the Lidcombe Program.

Method: Thirty-seven 6- to 12-year-old children participated in a Phase II trial of the Lidcombe Program using video telehealth. Treatment progress was documented using stuttering severity ratings and three psychosocial outcome measures (Overall Assessment of the Speaker's Experience of Stuttering-School-Age Children, Communication Attitude Test, and Spence Children's Anxiety Scale). We examine the results of these psychosocial outcomes in relation to children who did and did not respond to the program.

Results: Significant improvements were observed across all psychosocial measures, irrespective of responsiveness group. Individual trajectories highlighted heterogeneity, but group data revealed statistically significant reductions in measures of stuttering impact, negative communication attitudes, and anxiety symptoms from pretreatment to 12 months posttreatment, with no evidence of differential effects between responsiveness groups.

Conclusions: Findings suggest that the Lidcombe Program may provide psychosocial benefits beyond stuttering reduction to some children, potentially through the therapeutic alliance fostered between clinicians, children, and families. The Lidcombe Program appears to be psychologically safe and may confer psychosocial advantages for school-age children who stutter, regardless of whether their stuttering partially reduced, stopped, or persisted. Future research should explore longer term maintenance of these psychosocial gains and conduct a randomized controlled trial to evaluate the effect of the Lidcombe Program relative to a control group.

Purpose: The Bilingual Input-Output Survey (BIOS)-Home (Peña et al., 2018) is used to provide speech-language pathologists (SLPs) with an estimate of children's exposure to two languages. The current hour-by-hour approach of the BIOS can be time consuming to administer and calculate. The current study seeks to improve the efficiency of the BIOS-Home by replicating Calandruccio et al.'s (2021) finding that the BIOS can be shortened by time periods around children's routines and extending these findings by preliminarily exploring the relationship of the shortened BIOS with results of a bilingual screener.

Method: The current study includes 1,337 Spanish-English bilingual children from two data sets. Children's ages ranged from 49 to 71 months (M = 60.58, SD = 4.96). BIOS-Home data were collected by trained bilingual research assistants and SLPs who interviewed caregivers on their children's language input and output hour by hour. Principal components analysis (PCA) was conducted using caregiver-reported BIOS-Home data from both data sets to determine the smallest number of time chunks that could be used to measure language exposure. To explore the validity of the shortened BIOS-Home, bivariate correlation analyses were conducted to examine the relationship between children's semantics and morphosyntax scores and the original and shortened versions of the BIOS-Home.

Results: PCAs using the two data sets identified three time periods (morning, afternoon, and late afternoon/evening) for weekday receptive language and three time periods (morning, afternoon, and evening) for weekend receptive language. Language test score correlations comparing the hour-by-hour and the shortened approaches are highly similar, supporting the validity of the shortened approach.

Conclusion: Consolidating the BIOS-Home questionnaire is a viable approach that can save time and elicit valid information about children's bilingual input and output.

Purpose: Parental recodes, a form of responsivity, help facilitate language development in children with Down syndrome (DS). However, little is known about the complexity and referents of recodes or differences between mothers and fathers and how this relates to child language.

Method: This study included 15 children with DS (M_age = 39.67 months, range: 24-61 months) and their mothers and fathers. Mother-child and father-child play interactions were recorded in the home.

Results: We found no differences between mothers' and fathers' use of recodes. A moderate positive association existed between child receptive language and total combined recodes from mothers and fathers. A weak positive association was found for expressive language and mothers' recodes.

Conclusions: Our preliminary findings highlight the need for further research into how mothers and fathers recode their children's communicative acts in ways that support later language development. We discuss the clinical implications of incorporating recodes into parent-mediated communication interventions for young children with DS.

Supplemental material: https://doi.org/10.23641/asha.30946781.

Purpose: This study aimed to (a) identify the incidence of acute post-traumatic language disturbance (aPTLD) and types of aphasia in adults with traumatic brain injury (TBI) in an inpatient neurorehabilitation setting, (b) investigate the relationship between aPTLD and inpatient neurorehabilitation length of stay (LOS), and (c) document rates of recovery from aPTLD from admission to discharge.

Method and procedure: This study is a retrospective analysis of adults with TBI admitted to inpatient neurorehabilitation between 2016 and 2018 who completed the Boston Naming Test-Second Edition (BNT-2) and subtests of the Western Aphasia Battery-Revised (WAB-R).

Results: Almost 70% of the patients, who were level V or higher on the Rancho Los Amigos Levels of Cognitive Function Scale, demonstrated impaired BNT-2 scores. Patients with impaired BNT-2 scores experienced significantly longer total and rehabilitation LOSs. Of the patients who had WAB-R subsections for aphasia typing, the majority had fluent aphasia. More than half of the patients with admission and discharge BNT-2 scores remained impaired on this assessment at the end of their rehabilitation stay.

Conclusions: Naming impairment was common during the inpatient rehabilitation period after TBI. Given the reliance of cognitive assessments on verbal output, the presence of aPTLD represents an important confound on the assessment of cognition after TBI. Assessment of language disturbance using the BNT-2 and WAB-R during subacute neurorehabilitation is feasible and provides valuable insight into the cognitive-communication status of persons with TBI.

Purpose: This study evaluated eye movements (i.e., regressions, fixations, and saccades) in a variety of reading contexts in school-age children with and without reading disorders (RDs).

Method: This study used an experimental design with two groups: peers with RDs and typically developing (TD) peers. A Tobii Pro Spectrum system was used to capture eye movement data for all participants during the reading tasks under the following conditions: (a) single words without cognitive demand, (b) single-word reading with cognitive demand, and (c) grade-level paragraph reading text.

Results: The results indicated significant differences between the groups in the duration of fixation and number of regressions. In addition, participants in the RD group exhibited significantly more saccades while reading than their TD counterparts.

Conclusions: Although reading is a language-based skill involving five areas of language (morphology, phonology, syntax, pragmatics, and semantics), this study offers a unique perspective and objective measurement while highlighting the role of eye movements in reading. The results of this study showed distinctive eye responses in school-age children with RDs. These findings underscore the value of eye tracking as a diagnostic and research tool, offering an objective window into the complex interplay among visual, linguistic, and cognitive processes that underlie reading.