American Journal of Speech-Language Pathology最新文献

Purpose: Digital domains are becoming increasingly important in creating and sustaining relationships. The purpose of this study was to understand the role of information and communication technology (ICT) in maintaining friendships for people with aphasia. Understanding how people with aphasia use ICT (e.g., smartphones, social media platforms) to stay connected is critical to developing components of clinical interventions focused on social relationships.

Method: Data were collected from a larger qualitative research project and included semistructured interviews about friendship maintenance and aphasia. Participants included 27 people with aphasia, eight significant others, and nine friends of people with aphasia. Data were analyzed according to inductive thematic analysis.

Results: The majority (> 90%) of participants emphasized the importance of ICT in maintaining friendships. Three themes were generated from the analysis: (a) flexibility is a core component of technology use, (b) the role of technology in identity negotiation, and (c) technology as a lifeline.

Conclusions: Findings indicate that ICT has a vital role in helping people with aphasia maintain friendships. Themes generated highlight important aspects that may be ignored in the rehabilitation process, such as the need for flexibility, the importance of identity negotiation in online spaces, and the need for training and support in digital technology use. These findings have clinical and research implications that can be further developed to help people with aphasia maintain friendships.

Purpose: Despite an abundance of manual, labor-intensive discourse analysis methods, there remains a dearth of clinically convenient, psychometrically robust instruments to measure change in real-world communication in aphasia. The Brief Assessment of Transactional Success (BATS) addresses this gap while developing automated methods for analyzing story retelling discourse. This study investigated automation of main concept (MC) analysis of stories by comparing scores from three large language models (LLMs) to those of human raters.

Method: After watching/listening to each of the eight short video/audio BATS stimuli and retelling each story, 96 persons with aphasia (PWA; n = 48 female) engaged in topic-constrained conversations over Zoom with 94 familiar and 107 unfamiliar conversation partners (CPs). CPs then retold each story as co-constructed during their conversations with PWA. Audio files from the resulting 1,760 story retells were transcribed using Python and AssemblyAI's speech-to-text application programming interface. Each MC was first scored by human raters for presence, accuracy, and completeness. Raters used a semiautomated application, MainConcept. For each transcript, an MC composite ratio score was obtained. We evaluated three state-of-the-art LLMs: two proprietary models, GPT-4 and GPT-4o, and one open-source model, Llama-3-70B. The interrater reliability between each LLM versus human MC scoring was assessed via the Pearson correlation coefficient and reliability coefficients based on the generalizability theory (G-theory).

Results: The Pearson correlation coefficients indicate strong positive linear relationships between LLM and human MC scores. G-theory reliability coefficients also indicate reliable scoring between LLM and human scoring across the spectrum of participants and conditions.

Conclusions: This promising proof-of-concept study affirms the reliability of three LLMs in evaluating BATS story retell MCs and justifies ongoing investigation into their use. Providing clinicians and clinical researchers with automated tools for analyzing discourse without the need for prohibitively labor-intensive manual scoring could be a paradigm shift, potentially revolutionizing the aphasia intervention landscape.

Purpose: Approximately 44% of individuals with chronic aphasia also present with apraxia of speech, necessitating integrated treatment approaches to optimize recovery. This study examined the effects of a combined treatment protocol, leveraging Treatment of Underlying Forms (TUF) and a modified version of Sound Production Treatment (SPT), on language and speech outcomes in individuals with mild aphasia and apraxia.

Method: Three participants underwent treatment involving alternating and combined TUF and modified SPT. The pre- and posttreatment assessments included standardized and treatment-specific speech and language measures.

Results: The results indicated significant improvements in the production of both trained and untrained items with similar syntactic and articulatory complexities, whereas generalization to simpler targets varied among participants.

Conclusion: Our findings suggest that combined TUF/modified SPT may enhance speech and language outcomes, warranting further investigation of individual variability in treatment responses and generalization patterns.

Purpose: A stakeholder-engaged, collaboratively developed video biopic about the lived experience of primary progressive aphasia (PPA) was examined to assess its impact on graduate students' understanding of the lived experience of PPA and best practice principles in PPA.

Method: Using a post-then-pre-design, 22 graduate students were surveyed after watching the biopic regarding their understanding of the neurological aspects of PPA and the lived experience of PPA. Additionally, they mapped the presence of Volkmer et al.'s (2023) PPA best practice principles within the biopic. Quantitative measures of central tendency, as well as qualitative measures, were used to analyze the data. Reflexive thematic analysis was used to identify themes related to understanding of the neurological and lived experience components of PPA prior to and after watching the biopic.

Results: After viewing the biopic, participants identified significant changes in understanding both the neurological aspects of PPA and the lived experience of PPA. However, their reported understanding of the lived experience of PPA was more influenced, impactful, and relevant than the changes in their understanding of the neurological aspects. Students identified occurrence of all seven PPA best practice principles within the biopic.

Conclusions: Students reported significant changes in understanding prior to and following viewing the biopic. Video biopics may be an effective tool to support increased understanding of the lived experience of conditions, including PPA, and support increased awareness and application of evidence-based practices.

Purpose: This study investigated the experiential perceptions of speech-language pathology graduate clinicians involved in a caregiver coaching clinical practicum.

Method: Employing a mixed-method approach combining reflexive thematic analysis and a paired-samples t test, this study examined speech-language pathology graduate clinicians' perceived development of self-efficacy and indirect acquisition of foundational counseling skills with a focus on how these skills informed the formation of therapeutic alliances with infant caregivers. Data were gathered through focus group interviews and the completion of a counseling self-efficacy (CSE) rating scale. Pre- and post-self-ratings of CSE were collected for comparison.

Results: Thematic analysis revealed one major theme, building connections, and three subthemes, highlighting challenges in communication, power dynamics, and role establishment with infant caregivers. While overall CSE ratings improved post program, specific subscale ratings remained low, indicating the need to enhance preprofessional preparation in complex counseling skills and emotional support provision.

Conclusions: The findings underscore the importance of preprofessional preparation for building therapeutic alliances and facilitating collaborative communication with caregivers. They also emphasize areas for strengthening the preprofessional training of speech-language pathology graduate clinicians in early intervention services.

Purpose: The current study investigated the impact of a short mobile training implemented in peer pairs to teach the Communicating Choices-CVI (Peers) strategy to support interactions with students with multiple disabilities.

Method: A pretest-posttest control group design was used to evaluate the effects of the training created on the INSTRUCT app, which used a checklist of steps with video models to teach elementary-age peers a strategy to structure opportunities for students with multiple disabilities to communicate choices. Peers were randomly assigned to the experimental group (n = 10) or control group (n = 10) and then video-recorded while interacting with students with multiple disabilities during one pretest and one posttest interaction in their typical educational settings. Peers in the experimental group completed the training between the pretest and posttest; peers in the control group did not.

Results: The training was found to be both efficient and effective with limited adult involvement required. Following the training, which took approximately 23 min, peers in the experimental group demonstrated statistically significant gains in accuracy of strategy substep implementation, which led to increased successful communication by the students with multiple disabilities.

Conclusions: This is the first communication partner training study to investigate the impact of the INSTRUCT app and peer pairs to teach a strategy for structuring opportunities to communicate choices to students with multiple disabilities including cortical visual impairment (CVI). By investigating the outcomes of the training in a real-world context (i.e., school environment), the results offer information that is directly transferrable and applicable to clinicians who may be interested in implementation of similar procedures.

Supplemental material: https://doi.org/10.23641/asha.29996182.

Purpose: A large proportion of children who use augmentative and alternative communication (AAC) devices to communicate are bilingual. However, many AAC devices predominantly feature vocabulary that is translated from English into the child's other language, lacking cultural and linguistic responsiveness. This can limit effective communication for bilingual users. The primary goal of the present study was to develop core vocabulary lists in Tagalog and in English for Tagalog-English bilingual preschoolers to create a more linguistically and culturally appropriate foundation for AAC systems used by these children. The secondary goal was to design linguistically responsive bilingual communication boards for Tagalog-English bilingual preschoolers using the core vocabulary lists.

Method: Secondary data analysis was conducted using a data set of personal narrative language samples from 100 Tagalog-English bilingual children from Metro Manila. In this data set, the language samples were pared down to a list of single vocabulary words. Frequency and commonality scores were calculated for each vocabulary word to generate separate core vocabulary lists for Tagalog and English.

Results: Applying the frequency score criteria, a total of 193 Tagalog words, 28 English words, and 60 Tagalog affixes were identified as frequently used by Tagalog-English bilinguals. Using the commonality score criteria, 56 Tagalog words, three English words, and 11 Tagalog affixes were identified as core vocabulary. These findings guided the creation of both a Tagalog communication board and a bilingual Tagalog-English communication board. The bilingual board integrated Tagalog and English core vocabulary into a single board.

Conclusion: The established Tagalog-English core vocabulary lists provide a foundation for the development of bilingual AAC systems that allow bilinguals equitable access to communication.

Purpose: Pediatricians are the first professionals to provide guidance about language development to families with young children and referrals for those who may have a language or communication disorder. One-quarter of children in the United States are dual language learners (DLLs), yet there is little information about pediatrician's readiness to provide culturally and linguistically responsive care for these children. This pilot study sought to examine pediatricians' knowledge of bilingual language development and its relation to the provision of language and literacy promotion and developmental surveillance for Latine DLLs.

Method: Sixty-seven pediatricians at two academic pediatric clinics completed a survey asking about their knowledge about bilingual language development, Spanish proficiency, and provision of culturally effective health care to Latine DLLs. Analyses examined mean levels of these variables as well as relationships between knowledge, proficiency, and practices.

Results: On average, pediatricians' responses to the knowledge-based questions agreed with the evidence 69% of the time. Only 29% of pediatricians said they felt comfortable counseling Latine parents on bilingual language development, and 75% indicated they had difficulty recognizing signs of a language or communication disorders in Latine children from Spanish-speaking homes. Multiple regressions showed that pediatricians with higher Spanish proficiency and those with greater knowledge of bilingual language development provided more culturally and linguistically responsive care to Latine DLLs.

Conclusions: We identified significant gaps in pediatricians' knowledge about bilingual language development that were associated with their practice patterns. Results highlight the need for incorporating training about bilingual language development into pediatric education and increasing the number of providers that speak languages other than English.

Supplemental material: https://doi.org/10.23641/asha.29954468.

Purpose: For most preterm infants, survival depends on support provided in the neonatal intensive care unit (NICU). Oral feeding skills are key criteria for discharge. The Supplemental Nursing System (SNS) is a device designed to assist breastfeeding by delivering human milk to the infant. This study investigated the impact of the SNS on the oral feeding skills of preterm infants in the NICU.

Method: The study included 60 preterm infants aged 33-37 weeks of postmenstrual age followed in the NICU of a training and research hospital in southeastern Türkiye between August 20, 2022, and August 27, 2023. Once considered ready for oral feeding, infants in the experimental group received three daytime feeds with the SNS; their other five feeds and all feeds in the control group were given by bottle per unit routine. In both groups, three daytime feedings were evaluated in terms of physiological parameters (heart rate, oxygen saturation, and respiratory rate) before, during, and after feeding; Early Feeding Skills score; transition time to full oral feeding; weight change during the first 2 days of oral feeding; feeding efficiency; and average feeding duration.

Results: The SNS had no significant effect on weight (p = .684). However, SNS infants transitioned to full oral feeding earlier (2.97 ± 1.00 days vs. 4.23 ± 0.90 days; p ≤ .001) and had higher Early Feeding Skills scores (44.58 ± 2.96; p = .005), shorter feeding duration (13.55 ± 4.99 min; p = .021), higher oral intake ratio (91.25% ± 8.82%; p ≤ .001), and greater feeding efficiency (2.24 ± 0.91 ml/min; p = .003). Heart and respiratory rates during feeding were more stable in the SNS group (135.37 ± 15.35 vs. 153.95 ± 4.51; p < .001).

Conclusion: The SNS improves oral feeding skills, feeding efficiency, and transition time to oral feeding in preterm infants, offering an effective alternative to bottle-feeding.

Purpose: Co-design of research and services alongside end users is increasingly required by funding bodies and governments. To enable a meaningful inclusion of people with communication disability, planning and modification are required, as standard co-design procedures involve extensive spoken and written language. Experience-based co-design (EBCD) is one co-design approach that is gaining popularity; however, there are few detailed reports to date on adapting EBCD for communication disability. This article outlines our modifications of EBCD to co-design a technology-enabled self-management platform (Communication Connect) for people living with poststroke aphasia and cognitive-communication disability from traumatic brain injury.

Method: Participants included individuals with communication disabilities (n = 8), care partners (n = 3), and health professionals (n = 20) across three Australian states. Data collection involved video-recorded interviews, focus groups, and structured prioritization workshops. This study describes the first four stages of EBCD (project setup, two experience-gathering stages, and identifying priorities).

Results: This article presents a detailed account of the practical decisions and modifications made throughout the EBCD process. Key adaptations are outlined, including the use of text-based video editing to efficiently create touchpoint films, nonlinear presentation of challenges to facilitate engagement, and visual aids to support prioritization and ranking. These modifications supported the meaningful participation of co-designers, including people with communication disability.

Conclusion: This method article contributes to the growing knowledge on adapting EBCD for communication disability, which may be of use to future EBCD projects and for improving the meaningful inclusion of people with communication disability in co-design research.