Language Speech and Hearing Services in Schools最新文献

Purpose: Clinicians address a wide range of oral language skills when working with school-age students with language and literacy difficulties (LLDs). Therefore, there is a critical need for carefully designed, rigorously tested, multicomponent contextualized language interventions (CLIs) that have a high likelihood of successful implementation and measurable academic impacts. This clinical focus article summarizes the development and testing of a CLI entitled Supporting Knowledge in Language and Literacy (SKILL), which is a supplementary narrative intervention program for elementary school-age children. Our aims are to (a) to review the foundational theoretical models that are the foundation of SKILL; (b) describe the iterative process used to develop the phases, lessons, procedures, materials, and progress monitoring tool; (c) summarize recent findings of the randomized controlled trial that was conducted to test its efficacy; and (d) discuss factors that may contribute to successful implementation of multicomponent language interventions.

Method: A total of 357 students in Grades 1-4 with LLDs were randomized to a treatment group or to a business-as-usual control group. The treatment group received the SKILL curriculum in small groups during 30-min lessons by trained speech-language pathologists, teachers, and special educators.

Results: Students who received SKILL significantly outperformed those who did not on oral and written measures of storytelling and comprehension immediately after treatment and after 5-months at follow-up. Gains were similar among students with different levels of language ability (at-risk, language impaired) and language status (monolingual, bilingual) at pretest.

Conclusions: There is growing support for the use of multicomponent CLIs to bring about educationally relevant outcomes for students with LLDs. The authors present this review of how SKILL was designed, manualized, and rigorously tested by a team of researchers and practitioners with the hope that this approach will serve as a springboard for the development of future multicomponent CLIs that may meaningfully improve communicative and educational outcomes for students with LLDs.

Purpose: Implicit racial and ethnic biases have been documented across a variety of allied health professions; however, minimal research on this topic has been conducted within the field of speech-language pathology. The purpose of this study was to understand implicit racial and ethnic bias in speech-language pathology students by examining their perceptions and attitudes about the acceptability of racial and ethnic microaggressions. We also examined whether the student ratings varied by their racial and ethnic identity (White vs. people of color [POC]).

Method: Fifty-nine students (72% White, 28% POC) currently enrolled in a speech-language pathology program voluntarily completed the Acceptability of Racial Microaggressions Scale via an online Qualtrics survey.

Results: Although 70% of the student ratings classified the microaggressive statements as unacceptable, 30% of their ratings classified the statements as either (a) acceptable or (b) neither acceptable nor unacceptable. Although both groups of students rated the majority of statements as unacceptable, students who self-identified as White rated more statements as acceptable than students who self-identified as POC.

Conclusions: Findings indicating relatively high rejection of microaggressive statements by speech-language pathology students are promising. However, responses were not uniform, and a nontrivial proportion of responses provided by speech-language pathology students reflected passivity toward or active endorsement of microaggressive statements.

Purpose: This study aimed to conduct a scoping review of research exploring the effects of slight hearing loss on auditory and speech perception in children.

Method: A comprehensive search conducted in August 2023 identified a total of 402 potential articles sourced from eight prominent bibliographic databases. These articles were subjected to rigorous evaluation for inclusion criteria, specifically focusing on their reporting of speech or auditory perception using psychoacoustic tasks. The selected studies exclusively examined school-age children, encompassing those between 5 and 18 years of age. Following rigorous evaluation, 10 articles meeting these criteria were selected for inclusion in the review.

Results: The analysis of included articles consistently shows that even slight hearing loss in school-age children significantly affects their speech and auditory perception. Notably, most of the included articles highlighted a common trend, demonstrating that perceptual deficits originating due to slight hearing loss in children are particularly observable under challenging experimental conditions and/or in cognitively demanding listening tasks. Recent evidence further underscores that the negative impacts of slight hearing loss in school-age children cannot be solely predicted by their pure-tone thresholds alone. However, there is limited evidence concerning the effect of slight hearing loss on the segregation of competing speech, which may be a better representation of listening in the classroom.

Conclusion: This scoping review discusses the perceptual consequences of slight hearing loss in school-age children and provides insights into an array of methodological issues associated with studying perceptual skills in school-age children with slight hearing losses, offering guidance for future research endeavors.

Purpose: There are well-established guidelines for the recording, transcription, and analysis of spontaneous oral language samples by researchers, educators, and speech pathologists. In contrast, there is presently no consensus regarding methods for the written documentation of sign language samples. The Handshape Analysis Recording Tool (HART) is an innovative method for documenting and analyzing word level samples of signed languages in real time. Fluent sign language users can document the expressive sign productions of children to gather data on sign use and accuracy.

Method: The HART was developed to document children's productions in Australian Sign Language (Auslan) in a bilingual-bicultural educational program for the Deaf in Australia. This written method was piloted with a group of fluent signing Deaf educational staff in 2014-2016, then used in 2022-2023 with a group of fluent signing professionals to examine inter- and intrarater reliability when coding parameters of sign accuracy.

Results: Interrater reliability measured by Gwet's Agreement Coefficient, was "good" to "very good" across the four phonological parameters that are components of every sign: location, movement, handshape, and orientation.

Conclusions: The findings of this study indicate that the HART can be a reliable tool for coding the accuracy of location, orientation, movement, and handshape parameters of Auslan phonology when used by professionals fluent in Auslan. The HART can be utilized with any sign language to gather word level sign language samples in a written form and document the phonological accuracy of signed productions.

Purpose: This study explored the relation between therapy group size and language outcomes for children receiving school-based language therapy through an implementation science lens.

Method: Data for the current study were gathered as part of the Speech-Language Therapy Experiences in Public Schools study. Participants included 273 English-speaking kindergarten through second-grade children with language impairment receiving business-as-usual therapy on the caseloads of 75 speech-language pathologists. Data were collected over an academic year, including weekly therapy logs, speech-language pathology questionnaires, and pre- and post-language measures.

Results: Descriptive analysis revealed that children primarily experienced small-group therapy sessions (two to four children); however, there was considerable variability in group size. Hierarchical general linear modeling indicated that caseload size did not explain group size variability. However, the number of student cancellations was positively associated with receipt of large-group sessions. Notably, a significant negative association was found between receipt of large-group sessions (i.e., five to 10 children) and language outcomes. Children who received more than the average number of sessions in large groups (i.e., more than 5% of total sessions) experienced 0.18 SD less language gain over the academic year compared to the mean (0.54 SD). No other group size configurations (i.e., individual, small group, and extra large) yielded significant associations with language outcomes.

Conclusions: The findings suggest that young children receiving language-based therapy in large groups make substantially fewer language gains over an academic year. These results have considerable implications for educational policy and clinical practice, which are discussed through an implementation science frame.

Purpose: We investigated the effectiveness of a highly individualized morphosyntactic intervention using the SHAPE CODING™ system delivered at different dosages.

Method: Eight children with developmental language disorder aged 8;0-10;10 (years;months) received 10 hr of explicit individualized intervention for morphosyntax delivered in 30-min individual sessions once per week for 20 weeks. Following at least four baseline probe tests, two grammatical targets per session received explicit instruction until they reached criterion (90%), when the next target was introduced. To control for session length and teaching episode density, either both targets received 20 teaching episodes per session or one target received 10 teaching episodes and the other 30. Maintenance testing of completed targets was also carried out.

Results: Scores on probe tests post-intervention were significantly higher than during the baseline phase (d = 1.6) with no change during the baseline or maintenance phases. However, progress during the intervention phase was highly significant. One participant showed significantly faster progress with intervention, while one (with the lowest attention score) made little progress. When considering progress relative to cumulative intervention sessions, progress was faster with 30 teaching episodes per session and slower with 10. However, when cumulative teaching episodes were used as the predictor, all three within-session dosages showed very similar rates of progress, with the odds of a correct response increasing by 3.9% for each teaching episode. The targets that were achieved required an average of 40-60 teaching episodes.

Conclusions: With the exception of one participant, the individualized intervention was highly effective and efficient. Thus, the individualized target identification process and intervention method merit further research in a larger group of children. The cumulative number of teaching episodes per target provided across sessions appeared to be key. Thus, clinicians should aim for high teaching episode rates, particularly if the number of sessions is constrained. Otherwise, intervention scheduling can be flexible.

Supplemental material: https://doi.org/10.23641/asha.25996168.

Purpose: Spanish-speaking families are a growing population that speech-language pathologists must be prepared to work with. To provide culturally responsive intervention, speech-language pathologists (SLPs) must understand the perspectives of Spanish-speaking caregivers when providing intervention. These values and experiences may differ from those of monolingual, mainstream culture. Understanding the impact of the COVID-19 pandemic on these experiences is also important. In this qualitative study, we explore the experiences of Spanish-speaking mothers whose children have received school-based speech-language intervention and the impact of the COVID-19 pandemic.

Method: We interviewed five Spanish-speaking mothers who were identified as having bilingual children who had or were currently receiving speech therapy, all through the public school system. The mothers participated in a semistructured interview to share their experiences with their children receiving intervention. We analyzed the transcripts through interpretative phenomenological analysis to identify salient themes among participants. All research team members reviewed and agreed upon themes to ensure credibility.

Results: The findings revealed six group experiential themes: (a) lack of services and frustration with and barriers to accessing services, (b) greater improvements in English compared with Spanish, (c) bilingual speech therapy has positive effects on children and Spanish-speaking mothers, (d) family involvement in speech therapy is highly important, (e) family stress related to speech difficulties, and (f) pandemic negatively impacted children's socialization and learning.

Discussion: The results are discussed in the context of equity. Through understanding the experiences of Spanish-speaking mothers, SLPs can work to ensure service levels comparable with those of monolingual children and support bilingual acquisition.

Purpose: The purpose of this study was to test the efficacy of the Teaching Early Literacy and Language (TELL) curriculum package for improving the early literacy and oral language skills of preschoolers from low-income families.

Method: In a randomized controlled trial (RCT), TELL was implemented in 30 TELL and 28 business-as-usual classrooms. TELL is a Tier 1 whole-class curriculum package that includes a scope and sequence of instruction, lesson plans and materials, high-quality books, curriculum-based measures (CBMs), and professional development training and coaching.

Results: Implementation fidelity was high; however, due to COVID-19 school closures, we did not collect end-of-year data for our third cohort of teachers. Results indicated significant TELL effects on all code-related CBMs and two code-related distal measures as well as receptive and expressive vocabulary CBMs. No significant differences were found on distal measures of oral language/vocabulary or listening comprehension.

Conclusions: Results of the present study, paired with findings from an earlier TELL RCT with children with developmental speech and/or language impairments, suggest that children enrolled in TELL classrooms achieve higher outcomes on a variety of code-related and vocabulary measures by the end of their final preschool year.

Supplemental material: https://doi.org/10.23641/asha.25345708.

Purpose: This study examined the clinical practice, self-efficacy, and beliefs about assessing and treating written language among speech-language pathologists (SLPs) working with school-aged clients (aged 5-21 years) in school and nonschool settings in the United States.

Method: A survey was completed by a nationwide sample of 344 SLPs working with school-aged clients in the United States. Statistical analyses were conducted to determine differences between (a) SLPs' self-efficacy in assessing and treating spoken versus written language and (b) school-based and non-school-based SLPs' clinical practice, self-efficacy, and beliefs about their roles with written language.

Results: All respondents reported significantly lower rates of self-efficacy in assessing and treating written language compared to spoken language, and their self-efficacy had a significant, positive relationship with the amount of clinical time devoted to written language. School-based SLPs devoted a significantly lower percentage of clinical time to written language, had significantly lower self-efficacy in addressing written language, and had lower rates of agreement on statements about their roles and responsibilities with written language compared to non-school-based SLPs. These differences were not found with spoken language. The most prevalent written language needs on respondents' workloads were reported as written expression (69.3%) and reading comprehension (66%).

Conclusions: School-based and non-school-based SLPs report different levels of clinical time devoted to written language, self-efficacy in addressing written language, and beliefs about their roles in addressing written language. There is a need to investigate the reasons for these differences and the potential impact of preservice and in-service training in ameliorating them.

Supplemental material: https://doi.org/10.23641/asha.25511047.