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Background Aims Methods & Procedures Outcomes & Results Conclusions & Implications WHAT THIS PAPER ADDS What is already known on the subject What this paper adds to the existing knowledge What are the potential or actual clinical implications of this work? Despite the ability of cochlear implants (CIs) to provide children with access to speech, there is considerable variability in spoken language outcomes. Research aimed at identifying factors influencing speech production accuracy is needed.To characterize the consonant production accuracy of children with cochlear implants (CWCI) and an age‐matched group of children with typical hearing (CWTH) and to explore several factors that potentially affect the ability of both groups to accurately produce consonants.We administered the Bankson‐Bernthal Test of Phonology (BBTOP) to a group of 25 CWCI (mean age = 4;9, SD = 1;6, range = 3;2–8;5) implanted prior to 30 months of age with a mean duration of implant usage of 3;6 and an age‐matched group of 25 CWTH (mean age = 5;0, SD = 1;6, range = 3;1–8;6). The recorded results were transcribed, and the accuracy of the target consonants was determined. Expressive vocabulary size estimates were obtained from a language sample using the number of different words (NDW). A parent questionnaire provided information about maternal education, duration of CIs experience and other demographic characteristics of each child.The CWCI group demonstrated some similarities to, and some differences from, their hearing peers. The CWCI demonstrated poorer consonant production accuracy overall and in various phonetic categories and word positions. However, both groups produced initial consonants more accurately than final consonants. Whilst CWCI had poorer production accuracy than CWTH for all phonetic categories (stops, nasals, fricatives, affricates, liquids and glides and consonant clusters), both groups exhibited similar error patterns across categories. For CWCI, the factors most related to consonant production accuracy when considered individually were expressive vocabulary size, followed by duration of CI experience, chronological age, maternal education and gender. The combination of maternal education and vocabulary size resulted in the best model of consonant production accuracy for this group. For the CWTH, chronological age followed by vocabulary size were most related to consonant production accuracy. No combination of factors yielded an improved model for the CWTH.Whilst group differences in production accuracy between the CWCI and CWTH were found, the pattern of errors was similar for the two groups of children, suggesting that the children are at earlier stages of overall consonant production development. Although duration of CI experience was a significant covariate in a single‐variable model of consonant production accuracy for CWCI, the best multivariate model of consonant production accuracy for these children was based on the combination of expressive vocabulary size and maternal education. Research has shown that a range of factors is associated with consonant production accuracy by CWCIs, including factors such as the age at implant, duration of implant use, gender, other language skills and maternal education. Despite numerous studies that have examined speech sound production in these children, most have explored a limited number of factors that might explain the variability in scores obtained. Research that examines the potential role of a range of child‐related and environmental factors in the same children is needed to determine the predictive role of these factors in speech production outcomes. Whilst the consonant production accuracy was lower for the CWCIs than for their typically hearing peers, there were some similarities suggesting that these children are experiencing similar, but delayed, acquisition of consonant production skills to that of their hearing peers. Whilst several factors are predictive of consonant production accuracy in children with implants, vocabulary diversity and maternal education, an indirect measure of socio‐economic status, were the best combined predictors of consonant production accuracy. Understanding the factors that shape individual differences in CWCI speech production is important for effective clinical decision‐making and intervention planning. The present findings point to two potentially important factors related to speech sound production beyond the duration of robust hearing in CWCI, namely, a lexical diversity and maternal education. This suggests that intervention is likely most efficient that addresses both vocabulary development and speech sound development together. The current findings further suggest the importance of parental involvement and commitment to spoken language development and the importance of receiving early and consistent intervention aimed both at skill development and parental efficacy. [ABSTRACT FROM AUTHOR]

Background Aims Methods & Procedures Outcomes & Results Conclusions & Implications What this paper adds What is already known on the subject What this paper adds to the existing knowledge What are the potential or actual clinical implications of this work? Concussion and communication researchers have yet to study how post‐concussion communication changes affect youths’ daily lives. The lack of attention paid to how young people respond to communication changes during concussion recovery constitutes a significant gap in current concussion management research and practices.To explore how youth respond to the effects of post‐concussion communication changes in their daily life, including (1) daily routines, (2) relationships with family members, (3) relationships with peers and (4) participation in school/work and community activities.Five youths (16–25 years) and three family members participated in this arts‐based reflexive collective case study. Ecocultural theory provided the theoretical framework for study design, data collection and analysis. Cases consist of (1) pre‐interview demographic information, (2) three 60–90‐min virtual interviews, (3) optional family member interviews, (4) multi‐media arts‐based participant‐generated materials representing participants’ experiences of communication change and concussion, and (5) researcher observations, discussions and reflexive journal entries. Reflexive thematic analysis was used to analyse the data.Analysis yielded four themes that illustrate the ways youth navigated and adapted to post‐concussion communication changes: (1) navigating changes in communication tasks, daily roles, and identity; (2) re‐negotiating relationships and emotional reactions; (3) seeking control and learning to let go during recovery; and (4) helping youth adapt to post‐concussion communication changes.The study findings deepen our understanding of the impact of post‐concussion communication changes on youths' daily lives and underscore considerations critical to the development of communication‐focused concussion education programs and interventions tailored specifically for youth. Youth is a critical period of social and emotional development. Communication is integral to identity, relationships, participation in daily activities and well‐being. Concussions can affect speech clarity, fluency, understanding and use of language, and social interactions. Re‐engaging in routine activities and pre‐injury roles can be challenging for youth experiencing communication changes as part of complex concussion recoveries. Findings from this research illuminate how youth navigate and adapt to communication changes post‐concussion and support the development of youth‐focused communication education programs, assessments and interventions. Youth participants actively managed their recoveries by developing innovative strategies to support their communication during daily activities, learning about communication, practicing communication tasks sequentially, and facing fears. Youth also reframed and challenged narrow views of ‘normal communication’. Findings highlight the need for more youth‐ and communication‐focused education materials and programs within youth concussion management protocols. Information about the specific ecological and sociocultural factors youth encounter during concussion recovery is needed to develop targeted communication‐focused education and intervention programs for youth and their families to mitigate risks of isolation, loneliness, and mental health concerns and increase youths’ participation in family, community and cultural life. By learning from youth about how communication changes affected their participation in daily activities, identity and relationships, clinicians can provide information and interventions to reduce adverse listener reactions and help young people feel supported and understood. [ABSTRACT FROM AUTHOR]

Background Aims Methods & Procedures Outcomes & Results Conclusions & Implications What this paper adds What is already known on this subject What this paper adds to the existing knowledge What are the potential or actual clinical implications of this work? Attainment inequalities exist for ethnic minority students graduating from higher education institutes (HEIs) in the UK. Previous research has investigated the outcomes and experiences of students from ethnic minority backgrounds on health and social care programmes. However, studies exploring ethnic minority speech and language therapy (SLT) students’ experiences have only focused on international students and were conducted in Australia. No known studies exploring the experiences of both home‐domiciled and international SLT students from ethnic minority backgrounds have been conducted in the UK.To explore the experiences of home‐domiciled and international ethnic minority students on a SLT training programme and to identify ways to improve these experiences.All SLT students attending a pre‐registration postgraduate course who identified as being from an ethnic minority background were invited to participate. Two focus groups, one for three international students and one for six home students, were conducted. Data were analysed using reflexive thematic analysis.Three themes were identified that illustrated students’ current experiences and how experiences could be improved: (1) feeling an outsider, explores students’ sense of belonging in SLT education; (2) finding ways to manage, describes the strategies used by students to cope with their experiences of marginalization, and how adopting these strategies impact on their well‐being; and (3) promoting inclusion, explains how the training programme could be modified to improve the experience of ethnic minority students.A better understanding of the experiences of ethnic minority SLT students can help others to support them more effectively. The findings suggest that making changes to SLT training programmes could improve ethnic minority students’ outcomes and experiences. These include: more training for staff and students, support groups for ethnic minority students, sharing lived experiences of students and experienced SLTs from ethnic minority backgrounds, and clearer ways of reporting racist incidents. International students would benefit from receiving more information on HEI support services and cultural practices in the UK. Previous studies have investigated the experiences of ethnic minority students on a range of HEI programmes, including those for students of physiotherapy and occupational therapy. The only studies investigating the experiences of ethnic minority SLT students are those exploring how international SLT students in Australia can be supported on professional placement. This study explores the experiences of home and international SLT students in the UK who identify as being from minority ethnic backgrounds. Findings suggest that these students feel like outsiders, affecting their sense of belonging. The need to find and implement strategies to manage their feelings of marginalization impacts on their well‐being. The findings suggest measures to promote the inclusion of ethnic minority SLT students to improve their experiences and support their well‐being. These include more training for all staff and students and the creation of a ‘lived experiences library’ where students and experienced SLTs from ethnic minority backgrounds could share positive experiences as well as ways of dealing with challenges. Clearer ways of reporting racist incidents would be beneficial for all students. International students would benefit from receiving more information on HEI support services and cultural practices in the UK. It is important that ethnic minority SLT students are involved in developments that aim to improve their experiences. [ABSTRACT FROM AUTHOR]

Background Aim Method & Procedures Outcomes & Results Conclusions & Implications What this paper adds What is already known on the subject What this paper adds to existing knowledge What are the practical and clinical implications of this work? Over 8 million children with disabilities live in Africa and are candidates for augmentative and alternative communication (AAC), yet formal training for team members, such as speech–language therapists and special education teachers, is extremely limited. Only one university on the continent provides postgraduate degrees in AAC, and other institutions provide only short modules at an undergraduate level. The need for an introductory training course on AAC that is accessible by university students continent‐wide was identified. An online programme, namely an intelligent tutoring system (ITS), was identified as a possible option to facilitate interactive learning without the need for synchronous teaching. The use of an ITS is shown to be effective in developing knowledge and clinical reasoning in the health and rehabilitation fields. However, it has not yet been applied to student teaching in the field of AAC.To determine both the feasibility of an ITS to implement an AAC curriculum for students in four African countries, and the usability and effectiveness of such a system as a mechanism for learning about AAC.The study included two components: the development of a valid AAC curriculum; and using the ITS to test the effectiveness of implementation in a pre‐ and post‐test design with 98 speech–language therapy and special education students from five universities.Statistically significant differences were obtained between pre‐ and post‐test assessments. Students perceived the learning experience as practical, with rich content.The findings suggest that the ITS‐based AAC curriculum was positively perceived by the students and potentially offers an effective means of providing supplementary AAC training to students, although modifications to the system are still required. Professionals typically lack formal training in AAC. In Africa, this presents a serious challenge as there are over 8 million children who are candidates for AAC. A need for an introductory training course on AAC, which can be accessed by university students continent‐wide, was identified. An AAC curriculum was developed and integrated into an ITS, an online programme allowing interactive learning through asynchronous teaching. Students from four African countries completed the AAC ITS curriculum. The curriculum was positively received by the students and statistically significant changes in knowledge were identified. This feasibility study shows that the use of an ITS is an effective means of providing AAC training to university students in these African countries. The results provide a valuable contribution toward ensuring the equitable distribution of AAC training opportunities in the African context. This will have a significant positive impact on those who are candidates for AAC. [ABSTRACT FROM AUTHOR]

Background Aim Methods & Procedures Outcomes & Results Conclusions & Implications WHAT THIS PAPER ADDS What is already known on this subject What this paper adds to existing knowledge What are the potential or actual clinical implications of this work? Over 50% of individuals with aphasia face ongoing word‐finding issues. Studies have found phonologically oriented therapy helpful for English speakers, but this has not yet been studied in French. It is essential to assess the effectiveness of such a therapy in French, considering the distinct linguistic typologies between both languages, which may impact the outcomes of phonologically oriented interventions.This paper evaluates the effectiveness of French Phonological Component Analysis (Fr‐PCA) on communication skills of individuals with chronic aphasia and the impact of individual factors on treatment success.Eighteen individuals with chronic aphasia received 15 h of Fr‐PCA therapy over 5 weeks. Naming accuracy for treated and untreated words was measured before and after therapy, as well as at 3‐ and 6‐month follow‐ups. Secondary outcome measures included standardized tests measuring within‐level generalization (object and action naming) and across‐level generalization (repetition, verbal fluency, oral comprehension, communication effectiveness reported by a frequent communication partner).Fr‐PCA led to improved accuracy for treated (17 participants out of 18) and untreated words (9 participants out of 18), with gains maintained at 6‐month follow‐up (7 participants out of 10 for treated and 6 participants out of 10 for untreated), and generalization to communication effectiveness reported by a frequent communication partner (11 participants out of 16). Age, apraxia of speech severity and initial anomia severity impacted therapy gains.Though more research is needed, results suggest Fr‐PCA benefits French individuals living with aphasia. Identifying individual factors influencing therapy gains could enable clinicians to improve therapy tailoring. Phonological Component Analysis (PCA) improves naming of treated and untreated items in individuals living with aphasia. There is also evidence supporting long‐lasting benefits following PCA. However, PCA has never been studied in French, a language presenting with a different linguistic typology than English, and we know little as to which individual factors can influence PCA therapy benefits. Through group‐level analyses on both personalized sets and standardized tests, this study shows that PCA constitutes an effective therapy protocol for francophone individuals living with aphasia. The gains are measured on treated and untreated items and generalized to levels other than naming, such as communication effectiveness. Individual factors such as age, initial anomia severity and apraxia of speech severity influence therapy outcomes. There is now evidence supporting PCA in French, a language with strong morphological‐phonological interactions. Furthermore, when working with individuals living with aphasia and severe anomia or apraxia of speech, gains can still be made, but might be longer to attain. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion WHAT THIS PAPER ADDS What is already known on the subject What this paper adds to existing knowledge What are the potential or actual clinical implications of this work? SPEAK OUT! has been shown to enhance various aspects of voice such as intensity, prosody, voice quality and perception of voice. However, their impacts on expiration and communication effectiveness have not yet been evaluated. This study aimed to evaluate the effectiveness of the Hybrid SPEAK OUT! method on aerodynamic measurements and patient‐reported outcome measures (PROMs) in individuals with Parkinson's disease (PD).This study included 157 participants with PD who underwent an intensive 8‐week multidisciplinary treatment program. The Hybrid SPEAK OUT! method consisted of three sessions per week, including two group sessions and one individual treatment session. Voice‐related aerodynamic measures included maximum phonation time (MPT), vocal cord function using the S/Z ratio, and expiratory flow measures including peak expiratory flow (PEF) and peak cough flow (PCF). Two PROMs were included: the Hebrew version of the voice handicap index‐10 and communication effectiveness questionnaire.The results of 111 participants were analysed. MPT duration increased, PEF and PCF increased, and better scores were found in PROMs.These findings would appear to support the effectiveness of the Hybrid SPEAK OUT! methods improving function, activity and participation in individuals with PD. However, further research is needed. Prior research has demonstrated the effectiveness of behavioral therapies, including the SPEAK OUT! program, in managing speech symptoms in individuals with Parkinson's disease (PD). These therapies have shown improvements in voice intensity, fundamental frequency, voice quality, and voice perception. However, the impact on aerodynamic measures, expiratory flow, and patient‐reported outcome measures has not been extensively studied. This study adds to the existing knowledge by demonstrating that a Hybrid SPEAK OUT! approach, can lead to improvements in aerodynamic measures, including maximum phonation time (MPT), expiratory and cough peak flow. In terms of motor learning, we found that two non‐speech exhalation‐related tasks that were not directly trained improved following the intensive speech training protocol. Furthermore, it shows positive changes in patient‐reported outcome measures, with reduced voice‐related disability and improved communication efficiency. The findings of this study have important clinical implications for the management of speech symptoms in individuals with PD. The Hybrid SPEAK OUT! program, which combines group and individual sessions, can effectively improve voice, aerodynamic measurements and patient‐reported outcome measures (PROMs), ultimately enhancing the overall quality of life for patients. These findings support the effectiveness of the Hybrid SPEAK OUT! methods for improving function, activity, and participation in individuals with PD. [ABSTRACT FROM AUTHOR]

Background Aim Methods & Procedures Outcomes & Results Conclusions & Implications WHAT THIS PAPER ADDS What is already known on the subject What this paper adds to existing knowledge What are the potential or actual clinical implications of this work? Speech and language therapists (SLTs) play an important role in assessing and rehabilitating communication disorders in people with dementia, but there is evidence to suggest that they do not receive appropriate training to provide management and support during their training.To investigate the level of awareness and knowledge that practising SLTs from Brazil have about dementia and their role in the care of dementia through an online survey.An online survey tool was developed to collect information from practising Brazilian SLTs regarding their knowledge about dementia, awareness about their role in the care of people with dementia, and opinions on how SLTs may be better prepared to work in the dementia field. The survey was disseminated via social media, websites, and e‐mail lists of researchers and stakeholders.A total of 227 SLTs completed the survey. Participants showed good knowledge of dementia in general, while their answers were less accurate on primary progressive aphasia. Regarding the awareness by SLTs of their role in the care of people with dementia, most agreed or strongly agreed that SLTs could help people in the diagnosis, treatment and prevention of dementia (> 80%). However, fewer participants agreed or strongly agreed that they felt confident in contributing to the treatment and diagnosis process of dementia (about 50%). To improve the training of SLTs in Brazil, most participants believed that it would be necessary to improve the teaching of dementia at the undergraduate speech and language therapy curriculum level and to develop recommendations or guidelines about speech and language therapy practice in dementia.The results of this survey point to a need for improvement in the knowledge and confidence of Brazilian SLTs about dementia. To reach this goal, targeted training courses and applied practice opportunities should be embedded within university curricula and training programmes. Many studies confirm the importance of speech and language therapy in the non‐pharmacological treatment of people with dementia. However, other evidence suggests to a possible lack of training for Brazilian SLTs, especially in the curriculum of undergraduate courses. This study reveals that Brazilian SLTs have substantial knowledge of dementia and recognize the significance of their role in treating people with dementia. However, a minority expressed confidence in their ability to assess and treat people with dementia. The findings of this research demonstrate that Brazilian SLTs have good knowledge of dementia and endorse their professional role in dementia care; however, they lack confidence in their own skills and expertise in diagnostic assessment and treatment of dementia. Interventions aimed at boosting the SLT's confidence level could lead to improved patients outcomes and overall quality of care within clinical settings. [ABSTRACT FROM AUTHOR]

Background Aims Methods & Procedures Outcomes & Results Conclusions & Implications WHAT THIS PAPER ADDS What is already known on the subject What this paper adds to existing knowledge What are the potential or actual clinical implications of this work? People with aphasia (PWA) typically exhibit deficits in spoken discourse. Discourse analysis is the gold standard approach to assess language deficits beyond sentence level. However, the available discourse assessment tools are biased towards English and European languages and Western culture. Additionally, there is a lack of consensus on which discourse measures to use and limited evidence of the psychometric properties of published discourse measurements.(1) To develop a standardized, norm‐referenced, culturally and linguistically appropriate Arabic Discourse Assessment Tool (ADAT); and (2) to examine the psychometric properties of content and construct validity and interrater reliability of different discourse measures elicited using three discourse genres (descriptive, narrative and procedural) in neurotypical control adults and matched PWA.Discourse samples were collected using three novel discourse stimuli that are sensitive to the Arabic language and culture from 70 neurotypical control adults and a matched group of 50 PWA. Transcription agreement was assessed. A standard approach was used to evaluate construct validity and interrater reliability for 16 discourse measures that assess fluency, language productivity, information content, lexical–semantics, lexical diversity, grammatical category, grammatical structure and syntactic complexity. Strong measures were identified based on their psychometric properties, and normative data were established on these measures. Discourse performance of PWA was then examined using the newly developed tool (ADAT).Transcription agreement was extremely high for all discourse stimuli in both groups. Eight discourse measures were proven to have consistently very high construct validity and consistently very good to excellent reliability across the three stimuli in both neurotypical control and aphasia groups: lexical information units, content information units, words per minute, discourse duration, number of different words, number of complete sentences and proportion of open and closed class words. Norms were established on these measures, and cut‐off scores of impairments were determined. Other measures showed low construct validity and variable or poor reliability across the two groups.The newly developed, standardized, and norm‐referenced tool (ADAT) consist of three discourse stimuli and eight high‐quality discourse measures that assess multiple aspects of spoken discourse and were able to differentiate PWA from neurotypical adults consistently. ADAT also includes normative data and cut‐off impairment scores. The tool has great potential to enhance clinical practice and research with Arabic speakers. Evidence was provided that not all discourse measures are of high quality, as some are vulnerable to differences between raters, discourse stimuli and groups. Clinicians and researchers can use ADAT for accurate aphasia assessments, better management plans and to monitor therapy effectiveness. ADAT can be further validated in other clinical populations with language impairments. Discourse analysis is the gold standard approach to assess language deficits beyond sentence level. However, existing discourse assessment tools are biased towards English and European languages and Western culture. Additionally, there is a lack of consensus on which discourse measures to use in aphasia, and limited evidence of the psychometric properties of published discourse measurements. A novel, standardized, norm‐referenced Arabic Discourse Assessment Tool (ADAT) was developed and validated in this study. ADAT was further validated among PWA. The study provides evidence that not all discourse measures are of high quality and thus should not be used with confidence. Specific measures are vulnerable to the type of stimuli, the rater and/or the tested group. On the other hand, eight discourse measures were identified to be reliable between different raters and across different stimuli for the two groups, and they were able to differentiate the discourse performance of PWA from neurotypical control adults. Normative data derived from neurotypical control adults were established on these strong measures, and the performance of PWA was classified as impaired based on these norms. The present study provides a novel, standardized, norm‐referenced, validated discourse assessment tool that is culturally and linguistically appropriate for use by Arabic speakers (ADAT). ADAT holds immense potential to enhance clinical practice and research with Arabic speakers. The study also identified strong discourse measures that can be used to assess language productivity, information content, lexical–semantics, lexical diversity, grammatical category, and syntactic complexity for accurate and comprehensive assessments. This will lead to better rehabilitation management by guiding the development of tailored client‐centred interventions. ADAT can be utilized in clinical and research settings in PWA and has the potential to be further validated with other clinical populations. [ABSTRACT FROM AUTHOR]

Background Aims Methods Results Conclusions WHAT THIS PAPER ADDS What is already known on this subject What this study adds to existing knowledge What are the potential or actual clinical implications of this work? Speech and language therapists (SLTs) regularly use phonetic transcription to record and analyse typical and disordered speech. Phonetic transcription is highly demanding of auditory perceptual skills so researchers are sceptical about its accuracy and reliability. The literature describes how phonetic transcription is prone to auditory illusions and biases, such as a preference to transcribe speech sounds from the transcriber's own language. Few empirical research studies have calculated agreement amongst transcribers where a range of agreement scores have been reported (51%–97%). There is a consensus that agreement rates decrease as phonetic detail increases. Vowels and consonants are characterised by different perceptual features within the International Phonetic Alphabet (IPA) so they may differ in agreement rates, and thus far there is contradictory evidence as to whether vowels or consonants are more agreed upon. Transcription agreement studies to date have most commonly recruited phoneticians rather than SLTs so further research is warranted to determine transcription agreement amongst SLTs and its impact on clinical practice.The study's primary aim was to calculate agreement scores from a group of English‐speaking SLTs who transcribed disordered speech samples in an ecologically valid setting. The study also sought to contribute to the pre‐existing contradictory evidence base regarding whether vowels or consonants may be more agreed upon by comparing their agreement scores. The researcher aimed to comment on SLTs’ use of diacritics and non‐native speech symbols (symbols not included in the English phonetic inventory) in terms of their frequency and agreement of use. By analysing transcriptions, the study aimed to discuss the impact transcription variability has on speech sound error patterns and thus its impact on clinical decision‐making such as diagnosis, choice of intervention and therapy targets.Twelve paediatric SLTs were recruited via a convenience sample at two National Health Service trusts, two of whom were specialists in Speech Sound Disorders (SSDs). Participants transcribed 16 words from a video of a boy with disordered speech completing the Diagnostic Evaluation of Articulation and Phonology (DEAP, Dodd et al., 2006) from a telehealth appointment. The use of diacritics and non‐English IPA symbols were manually analysed. A classic agreement score was calculated for each target word using a Python script, and then for vowels and consonants in isolation. Datasets were manually analysed to determine whether differences in transcription resulted in the identification of different speech sound error patterns. The researcher considered the implications this had within clinical practice.The average classic agreement score was 56.3%. Consonants were more agreed upon than vowels with agreement scores of 62.8% and 48.6%, respectively. Nine participants (75%) used diacritics (most commonly length marks) and eight participants (67%) transcribed non‐native IPA symbols at least once in their datasets, but generally with low frequencies and agreements amongst their use. Transcriptions captured the occurrence of typical and atypical error patterns but only three error patterns, out of the 20 identified, were present in all 12 participants’ transcriptions.The agreement score of 56.3% questions the accuracy and reliability of transcription amongst SLTs which is an essential skill of the profession. The findings highlight SLTs should be more cautious of interpreting vowels than consonants given lower agreement rates. The frequency of use of non‐native symbols and diacritics was relatively low which could reflect a low accuracy of their use or reduced confidence in transcribing these. The study discussed how variations in transcriptions can impact phonological and phonetic analysis, which in turn can influence clinical decision‐making such as diagnosing SSDs, selecting further diagnostic assessments and choosing therapy targets and interventions. The Royal College of Speech and Language Therapists‐endorsed transcription guidelines (Child Speech Disorder Research Network, 2017) could be revised to convey realistic expectations of SLTs’ transcription skills, or SLTs should be offered more training to improve transcription skills to meet current expectations. Other suggestions to improve transcription accuracy are discussed such as via instrumental methods, yet these come with their own limitations such as practicality, costs and need for specialist training. Phonetic transcription is highly demanding of human perceptual skills, and researchers are sceptical about its reliability. There are few empirical research studies calculating agreement amongst transcribers, and a range of agreement scores have been reported (51%−97%) dependent on the research conditions. Research mostly involves experienced transcribers (e.g., phoneticians) rather than speech and language therapists (SLTs), a profession expected to regularly use phonetic transcription to record and analyse typical and disordered speech. A range of transcription agreement scores have been reported in previous studies, mainly comparing pairs or small groups of specialist transcribers rather than SLTs. This study provides an agreement score of 56.3% when a group of 12 SLTs transcribed a disordered speech sample in an ecologically valid setting (where speech samples were taken from a real‐life speech sound assessment over a telehealth appointment using the Diagnostic Evaluation of Articulation and Phonology). The study found consonants are more agreed upon than vowels, adding to the contradictory evidence base. Unlike other studies, the researcher analysed transcriptions to identify error patterns to examine the impact that transcription variation has on clinical decision‐making. The researcher questions whether SLTs are meeting the expectations of ‘accurate transcription’ as listed by the Royal College of Speech and Language Therapists (RCSLT) endorsed transcription guidelines (Child Speech Disorder Research Network, 2017) given the relatively low agreement score of 56.3%. The study also questions the reliability of the use of diacritics and non‐English International Phonetic Alphabet (IPA) symbols and whether SLTs should be expected to use these due to perceptual limitations. Twenty phonological processes emerged from the datasets, only three of which were agreed upon across all 12 participants. The researcher therefore discusses how transcription variations could result in different diagnoses, therapy targets and interventions choices. The paper suggests more training is required to enhance transcription accuracy, and also considers the appropriateness of utilising instrumental methods whilst recognising its limitations such as feasibility, costs and specialist training needs. [ABSTRACT FROM AUTHOR]

Background Aims Methods & Procedures Outcomes & Results Conclusions & Implications WHAT THIS PAPER ADDS What is already known on the subject What this paper adds to existing knowledge What are the potential or actual clinical implications of this work? A recent literature review identified that past research has described the impacts of dysphagia on quality of life; but there is limited research on these impacts from the perspective of people with dysphagia, their supporters and allied health professionals. Recent qualitative research has provided details about these perspectives, but researchers have also called for verification of these findings with a larger group of participants.To expand upon the findings of the prior qualitative research on the views of people with dysphagia, supporters of people with dysphagia, and allied health professionals on the impacts of dysphagia and texture‐modified food on quality of life.An online survey of adults with dysphagia (n = 30), supporters of people with dysphagia (n = 4) and allied health professionals (n = 18) was conducted between November 2021 and February 2022. Categorical questions were analysed descriptively and open‐ended questions were analysed for content categories of meaning.Participants with dysphagia reported that dysphagia and texture‐modified foods had a greater impact on their physical health than on their choice and control or social engagement. Supporters and allied health professionals viewed that dysphagia impacted the physical health and their choice and control of people with dysphagia. Across groups, participants considered that mealtime enjoyment, participation, and inclusion were influenced by the control the person had over their meals, the accessibility of the mealtime environment, and the attitudes of others.Dysphagia and its interventions negatively impact quality of life for people with dysphagia. People with dysphagia were the most affected by the physical impacts of dysphagia. Their perspectives contrasted with those of supporters and allied health professionals in some domains, highlighting the need for people with dysphagia to be included in research. Future research exploring how these perspectives are integrated into person‐centred dysphagia management is warranted. Recent qualitative research has provided insights into the impacts of dysphagia on quality of life from the perspective of people with dysphagia, supporters of people with dysphagia, and allied health professionals. However, the small scale of these studies means that further research is needed with a larger group of people with dysphagia, supporters of people with dysphagia, and allied health professionals. This paper verifies and extends upon the findings of prior qualitive research on the views of people with dysphagia, supporters of people with dysphagia, and allied health professionals on the impacts of dysphagia and its interventions on quality of life, participation, and inclusion. This research shows the importance of supporters of people with dysphagia and allied health professionals discussing mealtime quality of life with the person with dysphagia so that their perspectives are considered in the mealtime decision‐making process. Furthermore, people with dysphagia should be able to specify strategies they want to trial to enhance their mealtime participation and inclusion. [ABSTRACT FROM AUTHOR]

Background Aims Methods & Procedures Outcomes & Results Conclusions & Implications WHAT THIS PAPER ADDS What is already known on the subject What this paper adds to existing knowledge What are the potential or clinical implications of this work? Communication disabilities, such as primary progressive aphasia (PPA), impact family members as well as the individuals with the condition. To provide adequate communication care to people with PPA (PwPPA) and their family members, it is crucial to understand the communication needs from the family members’ perspectives. To date, research on the communication needs of people with primary progressive aphasia and their family members from the perspectives of family members has been limited.The specific research objectives were to explore (a) the communication needs pertaining to PwPPA in the early, middle and late stages; and (b) the communication needs pertaining to family members of PwPPA in the early, middle and late stages, from the perspectives of family members.This study employed a qualitative description approach, underpinned by the pragmatic paradigm. Data collection involved semi‐structured qualitative interviews with eight family members (relatives of four individuals with the logopenic variant of PPA, of two individuals with the nonfluent variant of PPA, of one individual with the semantic variant of PPA and of one individual with mixed PPA). Qualitative content analysis was used to identify codes and categories in relation to the research objectives.Qualitative content analysis revealed eight categories of communication needs pertaining to the PwPPA: person‐specific needs; diagnosis and disclosure; general communication difficulties; impact on communication in everyday life; impact on cognition; impact on psychosocial well‐being; impact on person's dignity and autonomy; and future planning. Six categories were identified pertaining to the family members: information about and awareness of PPA; impact of communication difficulties on family/others; increased responsibilities for the family in everyday life; impact on psychosocial well‐being; and future planning.This investigation has expanded our knowledge in the area by providing insights about communication needs which speech‐language pathologists and other health professionals should be aware of and take into account when providing communication care to PwPPA and their families. Person‐ and family‐centred communication care is optimally guided by the person's and family's needs and values. Research on communication care for people with primary progressive aphasia has underscored the inclusion of family members. Previous research has investigated the impact and experiences of living with primary progressive aphasia from the family member perspective. To date, research focusing on identifying the communication needs of people with primary progressive aphasia and their family members from the perspective of family members is limited. This study adds the family members’ perspectives on the communication needs pertaining to themselves and their relatives with primary progressive aphasia in the early, middle and late stages of primary progressive aphasia. Several clinical implications have been raised. Family members experience communication needs for themselves and should be included as recipients of communication care. Clinicians supporting people with primary progressive aphasia should be cognizant of the impact of communication fatigue on everyday life and therapy tasks. Communication care for this population should include communication partner training, support for psychosocial well‐being and support with communication around future planning. [ABSTRACT FROM AUTHOR]

Background Aims Methods Main contribution Conclusions WHAT THIS PAPER ADDS What is already known on the subject What this paper adds to existing knowledge What are the potential or actual clinical implications of this work? The development of communication, speech and language follows three stages (development of the parent–child relationship, interactions and actual speech and language acquisition). Children born with cleft lip and/or palate are at increased risk of communicative problems while parents may be going through an emotionally difficult time. Early parent‐implemented logopaedic intervention that supports both parents and child is important. Three systematic reviews have examined the effects of early speech and language interventions, but not their structure and content.To investigate which early parent‐implemented logopaedic interventions already exist for children with cleft lip and/or palate, and to evaluate their structure, content and time of onset against the three stages of communicative development.Six databases (PubMed, Embase, Web of Science, APA PsycInfo, Cinahl and Scopus) were searched between inception and 31 March 2023 to identify published articles that reported early parent‐implemented logopaedic interventions in children with cleft lip and/or palate, aged 0 to 3 years, clearly describing the strategies used to train parents. Two authors independently assessed the eligibility of the studies. Quality assessment was conducted using the Physiotherapy Evidence Database quality assessment tool, Single‐Case Experimental Design tool and the National Institutes of Health pre‐post‐study tools. The structure and content of the interventions were analysed taking into account the needs and difficulties of both the parents and the child according to the three stages of communicative development.The systematic literature search identified four studies that met the inclusion criteria. Three of them had a Level of Evidence III and one study had a Level of Evidence IV. Strategies appropriate for Stage 1 of communicative development (parent–child relationship) are well represented in only one study, but the psychosocial needs of parents are currently not included in these programmes. However, research shows that parental emotional difficulties can adversely impact a child's communicative development. Strategies appropriate for Stage 2 (promoting social interactions) are better represented. However, strategies appropriate for Stage 3 (acquiring correct speech and language patterns) are most represented in all intervention programmes.Three out of four intervention programmes focus on Stage 3 (actual speech and language stimulation). Stage 1 is underrepresented and the psychosocial needs of parents are currently not included in existing intervention programmes. Further research is needed in close collaboration with psychologists to construct a comprehensive, longitudinal, developmentally appropriate intervention programme that equally represents the three stages of communicative development and considers the psychosocial needs of parents. Children with cleft lip and/or palate are at increased risk of speech and language problems from birth. Parents of these children often have emotional problems following their child's diagnosis. The effectiveness of early intervention to facilitate the child's speech and language development has already been proven. Early intervention is recommended for both parents and child, but little is known about early parent‐implemented logopaedic interventions that also provide psychosocial support for parents. This review has shown that existing early parent‐implemented logopaedic interventions for children with cleft lip and/or palate focus mainly on facilitating responsive interactions and actual speech and language development (Stages 2 and 3 of communicative development). However, Stage 1, where the parent–child relationship develops, is currently not included, even though this stage is a prerequisite of subsequent stages. If parents are struggling with emotional problems (following their child's diagnosis) this can negatively impact their mental health, the parent–child relationship, attachment and their child's development. A clinical implication of the findings in this review is that more attention should be paid to Stage 1 of communicative development in early parent‐implemented logopaedic interventions. By working closely with the psychologist of the cleft (and craniofacial) team, any psychosocial needs of the parents can be included in the counselling. As a result, the parents and their child are seen and supported as a unit and the parent–child relationship can develop optimally. [ABSTRACT FROM AUTHOR]

Background Aims Outcomes & Results Conclusions & Implications WHAT THIS PAPER ADDS What is already known on the subject What this paper adds to existing knowledge What are the potential or actual clinical implications of this work? Cleft lip and palate is one of the most common oral and maxillofacial deformities associated with a variety of functional disorders. Cleft palate speech disorder (CPSD) occurs the most frequently and manifests a series of characteristic speech features, which are called cleft speech characteristics. Some scholars believe that children with CPSD and poor speech outcomes may also have weaknesses in speech input processing ability, but evidence is still lacking so far.(1) To explore whether children with CPSD and speech output disorders also have defects in speech input processing abilities; (2) to explore the correlation between speech input and output processing abilities.Methods & Procedures: Children in the experimental group were enrolled from Beijing Stomatological Hospital, Capital Medical University, and healthy volunteers were recruited as controls. Then three tasks containing real and pseudo words were performed sequentially. Reaction time, accuracy and other indicators in three tasks were collected and then analysed.The indicators in the experimental group were significantly lower than those in the control group. There was a strong correlation between speech input and output processing tasks. The performance of both groups when processing pseudo words in the three tasks was worse than that when dealing with real words.Compared with normal controls, children with CPSD have deficits in both speech input and output processing, and there is a strong correlation between speech input and output speech processing abilities. In addition, the pseudo words task was more challenging than the real word task for both groups. Children with cleft lip and palate often have speech sound disorders known as cleft palate speech disorder (CPSD). CPSD is characterised by consonant errors called cleft speech characteristics, which can persist even after surgery. Some studies suggest that poor speech outcomes in children with CPSD may be associated with deficits in processing speech input. However, this has not been validated in mainland China. The results of our study indicate that children with CPSD exhibit poorer performance in three tasks assessing speech input and output abilities compared to healthy controls, suggesting their deficits in both speech input and output processing. Furthermore, a significant correlation was observed between speech input and output processing abilities. Additionally, both groups demonstrated greater difficulty in processing pseudo words compared to real words, as evidenced by their worse performance in dealing with pseudo words. The pseudo word tasks designed and implemented in our study can be employed in future research and assessment of speech input and output abilities in Chinese Mandarin children with CPSD. Additionally, our findings revealed the significance of considering both speech output processing abilities and potential existence of speech input processing ability for speech and language therapists when evaluating and developing treatment options for children with CPSD as these abilities are also important for the development of literacy development. [ABSTRACT FROM AUTHOR]

Background Aims Methods and Procedures Outcomes and Results Conclusions and Implications WHAT THIS PAPER ADDS What is already known on the subject What this paper adds to existing knowledge What are the potential or actual clinical implications of this work? Stuttering, a neurodevelopmental speech fluency disorder, is associated with intermittent disruptions of speech‐motor control. Behavioural treatments for adults who stutter (AWS) concentrate on adopting speech patterns that enhance fluency, such as speaking rhythmically or prolonging speech sounds. However, maintaining these treatment benefits can be challenging. Neuroimaging studies suggest that supplementary motor area (SMA) which play a crucial role in speech initiation, planning and internal timing shows aberrant activation in speech production of AWS and may contribute to stuttering. Preliminary evidence suggests that brain stimulation may impact responsiveness to behavioural treatments.The present study aims to investigate whether excitatory repetitive transcranial magnetic stimulation (rTMS) of the SMA and rhythmic speech can consistently reduce stuttering severity across various measures.Ten self‐identified Cantonese‐speaking AWS participated in this double‐blinded, sham‐controlled clinical trial study (NCT 05472181). The participants underwent 10 sessions of rhythmic speech training across two phases, combined with either neuronavigated rTMS or sham, with a 2‐week washout period between phases. The stuttering severity was assessed through various outcome measures, including the percentage of syllables stuttered, self‐perceived stuttering severity, and the brief version of Unhelpful Thoughts and Beliefs About Stuttering before and after each treatment phase.Results demonstrated improved speech fluency in various speaking contexts, with no significant difference between rTMS and sham conditions immediately and 1 week post‐treatment. Notably, rTMS specifically led to less stuttering in tongue twister production (d = –0.70). Both treatment conditions effectively reduced self‐perceived stuttering severity and negative thoughts and beliefs about stuttering.The findings of this study indicate that stimulating the SMA reduced stuttering, only in the production of tongue twisters that may require greater motor control and coordination. Furthermore, it indicates that rhythmic speech might help alleviate negative beliefs and anxiety related to stuttering. This research contributes to our understanding of neuromodulation in stuttering treatment and the role of the SMA in speech motor control and emphasises the need for more research on the potential benefits and limitations of applying rTMS in this condition. Behavioural treatments for adults who stutter concentrate on adopting speech patterns that enhance fluency, such as speaking rhythmically or prolonging speech sounds. However, maintaining these treatment benefits can be challenging. Neuroimaging studies indicate that aberrant neural activation in speech production regions, like the supplementary motor area (SMA), is involved in stuttering. The SMA plays a crucial role in initiating, planning, and sequencing motor behaviours. Preliminary evidence suggests that brain stimulation (e.g., transcranial direct current stimulation or transcranial magnetic stimulation) may impact responsiveness to behavioural treatments. There is limited knowledge regarding the potential effects of stimulating the SMA to enhance speech fluency in people who stutter. Existing research primarily consists of single case studies that lack proper control conditions or involve only a single stimulation session. Due to their limited scope and power, these studies may not provide sufficient evidence. The current study expands upon existing research by investigating whether multiple sessions of repetitive transcranial magnetic stimulation over the SMA, combined with rhythmic speech, improve speech fluency in adults who stutter. Furthermore, it addresses the limitations of brain stimulation methods and proposes directions for future research. This study implies that the stimulation of SMA reduced stuttering only in speaking contexts that may require greater motor control and coordination such as tongue twisters. Additionally, the research suggests that using rhythmic speech could potentially alleviate negative beliefs and anxiety associated with stuttering. [ABSTRACT FROM AUTHOR]

Background: In 2016–17 an important consensus was established regarding the use of the diagnostic label 'developmental language disorder' (DLD) to describe children with a persistent language problem having a functional impact on communication or learning and in the absence of any other biomedical condition. Despite this consensus, past research has revealed ongoing uncertainty regarding when to use the DLD label among speech–language pathologists (SLPs). Aims: In response to this uncertainty, a survey of SLPs was conducted aimed at investigating which types of clinical language profiles, and specific assessment results, were viewed as warranting the diagnostic label DLD. Methods & Procedures: SLPs were presented with 10 childhood language profiles and assessment results. Participants reviewed each case and described if they felt a diagnosis of DLD was warranted, which presented symptoms were consistent/inconsistent with DLD and if further information/testing was desired. Additionally, participants provided details regarding their personal diagnostic processes. Outcomes & Results: Results indicated a general consensus among SLPs as to when the DLD label should be applied. However, free‐text responses demonstrated considerable variation between clinicians regarding symptoms of importance, points of contention/confusion in language profiles and minimal assessment results viewed as necessary in the diagnostic process. Conclusions & Implications: This detailed look at the assessment/diagnostic process for DLD provides valuable insight into how to build further practice consistency in the provision of the diagnostic label DLD, especially in cases of complex language profiles and assessment results. WHAT THIS PAPER ADDS: What is already known on this subject: The label DLD should be used as a diagnostic label to describe children with persistent language problems having a functional impact on communication or learning and in the absence of any biomedical condition. However, in current clinical practice, actual use of the label is inconsistent and SLPs face a number of challenges in diagnosing DLD. What this paper adds to the existing knowledge: This investigation provides clarity regarding which complexities in paediatric language profiles are most challenging for SLPs when determining if a child does/does not have DLD. Additionally, details regarding current assessment beliefs and practices are explored. What are the practical and clinical implications of this work?: By providing a detailed look at the diagnostic processes of practising SLPs, valuable insight is provided into how to build further practice consistency and confidence in the provision of the diagnostic label DLD, especially in cases of complex language profiles and assessment results. [ABSTRACT FROM AUTHOR]

Introduction: Speech Language Therapy First Point of Contact Clinic (SLT‐FPOCC) models can assist assessment of low‐risk patient populations referred to ear, nose and throat (ENT) services. To further improve ENT waitlist management and compliance with best‐practice care, consideration of other low‐risk populations that could be safely managed through this service model is needed. The aims of this paper are to evaluate the clinical and service outcomes of completing vocal cord check (VCC) assessments for patients' pre and post thyroid/parathyroid surgery within an SLT‐FPOCC model and examine consumer perceptions. Methods & Procedures: The service followed existing SLT‐FPOCC procedures, with ENT triaging referrals, then SLT completing pre‐ and postoperative VCC assessment (interview, perceptual assessment, flexible nasendoscopy), with assessment data later reviewed by ENT to diagnose laryngeal pathology. Clinical and service outcomes were collected prospectively. Patients completed an anonymous post‐service satisfaction survey. Results: Of the first 100 patients referred for preoperative VCCs, SLT assessment identified 42 with dysphonia and 30 reporting dysphagia, while ENT confirmed 9 with significant preoperative anatomical findings. Eighty‐three underwent surgery, with 63 (95 nerves at surgical risk) returning for a postoperative VCC. Postoperative VCC identified three temporary neuropraxias (3.2%) and three unilateral vocal fold paresis (3.2%). Patients were highly satisfied with the service. All 163 pre‐/postoperative VCCs were completed with no adverse events. Conclusion & Implications: The current data support SLT‐FPOCC service expansion to include pre and post thyroid/parathyroid surgery VCC checks, with positive consumer perception. The model supports delivery of best practice management (i.e., pre‐ and postoperative VCC) for patients receiving surgery for thyroid/parathyroid dysfunction, and associated efficiencies for ENT services. WHAT THIS PAPER ADDS: What is already known: Assessment of laryngeal function via flexible nasoendoscopy is recommended best practice for patients pre and postthyroid/parathyroid surgery, as recurrent laryngeal nerve injury is a low incidence (<10%), yet well‐recognised risk of these surgeries. Traditionally, general surgeons refer presurgical patients to ear, nose and throat (ENT) for vocal cord check (VCC) assessment. However, with access to specialist outpatient services under increasing pressure, there is growing support for utilisation of other health professionals, such as speech‐language therapists working in first point of contact (FPOCC) models, to assist with the administration of pre‐ and postsurgical assessments of such low‐risk populations. What this study adds: This work expands on the emerging body of evidence for speech language therapy (SLT) led FPOCC models within ENT outpatient services, providing clinical and service outcomes to support the safety of a new model designed to administer VCCs for patients pre and post thyroid/parathyroid surgery. Adopting a similar model to a prior published SLT‐led FPOCC model, the trained SLT completes the pre‐ and postsurgical VCC including flexible nasoendoscopy and videostroboscopy, with images and clinical information then presented to ENT for diagnosis and management planning. This study also provides the first data on consumer perceptions of this type of service model. Clinical implications of this study: Data on 100 consecutive presurgical patients revealed positive service findings, supporting the safety of this model. Nature and incidence of clinical findings pre and post surgery were consistent with previously published studies using traditional models of care (i.e., ENT completing the flexible nasendoscopy). Consumer perception was positive. This model enables delivery of pre‐and postsurgical assessments for patients receiving thyroid/parathyroid surgery, consistent with best practice care, and reduces burden on ENT services. In total 163 ENT appointments were avoided with this model, with positive implications for ENT waitlist management. [ABSTRACT FROM AUTHOR]

Background: Although existing studies have shown that both repetitive transcranial magnetic stimulation (rTMS) and music therapy have advantages in the treatment of non‐fluent aphasia, the efficacy of the combination of these two methods remains to be investigated. Aims: To investigate the clinical efficacy of low‐frequency rTMS combined with music therapy on language function and depression in patients with non‐fluent aphasia after stroke. Methods & Procedures: A single‐blind parallel randomised controlled trial was conducted. Sixty patients (mean duration = 93.78 days) with non‐fluent aphasia after stroke were randomly divided into a traditional therapy group (n = 20), a music therapy group (n = 20) and a combined therapy group (n = 20, 1 Hz). The language function and depression were evaluated before and 3 weeks after treatment with the Chinese version of the Western Aphasia Battery scale, Boston Diagnostic Aphasia Examination scale and Stroke Aphasic Depression Questionnaire Hospital Version scale. Outcomes & Results: The combined therapy group was significantly better in all outcomes than the traditional therapy group and was significantly better in depression than the music therapy group. The music therapy group was significantly better in repetition and depression than the traditional therapy group. Language improvement was positively correlated with depression improvement. For adverse events, only two patients in the combined therapy group showed slight dizziness during rTMS treatment and their symptoms improved after rest. Conclusions & Implications: Our preliminary randomised controlled study indicates that low‐frequency rTMS combined with music therapy is feasible and safe in improving language function and depression in non‐fluent aphasia patients after stroke. WHAT THIS PAPER ADDS: What is already known on this subject: Repetitive transcranial magnetic stimulation (rTMS) and music therapy respectively have advantages in the treatment of non‐fluent aphasia after stroke, but whether the combination of the two methods is more effective is still unknown. What this paper adds to the existing knowledge: This is one of the first randomised control trials to investigate whether the clinical efficacy of low‐frequency rTMS combined music therapy for non‐fluent aphasia is better. The findings show that low‐frequency rTMS combined music therapy is superior to traditional therapy in spontaneous speech, auditory comprehension, repetition, naming, aphasia quotient, functional language level and depression, and superior to music therapy in depression, while music therapy is superior to traditional therapy in repetition and depression. What are the potential or actual clinical implications of this work?: Low‐frequency rTMS combined music therapy may be a better method for treatment of non‐fluent aphasia. [ABSTRACT FROM AUTHOR]

Background: Telehealth for paediatric speech and language therapy became one of the most salient modes of service delivery during the COVID‐19 pandemic. Evidence for speech and language therapy services via telehealth in comparison to face‐to‐face delivery demonstrates promising outcomes, and studies have begun to explore practitioner and client experiences. However, across the literature, many critical elements of services are overlooked, and there is a need to frame the evidence base within a theoretical model that can draw out practical implications that consider the range of factors having an impact on clinical implementation in real‐world contexts. The APEASE (Acceptability, Practicability, Effectiveness, Affordability, Side‐effects, and Equity) criteria offer such a model. The current study explored practising UK speech and language therapists' (SLTs) clinical experience of telehealth through the lens of the APEASE criteria and aimed to identify recommendations for future service provision from the practitioner perspective. Methods: An online survey structured using the APEASE criteria was developed in collaboration with the UK Royal College of Speech and Language Therapists. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using reflexive thematic analysis. Results: Four hundred and thirty‐eight qualified and practicing UK paediatric SLTs completed the survey. Telehealth was broadly acceptable and practicable to SLTs yet there remains some uncertainty about its efficacy and cost‐effectiveness compared to face‐to‐face interventions and how equitable it is for different population groups. SLTs reported that effective implementation of telehealth services was dependent upon several contextual factors; affordability was a perceived barrier to clients having access to telehealth resources, intervention via telehealth was perceived as more acceptable than assessment, and whilst many SLTs welcomed aspects of telehealth, there were concerns about the physical and mental health consequences for practitioners. Six themes for the future development of telehealth in paediatric speech and language therapy were identified: (1) balanced and tailored services; (2) technology and equipment; (3) information and communication; (4) capacity building; (5) monitoring and evaluation; and (6) leadership and governance. Conclusions: Outcomes highlight promising, concerning and uncertain aspects of telehealth in paediatric speech and language therapy. SLTs value a flexible and tailored approach to service delivery and recommend that effective leadership, clear communication, ongoing policy and guidance development, upskilling of users and careful evaluation of impact are required to ensure optimal implementation. The APEASE criteria offer a valuable opportunity to enhance and streamline practice and research to ensure sustainable implementation of telehealth in the paediatric speech and language therapy services of tomorrow. WHAT THIS PAPER ADDS: What is already known on this subject: The COVID‐19 pandemic led to the increased use of telehealth as a main mode of service delivery in paediatric speech and language therapy. Pre‐COVID‐19, evidence for the use of telehealth in this field included small‐scale experimental studies that reported on children with particular disorders and explored telehealth outcomes in comparison to face‐to‐face delivery. The realities of at‐scale clinical practice were not well‐represented, and critical elements of service such as cost‐effectiveness were often overlooked in the paediatric literature. Furthermore, despite emerging global evidence for temporary telehealth responses to the crisis in speech and language therapy, the long‐term and future use of telehealth remains unclear. What this paper adds to existing knowledge: The current study applied the lens of the APEASE (Acceptability, Practicability, Effectiveness, Affordability, Side‐effects, and Equity) criteria, which were used in this case to consider socioeconomic, ecological and cultural factors to capture an overarching understanding of the use of telehealth in paediatric speech and language therapy, and to inform the role of telehealth in future, longer‐term and at‐scale service development. Results indicated emerging trends in UK paediatric speech and language therapists' (SLTs') perceptions of telehealth and SLTs perceived a hybrid approach to service delivery, combining mostly face‐to‐face services with some telehealth, was likely to continue in the future. We identified six themes to guide the future development of telehealth in paediatric speech and language therapy services: (1) balanced and tailored services; (2) technology and equipment; (3) information and communication; (4) capacity building; (5) monitoring and evaluation; and (6) leadership and governance. What are the potential or actual clinical implications of this work?: UK SLTs believe that speech and language therapy services using telehealth should be reflective, tailored and flexible to meet the requirements and circumstances of the children, young people and families served, as well as the physical and emotional needs of practitioners. SLTs recommend that this service development is clearly communicated to all stakeholders and suggested that those using telehealth should be supported through appropriate training, and ongoing effectiveness should be monitored. Telehealth is here to stay and the APEASE criteria offer a unique opportunity to ensure sustainable models of service delivery; to support co‐ordinated leadership at the local, national and international levels and the development of policy and clinical guidance. [ABSTRACT FROM AUTHOR]

Background: The aim of many interventions used by speech and language therapists (SLTs) is to change behaviours related to communication and interaction. Parent‐led language interventions for children in the early years (0–5 years) rely on SLTs supporting parents to change their behaviour in child‐focused interactions to effect a change in the child's communication. Therapeutic techniques used by SLTs in parent‐led language interventions are largely underspecified, impacting on intervention reporting, replication, trialling and development. The Behaviour Change Technique Taxonomy Version 1 (BCTTv1) offers a method of describing intervention techniques developed for use in public health interventions, but with several examples of its application to speech and language interventions. Aims: To identify behaviour change techniques (BCTs) from the BCTTv1 occurring in parent‐led language interventions for children in the early years. Methods & Procedures: A literature search identified relevant descriptions of parent‐led language interventions. These were coded using the BCTTv1. A reliability check was carried out on 10% of the descriptions. To confirm the use of identified BCTs in clinical practice, results of the literature search were triangulated with an online survey of SLTs, and observations of SLTs delivering parent‐led language intervention. Outcomes & Results: A total of 84 papers containing descriptions of 45 interventions were coded; 62 SLTs responded to the survey and three SLTs were observed delivering parent‐led language intervention. A total of 24 BCTs were identified in the literature search, replicated in the observations and verified by SLTs in the survey. BCTs were identified at two levels: Level 1 SLT implemented to change parent interactive behaviour; and Level 2 parent implemented to change child communicative behaviour. Conclusions & Implications: The BCTTv1 is a useful starting place for describing parent‐led language interventions. With some additions and adjustments, BCTs identified in this study were immediately recognized by practitioners and can easily be adopted into practice. WHAT THIS PAPER ADDS: What is already known on this subject: Techniques used in SLT interventions are often not clearly described. The BCTTv1 has been used to clarify technique descriptions with success in a small number of SLT disciplines, but not yet in parent‐led language interventions for preschoola children. What this paper adds to the existing knowledge: This paper constitutes the first research into quantifying the techniques used in parent‐led language interventions using the BCTTv1. What are the potential or actual clinical implications of this work?: This paper provides a clear list of techniques used by SLTs implementing interventions for preschool children, which can be immediately adopted and used in practice. It also highlights potential adjustments and gaps in the BCTTv1 in relation to SLT which can contribute to future iterations. [ABSTRACT FROM AUTHOR]

Background: Humans often use co‐speech gestures to promote effective communication. Attention has been paid to the cortical areas engaged in the processing of co‐speech gestures. Aims: To investigate the neural network underpinned in the processing of co‐speech gestures and to observe whether there is a relationship between areas involved in language and gesture processing. Methods & Procedures: We planned to include studies with neurotypical and/or stroke participants who underwent a bimodal task (i.e., processing of co‐speech gestures with relative speech) and a unimodal task (i.e., speech or gesture alone) during a functional magnetic resonance imaging (fMRI) session. After a database search, abstract and full‐text screening were conducted. Qualitative and quantitative data were extracted, and a meta‐analysis was performed with the software GingerALE 3.0.2, performing contrast analyses of uni‐ and bimodal tasks. Main Contribution: The database search produced 1024 records. After the screening process, 27 studies were included in the review. Data from 15 studies were quantitatively analysed through meta‐analysis. Meta‐analysis found three clusters with a significant activation of the left middle frontal gyrus and inferior frontal gyrus, and bilateral middle occipital gyrus and inferior temporal gyrus. Conclusions: There is a close link at the neural level for the semantic processing of auditory and visual information during communication. These findings encourage the integration of the use of co‐speech gestures during aphasia treatment as a strategy to foster the possibility to communicate effectively for people with aphasia. WHAT THIS PAPER ADDS: What is already known on this subject: Gestures are an integral part of human communication, and they may have a relationship at neural level with speech processing. What this paper adds to the existing knowledge: During processing of bi‐ and unimodal communication, areas related to semantic processing and multimodal processing are activated, suggesting that there is a close link between co‐speech gestures and spoken language at a neural level. What are the potential or actual clinical implications of this work?: Knowledge of the functions related to gesture and speech processing neural networks will allow for the adoption of model‐based neurorehabilitation programs to foster recovery from aphasia by strengthening the specific functions of these brain networks. [ABSTRACT FROM AUTHOR]

Background: The Pediatric Eating Assessment Tool (PEDI‐EAT‐10) is a reliable and valid tool for rapid identification of dysphagia in patients aged 18 months to 18 years. Aims: To translate and adapt the PEDI‐EAT‐10 into the Italian language and evaluate its validity and reliability. Methods & Procedures: The translation and cross‐cultural adaptation of the tool consisted of five stages: initial translation, synthesis of the translations, back translation, expert committee evaluation and test of the prefinal version. The internal consistency of the translated tool was analysed in a clinical group composed of 200 patients with special healthcare needs aged between 18 months and 18 years. They were consecutively enrolled at the Rare Disease Unit, Paediatrics Department, Fondazione Policlinico Agostino Gemelli‐IRCCS, Rome. For test–retest reliability, 50 caregivers filled in the PEDI‐EAT‐10 questionnaire for a second time after a 2‐week period. Construct validity was established by comparing data obtained from patients with data from healthy participants (n = 200). The study was approved by the local ethics committee. Outcomes & Results: Psychometric data obtained from patients (104 M; mean age = 8.08 ± 4.85 years; median age = 7 years) showed satisfactory internal consistency (Cronbach's α = 0.89) and test–retest reliability (Pearson r = 0.99; Spearman r = 0.96). A total of 30% of children were classified as having a high risk of penetration/aspiration. The Italian PEDI‐EAT‐10 mean total score of the clinical group was significantly different from that resulting from healthy participants. Conclusions & Implications: The PEDI‐EAT‐10 was successfully translated into Italian, validated and found to be a reliable one‐page rapid screening tool to identify dysphagia in children and adolescents with special needs. What this paper adds: What is already known on the subject: The PEDI‐EAT‐10 is a valid and reliable quick discriminative paediatric tool for identifying penetration/aspiration risks. What this paper adds to the existing knowledge: In the present study we successfully translated and adapted the PEDI‐EAT‐10 into the Italian language. What are the potential or actual clinical implications of this work?: This translation and adaptation increase access to valid feeding and swallowing assessment for children of Italian‐speaking families. In addition, the I‐PEDI‐EAT‐10 can suggest further assessment of patients' swallowing abilities. [ABSTRACT FROM AUTHOR]

Background: Aspiration pneumonia (AP) is a subset of pneumonia caused by the aspiration of food and fluids to the lungs and is highly prevalent in the older population. Oropharyngeal dysphagia (OD) is one of the risk factors for AP and it is also associated with malnutrition, dehydration and poor functional outcomes. As pneumonia is the second most common infection in nursing homes (NHs) and OD represents a major concern to NH staff, good practices for the prevention of AP in older adults at risk of OD are needed. Purpose: The aim of this modified e‐Delphi study is to build consensus among a panel of experts regarding a set of recommendations for NH staff on good practices to prevent AP in older adults at risk of OD living in NHs. The objective of this paper is to establish the methodology inherent to the Delphi study. Methods: An online modified Delphi study will be developed in three rounds. Criteria for the Delphi panel participants include holding a master's or doctoral degree in OD or speech and language therapy; or having 10 or more years of experience in OD; or having at least one scientific publication related to OD. A previously described modified Delphi methodology will be used to achieve consensus (75% agreement). An additional round will be performed to collect the experts' perspectives regarding the priority for application of each recommendation previously validated. Discussion: This protocol aimed to describe the methodology of a future Delphi study on the prevention of AP, seeking to fulfil the gap in the literature regarding this topic. The modified Delphi technique is a widely used method for collecting experts' opinion in health sciences, but the absence of standardised guidelines allows some heterogeneity between studies with the same aim. WHAT THIS PAPER ADDS: What is already known on the subject: Aspiration pneumonia (AP) is related to three main risk factors: impaired safety of swallow, impaired nutritional status and poor oral health. It is known that being dependent for feeding is one of the main risk factors for AP and around 50% of nursing home (NH) residents need feeding assistance. Thus, it is important to promote specialised intervention and care by the NH staff for preventing AP. What this paper adds to existing knowledge: It is hypothesised that increasing the knowledge of NH staff regarding the best practices for preventing AP in older adults at risk of oropharyngeal dysphagia (OD) will improve outcomes such as quality of life, incidence of AP and mortality. What are the potential or actual clinical implications of this work?: The recommendations resulting from this study will address a current gap in healthcare practice of NH staff regarding older adults at increased risk for OD and, consequently, for AP. [ABSTRACT FROM AUTHOR]

Background: We explore the theoretical and methodological aspects of decolonising speech and language therapy (SLT) higher education in the United Kingdom. We begin by providing the background of the Rhodes Must Fall decolonisation movement and the engagement of South African SLTs in the decoloniality agenda. We then discuss the evolution of decoloniality in SLT, highlighting its focus on reimagining the relationships between participants, students, patients and the broader world. Objective: The primary objective of this discussion is to fill a gap in professional literature regarding decoloniality in SLT education. While there is limited research in professional journals, social media platforms have witnessed discussions on decolonisation in SLT. This discussion aims to critically examine issues such as institutional racism, lack of belonging, inequitable services and limited diversity that currently affect the SLT profession, not just in the United Kingdom but globally. Methods: The methods employed in this research involve the engagement of SLT academics in Critical conversations on decolonisation. These conversations draw on reflexivity and reflexive interpretation, allowing for a deeper understanding of the relationship between truth, reality, and the participants in SLT practice and education. The nature of these critical conversations is characterised by their chaotic, unscripted and fluid nature, which encourages the open discussion of sensitive topics related to race, gender, class and sexuality. Discussion points: We present our reflections as academics who participated in the critical conversations. We explore the discomfort experienced by an academic when engaging with decolonisation, acknowledging white privilege, and the need to address fear and an imposter syndrome. The second reflection focuses on the experiences of white academics in grappling with their complicity in a system that perpetuates racism and inequality. It highlights the need for self‐reflection, acknowledging white privilege and working collaboratively with colleagues and students toward constructing a decolonised curriculum. Finally, we emphasise that while action is crucial, this should not undermine the potential of dialogue to change attitudes and pave the way for practical implementation. The paper concludes by emphasising the importance of combining dialogue with action and the need for a nuanced understanding of the complexities involved in decolonising SLT education. Conclusion: Overall, this paper provides a comprehensive overview of the background, objectives, methods and key reflections related to the decolonisation of SLT higher education in the United Kingdom. It highlights the challenges, discomfort and responsibilities faced by academics in addressing decoloniality and emphasizes the importance of ongoing critical conversations and collective action in effecting meaningful change. WHAT THIS PAPER ADDS: What is already known on this subject: Prior to this paper, it was known that the decolonial turn in speech and language therapy (SLT) was a recent focus, building on a history of professional transformation in South Africa. However, there was limited literature on decoloniality in professional journals, with most discussions happening on social media platforms. This paper aims to contribute to the literature and provide a critical conversation on decolonising SLT education, via the United Kingdom. What this paper adds to existing knowledge: This paper adds a critical conversation on decolonising SLT higher education. It explores theoretical and methodological aspects of decoloniality in the profession, addressing issues such as institutional racism, lack of sense of belonging, inequitable services and limited diversity. The paper highlights the discomfort experienced by academics in engaging with decolonisation and emphasizes the importance of reflection, collaboration and open dialogue for meaningful change. Notably we foreground deimperialisation (vs. decolonisation) as necessary for academics oriented in/with the Global North so that both processes enable each other. Deimperialisation is work that focuses the undoing of privilege exercised by academics in/with the Global North not only for localising their research and education agenda but checking their rite of passage into the lives of those in the Majority World. What are the potential or actual clinical implications of this work?: The paper highlights the need for SLT practitioners and educators to critically examine their practices and curricula to ensure they are inclusive, decolonised and responsive to the diverse needs of communities. The discussions emphasise the importance of addressing institutional racism and promoting a sense of belonging for research participants, SLT students and patients. This paper offers insights and recommendations that can inform the development of more equitable and culturally responsive SLT services and education programmes. [ABSTRACT FROM AUTHOR]

Background: People who have communication difficulties may benefit from using augmentative and alternative communication (AAC). Understanding and measuring outcomes from the use of AAC is an important part of evaluating the impact of devices and services. Outcome measurement needs to reflect the changing nature of the impact of using AAC on an individual's ability to participate in activities of daily life. There is a limited understanding of the concepts that should inform the evaluation of outcomes from AAC device provision, nor how people's expectations from AAC may change over time. Aims: To inform the development of a patient‐reported outcome measure for AAC by understanding more about people's expectations from AAC and how these change over time. Methods & Procedures: A longitudinal qualitative research study was designed and carried out with seven participants over a period of 2 years. Participants were recruited from a regional specialist assessment service for AAC in the south‐west of the UK. Four semi‐structured interviews were carried out: (1) before assessment for AAC, (2) after assessment, (3) directly after provision of an AAC device and (4) between 6 and 12 months after provision. An original analytic method was used in this study that built on the principles of longitudinal interpretative phenomenology analysis, applied with a dialogic theoretical lens. This approach enabled the inclusion of a range of multimodal and embodied data collected to this study and allowed the research team to draw out salient themes across the cohort group while attending to the influence of time and context on experience. Outcomes & Results: The results confirm and extend the three core concepts that were used to guide analysis: changes; contexts; future possibilities. The contextual and temporal influences on outcomes attainable from AAC for this cohort were also identified and illustrated through cross‐case comparison. Deeper, analytic, and conceptual engagement with theory, which was then applied to analysis of the data, provided methodological rigour in the study. The results enhance our understanding of people's hopes and expectations from AAC and how these change over time. Conclusions & Implications: This qualitative longitudinal research study provides new insights into the journeys of people who experience communication disability, and the shifting nature of their sense of identity as they engage with, and learn from using, AAC. The study is significant as it attends to the dynamic nature of experience and how contextual and experiential factors influence people's hopes and expectations from AAC. The paper presents an original application of longitudinal qualitative research methodology with people who use AAC which can be further applied and tested in the field of communication disability research. WHAT THIS PAPER ADDS: What is already known on this subject: We did not know the impact that time has on the concepts that have been identified to represent important outcomes from AAC. The existing concepts used to define outcomes from AAC were not adequately conceptualized to develop a patient‐reported outcome measure. This study sought to extend our knowledge about outcomes from AAC. What this paper adds to the existing knowledge: This study adds to the methodological toolkit available for qualitative inquiry in the field of communication disability research by presenting a longitudinal qualitative research methodology. It adds depth to our understanding of the concepts that underpin outcomes from AAC and highlights the dynamic nature of contexts and how this influences desired outcomes. What are the potential or actual clinical implications of this work?: This longitudinal qualitative research study provides a broader perspective on the experience of getting AAC. It will enable clinicians to better navigate the contextual and transitionary factors that influence people's experience of acquiring AAC devices. The enhanced concepts described will also support clinical conversations that consider the wider facets of communication and what AAC can add to existing communicative tool kits beyond getting a message across. [ABSTRACT FROM AUTHOR]

Background: Early intervention is recommended for pre‐school children with low language. However, few robustly evaluated language interventions for young children exist. Furthermore, in many interventions the theoretical underpinnings are underspecified and the 'active ingredients' of the interventions not tested. This paper presents a quasi‐experimental study to test the efficacy and examine the active ingredients of Building Early Sentences Therapy (BEST): an intervention based on usage‐based theory designed to support young children to understand and produce two‐, three‐ and four‐clause element sentences. BEST manipulates the input children hear to support them to harness the cognitive mechanisms hypothesized in usage‐based theories to promote the development of abstract linguistic representations. One such input manipulation is the use of signing alongside verbal input signalling both content and morphology of target sentences. Aims: To examine whether (1) BEST is more efficacious than treatment as usual (TAU); and (2) signing of content and morphology is an active ingredient of the intervention. Methods & Procedures: A quasi‐experimental study recruited children aged 3;5–4;5 years from 13 schools. Schools were assigned to receive either BEST with sign, BEST without sign or TAU. The TAU group received their usual classroom provision. Across arms schools were matched with respect to classroom oral language environment and indices of deprivation. Participants were 48 children (28 boys) with expressive and/or receptive language abilities ≤ 16th centile measured using the New Reynell Developmental Language Scales (NRDLS). Outcomes gathered by researchers blind to treatment arm were NRDLS production and comprehension standard scores and measures of production of targeted sentence structures. Outcomes & Results: Primary outcomes indicate that BEST with sign was significantly more efficacious than TAU with respect to NRDLS production standard score, but not comprehension. The advantage for production was maintained at follow‐up. BEST without sign was significantly more efficacious than TAU on measures of targeted vocabulary, sentence structure and morphology. The results from this quasi‐experimental study provide evidence for the efficacy of a usage‐based intervention on expressive language outcomes for preschool children with low language abilities. There is also evidence to support the inclusion of sign as an active ingredient, and so efforts to train interventionists in its use are worthwhile. Conclusions & Implications: Patterns of findings across outcomes suggest signing of content and morphology may support the development of abstract linguistic representations and accelerate language learning. Given these positive results and the scale of this study, a fully powered randomized controlled trial is warranted. WHAT THIS PAPER ADDS: What is already known on the subject: Robust language skills are crucial for positive social, emotional, academic and economic outcomes across the lifespan. There is a paucity of robustly evaluated interventions for preschool children with language difficulties. The development of such interventions is crucial for ameliorating language difficulties and promoting positive educational and psychosocial outcomes. What this study adds to the existing knowledge: This paper evaluates BEST, a novel usage‐based language intervention targeting children with language difficulties in the early years. Findings indicate that a usage‐based intervention is efficacious for treating language difficulties. In particular, BEST benefited expressive language development, bringing benefits to both treated and untreated language structures and improving standard scores. The role of sign as an active ingredient is also supported. Further evaluation is warranted. What are the practical and clinical implications of this work?: Findings suggest that BEST may be effective for targeting children who have been identified as having language difficulties. In particular, expressive language may be improved when the intervention is delivered as it was originally manualized, including a signing system to represent content and grammatical morphology. More broadly, these findings also provide preliminary evidence that the use of a signing system does not hinder oral language development in children with language difficulties and may conversely support their expressive language. Future research exploring the role and underpinning mechanisms of sign in language intervention is warranted. [ABSTRACT FROM AUTHOR]

Background: Many speech sound disorder (SSD) interventions with a long‐term evidence base are 'new' to clinical practice, and the role of services in supporting or constraining capacity for practice change is underexplored. Innovations from implementation science may offer solutions to this research–practice gap but have not previously been applied to SSD. Aim: To explain variation in speech and language therapy service capacity to implement new SSD interventions. Methods & Procedures: We conducted an intensive, case‐based qualitative study with 42 speech and language therapists (SLTs) in three NHS services (n = 39) and private practice (n = 3) in Scotland. We explored therapists' diverse experiences of SSD practice change through individual interviews (n = 28) or self‐generated paired (n = 2) or focus groups (n = 3). A theoretical framework (Normalization Process Theory) helped us understand how the service context contributed to the way therapists engaged with different practice changes. Outcomes & Results: We identified six types ('cases') of practice change, two of which involved the new SSD interventions. We focus on these two cases ('Transforming' and 'Venturing') and use Normalization Process Theory's Cognitive participation construct to explain implementation (or not) of new SSD interventions in routine practice. Therapists were becoming aware of the new interventions through knowledge brokers, professional networks and an intervention database. In the Transforming case, new SSD interventions for selected children were becoming part of local routine practice. Transforming was the result of a favourable service structure, a sustained and supported 'push' that made implementation of the new interventions a service priority, and considerable collective time to think about doing it. 'Venturing' happened where the new SSD interventions were not a service priority. It involved individual or informal groups of therapists trying out or using one or more of the new interventions with selected children within the constraints of their service context. Conclusions & implications: New, evidence‐based SSD interventions may be challenging to implement in routine practice because they have in common a need for therapists who understand applied linguistics and can be flexible with service delivery. Appreciating what it really takes to do routine intervention differently is vital for managers and services who have to make decisions about priorities for implementation, along with realistic plans for resourcing and supporting it. WHAT THIS PAPER ADDS: What is already known on the subject: Many SSD interventions have an evidence base but are not widely adopted into routine clinical practice. Addressing this is not just about individual therapists or education/training, as workplace pressures and service delivery models make it difficult to change practice. What this paper adds to the existing knowledge: This paper applies innovations from implementation science to help explain how what is going on in services can support or constrain capacity for implementing evidence‐based SSD interventions. What are the potential or actual clinical implications of this work?: Service managers and therapists will have a clearer idea of the time and support they may realistically have to invest for new SSD interventions to be used routinely. [ABSTRACT FROM AUTHOR]

Background: Disfluency is a multifactorial concept that can be linked to several of the language production levels, in both typical and atypical populations. In children, the language system is still developing and few studies have explored disfluency patterns. In typical development (TD), in particular, studies have shown discrepancies according to the language being considered. In neurodevelopmental disorders, such as developmental dyslexia (DD), it is still unclear whether the pattern of disfluency is similar to TD. Aims: To analyse the type of disfluency and their evolution in French children aged 8–12 years. Also to compare the pattern of disfluency in DD and TD, and to test whether disfluencies were correlated with reading difficulties. Methods & Procedures: A total of 25 children with DD and 21 children with TD aged 8–12.6 years produced an autobiographical narrative. Seven types of disfluencies were coded: part‐word repetitions; repetitions of monosyllabic words; other types of repetitions (words and phrases); filled pauses; revisions—substitutions; revisions—additions; and abandoned utterances. We compared the proportion of each disfluency in DD and TD. Spearman correlations were then performed between disfluencies, reading performance and age. Outcomes & Results: The results showed that both DD and TD children mainly produced filled pauses, repetitions of monosyllabic words and substitutions. Both groups displayed a high rate of disfluency (> 10%). No correlations with age were found. Correlations with reading performance were significant in the TD group only. Conclusions & Implications: The study showed that DD is not characterized by a specific pattern of disfluency. Additionally, disfluency rates were similar in children aged 8–12 years. In contrast to other languages, the current study suggests that French‐speaking children have a high rate of disfluency. The study also suggests that disfluency should be interpreted with caution in DD, given that TD children also have a high rate of disfluency. Therefore, it seems important to adapt the pathological threshold of disfluency to the language being spoken in order to avoid an overestimation of the prevalence of these deficits in French‐speaking children. WHAT THIS PAPER ADDS: What is already known on this subject: TD children produce a high rate of disfluency, which is also influenced by the language being spoken. No study looked at the effect of DD on disfluency production. Nonetheless, problems in reading comprehension and reduced reading experience may impact lexical development and speech fluency. What this paper adds to the existing knowledge: In our study, both groups (French‐speaking children) produced a substantial amount of disfluency as compared with other languages (> 10%). Additionally, the pattern of disfluency was similar in TD and DD (namely, filled pauses, prolongations repetitions of monosyllabic words and substitutions). In the DD group, disfluency production was not correlated with reading performance. What are the potential or actual clinical implications of this work?: These results indicate that it is crucial to consider the language being spoken when examining disfluency in order to avoid an overestimation of language difficulties in some languages, such as in French. Moreover, the production of disfluencies in DD should not be considered as language dysfunction since the pattern of disfluency what quite similar in TD and DD, and did not correlate with their reading difficulties. [ABSTRACT FROM AUTHOR]

Background: Stroke profoundly affects quality of life (QOL), including loss of employment, reduced social activity, shrinking social networks and low mood. Dysgraphia (impaired writing) is a common symptom of aphasia yet is rarely targeted in rehabilitation. Recent technological advances might challenge this, since much communication is now conducted digitally through writing. The rehabilitation of writing may therefore help to address the wider consequences of stroke and aphasia. Aims: Can assistive technology (AT) training for people with dysgraphia: (1) improve written output, and are gains achieved only with AT? (2) improve reading comprehension scores, and are gains achieved only with AT? and (3) affect social participation, mood or QOL Methods and Procedures: Design A mixed‐methods, repeated measures, small group study design was adopted (qualitative outcomes will be reported elsewhere). Participants: Recruited from community settings, for example, Stroke Association communication support groups. Inclusion criteria: over 18 years old, aphasia due to stroke, acquired dysgraphia, writing more impaired than speech, fluent English prior to stroke, access to computer and Internet. Exclusion criteria: currently receiving speech and language therapy, significant cognitive impairment, neuromuscular/motor‐speech impairments/structural abnormalities, developmental dyslexia, uncorrected visual/auditory impairments. Procedures: Screening and diagnostic assessments at time T1 (first baseline). Outcome measures at T1; repeated at T2 (second baseline), T3 (end of intervention), T4 (3‐month follow up). Social participation assessment and cognitive monitoring at T2, T3, T4. Intervention: Seven–ten hours individual therapy weekly and additional email support. Participants were trained to operate Dragon NaturallySpeaking (speech to text package) and ClaroRead (read writing aloud). Outcome measures were administered on pen and paper (control) and on computer, with AT enabled only at T3, T4. Outcomes and Results: Computer narrative writing was significantly improved by AT training (Friedman's χ2 (3) = 8.27, p = 0.041), indicating a compensatory effect of AT. Though reading comprehension significantly improved in the computer condition (Friedman's χ2 (3) = 21.07, p = 0.001), gains could not be attributed to the AT. Gains were achieved only when measures were administered on the keyboard, with AT enabled. Thus, a compensatory rather than remediatory effect was suggested. Social network size significantly increased; there were no significant changes in mood/QOL. Individual success rates varied. Conclusion and Implications: The customisable AT training was acceptable to participants and resulted in significantly improved narrative writing. Compensatory AT interventions are a useful adjunct to remediatory writing interventions and may particularly support functional writing. WHAT THIS PAPER ADDS: What is already known on this subject: Writing is rarely spared in aphasia and may present as the most impaired communication modality. Yet, people with aphasia report that writing is seldom included in their rehabilitation. Many communication activities are now conducted digitally through writing, therefore rehabilitation of this is more important than ever before. This study sought to address whether an assistive technology (AT) software package can improve writing and whether any changes were compensatory or remediatory. What this study adds to existing knowledge: This group study found that AT training led to gains in written discourse and social network in people with aphasia and dysgraphia. Gains were not replicated in handwritten tasks, suggesting this was a compensatory therapeutic approach. What are the clinical implications of this work?: AT programs such as this may present speech and language therapists with a practical, pragmatic adjunct to writing or typing therapy, particularly for clients with chronic, intractable impairments for whom remediatory therapy may have a low chance of success. [ABSTRACT FROM AUTHOR]

Background: Dementia is a cognitive decline that leads to the progressive deterioration of an individual's ability to perform daily activities independently. As a result, a considerable amount of time and resources are spent on caretaking. Early detection of dementia can significantly reduce the effort and resources needed for caretaking. Aims: This research proposes an approach for assessing cognitive decline by analysing speech data, specifically focusing on speech relevance as a crucial indicator for memory recall. Methods & Procedures: This is a cross‐sectional, online, self‐administered. The proposed method used deep learning architecture based on transformers, with BERT (Bidirectional Encoder Representations from Transformers) and Sentence‐Transformer to derive encoded representations of speech transcripts. These representations provide contextually descriptive information that is used to analyse the relevance of sentences in their respective contexts. The encoded information is then compared using cosine similarity metrics to measure the relevance of uttered sequences of sentences. The study uses the Pitt Corpus Dementia dataset for experimentation, which consists of speech data from individuals with and without dementia. The accuracy of the proposed multi‐QA‐MPNet (Multi‐Query Maximum Inner Product Search Pretraining) model is compared with other pretrained transformer models of Sentence‐Transformer. Outcomes & Results: The results show that the proposed approach outperforms the other models in capturing context level information, particularly semantic memory. Additionally, the study explores the suitability of different similarity measures to evaluate the relevance of uttered sequences of sentences. The experimentation reveals that cosine similarity is the most appropriate measure for this task. Conclusions & Implications: This finding has significant implications for the early warning signs of dementia, as it suggests that cosine similarity metrics can effectively capture the semantic relevance of spoken language. The persistent cognitive decline over time acts as one of the indicators for prevalence of dementia. Additionally early dementia could be recognised by analysis on other modalities like speech and brain images. WHAT THIS PAPER ADDS: What is already known on this subject: It is already known that speech‐ and language‐based detection methods can be useful for dementia diagnosis, as language difficulties are often early signs of the disease. Additionally, deep learning algorithms have shown promise in detecting and diagnosing dementia through analysing large datasets, particularly in speech‐ and language‐based detection methods. However, further research is needed to validate the performance of these algorithms on larger and more diverse datasets and to address potential biases and limitations. What this paper adds to existing knowledge: This study presents a unique and effective approach for cognitive decline assessment through analysing speech data. The study provides valuable insights into the importance of context and semantic memory in accurately detecting the potential in dementia and demonstrates the applicability of deep learning models for this purpose. The findings of this study have important clinical implications and can inform future research and development in the field of dementia detection and care. What are the potential or actual clinical implications of this work?: The proposed approach for cognitive decline assessment using speech data and deep learning models has significant clinical implications. It has the potential to improve the accuracy and efficiency of dementia diagnosis, leading to earlier detection and more effective treatments, which can improve patient outcomes and quality of life. [ABSTRACT FROM AUTHOR]

Background: The use of telepractice in aphasia research and therapy is increasing in frequency. Teleassessment in aphasia has been demonstrated to be reliable. However, neuropsychological and clinical language comprehension assessments are not always readily translatable to an online environment and people with severe language comprehension or cognitive impairments have sometimes been considered to be unsuitable for teleassessment. Aim: This project aimed to produce a battery of language comprehension teleassessments at the single word, sentence and discourse level suitable for individuals with moderate‐severe language comprehension impairments. Methods: Assessment development prioritised response consistency and clinical flexibility during testing. Teleassessments were delivered in PowerPoint over Zoom using screen sharing and remote control functions. The assessments were evaluated in 14 people with aphasia and 9 neurotypical control participants. Modifiable assessment templates are available here: https://osf.io/r6wfm/. Main Contributions: People with aphasia were able to engage in language comprehension teleassessment with limited carer support. Only one assessment could not be completed for technical reasons. Statistical analysis revealed above chance performance in 141/151 completed assessments. Conclusions: People with aphasia, including people with moderate‐severe comprehension impairments, are able to engage with teleassessment. Successful teleassessment can be supported by retaining clinical flexibility and maintaining consistent task demands. WHAT THIS PAPER ADDS: What is already known on the subject: Teleassessment for aphasia is reliable but assessment of auditory comprehension is difficult to adapt to the online environment. There has been limited evaluation of the ability of people with severe aphasia to engage in auditory comprehension teleassessment. What this paper adds to existing knowledge: Auditory comprehension assessment can be adapted for videoconferencing administration while maintaining clinical flexibility to support people with severe aphasia. What are the potential or actual clinical implications of this work?: Teleassessment is time and cost effective and can be designed to support inclusion of severely impaired individuals. [ABSTRACT FROM AUTHOR]

Background: Increasing research capacity and capability for the speech and language therapy (SLT) profession is a key national strategic driver, with many speech and language therapists (SLTs) aspiring to a clinical academic (CA) career. There are known benefits but also acknowledged challenges with this career path, including limited funding opportunities and a poorly established career trajectory. Aims: To present models, frameworks and support structures that can be used by aspiring SLT CAs to chart research knowledge and skills, and plan career development. Organisational models are also presented to facilitate SLT CA career development and research capacity‐building. Methods & Procedures: A narrative review was conducted using a literature search of published peer‐reviewed journals across four electronic databases: Medline, CINAHL, AMED and Embase, with additional search for grey literature through internet searches. Search results were screened against eligibility criteria by two researchers, with full‐text articles retrieved and reviewed by four researchers independently. Results & Discussion: The database search and grey literature search combined identified 610 records. Full‐text screening of 66 records resulted in 19 articles or grey literature sources being included within the narrative review. Main Contribution: This paper details models, frameworks and support structures pertinent to SLTs that can be used at an individual and organizational level to assist CA skill development and career paths. Conclusion & Implications: The national climate is looking positive for aspiring SLT CAs. The time is now to take the initiative and use the support structures available to show our CA value and develop the necessary skills outlined within these resources to fulfil our ambitions. WHAT THIS PAPER ADDS: What is already known on the subject: Interest in CA careers within the SLT profession is increasing. Whilst there are known benefits to embedding research within clinical practice, barriers exist including the strategic and operational steps individuals can take to make the career path a reality. What this study adds: This narrative review has searched the literature for CA models, frameworks and support structures created for nurses, midwives and allied health professionals. These tools are presented and discussed, with special consideration and focus to the SLT profession. What are the clinical implications of this work?: This paper will provide SLTs with the tools to support their personal CA career development as well as advocate for CA roles within their teams and organisations. Organisational models are also presented to support SLT managers to foster a CA path for workforce development. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion What this paper adds What is already known on the subject What this paper adds to existing knowledge What are the potential or actual clinical implications of this work? This study aimed to assess anxiety, depression and quality of life (QoL) in patients with head and neck cancer undergoing laryngectomy using comprehensive self‐reported questionnaires for a period of up to 5 years.This prospective observational study enrolled 150 consecutive patients with locally advanced head and neck cancer who underwent laryngectomy at Nagoya University Hospital between 2007 and 2020. Anxiety, depression and QoL were assessed at baseline (preoperative) and at 3, 6, 12, 24, 36, 48 and 60 months after surgery using two brief self‐reported questionnaires, such as the eight‐item Short Form Health Survey (SF‐8) and the Hospital Anxiety and Depression Scale (HADS).The surgical procedures were total laryngectomy, pharyngo‐laryngectomy and pharyngo‐laryngo‐oesophagectomy in 97 (65%), 41 (27%) and 12 (8%) patients, respectively. All eight items of the SF‐8 were significantly worse than those of the normal population at baseline and at 3 months after surgery. However, general health, vitality, mental health and bodily pain improved to normal levels within 1 year after surgery and were maintained for 5 years. In this study, 35% of patients were categorised as potential cases of depression, and 35% were potential cases of anxiety. During the follow‐up period, the proportion of patients with anxiety gradually decreased after surgery. Further analysis revealed that the SF‐8 and HADS scores and trends in 89 patients without tumour recurrence were similar to those in the total enrolled 150 patients.Anxiety, depression and QoL in laryngectomised patients improved at 1 year after surgery and were maintained for up to 5 years. Laryngectomy is associated with prolonged functional and psychological effects and has a major impact on patient quality of life (QoL). Several prospective studies evaluating the QoL in laryngectomised patients have been reported, in which significant deterioration in social functioning was found even 1 year after surgery. One year is not a sufficient period for laryngectomised patients to return to normal life and spend their time in a social community. A recent review showed that most studies on QoL in laryngectomised patients were conducted under 1 year after the procedure, and there were not enough studies of sufficient quality. This is the first long‐term prospective observational study of Japanese patients with head and neck cancer who underwent laryngectomy up to 5 years after surgery. Our long‐term observational study showed that the scores for anxiety, depression and QoL in laryngectomised patients improved at 1 year after surgery and were maintained for up to 5 years. Clinicians should recognize the importance of psychosocial risk factors in their QoL and multidisciplinary management, including social and psychological support, is essential for long‐term laryngectomised survivors. [ABSTRACT FROM AUTHOR]

Introduction Method Results Conclusion WHAT THIS PAPER ADDS What is already known on this subject What this paper adds to existing knowledge What are the potential or actual clinical implications of this work? There is a substantial discrepancy between international and local prevalence rates for speech, language and communication needs (SLCN) amongst children in New Zealand. Reports of communication impairment are likely to be underestimates. Prevalence data can describe population characteristics and inform the scope and nature of services to adequately meet demand. Parents and other caregivers are central to the early identification of children with communication needs but they may not recognise their child's needs or act on their concerns.Cross‐sectional data were available for the Growing Up in New Zealand (GUiNZ) longitudinal study cohort at 24, 54 and 72 months of age, with 76% of whānau (families; n = 5241) completing three data waves. Descriptive and chi‐square analyses were used to address: (1) What are the communication abilities of children in the first 5 years of life? (2) What do New Zealand parents understand of their children's communication? (3) Do New Zealand parents have concerns? (4) What are the trajectories of parental concern for children's communication in the first 6 years of life?At 24 months old, 16% of children had communication skills that were of concern to their parents. At 54 months, there were concerns for 12.6% of children. Although most parents were able to describe their child's expressive abilities, many parents remained unconcerned when their child demonstrated communication skills that did not met developmental expectations.Parents can offer valuable insights about their children, but in many cases their level of concern about SLCN did not align with a professional view which reflects a more nuanced understanding of children's speech and language and the impact on future communication skills and needs. Increased awareness through public health messaging specifically regarding lifelong influences of communication challenges will aid in prevention, early detection and intervention. Parent's expectations of child speech and language development will inform how responsive they are to difficulties in their child. Appropriate parental concern is key to recognition of children with speech, language and communication needs that warrant referral to a professional. Parents are aware of expressive language skills that children acquire and can accurately identify their children's skills but have less knowledge of the ages of acquisition. Some parents are not concerned, do not seek support despite recognisable difficulties, and demonstrate limited understanding of the future consequences for children with communication needs that are unmet. Public health messaging should include both skills and age ranges for speech and language acquisition. Additionally, educating the public of the impact of speech, language and communication skills on children's futures is needed. [ABSTRACT FROM AUTHOR]

Background Aims Methods Main Contribution Conclusions What this paper adds What is already known on this subject What this paper adds to existing knowledge What are the potential or actual clinical implications of this work? Primary progressive aphasia (PPA) is a neurodegenerative condition characterised by a prominent and progressive deterioration in language abilities, which significantly impacts quality of life and interpersonal relationships. Speech and language therapy plays a crucial role in offering interventions. Group intervention is one mode of delivery that could benefit communication functioning and overall wellbeing of people with PPA (pwPPA) and their care partners. Group interventions are also more efficient than one‐to‐one intervention and may facilitate peer support.The aim of this review was to systematically evaluate the current evidence for the effectiveness of speech and language therapy groups for pwPPA and their care partners. Specifically, this paper considered three questions: 1.What evidence‐based speech and language therapy groups for pwPPA and their care partners have been reported to date? 2.Are group communication interventions effective in improving quality of life and communication function for pwPPA and their care partners? 3.Are group communication interventions that are designed for people with communication difficulties of other aetiologies (such as stroke) effective for pwPPA? In addition, this review aimed to describe the structure and content of groups, including aims, disciplines involved, size and frequency of group meetings, and outcome measures.MEDLINE, CINAHL and PsycINFO were used to retrieve articles of interest. A total of 10 studies published between 2009 and 2022 met the eligibility criteria and therefore were included in this study. Data were extracted from the articles regarding the structure and content of groups.Although evidence is currently limited, results suggest that speech and language therapy group intervention can improve specific linguistic processes, the use of communication strategies and psychosocial well‐being. The importance of multidisciplinary input and care partners’ involvement in groups was highlighted, along with the benefits of creative non‐verbal activities as tools for self‐expression. There is also initial evidence that telehealth group provision and one‐off group sessions may be feasible and can benefit psychosocial well‐being. Lastly, intentional recruitment and explicit education on different aphasia types are described as important when pwPPA participate in groups with mixed diagnoses.The literature on speech and language therapy group interventions for PPA shows promise of positive effects on communication function and psychosocial well‐being of both pwPPA and their care partners. Speech and language therapists can consider these published interventions when designing and implementing similar groups, but more robust evidence is required to confirm the relative effectiveness of this approach. Speech pathology led group intervention shows some promise in benefitting communication functioning and overall well‐being of pwPPA and their carers, but there has been no systematic evaluation of all the evidence regarding the efficacy of speech and language therapy led groups. Establishing feasibility, acceptability and efficacy of speech and language therapy group interventions for pwPPA and their carers may present a valuable addition for managing this progressive language disability. Although evidence is currently limited, results from this systematic review suggest that speech and language therapy led group intervention can improve specific linguistic processes, the use of communication strategies and psychosocial well‐being for pwPPA and their carers. The importance of multidisciplinary input and carers’ involvement in groups was highlighted, along with the benefits of creative non‐verbal activities as tools for self‐expression. There is also initial evidence that telehealth group provision for carers may be feasible and can benefit psychosocial wellbeing. Lastly, intentional recruitment and explicit education on different aphasia types are described as important when pwPPA participate in groups with mixed diagnoses. A synthesis of the evidence base for speech and language therapy led PPA groups, as well as a description of the group components and formats, will be valuable for clinical service planning, and will guide future examination of group options for pwPPA and their carers. Speech and language therapists can also consider the research findings from this systematic review when designing and implementing similar groups in their local context. [ABSTRACT FROM AUTHOR]

Background Aims Methods and procedures Outcomes and results Conclusions and implications What this paper adds What is already known on the subject What this paper adds to existing knowledge What are the potential or actual clinical implications of this work? In typically developing (TD) children, gesture emerges around 9 months of age, allowing children to communicate prior to speech. Due to the important role gesture plays in the early communication of autistic and TD children, various tasks have been used to assess gesture ability. However, few data exist on whether and how tasks differentially elicit gesture, particularly for samples of racially and ethnically diverse autistic children.In this study, we explored if task (a naturalistic parent–child interaction [NPCI]; structured assessment of child communication) differentially elicited rate or type of gesture production for young autistic children.This secondary analysis included baseline data from 80 racially and ethnically diverse autistic children aged 18–59 months who participated in one of two larger studies. Video recordings of NPCIs and an assessment of child communication with standardised administration procedures were collected at baseline. Child gesture rate (number of gestures produced per 10 min) and type were extracted from these recordings and analysed.The structured assessment elicited more gestures than the NPCI. In terms of gesture type, points, gives, and reaches accounted for 76% of child gestures. Points (which are developmentally more advanced than reaches and gives) were produced at the highest rates within book exploration. Distal points (which are more developmentally advanced than proximal or contact points) were produced at the highest rates when children were tempted to request.Our findings indicate elicitation tasks differentially elicit type and rate of gesture for young autistic children. To assess the gesture production of young autistic children, a structured task designed to elicit child requests will probe the developmental sophistication of the child's gesture repertoire, eliciting both the most gestures and the most developmentally advanced gestures. Because of the importance of gesture in early communication for autistic and typically developing children, various tasks have been used to assess it. However, little is known about whether tasks differentially elicit type or rate of gesture for young autistic children from diverse racial and ethnic backgrounds. Elicitation tasks differentially elicit type and rate of gesture for young autistic children in the early stages of gesture. We recommend a structured task designed to elicit child requests to assess the developmental sophistication of a child's gesture repertoire. [ABSTRACT FROM AUTHOR]

Background Aims Methods Main Contribution Conclusion What this paper adds What is already known on the subject What this paper adds to existing knowledge What are the potential or actual clinical implications of this work? The ability to understand the mental state of others (social cognition), as well as language, is crucial for children to have good social adaptation. Social cognition (SC) has been shown to be a hierarchical model of three factors (Cognitive, intermediate and affective SC) interrelated with linguistic processes. Children on the autism spectrum and children with developmental language disorder (DLD) or social communication disorder (SCD) manifest language and SC difficulties, albeit in different ways.This systematic review aims to find how language and SC interact with each other and identify linguistic and socio‐affective profiles in the target population.About 1593 articles were systematically reviewed according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guide in November 2022, obtaining, through inclusion/exclusion criteria, a total of 38 articles for qualitative assessment. The majority of them were on autism (26) or DLD (14) and to a lesser extent SCD (3).Although SC is related to all components of language, SC is strongly related to narrative and morphosyntax and partially related to lexicon. Pragmatics shows a complex relation with SC due to greater sensitivity to other factors such as age or task, and prosody appears to be more related to emotional processes. Besides, autistic, SCD and DLD children showed differences in their language and socio‐affective performance. Mainstream DLD children have lower performance in general language, where autistic and SCD children have more linguistic variation and are lower in pragmatic and SC tasks, SCD children being more associated with language production difficulties and autistic children with both receptive and productive language.Each language component has a different interaction with SC. Likewise, different linguistic profiles are partially found for each disorder. These results are important for future lines of research focusing on specific components of interaction and socio‐emotional processes, as well as for clinical and educational treatment. The hierarchical model of Schurz et al. (2021), divide social cognition into three brain constructs: cognitive social cognition (CSC), affective social cognition (ASC) and intermediate social cognition (ISC). They observe a large relationship between language and ISC, a fact that has been corroborated with some other studies. Studies have also found lower linguistic and socio‐affective abilities in children with autism and language and communication disorders compared with children with neurotypical development, and large behavioural and neurocognitive overlaps between these disorders (Durrleman et al., 2019; Löytömäki et al., 2019). This is the first review that relates all linguistic components (narrative, lexicon, morphosyntax, pragmatic and prosody) with the three constructs of social cognition (Cognitive, intermediate and affective). Moreover, it is the first review that studies the socio‐linguistic factors comparing autism, developmental language disorder and social communication disorder with each other and with neurotypical development in children aged from 4 to 9 years. Understanding how language and social cognition interact with each other in autism spectrum disorder, developmental language disorder and social communication disorder allows us to trace socio‐linguistic profiles for each of the studied disorders, understand better children with these difficulties, and, with this, find specific potential intervention points to improve and prevent these difficulties.  [ABSTRACT FROM AUTHOR]

Background Aims Methods and Procedures Outcomes and Results Conclusions and Implications WHAT THIS PAPER ADDS What is already known on this subject What this paper adds to existing knowledge What are the potential or actual clinical implications of this work? Assessment tools that assess pragmatic skills in adults with a mild‐severe traumatic brain injury (TBI) are hard to access, not person‐centred and have a high risk of clinician bias. The Pragmatics Profile is an informant report tool that was originally designed to assess pragmatic skills in people with a developmental disability.The aim of this study was to seek consensus from a panel of experts and create a version of the Pragmatics Profile for the TBI population.A three‐round modified Delphi methodology panel of 13 experts were invited to comment anonymously on the suitability of each question from the Pragmatics Profile modified for those with TBI until ≥ 80% agreement was reached.The Pragmatics Profile (TBI) included 66 questions that achieved consensus after three rounds of the Delphi panel. Qualitative analysis illuminated themes relating to adults with TBI and the need to include contextual factors.The outcome of this project was a revised version of the Pragmatics Profile which is suitable for adults with a mild‐severe TBI, informed by experts and freely available online. Future research exploring the tool's utility and acceptability is the next step in its evaluation. Assessment of the everyday functional use of language is challenging but vital. This is particularly true for those who have traumatic brain injury (TBI) where the communication outcomes can be highly variable and may include difficulties with conversational turn‐taking, topic maintenance and reading social cues. There are limited tools available to clinicians and those tend to be rating scales or checklists which have a high risk of clinician bias. Available tools have a limited ability to capture the individual's personal social communication goals. This study created an online Pragmatics Profile (PP) for TBI based on experts’ opinions. This paper details the themes that emerged during the process of revising the PP for those with TBI. The PP‐TBI adds to the toolkit for speech and language therapists working with people with TBI. It meets recent recommendations in the literature to create an interview‐based tool. The versatility of an online tool combined with revised input from a panel of experts increases the likelihood that clinicians will utilise this tool. Given the long‐term use of the original PP by clinicians for almost 30 years and a focus on personalised care, the format and approach are also likely to be acceptable to clinicians. [ABSTRACT FROM AUTHOR]

Background: Vocal fold nodules (VFNs) are the main cause of paediatric dysphonia. Voice therapy is recommended as the preferable treatment option for VFNs in children. Aim: The aim of this systematic review is to provide an overview of the existing literature concerning the effects of voice therapy in children with VFNs. Methods & Procedures: This systematic literature review was developed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) guidelines. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (via PubMed) and Embase were searched and the grey literature was checked. The search strategy was based on three concepts: VFNs, voice therapy and children. Two examiners independently determined article eligibility and extracted all relevant data from the included studies. The methodological quality of the included study was assessed using the QualSyst tool. Main contributions: By identifying, evaluating and summarizing the results of all relevant studies about voice therapy in paediatric VFNs, this systematic review makes the available evidence more accessible to voice therapists, otolaryngologists and other relevant stakeholders. Conclusions & Implications: 24 studies were included in this systematic review. Eight studies (8/24) reported a significant improvement for at least one outcome parameter after voice therapy. However, five papers (5/24) could not demonstrate significant changes after voice therapy. All studies that did not test for significance (11/24) found improvements for one or more outcome parameters. The overall quality of the included studies is adequate (55%). In sum, there is some evidence that voice therapy is effective in children with VFNs, but further well‐designed research, especially randomized controlled trials, is necessary to confirm these results. WHAT THIS PAPER ADDS: What is already known on the subject: Voice therapy is preferable in children with VFNs because of the phonotraumatic nature of the nodules and the associated high recurrence rate after phonosurgery. Most voice therapists in clinical practice offer an eclectic voice therapy programme, consisting of direct and indirect voice therapy techniques. What this study adds to existing knowledge: This systematic review provides a clear overview of the available evidence concerning the effects of voice therapy in paediatric VFNs. There is some evidence that voice therapy is an effective treatment option in children with VFNs, but well‐designed research is scarce on this subject. What are the potential or actual clinical implications of this work?: This review shows that effectiveness studies with strong designs are very scarce in children with VFNs. Clinicians should be aware that few therapy techniques have been thoroughly investigated in this population. However, this review may guide voice therapists when creating a treatment plan for a child with VFNs because it identifies, evaluates and summarizes the results of all relevant individual studies about voice therapy in paediatric VFNs. Voice therapy seems to be effective in treating paediatric patients with VFNs, given the fact that a considerable number of included studies report significant improvements after voice therapy. Both direct and indirect therapy approaches appear to have a positive effect on the phonation of children with VFNs. [ABSTRACT FROM AUTHOR]

Background: Eating, drinking and swallowing (EDS) difficulties are important to identify early. Awareness of EDS changes starts with those living with dementia or their family carers. However, little is known about early identification from the perspective of people with dementia. Aim: The aim of this study was to understand the experience of EDS by people living with dementia in their own home. Methods: Published evidence pertaining to EDS difficulties in dementia was used to inform an online semi‐structured interview guide. Four people living with dementia and a third‐sector Empowerment Lead were invited to become co‐researchers. People living with dementia and their carers were invited to be interviewed. We enquired about their past and present experiences, and future expected changes in EDS, information needs, opinions on early problem identification, and lifestyle modifications following onset of EDS difficulty. Narrative concepts of heroes and villains in their 'stories' were identified. Responses were subjected to framework analysis informed by narrative enquiry. Results: Seven people living with dementia and five family carers were interviewed. The overarching theme was a 'missed connection' between EDS difficulty and dementia. Where EDS difficulties were identified, 'compensatory changes' and a need for 'access to information' were noted. Conclusions: The connection between potential EDS difficulties and a dementia diagnosis may not be made, even though EDS changes were recognised by people living with dementia and their family carers. This may be explained by behaviours that mask problems or allow individuals to cope or compensate. Reduced awareness may also be due to inadequate access to information and lack of specialist services. If the connection between dementia and EDS difficulty is missed it could further delay access to support services. WHAT THIS PAPER ADDS: What is already known on the subject: The prevalence of dementia is increasing and is expected to affect 9% of the population by 2040. EDS difficulties are common in people living with dementia and predispose to poorer outcomes. Better awareness of EDS changes early in the disease process of dementia or at preclinical stages can identify individuals at risk and allow for intervention prior to advanced EDS difficulties developing. What this paper adds to existing knowledge: This paper reports the perspective of people living with dementia and family carers and provides insights into experiences of EDS and the challenges faced and identifies commonalities. The connection between potential EDS difficulties and dementia is missed despite various changes reported by both people living with dementia and their family carers, who tend to make compensatory lifestyle changes without support. What are the potential or actual clinical implications of this work?: Lack of awareness of the connection between potential EDS difficulties and dementia may arise due to inadequate access to information to support people living with dementia and their family carers. Access to such information is needed and the quality assurance of information from reputable sources is important to people living with dementia. There is a need for greater service user awareness of signs of EDS difficulty and how to access specialist services. [ABSTRACT FROM AUTHOR]

Background: Aims: To investigate the developmental trajectory of the rate and perceptual assessment of oral diadochokinesis (DDK) in typically developing children compared with adults. Also to examine the characteristics of DDK productions in children with speech sound disorders (SSD) and the relationship between DDK production and percentage of consonants correct (PCC). Methods & Procedures: Participants were 316 typically developing children and 90 children with SSD from 3 to 9 years old, as well as 20 adults with normal speech. The mono‐, bi‐ and trisyllabic nonsense strings containing Korean tense consonants and the vowel [a] were used for DDK tasks. The number of iterations per s was measured as the DDK rate for each stimulus. The perceptual assessment of DDK productions was also performed for regularity, accuracy and rate. Outcomes & Results: The DDK rates increased throughout childhood, but the oldest children, 9‐year‐olds in the current study, did not achieve adult‐like rates for all mono‐ and trisyllabic strings. Children with SSD also did not show significant differences from typically developing children when the DDK productions were analysed using only accurate tokens. The PCC of children with SSD showed higher correlations with regularity, accuracy and rate of perceptual ratings than the timed DDK rate. Conclusions & Implications: This study highlighted the fact that the comprehensive evaluation of DDK productions may provide even more useful information about children's oral motor skills. WHAT THIS PAPER ADDS: What is already known on the subject: Rates of DDK reflect the motor skills of the articulatory systems independently of phonological skills; therefore, the tasks are widely used in the diagnostic evaluations of speech disorders in both children and adult populations. However, a substantial number of studies have questioned the validity and usefulness of DDK rates for evaluating speech abilities. Also, the literature suggested that the measure of DDK rate alone does not provide a clear and useful indication of children's oral motor skills. DDK tasks should be analysed in terms of accuracy and consistency as well as rate. What this paper adds to the existing knowledge: The literature reporting normative DDK performance has mainly been based on English speakers. As different consonants have different temporal characteristics, the linguistic and segmental features of DDK tasks can impact the DDK rate. This study established a norm for DDK rate for Korean‐speaking children and investigated the developmental trajectory of DDK performance in typically developing children compared with adults. This study suggested that the comprehensive evaluation of DDK productions may provide even more useful information about children's oral motor skills by examining the characteristics of DDK productions in children with SSD. What are the potential or actual clinical implications of this work?: This study provided normative data of young Korean‐speaking children aged 3–9 years. Normative data in children under 5 years of age are valuable given that the majority of children referred for speech difficulty assessments are between 3 and 5 years of age, but only a few studies have provided the normative data in young children. This study showed that many children could not complete DDK tasks correctly and provided additional support for the notion that other aspects of DDK performance, including accuracy and regularity, may yield more useful diagnostic indications than timed DDK rates alone. [ABSTRACT FROM AUTHOR]

Background: Indirect speech and language therapy, such as parent‐implemented intervention, has been shown to be an effective approach for young children with speech and language disorders. However, relatively few studies have compared outcomes of parent‐directed therapy with child‐directed intervention, that is, individual therapy of a child delivered by a speech and language therapist (SLT). Although speech and language therapists (SLTs) regard parental engagement as imperative for successful intervention, currently they predominantly use child‐directed intervention. Aim: To evaluate the effect of parent‐ versus child‐directed speech–language therapy embedded in usual care intervention for young children with developmental language disorder (DLD). Methods & Procedures: In a randomized trial, forty‐six 3‐year‐old monolingual children with DLD were assigned to parent‐directed intervention or child‐directed intervention groups. In addition, all children received usual care in special‐language daycare centres. Outcomes included children's language development and functional communication, parents' language output, parents' perceptions and their self‐efficacy. These were assessed at three time intervals, that is, at baseline, immediately after 6 months of treatment, and 1 year after baseline. The parent‐directed intervention consisted of twelve 50‐min sessions every 2 weeks with parent and child, consisting of parental training with immediate feedback by (SLTs. Children in the child‐directed intervention group received individual speech–language therapy in weekly 30‐min sessions for 6 months. Outcomes & Results: Intervention in both groups was equally effective. All children improved significantly in receptive and expressive language measures as well as in functional communication at all intervals. All parents used significantly more language support strategies and were less concerned about their child's participation in communication. Parents in the parent‐directed intervention group reported increased self‐efficacy in stimulating their child's language development. In contrast, parents in the child‐directed intervention group reported a decrease in self‐efficacy. Though modest, these group differences were significant in both the short and long terms. Both parents and SLTs were positive about the parent‐directed intervention. Conclusions & Implications: The effects of parent‐ and child‐directed intervention for young children with DLD are similar. The parent‐directed intervention adds to treatment options for parents as well as for SLTs and creates choices for shared decision‐making. WHAT THIS PAPER ADDS: What is already known on the subject: Language therapy for young children with DLD comprises various delivery models. Two of these are child‐ and parent‐directed therapy by SLTs. Compared with no treatment, both delivery models are effective, but it is unclear if one of these results in better language outcomes than the other. SLTs value child‐directed intervention more highly than indirect approaches where treatment is delivered by others. This study aims to compare the relative effectiveness of parent‐directed intervention with child‐directed intervention, both parts of multi‐component usual care intervention. What this paper adds to existing knowledge: This randomized trial indicates that a parent‐directed intervention model is as effective as child‐directed intervention by SLTs for children's language development and functional communication. Parents' use of language support strategies was also similar in both intervention models, in the short and long terms. Like in child‐directed therapy, parent‐directed intervention reduces parents' concerns. Contrary to child‐directed treatment, parent‐directed intervention increases parents' self‐efficacy, that is, supporting their child's language development. What are the potential or actual clinical implications of this work?: Though SLTs predominantly choose a child‐directed intervention model, the study results show that they can consider parent‐directed approaches too. There are no significant differences in children's language outcomes as a function of parent‐ or child‐directed intervention. Furthermore, parents and SLTs were positive about the parent‐directed intervention program and the SLTs evaluated it as valuable and feasible. [ABSTRACT FROM AUTHOR]

Background: Children with communication disorders experience difficulty in one or more areas of articulation and speech, language, fluency, voice and social communication, and they work with speech‐language pathologists (SLPs) to improve their communication. With the rise of adoption and use for mobile applications among special education and healthcare service providers, SLPs also have implemented, and for some, contributed to the design of, mobile applications (apps) during clinical practice. However, how these mobile apps are designed and implemented for clinicians to facilitate their clients' communication and learning experiences during therapy remains underinvestigated. Aims: This qualitative research study investigated how mobile apps were designed for clinicians to target assessment and intervention goals. Additionally, it focused on how clinicians adopted these apps while integrating therapy techniques to facilitate their clients' learning. Methods and Procedures: Informed by the Research, Practice, and Design for iPad Apps (iRPD) framework and the Consolidated Framework for Implementation Research (CFIR), semi‐structured interviews were conducted with 37 licensed pediatric SLPs, including 23 SLPs who have used apps and 14 SLPs who have contributed to the design of their own mobile apps. Two rounds of qualitative coding via template analysis and thematic analysis were then used to analyse client and clinician characteristics, clinical practice, therapy tools, app characteristics, influential factors and app design and use recommendations. Outcomes and Results: Results showed SLPs utilise different genres of assistive, educational and recreational game apps to support children's communication development when working with children who have diverse disorders and therapy needs across different age groups. SLPs who have designed their own apps emphasised the importance of following evidence‐based practice, well‐researched teaching methods and learning theories. Additionally, multiple financial, sociocultural, political and ethical factors contributed to the design, adoption and implementation of mobile apps during services. Conclusions and Implications: By understanding the clinician's app use practices situated in various therapy activities and techniques, we specified a list of design recommendations for app designers who are interested in creating mobile apps for supporting children's speech and language development. By bringing insights from both clinical practitioners as well as those with additional technical design backgrounds, this study contributes to the understanding of clinical practice needs and strategies and will lead to the most optimal app design and adoption practice to support the well‐being of children with communication disorders. WHAT THIS PAPER ADDS: What is already known on the subject: Speech language pathologist (SLPs) implement mobile apps for clients with diverse therapy needs, and their app adoption and use are influenced by multifaceted factors. Although prior studies have reported SLPs' mobile app use, additional information is still needed. For example, the research literature does not include how specific technology is used during therapy practice, or specific details about challenges and needs in implementing and utilising the technology. Additional research also needs to include influential factors (e.g., financial, sociocultural, political, ethical) that are considered when selecting, implementing, assessing and designing an app. The lack of research in these areas directly affects the understanding of clinical mobile technology practices and further hinders clinicians' abilities to advocate for better clinical and design decisions towards identifying and implementing effective mobile apps that facilitate children's communication. What this study adds to existing knowledge: This qualitative study is the first known empirical research that interviewed pediatric speech‐language pathologists who have used and designed mobile apps for children who receive speech‐language therapy across different clinical settings. By investigating experiences from clinician stakeholders to illustrate a holistic overview of app design and development to deployment, this study reported finding on (1) how clinicians use mobile apps to help children to participate in different therapy activities, and (2) a list of recommended design and development guidelines that informs the design and use of mobile apps that best support and motivate children to engage in therapy. What are the potential or actual clinical implications of this work?: This study disseminates clinician‐reported practices of app design and use with pediatric clients across different speech‐language disorders, and identifies gaps and needs for clinicians and researchers who are interested in understanding the role of mobile technology in relationship to human communication and interaction. Additionally, the paper demonstrates that SLPs have instrumental roles rather than passive users in influencing the design and implementation of different genres of mobile apps through evidence‐based clinical practice, and call for partnerships across clinicians, special educators and technologists to support children's communication development. [ABSTRACT FROM AUTHOR]

Background: Acute and late toxicities in patients treated with (chemo)radiotherapy for head and neck cancer (HNC) is common and can negatively impact quality of life and performance. Performance status instruments measure the functional ability to perform daily life activities and are important tools in the oncologic population. Aims: Since Dutch performance status scales for the HNC population are lacking, we conducted this study to translate the Performance Status Scale for Head and Neck Cancer Patients (PSS‐HN) into Dutch (D‐PSS‐HN) and to validate this version. Methods & Procedures: The D‐PSS‐HN was translated into Dutch according to the internationally described cross‐cultural adaptation process. It was administered to HNC patients and together with the Functional Oral Intake Scale completed by a speech and language pathologist at five different time points during the first 5 weeks of (chemo)radiotherapy. Patients were asked each time to complete the Functional Assessment of Cancer Therapy and the Swallowing Quality of Life Questionnaire. Pearson correlation coefficients were used to calculate convergent and discriminant validity and the evolution of D‐PSS‐HN scores was assessed by means of linear mixed models. Outcomes & Results: A total of 35 patients were recruited and > 98% of the clinician‐rated scales were completed. Convergent and discriminant validity were demonstrated, with all correlations rs between 0.467 and 0.819, and between 0.132 and 0.256, respectively. The subscales of the D‐PSS‐HN are sensitive to detect changes through time. Conclusion & Implications: The D‐PSS‐HN is a valid and reliable instrument to assess performance status in patients with HNC treated with (chemo)radiotherapy. It is a useful tool to measure HNC patients' current diet level and functional abilities to perform daily life activities. WHAT THIS PAPER ADDS: What is already known on the subject: Acute and late toxicities in patients treated with (chemo)radiotherapy for HNC are common and can negatively impact quality of life and performance. Performance status instruments measure the functional ability to perform daily life activities and are important tools in the oncologic population. However, Dutch performance status scales for the HNC population are lacking. Therefore, we translated the Performance Status Scale for Head and Neck Cancer Patients (PSS‐HN) into Dutch (D‐PSS‐HN) and validated this version. What this paper adds to existing knowledge: We translated the PSS‐HN and demonstrated its convergent and discriminant validity. The subscales of the D‐PSS‐HN are sensitive to detect changes through time. What are the potential or actual clinical implications of this work?: The D‐PSS‐HN is a useful tool to measure HNC patients' functional abilities to perform daily life activities. The tool can easily be used in clinical settings: since data collection duration is very short, this facilitates clinical (and research‐related) implementation of the scale. Patients' individual needs could be identified by using the D‐PSS‐HN, resulting in more appropriate approaches and (early) referrals if needed. Interdisciplinary communication could be facilitated. [ABSTRACT FROM AUTHOR]

Background: In the governmental delineation of the speech‐language therapist (SLT) profession and in preservice SLT education, Flemish SLTs are considered as gatekeepers of the standard language in Flanders. Yet, most Flemish clients typically use a colloquial language style. Following earlier research on how teachers' language style affects teacher–student interactions, an SLT's strict adherence to standard Dutch may potentially evoke perceptions of inequality in their clients. As a result, Flemish SLTs may find themselves torn between on the one hand adhering to the standard language and on the other hand adapting to the sociolinguistic style of their client and establishing trust. In the present study, we explored SLTs' views on using standard/colloquial language varieties in their practice. Methods & Procedures: Individual semistructured interviews were conducted with 13 Flemish SLTs who worked with children, adolescents and adults in special schools, private practices and hospitals. Interview transcripts were analysed with reflexive thematic analysis. Outcomes & Results: Analyses yielded three themes. Switching between styles was (1) triggered by client characteristics (age, style, therapeutic needs), and it was shaped by (2) the need for establishing trust and (3) a balance between the SLT's professional and personal identity. Notably, most SLTs described partially converging with their clients' colloquial style, effectively reconciling their professional identity as expert speakers with their personal identity as a colloquial language user. Conclusions & Implications: Despite consensus on the role of the SLT as gatekeeper of standard language, many SLTs felt that colloquial language also plays an important role as it bolsters therapeutic alliance and rehabilitation of functional communication. By implementing reflective mixed methods and integrating the client perspective, future studies should further examine how authentic style‐switching occurs and how various styles used by the SLT are evaluated by clients in different contexts. These findings may guide the development of style‐switching as a communicative strategy that can be addressed in preservice education. What this paper adds: What is already known on the subject: In Flanders, the existence of various (non‐)standard varieties of Dutch may evoke some tension regarding the preferred variety in a given context. Flemish teachers switch between standard language and colloquial language (style‐shifting), depending on the foregrounding of the transactional or relational nature of the context. Moving towards students' colloquial speech builds trust and perceptions of equality. Despite the importance of alliance in speech‐language therapy, little is known about how speech‐language therapists (SLTs) feel about using colloquial speech given that they are considered expert speakers. What this paper adds to existing knowledge: While 'talking properly' is part of the SLT's professional identity, many Flemish SLTs felt that strict adherence to the standard language variety hinders therapeutic alliance. While standard language was strongly associated with professionalism, strict adherence to standard language was used only when SLTs felt they had to prove their clinical competency or when language scaffolding was in the foreground. Partially converging with the clients' language use allowed SLTs to reconcile their professional identity as expert speaker with personal identity and authenticity. What are the potential or actual clinical implications of this work?: Both colloquial speech and standard speech serve a function in SLT practice. Therefore, switching between standard and colloquial speech needs further consideration as a communicative strategy rather than instilling in therapists an ideological, normative stance towards language. [ABSTRACT FROM AUTHOR]

Background: Verbal fluency tests (VFT) are highly sensitive to cognitive deficits. Usually, the score on VFT is based on the number of correct words produced, yet it alone gives little information regarding underlying test performance. The implementation of different strategies (cluster and switching) to perform efficiently during the tasks provide more valuable information. However, normative data for clustering and switching strategies are scarce. Moreover, scoring criteria adapted to Colombian Spanish are missing. Aims: (1) To describe the Colombian adaptation of the scoring system guidelines for clustering and switching strategies in VFT; (2) to determine its reliability; and (3) to provide normative data for Colombian children and adolescents aged 6–17 years. Methods & Procedures: A total of 691 children and adolescents from Colombia completed phonological (/f/, /a/, /s/, /m/, /r/ and /p/) and semantic (animals and fruits) VFT, and five scores were calculated: total score (TS), number of clusters (NC), cluster size (CS), mean cluster size (MCS) and number of switches (NS). The intraclass correlation coefficient was used for interrater reliability. Hierarchical multiple regressions were conducted to investigate which strategies were associated with VFT TS. Multiple regressions were conducted for each strategy, including as predictors age, age2, sex, mean parents' education (MPE), MPE2 and type of school, to generate normative data. Outcomes & Results: Reliability indexes were excellent. Age was associated with VFT TS, but weakly compared with strategies. For both VFT TS, NS was the strongest variable, followed by CS and NC. Regarding norms, age was the strongest predictor for all measures, while age2 was relevant for NC (/f/ phoneme) and NS (/m/ phoneme). Participants with higher MPE obtained more NC, and NS, and larger CS in several phonemes and categories. Children and adolescents from private school generated more NC, NS and larger CS in /s/ phoneme. Conclusions & Implications: This study provides new scoring guidelines and normative data for clustering and switching strategies for Colombian children and adolescents between 6 and 17 years old. Clinical neuropsychologists should include these measures as part of their everyday practice. WHAT THIS PAPER ADDS: What is already known on the subject: VFT are widely used within the paediatric population due to its sensitivity to brain injury. Its score is based on the number of correct words produced; however, TS alone gives little information regarding underlying test performance. Several normative data for VFT TS in the paediatric population exist, but normative data for clustering and switching strategies are scarce. What this paper adds to existing knowledge: The present study is the first to describe the Colombian adaptation of the scoring guidelines for clustering and switching strategies, and provided normative data for these strategies for children and adolescents between 6 and 17 years old. What are the potential or actual clinical implications of this work?: Knowing VFT's performance, including strategy development and use in healthy children and adolescents, may be useful for clinical settings. We encourage clinicians to include not only TS, but also a careful analysis of strategies that may be more informative of the underlying cognitive processes failure than TS. [ABSTRACT FROM AUTHOR]

Background: Reading comprehension is frequently impaired in persons with aphasia (PWA). For goal‐setting and outcome measurement, speech and language therapists (SLTs) need to determine an individual's perspective of their reading difficulties and everyday reading activities. The Comprehensive Assessment of Reading in Aphasia (CARA) reading questionnaire provides a person‐centred tool to find out the individual perception of reading functions, reading‐related emotions and reading activities in PWA. It was developed and evaluated in English. So far, there is no equivalent instrument in German. Aims: To translate and adapt the CARA reading questionnaire into German language and culture, to evaluate its practicability and acceptance, and to provide the first psychometric properties of the German version. Methods & Procedures: Based on translation and adaptation guidelines, we conducted two forward translations that were merged and then adapted. A back translation was prepared and compared with the original version. It was found to be semantically equivalent by one of the authors of the original version. We performed pilot testing with 12 PWA, and the pilot version was adapted according to the comments of these participants. We then collected data on self‐reported perception of reading and on psychometric properties of the translated and adapted German version. A total of 22 German‐speaking PWA completed the questionnaire at least five times during an intervention study. We analysed retest reliability with Spearman correlation, internal consistency with Cronbach's alpha, internal responsiveness with the standardized response mean, as well as the relationship between outcomes of the questionnaire and text comprehension measures using repeated measures correlations. Outcomes & Results: Our data suggest good practicability and acceptance of the German version of the CARA reading questionnaire as well as appropriate validity, reliability and sensitivity to measure therapy‐induced change. We found moderate correlations between outcomes of the questionnaire and text‐level reading speed. Conclusions & Implications: The German version of the CARA reading questionnaire could be helpful in intervention planning and goal‐setting with German‐speaking PWA. By using the questionnaire, SLTs can find out about a person's individual perception of reading difficulties as well as individually relevant reading activities. The questionnaire provides a tool to measure change and is therefore valuable to demonstrate self‐reported individual progress. As reading speed seems to be an indicator of personal perception of reading difficulty, it is important to consider reading speed in reading interventions and in reading comprehension assessments. WHAT THIS PAPER ADDS: What is already known on the subject: Reading comprehension is frequently impaired in PWA. Reading preferences, the perception of difficulties and the impact on everyday life reading activities are specific to the individual and thus need to be known for goal‐setting, intervention planning and monitoring of change. As part of a comprehensive assessment of reading, Morris et al. developed a person‐centred English language questionnaire for this purpose. So far, there is no equivalent tool in German. What this paper adds to the existing knowledge: In this study, we translated and adapted the questionnaire to German language and culture, and analysed its validity and reliability with German‐speaking PWA. We demonstrated that the German version is accessible for German‐speaking PWA, and that it has appropriate validity, reliability and sensitivity to measure self‐reported change. Outcomes of the questionnaire correlate with text level reading speed. What are the potential or actual clinical implications of this work?: The German version of the questionnaire could be a valuable self‐reported outcome measure to assess individual perceptions of reading and to measure progress (as perceived by an individual) as a consequence of recovery or intervention in either clinical or research settings. As reading speed might be an indicator of everyday life reading as perceived by an individual, it should be considered in reading assessments and interventions. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic necessitated that speech–language therapists (SLTs) make a radical change to provide services to their clients safely via telepractice. For many practitioners, telepractice was an unfamiliar mode of practice that had to be implemented under emergency conditions. Limited literature on SLTs' experiences of implementing telepractice in the Global South during this time is available. Aims: To explore the experiences of South African SLTs (N = 45) who implemented telepractice services during the COVID‐19 pandemic. Methods & Procedures: SLTs across the country were invited via professional bodies to participate in an online qualitative survey distributed in 2021. Data were analysed using thematic analysis principles. Outcomes & Results: We describe participants' reports of their current telepractices, discuss their perspectives on accessibility to telepractice for SLTs, clients and caregivers, and working with specific diagnoses, and consider the support needs of SLTs to enhance telepractice services. Most participants work in private practice or school settings with primarily paediatric caseloads. They reported telepractice as a positive experience and felt it was effective, although they judged that some clients were not well served by telepractice. SLTs felt underprepared for the rapid switch to telepractice and the flexibility required, especially given the limited availability of guidelines given the pandemic crisis. Greater preparation is required for telepractice sessions and more attention needs to be paid to supporting caregiver involvement online. Conclusions & Implications: Telepractice involves various barriers and facilitators, many of which seem common across Global North and South contexts. Support is required to enhance current telepractices in terms of computer literacy, technical education, different telepractice methods and caregiver coaching. Our findings have the potential to enable the development of support, training and guidelines to improve SLTs' confidence in providing telepractice whilst delivering quality services in an accessible and safe manner. WHAT THIS PAPER ADDS: What is already known on the subject: Many SLTs had to transition quickly to telepractice service provision during COVID‐19, with limited existing guidelines and support. Although there is some literature available on SLTs' experiences of implementing telepractice in the Global North, perspectives from the Global South during this time are limited. It is important to understand experiences, barriers and facilitators to telepractice provision to provide tailored support to practitioners. What this paper adds to existing knowledge: Telepractice provides a viable alternative to in‐person therapy for specific clients and contexts. Telepractice presents both benefits and barriers for effective clinical practice across Global North and South contexts. Greater preparation is required for telepractice sessions and more attention needs to be paid to enhancing caregiver involvement online, especially since many practitioners are likely to continue offering telepractice services post‐pandemic. What are the potential or actual clinical implications of this work?: Clinicians felt underprepared for the rapid switch from service delivery mode to telepractice. Greater support, training and guidelines for students and practitioners are required to enhance current practices and ensure practitioners are equipped to provide effective telepractice in the future. In particular, support should cover technological aspects, caregiver coaching and online assessment options, especially for paediatric clients. [ABSTRACT FROM AUTHOR]

Background: At the beginning of the 21st century, international adoptions of children with cleft lip and/or palate increased dramatically in Sweden. Many children arrived partially or totally unoperated, despite being at an age when palatoplasty has usually been performed. To date, the speech development of internationally adopted (IA) children has been described up to age 7–8 years, but later development remains unstudied. Aims: To investigate speech development between ages 5 and 10 years in children born with cleft lip and palate (CLP) adopted from China and to compare them with non‐adopted (NA) children with CLP. A secondary aim was to compare the frequencies of secondary palatal surgery and number of visits to a speech and language pathologist (SLP) between the groups. Methods & Procedures: In a longitudinal study, 23 IA children from China were included and matched with 23 NA children born in Sweden. Experienced SLPs blindly reassessed audio recordings from routine follow‐ups at ages 5 and 10 years. Velopharyngeal function (VPF) was assessed with the composite score for velopharyngeal competence (VPC‐Sum) for single words and rated on a three‐point scale (VPC‐Rate) in sentence repetition. Target sounds in words and sentences were phonetically transcribed. Per cent correct consonants (PCC) were calculated at word and sentence levels. For in‐depth analyses, articulation errors were divided into cleft speech characteristics (CSCs), developmental speech characteristics (DSCs) and s‐errors. Information on secondary palatal surgery and number of visits to an SLP was collected. Outcomes & Results: VPF differed significantly between the groups at both ages when assessed with VPC‐Sum, but not with VPC‐Rate. Regardless of the method for assessing VPF, a similar proportion in both groups had incompetent VPF but fewer IA than NA children had competent VPF at both ages. IA children had lower PCC at both ages at both word and sentence levels. More IA children had CSCs, DSCs and s‐errors at age 5 years, and CSCs and s‐errors at age 10. The development of PCC was significant in both groups between ages 5 and 10 years. The proportion of children receiving secondary palatal surgery did not differ significantly between the groups, nor did number of SLP visits. Conclusions & Implications: CSCs were more persistent in IA children than in NA children at age 10 years. Interventions should target both cleft and DSCs, be comprehensive and continue past the pre‐school years. WHAT THIS PAPER ADDS: What is already known on this subject: At the beginning of the 21st century, IA children with cleft lip and/or palate arrived in Sweden partially or totally unoperated, despite being at an age when palatoplasty has usually been performed. Studies up to age 7–8 years show that adopted children, compared with NA peers, have poorer articulation skills, demonstrate both cleft‐related and developmental articulation errors, and are more likely to have velopharyngeal incompetence. Several studies also report that adopted children more often require secondary palatal surgery due to fistulas, dehiscence or velopharyngeal incompetence compared with NA peers. What this paper adds to existing knowledge: This longitudinal study provides additional knowledge based on longer follow‐ups than previous studies. It shows that the proportion of children assessed to have incompetent VPF was similar among IA and NA children. It was no significant difference between the groups regarding the proportion that received secondary palatal surgery. However, fewer IA children were assessed to have a competent VPF. Developmental articulation errors have ceased in most IA and all NA children at age 10 years, but significantly more adopted children than NA children still have cleft‐related articulation errors. What are the potential or actual clinical implications of this work?: Speech and language therapy should target both cleft‐related and developmental articulation errors. When needed, treatment must be initiated early, comprehensive, and continued past the pre‐school years, not least for adopted children. [ABSTRACT FROM AUTHOR]