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Current speech-language pathology (SLP) services in Cambodia are limited in scope, service accessibility and integration into government systems. However, momentum is growing to develop an internationally recognised profession. This paper examines the depth and breadth of SLP support available to people with communication and/or swallowing difficulties in relation the Sustainable Development Goals (SDGs). Qualitative interview data collected from service facilities (n = 13) and speech therapy practitioners (n = 27) were mapped and analysed for accessibility and scope of SLP services. Data revealed a workforce density of 0.16:100 000. Disparity in service accessibility was identified between provincial and urban locations, adult and paediatric populations and range of practice areas. The findings demonstrate the importance of partnerships (SDG 17) among government departments, non-government organisations and private sector entities to establish a sustainable and culturally responsive SLP profession in Cambodia. Although there is no Cambodian university training program, there is a growing momentum and local commitment to establishing a workforce to support Cambodians with communication and/or swallowing difficulties. This commentary paper focuses on good health and well-being (SDG 3), decent work and economic growth (SDG 8), reduced inequalities (SDG 10), and also addresses no poverty (SDG 1), quality education (SDG 4) and partnerships for the goals (SDG 17). [ABSTRACT FROM AUTHOR]

Purpose: Picture naming assessments are one of the most common methods of examining word retrieval in aphasia. However, currently, it is unclear whether these assessments are able to accurately predict word retrieval in "real-life" communication. This paper aims to explore the evidence in the current literature regarding the relationship between picture naming and word retrieval in connected speech in people with aphasia. Method: Literature was reviewed that examined the correlation between picture naming and word retrieval in connected speech. The literature search was limited to articles that were English language, participants with aphasia, and that were not therapy studies. Result: The existing studies showed mixed findings. However, comparison of study outcomes was complicated by inconsistency in the research methods used, including in word retrieval measures and connected speech elicitation. Conclusion: While there is some evidence of a relationship between picture naming and word retrieval in connected speech, correlation outcomes were mixed with possible influences from participant characteristics, assessment method and speech sample type. We therefore suggest that clinical decision-making would benefit from supplementing picture naming tests with an analysis of word retrieval in connected speech. Further research is required with a focus on natural conversation and the development of standard testing procedures for connected speech. [ABSTRACT FROM AUTHOR]

To examine the need, feasibility and acceptability of speech-language pathologists (SLPs) implementing a systematic, routine, unmet social needs identification and referral pathway, as a means of promoting health equity and addressing Sustainable Development Goals (SDGs). Quality Improvement methodologies were used to adapt and pilot an unmet social needs identification and referral pathway for use with parents/carers of children with communication disabilities referred to an urban Australian speech-language pathology service. SLPs were surveyed about the acceptability and feasibility of this practice. The majority of parents/carers, 289 of 293 (99%), agreed to participate in the study, with 31 of the 289 (11%) reporting concerns about unmet social needs. The most common unmet need related to household bills (n = 17, 28%), followed by childcare (n = 12, 20%), employment (n = 10, 16%), food (n = 8, 13%), housing (n = 7, 11%), and parent/carer education (n = 7, 11%). The majority of these families, 26 of 31 (84%), requested referral to, or information about, local community services/resources. SLPs reported high levels of acceptability (93%) and feasibility (98%). This study demonstrates the need, feasibility and acceptability of SLPs implementing an unmet social needs identification and referral pathway, and the potential to scale this initiative across other speech-language pathology services and allied health contexts. This paper focusses on SDG 1, SDG 2, SDG 3, SDG 4, SDG 8, SDG 10, SDG 11, SDG 16, and also addresses SDG 17. [ABSTRACT FROM AUTHOR]

The Foundations of Early Literacy Assessment – Northern Territory (FELA-NT) was funded, developed, and implemented as part of a strategy designed to address the English literacy learning needs of the Northern Territory's Aboriginal student population. In this paper we question whether the FELA-NT English literacy learning benchmarks are representative of remote and very remote Aboriginal students since many speak English as an Additional Language (EAL) or Dialect (EAD). Using a new data set of scores from 72 Aboriginal students from remote, very remote, and outer-regional communities on the FELA-NT, we demonstrate that it is the student's experience with Standard Australian English, not their remoteness, that impacts their early literacy development. We use this example to illustrate how current practices and policies homogenise the Australian Aboriginal student population, silencing linguistic diversity in the process. We call for clinical practitioners and educators to shift their practices to assessments and tools that recognise children and youths' diverse linguistic skills and pathways. We talk about what empowerment, participation, and inclusion might really mean in current Australian educational and clinical contexts. We argue here that we need to fundamentally rethink how we work with children with diverse language and literacy knowledge, skills, and backgrounds if we are to reduce inequalities (SDG 10), honour quality education (SDG 4), and support sustainable communities (SDG 11). [ABSTRACT FROM AUTHOR]

Although Akan is one of the most widely spoken indigenous languages in Ghana, very little is known about children's phonological development. This paper investigates the development of consonants in Akan among typically developing children aged 3–5 years. A list of 103 Akan words was compiled, sampling the full range of prosodic structures, sound positions, features and segments, and controlling for word familiarity. A native Akan speaker audio-recorded the 103 single-word productions from each of nine typically developing children aged 3–5 years. The child productions were transcribed and analysed following procedures used in a larger cross-linguistic study. The current study presents results on the acquisition of consonants across the various ages. Preliminary results indicate that most consonants in Akan are mastered by age 4 or 5, similar to reports for other languages, although /w/ and /l/ showed late mastery, contrary to cross-linguistic observations. The rhotic /ɹ/ and consonants with secondary articulation were still developing at age 4 and showing a variety of mismatch patterns across children. The findings provide preliminary information for developmentalists and speech-language pathologists on typical phonological development in Akan and contribute to a growing database on language acquisition in Niger-Congo languages. [ABSTRACT FROM AUTHOR]

Purpose: Improving language and literacy skills in preschoolers can lead to better life outcomes. One way speech-language pathologists (SLPs) can improve these skills in preschoolers is by supporting educators through professional development (PD). However, PD in early childhood education and care (ECEC) settings is a complex intervention. To improve preschoolers' language and literacy skills using PD, SLPs must first work with educators to change or increase educators' language and literacy-promoting behaviours. This paper aimed to describe educator behaviours and preschooler skills following a real-world language and literacy PD intervention facilitated by two community SLPs. Method: Two pragmatic studies were conducted across four ECEC centres: (1) an observation study of 13 educators' self-reported language and literacy promoting behaviours, and (2) a non-randomised controlled trial investigating the language and literacy skills of 82 preschoolers as reported by their educators and parents/carers. Result: After the intervention, educators rated themselves as performing language and literacy-promoting behaviours more frequently. Educators also rated the early reading skills of preschoolers more highly after the PD intervention, but not preschoolers' oral language or early writing skills. Parents/carers did not report any significant improvements in preschoolers' skills. Conclusion: PD as an SLP intervention, whilst promising, showed mixed outcomes. Educator outcomes improved; however, preschooler outcomes were varied. [ABSTRACT FROM AUTHOR]

Purpose: Communication changes in multiple sclerosis (MS) are under-explored and under-recognised. Persons with MS (PwMS) are experts in their condition and play a valuable role in informing clinicians and researchers of their condition. This study aimed to investigate the perspectives of PwMS on: (1) MS-related communication changes, (2) the impact of these communication changes across key aspects of a person's life, including work/studies, relationships, and general quality of life, and (3) strategies used to facilitate communication in daily interactions. Method: Two-hundred and sixty PwMS were recruited internationally and completed an online questionnaire. Content analysis was used to analyse open-ended questionnaire responses. Result: One-hundred and ninety-seven (75.8%) participants reported communication changes, including language, cognitive, speech, voice, and fluency changes. Participants described a variety of personal and environmental factors that influence communication negatively, such as fatigue, stress, and heat. Communication changes were reported to impact on psychological wellbeing, interpersonal relationships, participation and identity in the workforce and career pathways, and tertiary studies. Around 40% of participants reported using a range of overt and covert strategies to manage communication changes. Only 11.2% (n = 22/197) of participants who reported communication changes accessed speech-language pathology (SLP) services. Conclusion: PwMS can experience a wide spectrum of communication changes. These communication changes can have a profound and far-reaching impact on psychological wellbeing and societal participation. Engagement with SLP services is limited compared to the reported prevalence of communication changes. There is a need to raise awareness of the role of SLP in service provision for PwMS to manage communication changes. This paper discusses and provides suggestions for SLP services for PwMS with communication changes. There is a timely need to develop evidence-based interventions to support PwMS manage communication changes and reduce their impact. [ABSTRACT FROM AUTHOR]

Purpose: Between 55–65% of residents living in residential aged care facilities (RACFs) experience dysphagia and are prescribed texture-modified diets by a speech-language pathologist (SLP). The aim of this study was to assess current adherence to prescribed texture modification for people with dysphagia; and explore barriers to implementation in a rural aged care setting. Method: Meal texture audits (N = 42) were completed with residents with dysphagia in a rural RACF who were prescribed texture-modified diets or fluids by a SLP. Semi-structured focus groups were conducted with nursing and food preparation staff (N = 11) to identify barriers to implementation. Result: Mealtime texture audits identified that 54.8% (n = 23) of residents' food modification requirements were incorrectly documented in the manual entry database (kitchen form) and 64.3% (n = 27) of meal trays contained foods that did not meet residents' dysphagia management plans. Focus group data revealed seven main themes impacting on the ability of staff to implement prescribed texture-modified diets. Complicated processes and communication between nursing, food services and SLP staff were identified as major barriers. These were complicated further by time pressures experienced by staff as well as staffing issues, resourcing of the kitchen, accommodating individual dietary preferences and the variety/presentation of dietary options at the aged care facility. Conclusion: There was low adherence to SLP prescribed texture-modified diets and fluids in the participating rural RACF. This study identified major barriers to implementing SLP prescribed texture-modified diets including complicated processes, communication breakdowns, time pressures and limited staffing. Implementation of an online menu management system and regular dysphagia-specific training may address barriers to communication and complicated paper-based menu systems and should be a priority for health services to ensure adequate dysphagia management. [ABSTRACT FROM AUTHOR]

The Basic Outcome Measure Protocol for Aphasia (BOMPA) is a practical tool that allows for a quick self-report on quality of life from the perspective of the person with aphasia, as well as a clinical evaluation of aphasia severity and the ability to participate in conversation. The primary aim of this paper is to describe development of BOMPA and report on results of an inter-rater reliability study involving speech-language pathology raters. The inter-rater reliability study utilised a fully crossed design and included independent ratings of 12 videos by 20 speech-language pathologists. Results indicate moderate to strong inter-rater reliability among participant speech-language pathology raters (0.65–0.96), as well as when comparing these participant ratings with an expert rater's gold standard (0.59–0.86). BOMPA may be a useful outcome measurement tool for time-pressed clinicians in clinical settings. [ABSTRACT FROM AUTHOR]

Purpose: This paper decribes the development of the Turkish adaptation of UTBAS (UTBAS-TR) and reports the results concerning its applicability and psychometric structure. Method: The sample consisted of 81 males and 19 females diagnosed with developmental stuttering in two centres. Test-retest reliability score was obtained by correlating results of repeated aplications of the scale within a one-week interval and a paired t-test was calculated to see the differences in the total and UTBAS I, II and III scores. The internal consistency was assessed using the Cronbach's alpha. Construct validity was also assessed by examining inter-scale correlations and with the correlations of the UTBAS-TR with two other scales (State-Trait Anxiety Inventory (STAI) and Beck Anxiety Inventory (BAI)). Result: The internal consistency of the UTBAS-TR and the test and retest reliability score was statiıstically significant. The correlation between UTBAS-TR total score and the UTBAS-TR I, II and III correlations were high. A significant correlation was observed between UTBAS-TR total score with State Anxiety Inventory. However, the correlations between UTBAS-TR-Total Score and Trait Anxiety Inventory and Beck Anxiety Inventory were low. Conclusion: The UTBAS-TR proved to be suitable for use with the Turkish population. [ABSTRACT FROM AUTHOR]

Purpose:This paper examined the production of intonation patterns in children with developmental dysarthria associated with cerebral palsy (CP) prior to and after speech intervention focussing on respiration and phonation. The study further sought to establish whether intonation performance might be related to changes in speech intelligibility. Method:Intonation patterns were examined using connected speech samples of 15 older children with moderate to severe developmental dysarthria due to CP (9 females; age range: 11–18). Recordings were made prior to and after speech intervention based on a systems approach. Analyses are focussed on the use of intonation patterns, pitch accentuation and phrasing. Result:Group analyses showed a significant increase in the use of rising intonation patterns after intervention. There were also some indications that this increase might have been related to gains in speech intelligibility for some of the children. No changes were observed regarding pitch accentuation and phrasing following intervention. Conclusion:The findings highlight that changes can occur in the use of intonation patterns in children with dysarthria and CP following speech systems intervention. It is hypothesised that the emergence of the rising pattern in some of the children’s intonational inventories possibly reflected improved breath support and control of laryngeal muscles. [ABSTRACT FROM PUBLISHER]

Purpose:This paper presents an exploratory investigation of the talk time of people with non-fluent aphasia, as measured by the CommFit™ app. Aims were to compare the talk time of people with aphasia with non-aphasic peers and measures of impairment, activity and participation. The variability of talk time over weeks and days of the week was also investigated. Method:Twelve people with post-stroke, non-fluent aphasia and seven non-aphasic controls measured their talk time using the CommFit™ app for 6 h/day for 14 days. Result:People with aphasia talked for a mean of 4.5 min/h and non-aphasic controls 7.2 min/h, which was not a significant difference (p = 0.056). Talk time of people with aphasia was not significantly correlated with WAB-R AQ or CADL-2 scores, but a moderate-high positive relationship between talk time and SIPSO scores was found (r = 0.648,p = 0.015). Talk time was not significantly different between the first and second weeks of recording for either group, and days of the week were not significantly different except for Saturdays, in which talk time was higher. Conclusion: This study provides some preliminary data on talk time in people with aphasia, suggesting that talk time is an indicator of participation. [ABSTRACT FROM PUBLISHER]

Background: Implementation fidelity refers to the degree to which an intervention or programme adheres to its original design. This paper examines implementation fidelity in the Sound Start Study, a clustered randomised controlled trial of computer-assisted support for children with speech sound disorders (SSD). Method: Sixty-three children with SSD in 19 early childhood centres received computer-assisted support (Phoneme Factory Sound Sorter [PFSS] – Australian version). Educators facilitated the delivery of PFSS targeting phonological error patterns identified by a speech-language pathologist. Implementation data were gathered via (1) the computer software, which recorded when and how much intervention was completed over 9 weeks; (2) educators’ records of practice sessions; and (3) scoring of fidelity (intervention procedure, competence and quality of delivery) from videos of intervention sessions. Result: Less than one-third of children received the prescribed number of days of intervention, while approximately one-half participated in the prescribed number of intervention plays. Computer data differed from educators’ data for total number of days and plays in which children participated; the degree of match was lower as data became more specific. Fidelity to intervention procedures, competency and quality of delivery was high. Conclusion: Implementation fidelity may impact intervention outcomes and so needs to be measured in intervention research; however, the way in which it is measured may impact on data. [ABSTRACT FROM PUBLISHER]

Purpose: This paper describes typical speech development of Setswana. Although there is information on Setswana phonology, very little is known about the acquisition of segmental phonology in this language. Method: An assessment tool was devised to collect speech samples from 36 first language Setswana-speaking children aged 3.0–6.0 years in the North-West Province of South Africa. This study describes the acquisition of consonants, vowels, syllable structures and phonological processes at various ages. Result: Findings indicate a relatively early acquisition of consonants, although trill /r/ continues to develop after 6.0 years, particularly in the penultimate syllable. Phonological features such as rounding develop in the later pre-school years. Findings also suggest that girls may achieve accuracy before boys. The older group of children presented with fewer phonological processes. Processes found in the speech of younger children included deletion of syllables, gliding, assimilation and simplifying complex words. Conclusion: These findings are discussed in relation to normative data from other languages, in particular to those belonging to the same language group. Knowledge of Setswana development will help Speech-Language Pathologists working with Setswana-speaking children to identify and manage phonological difficulties in this population. The results contribute to an increasing body of locally relevant information on typical phonological development. [ABSTRACT FROM AUTHOR]

Purpose: The study examines F1, F2 and F3 formant frequencies of vowels produced by six Greek intelligible speakers with profound hearing impairment and six speakers with normal hearing (three male and three female in each group). Method: The formant frequencies are measured in words of the form /ʹpVCV/ where V = /i, , , , u/ and C = /p, t, k, s/. The study examines differences in formant frequencies between the two groups and as a function of gender. Three measures are calculated to examine the area of the vowel space and differences along the F1 and F2 axes between the groups and genders. Result: The results show that the vowel space produced by the speakers with hearing impairment is considerably reduced. Greater reduction was evident for F2 compared to F1. Restricted formant frequency ranges and relatively large variation along F1 and/or F2 for selected vowels resulted in overlap among vowel categories. F3 frequencies were systematically lower and showed greater variation for the speakers with hearing impairment. Conclusion: The paper discusses findings with reference to perceptual and production constraints affecting the speech of individuals with hearing impairment. [ABSTRACT FROM AUTHOR]

Purpose: A systematic review of behavioural intervention for the treatment of adults with muscle tension voice disorders (MTVD). Method: A search of 12 electronic databases and reference lists for studies published between the years 1990-2014 was conducted using the PRISMA guidelines. Inclusion and exclusion criteria included type of publication, participant characteristics, intervention, outcome measures and report of outcomes. Methodological quality rating scales and confidence in diagnostic scale supported the literature evaluation. Result: Seven papers met the inclusion criteria. Significant improvement on at least one outcome measure was reported for all studies. Effect sizes were small-to-large. Methodological qualities of research were varied. No study explicitly reported treatment fidelity and cumulative intervention intensity could only be calculated for two out of seven studies. Outcome measures were used inconsistently and less than half of the measures had reported reliability values. Confidence in the accuracy of subject diagnosis on average was rated as low. Specific 'active ingredients' for therapeutic change were not identified. Conclusion: Voice therapy for the treatment of MTVD is associated with positive treatment outcomes; however, there is an obvious need for systematic and high quality research designs to expand the evidence base for the behavioural treatment of MTVD. [ABSTRACT FROM AUTHOR]

Purpose. Little is known about the needs of Indigenous Australian adults with acquired communication disorders (ACD) following stroke or brain injury and how these needs are met by speech-language pathology (SLP) services. In order for the profession to respond to the challenges of providing culturally appropriate, well-tailored and accessible services, more information on current practice and SLPs' concerns and attitudes is required. Method. This paper reports on a national survey with completed responses from 112 SLPs, who worked with adult neurological populations, about their levels of contact with Indigenous clients, cultural competency training and potential sources of support. Results. Of the total respondents, 63 SLPs reported clinical contact with Indigenous clients and they also answered questions on their assessment, intervention and discharge practices; liaison with family; and involvement with Aboriginal Health Professionals and interpreters. This group reported insufficient knowledge about Indigenous culture, lack of support and lower levels of confidence overall in working with these clients as compared to non-Indigenous clients. They wanted more flexible services for their Indigenous clients, good access to interpreters and culturally appropriate assessments and treatments delivered in culturally appropriate settings. Conclusions. This research provides a useful starting point towards understanding SLPs' perspectives and practice at a national level. [ABSTRACT FROM AUTHOR]

There is widespread concern that individuals with dysphagia as a result of stroke do not drink enough fluids when they are prescribed thickened liquids. This paper details a retrospective audit of thickened liquid consumption of 69 individuals with dysphagia following stroke in acute and rehabilitation hospitals in Adelaide, South Australia. Hospitalized individuals with dysphagia following stroke drank a mean of 781 ml (SD = 507 ml) of prescribed thickened liquids per day, significantly less in the acute setting (M = 519 ml, SD = 305 ml) than in the rehabilitation setting (M= 1274 ml, SD = 442 ml) (t(67) = --8.34, p < .001). This daily intake of thickened liquids was lower than recommended standards of fluid intake for hospitalized adults. Fluid intake could be increased with definitive protocols for the provision and monitoring of consumption of thickened liquids, by offering more fluid via food or free water protocols or by routine use of non-oral supplementary routes. Future research into the effectiveness of such recommendations needs to evaluate not only the impact on fluid intake but also on health outcomes. [ABSTRACT FROM AUTHOR]

Well-specified phonological representations are important for the development of spoken and written language. This study investigates the types of speech errors and the quality of phonological representations in Greek-speaking school-age children with high-functioning autism spectrum disorder (HF-ASD), as well as the relationship between stored phonological representations and speech output in this sample, according to Stackhouse and Wells' (1997) model. All participants completed a phonological and a naming test, and a non-word repetition task. A receptive phonological task was administered to a subgroup of HF-ASD and typically developing (TD) participants. According to performance in the phonological test, the HF-ASD children were categorised as ASD with Speech Sound Disorder (SSD) or ASD without SSD. The HF-ASD children made significantly more speech errors and showed significant difficulties in the repetition of non-words and the stored phonological representations compared to the TD group but had the same naming abilities with their TD peers. The ASD children with SSD and without SSD performed alike in the receptive task, indicating that both groups had unspecified phonological representations. These results support the hypothesis of distinct phonological representations for speech input and output and highlight the need of using receptive tasks to evaluate underlying phonological knowledge, a process which could allow clinicians to identify the level of speech breakdown. [ABSTRACT FROM AUTHOR]

There is building evidence that oesophageal screening (OS) should be considered a critical component of videofluoroscopic swallow studies (VFSS). This study surveyed Australian speech-language pathologists (SLPs) regarding current practices and perceptions of OS in VFSS. A 16–24 item online survey was distributed to Australian SLPs via relevant email forums. One response per site was requested. Survey questions explored experience and training in VFSS, skill and confidence with OS, OS protocol use, and pathways following OS. One hundred and one SLPs across all Australian states and territories responded, with 70% (n = 69/99) from metropolitan hospitals and 74% (n = 75/101) having more than five years' VFSS experience. While 69% (n = 70/101) of SLPs conducted OS, only half (n = 35/70) conducted OS routinely, and only 4% (n = 3/70) always used published OS protocols. Barriers to OS, for some participants, were concerns about scope of practice and confidence. This study confirms higher levels of OS in Australia compared to similar international surveys and provides rich data on the Australian context. Prescriptive clinical guidelines for OS, consensus regarding a preferred OS protocol, and specific OS training may clarify SLP scope of practice and improve SLP confidence and standardisation in OS. [ABSTRACT FROM AUTHOR]

The primary aim was to compare adolescents with mental illness and non-clinical adolescents on vocabulary, social problem-solving, trust in parents, attachment and mentalisation. A secondary aim was to investigate whether adolescents' language skills were associated with trust in parents. Seventy-eight adolescents (16–18 years) participated in this cross-sectional quantitative study: a clinical sample (n = 28, M = 16.7 years, 19F) recruited from a mental health service and a non-clinical sample (n = 50, M = 17.0 years, 28F). Standardised language measures and self-report measures of trust in parents; communication quality; attachment; and mentalisation were used. Primary and secondary aims were addressed through independent samples t-tests and Pearson's correlation analyses, respectively. Adolescents experiencing mental illness reported significantly poorer vocabulary, less trust in mother/father, greater attachment anxiety/avoidance, and poorer reflective functioning, than non-clinical adolescents. Expressive vocabulary of clinical (but not non-clinical) adolescents significantly negatively correlated with trust in mother (but not father). Results highlight a role for speech-language pathologists (SLPs) in supporting communication needs of adolescents with mental illness. SLPs should consider trust by: i) understanding adolescents with mental illness may have difficulty trusting them potentially impacting therapeutic engagement; and ii) delivering services in ways that might build trust, such as involving adolescents in treatment planning. [ABSTRACT FROM AUTHOR]

To provide normative data on swallowing capacity (mL/s) in people older than 60 years using the Timed Water Swallow Test (TWST), stratified by sex. Intra- and inter-rater reliability for swallowing time in TWST was further investigated. A total of 165 participants, aged 60 years and above, were included in the study. The time taken to consume 150 mL of tap water and the swallowing capacity (mL/s) was observed in a clinical context using the TWST. Video recordings of the performances were collected for 118 of the 165 participants for inter-rater reliability testing, of which a random set of 25 performances were assessed for intra-rater reliability. Analysis of the agreement between TWST rated by an in-person clinician and rated from a video recording was further evaluated. There were significant age and sex effects observed for swallowing capacity. The average reduction in swallowing capacity in the investigated age range (60–92 years) was 8.8 and 7.3 mL/s, for women and men respectively. The results showed high inter-and intra-rater reliability and agreement between the clinical assessment and the video recording. The presented measurements indicate a clear effect of age on swallowing capacity and that women may be expected to have lower capacity scores than men when tested using TWST. The provided norms can be used as reference points in the clinical identification of people at risk of dysphagia in the older population. [ABSTRACT FROM AUTHOR]

Guidelines recommend routine discourse assessment and treatment in paediatric acquired brain injury (ABI) but provide little guidance for clinical practice. The degree to which this has influenced the nature of discourse assessment and treatment in clinical practice has not been examined in detail. Speech-language pathologists working in paediatric ABI (clients aged <18 years) in Australia, New Zealand, the UK, the USA, Canada, and the Asia Pacific region were invited to complete a survey of discourse assessment and intervention practices (n = 77). Clinicians from Australia and New Zealand comprised over half of a responses (53%). The largest proportion had over 10 years' experience (60%), worked in the metropolitan area (58%), and with secondary school-age children (64%). Routine discourse assessment was undertaken by 80% of respondents, focussing on a limited range of genres. No preferred intervention approach was identified. One-quarter of clinicians routinely considered holistic factors during clinical decision-making. Limited normative data and treatment evidence, insufficient time and training were identified as clinical barriers. Assessment practices were consistent with guidelines, yet interventions were highly variable, reflecting limited evidence, client heterogeneity, time constraints, and limited training. A biopsychosocial approach to practice was evident, yet a focus on impairment level factors was prominent. Findings support the need for standardised discourse assessment and discourse intervention methods. Translation into practice guidelines would promote consistency and confidence in clinical practice. [ABSTRACT FROM AUTHOR]

Health funding provisions supported by governments are pivotal for families accessing independent speech-language pathology services in Australia. Little is known of the facilitators and barriers that exist for accessing public funding for speech-language pathology services through independent providers. This study aimed to investigate and describe the perceptions of speech-language pathologists in accessing public funding models (PFMs) for children and young persons with communication and swallowing needs within Australian independent practice. Semi-structured qualitative interviews were conducted with twenty independent speech-language pathologists who had experience of PFMs in Australia. Digitally recorded interviews were transcribed verbatim and subjected to thematic analysis. Data analysis revealed five superordinate and eighteen subordinate themes. The five superordinate themes were: (a) accessibility in securing funding provisions; (b) time as a commodity; (c) incongruence between funding provisions and speech-language pathology evidence; (d) trust as a multifaceted quality; and (e) consequences of PFMs. This original and timely research offers perceptive descriptions of the multifaceted facilitators and barriers for families seeking to access public funding for independent speech-language pathology services in Australia. Research findings illuminate challenges for the speech-language pathology profession. Accessibility to funding was identified as a major issue. Research findings suggest that current funding provisions do not align with the dosage required for evidence-based speech-language pathology management. Further, this research has highlighted the need for funding to be equitable, acceptable to stakeholders, and for services to be delivered in an efficient and sustainable manner. Future research is recommended to understand which Australian PFMs: (a) facilitate consumer access to speech-language pathology services; (b) enrich consumer experiences; and (c) align with scientific evidence to promote optimal outcomes. [ABSTRACT FROM AUTHOR]

To evaluate the effect, usage, and user-experience for SayBananas!, a Mario-style mobile game providing Australian children access to high-dose individualised speech therapy practice. Participants were 45 rural Australian children with speech sound disorders (SSD; 4;4–10;5 years) with internet access. This mixed-methods study involved: (a) recruitment, (b) eligibility screening, (c) questionnaire, (d) online pre-assessment, (e) SayBananas! intervention using motor learning principles (4 weeks, 10–15 target words), and (f) online post-assessment and interview. Usage and performance were automatically monitored. Most participants were highly engaged with SayBananas! completing a median of 44.71 trials/session (∼45% of the 100 trial/session target, range 7–194). After intervention, participants made significant gains on treated words and on formal assessment of percentage of consonants, vowels, and phonemes correct. There was no reliable change for parent-rated intelligibility or children's feelings about talking. The number of practice sessions was significantly correlated with percent change on treated words. On average, children rated the app as "happy/good/fun" providing detailed drawings of playing SayBananas!. Families provided high ratings of engagement, functionality, aesthetics, and quality. SayBananas! is a viable and engaging solution for rural Australian children with SSD to gain access to equitable, cost-effective speech practice. The amount of app use was associated with amount of speech production improvement over a 4-week period. [ABSTRACT FROM AUTHOR]

This study aimed to gain insight into the experiences in adolescence of people with aphasia following childhood stroke. Adolescence is a unique period of developmental changes, yet little is known about the impacts of childhood stroke and aphasia during this critical period. With YouTube emerging as an information sharing platform for adolescents, the perspectives shared by YouTubers who have experienced aphasia during adolescence can provide insight into lived experiences. Eleven videos were identified on YouTube via keyword searches. Included videos contained YouTubers' reports of childhood stroke and impacts of aphasia and/or stroke related language difficulties during adolescence (13–17 years). Videos were transcribed verbatim and analysed with reflexive thematic analysis. Five themes were generated from analysis. These themes revealed the various impairments adolescents experienced after their unexpected stroke, including language difficulties such as word finding, reading, and writing difficulties. The YouTubers shared sources that aided their recovery, aspirations for the future, and their desire to raise awareness of stroke and aphasia in adolescents. The perspectives identified can inform person-centred and tailored care for adolescents with aphasia after childhood stroke. Further, the need for increased public education about stroke and aphasia specifically during adolescence has been highlighted. [ABSTRACT FROM AUTHOR]

Eating and drinking outside the home is important for participation and social inclusion for people with intellectual disability and dysphagia (swallowing difficulties) but is likely to come with additional challenges. This qualitative research aimed to identify the challenges and strategies used by people with intellectual disability and dysphagia and their carers when eating outside the home. This study used a qualitative research design and reflexive researcher stance following an interpretive phenomenological methodology to understand the nature of the phenomenon "supporting people to eat and drink outside the home". Participants (n = 20) including those with intellectual disability and dysphagia (ages 20–30 years), their support staff and families were interviewed about eating and drinking outside the home. Semi-structured interviews were used. Interviews were analysed thematically. Three overarching themes were extracted using thematic analysis. These were being fully prepared; being a confident and respectful advocate; and being open to the varied responses of other people. The findings of this study suggest that there are unique challenges for people with intellectual disability and dysphagia and their carers when eating outside the home. There was a need to be practically, professionally, and personally prepared for eating outside the home. There is a need, therefore, to specifically address the challenges of eating outside the home and sharing the strategies used by others to overcome these challenges. [ABSTRACT FROM AUTHOR]

Patients admitted to critical care (CC) are at risk of impaired swallowing and communication function. Speech-language pathologists (SLPs) play an important role in this context. In Ireland and internationally speech-language pathology CC guidelines are lacking, with possible variations in practice. To compare clinical practices in dysphagia, communication and tracheostomy management among SLPs working in adult CC units in Ireland and internationally, and explore their perspectives on training, skills and resources. Participants were SLPs working in CC. An international online survey sought information on (i) SLP workforce demographics and staffing levels, (ii) current dysphagia and communication assessment and management practices, (iii) practices and perspectives on training, skills and resources. 366 responses were received across 29 countries. 18.03% (66/366) of these respondents worked in Ireland. Findings showed similarities and differences in practices. Total CC SLP whole-time equivalent (WTE) at each staff grade was lower (mean difference: −0.21 to −0.65 WTE p <.001) than desired for optimal service delivery. Negative effects of under-staffing were reported. Recommendations that all tracheostomised patients receive SLP input was unmet in 66% (220/334) of services. SLP input in CC is limited in terms of dedicated posts, multidisciplinary team (MDT) involvement, consistent management approaches and training opportunities internationally. Implications of findings are discussed. [ABSTRACT FROM AUTHOR]

To explore speech-language pathologists' (SLP) practice in literacy prior to, and during, COVID-19 to understand the practicalities, feasibility and sustainability of telepractice literacy services. This exploratory study employed a cross-sectional survey comprising 46 questions covering participants' caseload profile and service delivery models, their assessment and intervention practices and telepractice delivery of literacy services. Participants were 44 SLPs working primarily in private practice and education with children and adolescents. Students with literacy difficulties comprised a significant proportion of SLPs' caseloads. Individual and group sessions were the most common format of delivery prior to COVID-19. In a telepractice model during COVID-19, SLPs saw fewer students overall. Most provided individual sessions only and reported cancellation of group sessions. SLPs described their practice in literacy as being aligned with evidence-based principles. A range of resources were used for literacy assessment and intervention. For most, their usual practice changed for telepractice. Many felt underprepared to use telepractice and experienced numerous challenges mostly relating to technology and family engagement. Literacy has become a core area of practice for SLPs; however, continued advocacy towards consultative and collaborative services is needed within onsite and telepractice models. Telepractice required SLPs to develop additional skills and modify usual practice. Despite experiencing challenges, many indicated they would continue with telepractice given its perceived benefits. [ABSTRACT FROM AUTHOR]

Communication and swallowing disabilities (CSwD) impact health and well-being (Sustainable Development Goal SDG 3), educational attainment (SDG 4) and employment (SDG 8) and contribute to poverty (SDG 1). In Vietnam, community-based rehabilitation (CBR) workers are often the first point of contact for people with CSwD. This commentary reports research exploring the knowledge, experiences and training needs of CBR workers and their preparedness to provide services to people with CSwD and their families living in a province of Vietnam. Two hundred and five CBR workers completed a written survey and eight participated in a semi-structured interview. Quantitative survey data were analysed using descriptive statistics and content analysis was used to analyse the qualitative data. Most participants were female, aged over 30 and worked in a variety of health settings. Multiple challenges to the delivery of services to people with CSwD were described, including lack of training and limited understanding of CSwD by CBR workers, communities and their leaders. Limited knowledge and preparedness of CBR workers is threatening the achievement of the SDGs for people with CSwD in Vietnam. There is a need for comprehensive education, training and the raising of awareness of the cause and impact of CSwD, and for this to be in partnership with people who experience CSwD and their families, local speech-language pathologists, and international collaborators. Future research exploring the needs of people with CSwD in Vietnam is critical to guiding the development of contextually relevant services and support. This commentary focuses on good health and well-being (SDG 3), quality education (SDG 4), decent work and economic growth (SDG 8), reduced inequalities (SDG 10) and partnerships for the goals (SDG 17), and indirectly addresses no poverty (SDG 1). [ABSTRACT FROM AUTHOR]

Purpose: The role of allied health practitioners providing physical rehabilitation of central facial palsy (CFP) is minimally reported in the literature. This study explores current practice and the roles, attitudes and perceptions of allied health professionals (AHPs) working with people with CFP. Method: An electronic survey was distributed to speech-language pathologists (SLPs), occupational therapists and physiotherapists. Responses (n = 78) were analysed using qualitative and quantitative methods. Result: SLPs often lead management of CFP; however, their role is not clearly defined nor well recognised. Several barriers were identified which prevent AHPs from providing consistent specialist rehabilitation to people with CFP. These included a lack of training, no clear delegation of role, limited evidence and lack of resources. Conclusion: Survey respondents viewed CFP to be within SLP scope of practice; although, ownership of management varies between countries and professions. Most SLPs recognise the negative impact of CFP and feel a sense of responsibility to provide assessment and treatment of this impairment, but many barriers to doing so have been identified. Suggestions to improve access to rehabilitation for people with CFP included increased access to training for SLPs, more evidence, clinical practice guidelines and more clinical resources. Further research is required to ensure people suffering from CFP can access services that provide skilled management of their impairment. [ABSTRACT FROM AUTHOR]

Purpose: To explore how language and executive function skills of pre-school-aged children contribute to semantic fluency (a form of verbal fluency) performance. This study investigated effect of age and contribution of vocabulary and executive function on qualitative aspects of the semantic fluency task. Method: Forty typically developing Australian-English-speaking pre-school children, aged 4;0–5;11 (mean age = 55.5 months, SD = 5.21) participated. Eight assessment tasks were presented in random order examining semantic fluency, vocabulary knowledge and executive function. Hierarchical multiple regression analyses determined the extent to which measures of executive function and vocabulary accounted for fluency (number of words correctly produced) and qualitative aspects of the semantic fluency task (number of clusters, number of clustered words, number of switches). Result: While executive function and vocabulary were positively correlated with fluency and all qualitative measures of semantic fluency performance, they were not significant predictors of any aspect of task performance. Age and vocabulary were the only significant predictors of fluency, number of words clustered, and number of switches. Performance on these tasks was strongly related to vocabulary and automated retrieval processes. Conclusion: Pre-school children do not predominantly rely on executive function during semantic fluency. The influence that vocabulary has on semantic fluency task performance outweighs that accounted for by age. [ABSTRACT FROM AUTHOR]

Purpose: Vocabulary relates to overall language proficiency and is important for academic success. Word definition (WD) tasks can be used to assess vocabulary depth and definition skills. We investigate monolingual and bilingual children's performances on a WD task, and how bilingualism, level of parental education, school characteristics (proportion of students with Swedish as second language and proportion of parents with tertiary education), CELF-4 Core Language Score, and non-verbal IQ contribute to their performance. We also evaluate the level of difficulty of the test items and the test's internal consistency. Method: Two hundred and eight children (mean age 7:8, range 6:8–9:0) were assessed with a 10-item WD task. Amount of information included in the definitions gave the WD score and number of words with at least partially correct information gave a Word knowledge score. Result: The bilingual group had lower scores on both measures. In isolation bilingualism explained 15% of the variance of the WD score. With all background factors included, the only significant predictor was CELF-4 Core Language Score, uniquely explaining 24.3% of the variance. Response patterns on the WD score were similar between groups. Internal consistency was > α = 0.7 for both measurements. Conclusion: Bilingual children performed lower than monolingual children on a WD task, but bilingualism alone cannot explain poor results. [ABSTRACT FROM AUTHOR]

Purpose: To explore how speech-language pathologists and nurses share information about the communication support needs of stroke patients through structured information-sharing routes and to consider how the two disciplines view their roles and interdependencies in addressing these needs. Method: Speech-language pathologist and nurse information-sharing was explored in context using ethnography. Ethnography has been used by researchers from other disciplines to understand the context of inpatient care, but the methodology has rarely been adopted within speech-language pathology. Fieldwork (357 hours) was carried out on three stroke wards in England for 40 weeks from 2015 to 2017. Data included fieldnotes, interviews with 43 members of speech-language pathology and nursing staff, and the patient records of 19 patients. Result: The findings provide a thematically organised explanation for how information about communication travelled through structured routes on the wards (meetings, the patient record, bedside signs, education, and nursing handover). Limitations were identified that appear underpinned by disciplinary differences in (1) how speech-language pathologists and nurses engaged with the wards in time and space, and (2) perceptions of roles and interdependencies. Speech-language pathologists routinely used meetings and the patient record to share communication information, however these formal structures were not easily accessible during nurses' caregiving roles. In addition, both speech-language pathologists (SLPs) and nurses were ambivalent about the usefulness of signage SLPs sometimes left at the bedside for supporting communication. There was little interdependency between SLP and nursing roles in meeting the communication support needs of patients. Conclusion: In-depth exploration of the context within which SLPs and nurses share information has revealed limitations in the capacity of structured routes to enhance collective knowledge about patients' communication support needs. [ABSTRACT FROM AUTHOR]

Purpose: Brain tumour and leukaemia represent the most common childhood cancers and can result in communication and swallowing difficulties. The purpose of this study was to survey health professionals and consumers regarding the management of communication and swallowing difficulties in children with brain tumour or leukaemia (CBTL). Method: In this study participants completed a survey focussing on (1) communication and swallowing assessment and intervention, (2) multidisciplinary team (MDT) practices and (3) risk factors. Quantitative data were reported using descriptive statistics. Qualitative data were analysed using NVivo12 Qualitative Data Analysis Software. Result: Twenty-four participants were included (22 health professionals; two consumers). Most participants (≥80%) agreed that comprehensive and regular communication and swallowing assessments improved outcomes. Communication and swallowing interventions were reported to improve outcomes by 96% of participants. MDT care was considered essential in improving outcomes. Speech-language pathologists were the primary health professional identified in communication management; additional multidisciplinary health professionals were highlighted in swallowing management. Risk factors were identified across three categories: cancer-related, treatment-related and child-factors. Conclusion: This study collates the expertise and experience of multidisciplinary health professionals and consumers which can be used to guide assessment and intervention for communication and swallowing in CBTL. It also provides perspectives on MDT care and consideration of patient values and risk factors. [ABSTRACT FROM AUTHOR]

Purpose: The Australian English Communicative Development Inventory (OZI) is a 558-item parent report tool for assessing language development at 12–30 months. Here, we introduce the short form (OZI-SF), a 100-item, picture-supported, online instrument with substantially lower time and literacy demands. Method: In tool development (Study 1), 95 items were drawn from the OZI to match its item distribution by age of acquisition and semantic categories. Five items were added from four other semantic categories, plus 12 gestures and six games/routines. Simulations computed OZI-SF scores from existing long-form OZI norm data, and OZI and projected OZI-SF scores were correlated. In an independent norming sample (Study 2), parents (n = 230) completed the OZI-SF for their children aged 12–30 months. Child scores were analysed by age and sex. Result: OZI-SF and OZI scores correlate highly across age and language development levels. Vocabulary scores (receptive, expressive) correlate with age and the median for girls is higher until 24 months. By 24 months, 50% of the sample combine words "often". The median time to OZI-SF completion was 12 minutes. Conclusion: Fitted percentiles permit working guidelines for typical (median) performance and lower cut-offs for children who may be behind on age-based expectations and/or at risk for a communication difficulty. The OZI-SF is a short-form of the OZI that has promise for research and clinical/educational use with Australian families. [ABSTRACT FROM AUTHOR]

Purpose: To examine (1) the association between low language (LL) and caregiver's health-related quality of life (HRQoL), (2) whether persistent LL affects caregiver's HRQoL and (3) whether child social-emotional-behavioural (SEB) difficulties attenuates the association between LL and caregiver's HRQoL. Method: Data were from the Early Language in Victoria Study (ELVS) and the Longitudinal Study of Australian Children (LSAC). Caregiver's HRQoL was measured using the EuroQoL-5 dimensions and the Assessment of Quality of Life-8 dimensions. Language ability was determined using the Clinical Evaluation of Language Fundamentals (CELF)-Preschool-2nd or 4th edition (ELVS) and the Peabody Picture Vocabulary Test-3rd edition or CELF-4 recalling sentences subscale (LSAC). Child SEB difficulties were measured using the Strengths and Difficulties Questionnaire. Multivariable linear regression was used for the analysis. Result: At 11–12 years, an association between LL and reduced caregiver's HRQoL was found in LSAC, but not in ELVS. Persistent LL from 4–11 years seemed to not affect caregivers' HRQoL in either cohort. Child SEB difficulties attenuated the association between caregiver's HRQoL and LL. Conclusion: Both LL and SEB difficulties contributed to reduced caregiver's HRQoL at children age 11–12 years. Interventions supporting children with LL should consider caregiver's well-being in provision of care that meets families' needs. [ABSTRACT FROM AUTHOR]

Purpose: Papua New Guinea (PNG) has extreme linguistic diversity reflected in its three national languages and sociolinguistic diversity comprising over 380 vernaculars or Tokples, English and the lingua francas, which include Tok Pisin (TP). This first clinical cross-sectional study of consonant acquisition in TP-speaking children sought to identify universal features and the impact of age on phonological development. Method: A local picture naming task was developed and used to elicit a speech sample from 80 children (aged 3;0–6;11). Phonetic and phonemic inventories and developmental phonological processes were analysed across the sample and also in 12-month age groups. Result: Statistically significant differences were found between the Percentage Consonants Correct (PCC) of the 3YO and other age groups. Mean PCC increased with age, but high variation within age groups meant differences were not statistically significant. Universal features observed included the early acquisition of plosives and late mastery of /r/. Language-specific features included processes such as fricatisation and earlier acquisition of /ʤ/ before /s/. Creolisation was seen in morphophonemic condensation and the influence of loanwords. Conclusion: This study demonstrates both universal and language-specific features amidst wide diversity influencing phonological acquisition in creolising TP. This first phonological study of TP consonant development will inform future clinical speech-language pathology practice in PNG. [ABSTRACT FROM AUTHOR]

Purpose: A lack of diversity in the speech-language pathology profession is widely recognised internationally. The role of speech-language pathology education in reproduction of this homogeneity and as a barrier to diversification is little understood. The potential of blended online education to increase access to education and diversify the speech-language pathology profession is yet to be explored. The purpose of the study was to investigate the profile of students engaging in the first blended online speech-language pathology course in Australia, including motivations for studying, experiences of studying via a blended online mode, and intentions for future practice. Method: Data were collected from 44 students in the first Australian blended online Master of Speech Pathology via an online survey. Quantitative data were analysed using descriptive statistics in SPSS and a content analysis of the qualitative data was conducted using NVivo. Result: With over 92% of participants choosing the course because it was offered online, flexible blended online study provided opportunity for those who would not have otherwise accessed speech-language pathology education, including rural students and those balancing work and home commitments. Participants found face to face elements of the course essential to their learning, but also the most challenging to manage and to fit around other commitments. Participants' ideal work scenarios revealed that 82.9% wished to practice within 50kms of their current location, indicating that provision of tertiary education to people in rural areas is contributing to establishing and retaining a rurally focussed speech-language pathology workforce. Conclusion: Blended online study provides an opportunity to diversify the speech-language profession by providing access to students such as rural students and those balancing work and home commitments with tertiary education. By reducing barriers to studying speech-language pathology, flexible learning is helping address issues of access and equity in service delivery across Australia. [ABSTRACT FROM AUTHOR]

Purpose: Individuals with stroke-related apraxia of speech (AOS) plus aphasia tend to produce more speech errors with increasing word length. The Words of Increasing Length task (WIL) uses a 3-point scale to score word accuracy but penalises for error types that can arise either from language or motor impairment, reducing the test's sensitivity and specificity. The purpose here was to identify error types explaining variance in the WIL score, and those associated with AOS and word length. Method: Speech errors were perceptually identified on the WIL task for 51 Australian English-speaking adults with stroke-related aphasia, 25 with concomitant AOS. Multiple regression and linear mixed effects modelling were applied. Result: Variance in WIL scores was best explained with four error types: consonant additions, incorrect number of syllables, false starts and consonant substitutions/distortions. False starts were significantly associated with AOS diagnosis. Incorrect number of syllables, consonant omissions, false starts, and lexical stress errors increased in frequency for longer words and, while the interaction with diagnosis did not reach significance, the effect appeared driven by the AOS group. Conclusion: Findings provide further support for using polysyllabic word production to assess apraxic speech. The WIL task has limitations that may bias patients' performance and clinicians' perceptual evaluation. Data provide valuable information for designing a more sensitive diagnostic protocol for AOS. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the practice patterns used by Malaysian speech-language pathologists (SLPs) with patients with dysarthria, identified challenges perceived by SLPs and explored strategies to address perceived barriers for improving dysarthria management. Method: Two studies were conducted. Study 1 disseminated a 30-item survey questionnaire electronically via google link to SLPs in the Malaysian Speech-Language-Hearing Association through e-mail lists. Responses were analysed using descriptive statistics. In Study 2, semi-structured interviews of twelve SLPs who managed patients with dysarthria were conducted. Data were transcribed verbatim and analysed using the thematic analysis method. Result: Three major themes and ten sub-themes emerged from the interviews, including "assessment and treatment practices", "challenges", and "overcoming challenges". SLPs' practice of assessment and treatment of dysarthria were predominantly impairment-based. Respondents (64%) who never used standardised assessment tools valued textbooks more as sources of evidence and had a lower level of confidence in their knowledge about dysarthria compared to those who used standardised tools. Conclusion: Focus now needs to be on the education needs of our SLPs, on both the university training and continuing education levels, for direction of the development of professional training courses. Ongoing research and public awareness are required to guide clinical management decisions. [ABSTRACT FROM AUTHOR]

The speech-language pathology workforce strives to provide equitable, quality services to multilingual people. However, the extent to which this is being achieved is unknown. Participants in this study were 2849 members of Speech Pathology Australia and 4386 children in the Birth cohort of the Longitudinal Study of Australian Children (LSAC). Statistical and geospatial analyses were undertaken to identify the linguistic diversity and geographical distribution of Australian speech-language pathology services and Australian children. One fifth of services offered by Speech Pathology Australia members (20.2%) were available in a language other than English. Services were most commonly offered in Australian Sign Language (Auslan) (4.3%), French (3.1%), Italian (2.2%), Greek (1.6%), and Cantonese (1.5%). Among 4-5-year-old children in the nationally representative LSAC, 15.3% regularly spoke and/or understood a language other than English. The most common languages spoken by the children were Arabic (1.5%), Italian (1.2%), Greek (0.9%), Spanish (0.9%), and Vietnamese (0.9%). There was a mismatch between the location of and languages in which multilingual services were offered, and the location of and languages spoken by children. These findings highlight the need for SLPs to be culturally competent in providing equitable services to all clients, regardless of the languages they speak. [ABSTRACT FROM AUTHOR]

Purpose: To examine two screening tools for phonological production, the Evaluation Sommaire de la Phonologie chez l'enfant d'âge préscolaire (ESPP) and the Test de Phonologie du Français Canadien-Dépistage (TPFC-D), developed according to differing theoretical perspectives. The TPFC-D, designed according to nonlinear phonology, includes more words and contains a greater variety of segments across word structure as compared to the ESPP, which was guided by a linear phonological framework. The greater response rate to test items, time of administration, and phonological complexity were expected on the TPFC-D. Method: Each screening tool was administered to 14 4-year-old French-speaking children living in Central Canada. Paired samples t-tests compared children's responses on the two tasks with regards to (a) response rate and time of administration, (b) an overall percentage of consonants correct (PCC) and percentage of vowel correct (PVC), and (c) complexity of productions (i.e. PCC and PVC in relation to word structure, Word Shape Match, Whole Word Match, Phonological Mean Length of Utterance (pMLU) and Proportion of Whole-Word Proximity). Result: Item response rates were higher for the TPFC-D whereas time of administration, PCC and PVC were similar for both the ESPP and TPFC-D. Complexity measures showed a higher proportion of deletions in clusters and higher pMLUs on the TPFC-D compared to the ESPP. Conclusion: Both screening measures are appropriate for speech-language pathologists who want to assess quickly pre-school-aged children. Since the TPFC-D is phonologically more complex, it is recommended for clinicians needing to screen children who likely present with multiple speech sound errors across their phonological system. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the practice patterns of private community speech–language pathologists (SLPs) when treating children with a repaired cleft of the palate with or without a cleft of the lip (CP ± L). Practices were explored in terms of diagnostics and treatment focus, treatment dosage and experienced difficulties when treating children with a CP ± L. Method: Eleven female private community SLPs, who lived in Flanders (i.e. the northern part of Belgium) and were aged between 23 and 62 years participated in this study. Data were collected from semi-structured face-to-face interviews. The qualitative software program NVivo 12 was used for data analysis. The interviews were analysed using an inductive thematic approach. Result: SLPs reported a lack of available information on speech-related cleft care. SLPs expressed the need to receive a referral letter from the hospital in order to make an adequate speech diagnosis. Most therapists reported that they performed an articulatory assessment combined with a language assessment. Most SLPs used a hybrid treatment model including a variety of intervention techniques. These techniques were not always in line with available scientific evidence. SLPs reported the desire to receive practical step-by-step guidelines on how to provide speech intervention to children with a CP ± L. In contrast, there was a strong consensus among the therapists that an individualised treatment plan is necessary. Conclusion: The results of this study have revealed gaps in the dissemination and implementation of scientific evidence relevant to speech services for children with a CP ± L (i.e. a research–practice gap) in Flanders. Research evidence needs to be adequately translated into clinical practice by providing concrete and practical guidelines. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this laboratory study was to investigate whether rhythmic speech was primarily responsible for stuttering reductions in four school-aged children after the instatement stage of the Westmead Program of syllable-timed speech (STS) intervention. The study was designed to inform further development of the program. Reduction in variability of vowel duration is a marker of STS, and it was predicted that this would be present in the children's conversational speech after Stage 1 of the program if they were using STS. To strengthen such a finding, it was also predicted that there would be no reduction in articulation rate, sentence complexity, and utterance length after treatment, as there is evidence that reductions in these can reduce stuttering. Perceptual judgments of speech quality after treatment were also made by independent listeners. Method: Participants were four children, ages 8–11 years, who completed Stage 1 of an STS program and whose stuttering had reduced significantly. Pre-treatment (PRE) and post-treatment (POST) within-clinic audio-visual recordings of conversational speech were analysed for percentage of syllables stuttered, variability of vowel duration, articulation rate, and length and complexity of utterance. Four blinded listeners made perceptual judgments of speech quality in the POST recordings. Result: Recordings of all children showed that variability of vowel duration clearly reduced from the PRE to POST speech samples. Importantly, articulation rate and language use were not compromised. Some possible indicators of rhythmicity were identified in one child in the perceptual study. Conclusion: The findings suggest that STS was primarily responsible for the clinically significant reductions in stuttering after Stage 1 of the program. There is an urgent need for more evidence-based interventions for stuttering in this age group and further development of STS interventions is warranted. [ABSTRACT FROM AUTHOR]

The purpose of this study was to use psychological measures of pre-schoolers who stutter and their parents to inform causal theory development and influence clinical practices. This was done using data from a substantive clinical cohort of children who received early stuttering treatment. The cohort (N = 427) comprised parents and their children who were treated with the Lidcombe Program, the Westmead Program, and the Oakville Program. The study incorporated demographic information, stuttering severity, and child and parent psychological measures prior to treatment. The cohort revealed nothing unusual about behavioural and emotional functioning, or the temperaments, of pre-school children that would influence treatment, be targeted during treatment, or influence causal theory development. However, a third of parents were experiencing moderate to high life stressors at the time of seeking treatment, and half the parents failed first-stage screening for Anankastic Personality Disorder. The present results are consistent with a number of previous reports that showed that the population of pre-schoolers who stutter have no unusual psychological profiles. Hence, these results suggest that the association between mental health and stuttering later in life is a consequence of the disorder rather than being a part of its cause. The finding of the life stress of parents who seek stuttering treatment for pre-school children has potential clinical importance and warrants further investigation. Further psychological research is required about parents of pre-school children who stutter, because half the parents in the cohort failed the screener for Anankastic Personality Disorder. This is of interest because a previous study associated screening failure for another personality disorder (Impulsive Personality Disorder) with treatment dropout for early childhood stuttering. [ABSTRACT FROM AUTHOR]

Purpose: To investigate speech-language pathologists' current perceptions, previous training experiences, resources, barriers, and training needs in terms of evidence-based practices (EBPs) in two Asian countries. Method: Their knowledge and attitudes about EBP were explored using an online questionnaire. A descriptive analysis was conducted with consideration of the effect of demographic variables on knowledge and attitudes about EBP. Result: Malaysian speech-language pathologists (n = 98) displayed more positive attitudes toward EBPs, with a significantly higher (t (143) = 5.91, p <.01) total mean score (Mean = 120.7, SD = 11) compared to the Japanese speech-language pathologists (n = 47, Mean = 107.8, SD = 13.5). Malaysian practitioners who were female, worked full-time, and worked in government settings reported higher motivation to develop EBP skills. Japanese practitioners who worked in private sectors reported higher EBPs training needs than those in government settings. In both countries, speech-language pathologists with higher education levels tended to express fewer perceived barriers towards EBP. Conclusion: Findings could help local governance and speech-language pathologist associations to understand the current practices and professional development needs of speech-language pathologists, leading to more effective training programs and educating employers and managers who can reinforce EBP among practitioners. [ABSTRACT FROM AUTHOR]

Purpose: Narrative is the dominant focus of traditional standardised discourse assessment, yet the complex discourse needs of adolescence has led to increased interest in profiling skills in other monologic genres for this age group. This interest is not commensurate with a robust understanding of the influence of genre on adolescent discourse across word to whole-text language features. This knowledge is important to inform context(s) for assessment to profile strengths and weaknesses in discourse-level language. Method: One hundred and sixty adolescents between 12 and 15 years (M= 13;1, SD= 1;1, 55% female, 45% male) completed the Curtin University Discourse Protocol – Adolescent. Samples of recount, narrative, expository and persuasive discourse were coded using a multi-level analysis procedure. Result: Genre had a significant influence on language variables regardless of age. Narrative tasks citied the longest, most lexically diverse, cohesive, coherent and well-structured output. Results were consistent with the oral to literate continuum and the order in which genres are introduced in the academic curriculum. Conclusion: Structure, content and domain-specific knowledge likely influenced the genre-related differences seen in this study. It would be advantageous to sample a range of monologic genres when assessing adolescent discourse. Declarative knowledge may be an important consideration in topic selection. [ABSTRACT FROM AUTHOR]

Purpose: This study was designed to evaluate the performance of typically developing Swedish-speaking children on DYMTA (Dynamisk Motorisk Talbedömning), a Swedish dynamic motor speech assessment. Method: Participants were 94 children, 45 boys/49 girls (9/8 multilingual), with typical oral motor, speech, and language skills, between 37 and 106 months divided into five age-groups. They performed two speech motor assessments, DYMTA-A and DYMTA-B using dynamic assessment. Result: Typically developing children show good motor speech performance on targeted speech characteristics already at the age of three. DYMTA median total score was high for all ages; 90% of maximum or above. A significant correlation with age was found for DYMTA-A (p = 0.000, r = 0.49) and DYMTA-B (p = 0.000, r = 0.77). No significant differences were found across gender or concerning being mono- or multilingual. Conclusion: DYMTA is the first Swedish assessment tool designed to identify children with CAS. The results of this study demonstrate that typically developing Swedish children perform well on DYMTA and that the test has possible utility for both mono- and multilingual children. [ABSTRACT FROM AUTHOR]

To synthesise the available evidence relating to best practice in training videofluoroscopy and barium swallow analysts. The review was conducted according to the PRISMA statement and registered in PROSPERO (CRD42017053744). Data were extracted from nine databases. Studies were included if they described training approaches for clinicians or students of any profession learning to interpret videofluoroscopic (VFSS) or barium swallow studies and were written in English. The methods were heterogeneous and a metanalysis was not possible; a narrative review is presented. Sixteen studies were eligible, including those designed to evaluate the influence of training as well as those that described training as part of validating an assessment tool or method. The quality of the studies was assessed with the Hawker scale and assigned an NHMRC rating. While the evidence was low quality (NHMRC level IV), training consistently improved the accuracy and reliability of clinicians and students conducting VFSS. No studies reported the outcome of training for barium swallow analysis. There was significant variability in the dose, method, and setting of training. To elucidate best practice in VFSS analysis to ensure training is cost effective and results in accurate diagnosticians requires further research. [ABSTRACT FROM AUTHOR]